1. What is Hydrotherapy?
2. What are the Benefits of Hydrotherapy?
3. Hydrotherapy for Recovery
4. Hydrotherapy for Rehabilitation
5. Does Hydrotherapy Work?
6. Conclusion

Hydrotherapy, derived from the Greek words “hydro” (water) and “therapeia” (healing), refers to the therapeutic use of water to treat various physical and mental health conditions. Hydrotherapy encompasses a range of treatments, including hydrotherapy massage, hydrotherapy pools, and hydrotherapy exercises, each utilising the properties of water to promote health and well-being.

What is Hydrotherapy?

Hydrotherapy is defined as the external or internal use of water in any form (liquid, steam, or ice) for health purposes such as pain relief, improved circulation, muscle relaxation, improved mobility, reduced stress, improved sleep quality, and fatigue reduction. It involves methods like thermotherapy, cryotherapy, contrast water therapy and thermoneutral therapy (1). Furthermore, aquatic exercise and underwater massage can be used with these methods.

Cryotherapy

Cryotherapy refers to the treatment of injury using extreme cold such as icepacks, or liquid nitrogen, and also includes cold water immersion (CWI) whereby subjects are immersed in cold water < 15 °C. A wide variety of techniques have been used to implement CWI including ice baths, ice bins, and plunge pools (1). More recently, portable ice bathtubs have become a popular and affordable alternative. An immersion duration of between 15-20 minutes has been suggested in research, however, the duration could be as low as 30 seconds due to individual tolerance to cold temperatures (1).

Thermotherapy

Thermotherapy, or hot water immersion (HWI) refers to immersion in warm water > 36 °C to increase core body temperature. This can be implemented using heated baths, spas and pools. An immersion duration of between 10-20 minutes has been suggested in research (1). 

Contrast Water Therapy

Contrast water therapy (CWT) refers to alternating between hot and cold temperatures. For example, an athlete may go from an ice bath to a hot shower. Protocols have varied widely, but often consist of 30-300 seconds at a hot temperature, followed by 30-300 seconds at a cold temperature. This is repeated between 3-7 times and lasts between 4-30 minutes (1).

Thermoneutral Therapy

Thermoneutral therapy is the simplest form of hydrotherapy to apply as temperatures typically range between 16-35°C. Immersion time ranges from between 5 minutes and 6 hours (1).

What are the Benefits of Hydrotherapy?

The benefits of hydrotherapy are multifaceted, encompassing both physical and psychological aspects of health and performance.

Physical Benefits

Reduced Muscle Soreness

CWI, HWI and CWT improved the recovery of maximal isometric squat force compared to a passive recovery group at 24, 48, and 72 hours following an eccentric leg press post-fatigue protocol. The hydrostatic pressure caused by water immersion is believed to displace fluids from the periphery to the central cavity. This causes physiological changes including increased substrate transport, cardiac output and a reduction in peripheral resistance. These changes may increase the removal of waste products, possibly enhancing recovery from exercise-induced muscle soreness. However, only CWI and contrast water therapy enhanced the recovery of squat jump power and post-exercise swelling. This demonstrates that water temperature also appears to affect recovery using hydrotherapy (2).

Improved Strength

Foley et al. (2003) investigated the effects of a 6-week intervention comprising three 30-minute thermoneutral water or gym-based training sessions per week on the strength and function of osteoarthritis patients (3). The same progressive loading strategy was utilised for both water and gym-based interventions. Both interventions successfully improved the physical function and strength of participants, however, gym-based sessions were more effective in improving the muscular strength of the quadriceps. Increased muscle strength around affected joints can improve shock absorption capacity and joint stability. Water resistance can therefore improve physical function and muscular strength without the load associated with land-based weight-bearing physical activity. 

Injury Rehabilitation

Mixed-level athletes suffering from femoroacetabular impingement underwent a hip arthroscopy as they were unable to perform their sport due to debilitating pain and restricted range of movement. Following surgery, the athletes were allocated to a control group comprised of land-based exercises or a hydrotherapy group including thermoneutral water and land-based exercises. The same progression principles and exercises were employed, regardless of group. The hydrotherapy group returned to play at 15 weeks, while the control group took 22.3 weeks, demonstrating an improved return. Furthermore, the athletes’ hip-specific scores and patient satisfaction scores improved considerably, suggesting that hydrotherapy is beneficial in post-operative injury rehabilitation (4).

Pain Relief

A 6-week intervention of one 30-minute thermoneutral hydrotherapy exercise session demonstrated a greater improvement in the Numeric Pain Rating  Scale ( NRPS) when compared with land-based exercises of the same volume and frequency. The hydrotherapy group demonstrated the maximum response compared to the land-based group. However, both interventions elicited a greater improvement in pain compared to the control group. This demonstrates that hydrotherapy offers a non-invasive, drug-free treatment option that can reduce pain and improve quality of life. The reduction in gravitational force allows for easier movement and pain reduction during exercise and therapy sessions (5).

Psychological Benefits

Reduced Anxiety 

Benfield et al. (2001) reviewed the use of hydrotherapy to decrease anxiety and pain during labour. The mean water temperature of the studies was 36 °C, however, temperature varied from 32-42°C (6). After bathing for 15 minutes the anxiety scores of all women in the hydrotherapy group decreased, whereas only 43 % reported a decrease in the control group. Furthermore, the hydrotherapy group demonstrated a mean decrease in anxiety, whereas the control group increased. This anxiety reduction is believed to increase relaxation, which is particularly beneficial during the physiological and psychological effects of labour. Therefore, during labour, immersion in warm water is hypothesised to decrease the production of stress-related hormones such as cortisol, whilst increasing the release of endorphins, which are natural mood enhancers.

Improved Sleep Quality

Patients with fibromyalgia completed a 2-month intervention consisting of 2 x 60-minute hydrotherapy sessions per week in a 32 °C pool. On completion of the intervention, patients reported an improvement in perceived physical function, work absenteeism, pain intensity, fatigue, morning tiredness, stiffness, anxiety, depression, sleep quality and daytime sleepiness. With regards to sleep quality, the Pittsburgh Quality Sleep Index (PSQI) was used to detect sleep disorders in the month leading up to the study. Prior to the intervention sleep disruption was scored at 39.5. Upon conclusion, 80 % of patients reported an improvement in sleep quality, with a mean reduction to a score of 33. It is stipulated that the physiological effects of hydrotherapy originate from the combination of the physical effects of water (thermal/mechanical) and exercise (7).

Improved General Health

A hot spring balneotherapy intervention was used for 30 minutes, 2-3 times per week for 5 months with 326 participants classified as ‘sub-healthy’ at two separate springs. The balenotherapy group bathed in a head-out immersion bath with naturally warm water (36-42 °C) mineral water. The research concluded that balenotherapy improved a range of factors including mental stress, women’s health problems, sleep quality and general health. Interestingly, despite mental stress being significantly relieved, bad/low mood, worry and irritability were not relieved. Symptoms of head pain, joint pain, leg or foot cramps and blurred vision were significantly relieved in the intervention group. 

Further analysis also revealed that increased bathing time increased relief and participants in the senior group (56-65 years old) had greater relief from insomnia, fatigue or cramps. Women’s health problems including breast pain, dysmenorrhea and irregular menstruation were significantly relieved in the intervention group possibly because of the thermal effects of spring water can regulate metabolism and blood circulation and metaboric acid can regulate the endocrine system (8).

Hydrotherapy for Recovery

Hydrotherapy has been found to improve the recovery of maximal force, power and swelling 24, 48 and 72 hours post-fatigue protocol (2). This could be particularly beneficial for athletes with short turnaround times between competitive fixtures. Examples include international football tournaments, tennis tournaments, basketball and baseball. 

Twelve cyclists completed five consecutive days of cycling consisting of 105 minutes, including 66 maximal sprints. They then completed a 14-minute recovery intervention consisting of either CWI, HWI, CWT or passive recovery. Sprint and time trial performance were enhanced across the five day period following a CWI and CWT recovery when compared with HWI and passive recovery. CWI and CWT appear to improve recovery from high-intensity cycling and therefore allow maintenance of performance across a five day period (9). 

However, a systematic review investigating the use of CWI post-resistance training stated that less muscle growth was achieved compared to no post-exercise immersion (10). Therefore, it should be considered whether recovery or adaptation is the goal post-exercise.

Hydrotherapy Massage

Hydrotherapy massage involves heated water and mechanical pressure provided by jets or manual manipulation to massage the body. This type of therapy is typically performed in specially designed tubs, hydrotherapy pools, whirlpool baths, and hydromassage tables.

WATSU

WATSU is a passive form of hydrotherapy in chest-deep thermoneutral water (35 °C) combining myofascial stretching, joint mobilisation, massage and shiatsu. A therapist stands in the water, supporting the supine patient with their upper body, slowly moving the patient in circular motion sequences. Simultaneously, the therapist uses their hands to stimulate acupuncture points (11).  

In a systematic review, it was reported that WATSU was predominantly used as an intervention for pain, physical function and mental health with chronic conditions such as fibromyalgia, asthma, neurological conditions and geriatric care. The meta-analyses concluded that WATSU had a beneficial effect on acute and chronic pain, however, this was not statistically significant. Similarly, the analysis concluded that WASTU indicated beneficial mental effects but was not statistically significant. Interestingly, WATSU appears to have moderate effects on physical function, linking to lower muscular tone and stiffness, translating to fewer muscle spasms and increased range of motion (12). 

Hydrotherapy for Rehabilitation

Hydrotherapy has been found to accelerate the return to play time of athletes following a hip arthroscopy. It is stipulated that the buoyancy of water reduces the impact on joints and muscles, making it ideal for individuals in the early stages of rehabilitation (4).

Eighteen male professional athletes who incurred a grade I or II acute ankle sprain began thermoneutral hydrotherapy with hydrogen-rich water (HRW) intervention or a standard RICE (rest, ice, compression, elevation) protocol 24 hours post-injury. The HRW group received 6 x 30-minute ankle baths every 4 hours during the intervention period. The RICE group offloaded the injured leg, administering ice packs for 8 x 20 minutes every 3 hours. HRW was equally as effective for reducing joint swelling and pain while regaining range of motion and balance 24 hours post-acute ankle sprain. Therefore, HRW could be applicable to athletes and healthcare professionals requiring an alternative strategy to reduce swelling and pain (13). Further investigation is required to identify the effectiveness of HRW on other upper and lower-limb injuries.

Patients with osteoarthritis of the knee were allocated into a land-based or thermoneutral water-based exercise group for an 18-week period. Both groups completed similar exercises, consisting of gait training and strengthening and stretching the muscles of the lower extremities 3 times per week for 50 minutes per session. A similar progressive volume-loading strategy was also used by both groups. Both land-based and water-based exercises reduced pain and improved function, showing that water-based exercises could be a suitable alternative to land-based exercises (14). 

Knee and hip implants with telemetric data transmission were used to measure the joint contact forces of twelve elderly participants completing thermoneutral aquatic and land-based exercises. In chest-high water, the buoyant force led to decreases of 65-68 % in body weight. Specifically, a reduction of 58 % was identified in the hip and 62 % in the knee during a one-legged stance. Furthermore, both higher movement velocity and increased water resistance led to an increase in joint forces. This indicates that aquatic exercises can be used for effective muscle activation. Furthermore, these joint forces and muscle activation can be manipulated through exercise selection, movement velocity and utilising additional resistive devices, proving a useful tool in rehabilitation (15).

Hydrotherapy Exercises

Hydrotherapy exercises, performed in water, help improve strength, flexibility, and balance. They are a viable option for individuals recovering from sprains, fractures, or post-surgical intervention. 

Throughout pregnancy, hydrotherapy exercises have also been found to help control heart rate and blood glucose levels, prevent excessive weight gain, and improve balance and mobility. These exercises can be adapted to suit individuals at different stages of recovery, rehabilitation or pregnancy (16). 

Walking or Jogging

Water walking or jogging is particularly beneficial for individuals recovering from lower limb injuries or surgeries. Additionally, it is an excellent method of reintroducing locomotion without the cost associated with equipment such as anti-gravity treadmills (14).

Water Squats

Water squats are performed by standing in the water at different depths, dependent upon the stage of rehabilitation. This exercise targets the lower body muscles and aims to improve strength and stability. The buoyancy of the water reduces the load on the lower limbs, making it easier for individuals with pain or injuries to perform (15).

Aqua Aerobics 

Aqua aerobics involves aerobic exercises performed in water, including jumping jacks, high knees, leg kicks, treading water and arm circles. These exercises can enhance cardiovascular fitness, strength and balance. Aqua aerobics is suitable for individuals of all fitness levels and ages (17,18).

Does Hydrotherapy Work?

There is still some speculation about the use of hydrotherapy for physical and psychological purposes. Furthermore, the method of hydrotherapy (thermotherapy, cryotherapy, contrast water therapy) applied will change the effect it has on an individual.

Cold Water Immersion (CWI)

CWI  has commonly been used to aid post-exercise recovery. A review including 27 studies measured the effects of various cryotherapy on delayed onset muscle soreness (DOMS). Analysis revealed that CWI significantly improves DOMS at 24, 48 and 96 hours post-exercise. It should be noted that CWI reduced DOMS more than cold air and ice packs. Furthermore, male participants responded better than female participants up to 48 hours (19). 

Thermotherapy

Despite its use in a physiotherapy setting, there is less research-based evidence to support thermotherapy. A review by Versey et al. (2013)  found that thermotherapy is unlikely to have a significant positive effect on the recovery of performance (20). However, studies have suggested there are a variety of psychological benefits to thermotherapy.

In labour, the anxiety of all women in hydrotherapy decreased, whereas only 43 % reported a decrease in the control group (6). A hot spring balneotherapy intervention improved a range of factors including mental stress, women’s health problems, sleep quality and general health (8).

Contrast Water Therapy

A review by Higgins et al. including 23 articles investigated the recovery effects of contrast water therapy with well-trained team sport athletes (21). Contrast water therapy did not enhance recovery of perceived muscle soreness 24 hours post-exercise; however, it appeared to reduce the detrimental effects of team sport on countermovement jump performance 24 hours post-exercise but had no additional benefit 48 hours post (21).

Thermoneutral Therapy

Hydrotherapy exercises completed in thermoneutral water have been used with individuals recovering from injury, surgical intervention or patients diagnosed with chronic conditions such as fibromyalgia (3). 

Although water-based exercise has been found to improve both physical function and strength, however, gym-based interventions have been more effective at improving the strength of osteoarthritis patients (3). Silva (2008) also found that hydrotherapy improved physical function and reduced pain similar to land-based exercises (14). Athletes recovering from femoroacetabular (hip) impingement returned to play at 15 weeks following a hydrotherapy intervention, while the control group took 22.3 weeks, demonstrating a significantly improved return to sport (4).

Patients with fibromyalgia reported an improvement in perceived physical function, work absenteeism, pain intensity, fatigue, morning tiredness, stiffness, anxiety, depression, sleep quality and daytime sleepiness (7).

Conclusion

Hydrotherapy offers a range of benefits, from physical and psychological improvements to aiding in recovery and rehabilitation. The method of hydrotherapy intervention seems to elicit different responses, therefore the individual’s goal should be considered before selecting a specific method. The therapeutic properties of water make it a versatile treatment option for various conditions. Whether used in clinical settings, sports facilities, or at home, evidence suggests hydrotherapy can enhance health and well-being. As research continues to investigate its efficacy, hydrotherapy remains a valuable tool in the arsenal of modern therapeutic practices.

The post Hydrotherapy appeared first on Science for Sport.

1. Summary
2. Introduction
3. Overview of the nature of injuries in grappling sports 
4. Mechanism of Injury (MOI)
5. Risk Factors
6. Barriers & Facilitators of introducing injury prevention warm-up
7. Appraising evidence for warm-up intervention protocols
8. Conclusion 
9. Appendix
10. References

Summary

Grappling sports are becoming more popular, but with this injuries associated with grappling sports are on the rise. At present, no injury prevention warm-up (IPW) specifically addresses the requirements of grappling athletes. Using existing guidelines and frameworks from other sports and disciplines, this article proposes an IPW to meet the specific needs of the grappling athlete.

Introduction

Greco-Roman wrestling has been featured in the Olympic games since they started in 1896, with Catch wrestling being introduced in 1904 before being replaced by Freestyle wrestling in 1924. Regardless of the long history of the three sports, no injury-prevention warm-up has been published (1) despite poor warm-ups previously being cited as a common cause of injury in grappling sports (2). Additionally, there is currently no injury prevention warm-up (IPW) for other grappling sports such as Brazilian jiu-jitsu (BJJ) and Sambo. 

Overall injury rates for grappling sports can be up to 19.6 per 1000 hours of athlete exposure (AE) (3), with competition rates reaching 109 injuries/1000 AE (4). High injury recurrence rates have also been highlighted in grappling sports (5). Research has shown that the successful employment of warm-ups before sports can reduce athlete injury and recurrence rates (6, 7, 8). 

The Team-Sport Injury Prevention (TIP) cycle is a revised version of Flinch’s (2006) Translating Research into Injury Prevention Practice Framework (TRIPP). `TIP details the process of development of an evidence-based injury prevention programme. TIP identifies stages of designing an injury prevention programme as; (re)evaluate, identify, and intervene (9) (Figure 1). 

Figure 1. The Team-Sport Injury Prevention (TIP) cycle is a revised version of Flinch’s (2006) Translating Research into Injury Prevention Practice Framework (TRIPP) (9).

This review proposes an evidence-based injury prevention warm-up intervention to reduce injury incident rates in grappling sports. It will discuss the sites and types of injuries seen in wrestling, BJJ and Sambo, and the mechanism of injury (MOI) and barriers to delivery of an injury prevention warm-up. The approach to developing the IPW was to first assess the available research to establish the current injury situation in grappling sports, including the nature and frequency of injuries. Followed by the barriers and facilitators of introducing an injury prevention warm-up. Once the appraisal of the research literature was complete, an IPW was designed with the input of grappling researchers and practitioners.

Overview of the nature of injuries in grappling sports 

Incidence of injury

There are multiple injury surveillance data studies available for Freestyle wrestling. However, the injury incident rate (IR) does differ between samples, with overall IR being as low as 3.40 per 1000 hours of athlete exposure (AE) in British wrestlers (10) to 19.6 injuries/ 1000 AE seen in American collegiate male wrestlers (3). There is a paucity of published injury surveillance data for BJJ. However, two studies do report competition injury incident reporting rates ranging from 9.2 to 24.9 injuries/ 1000 AE (11. 12). This is much lower than rates seen in freestyle wrestling competitions, where rates range from 13.1 to 42.01/ 1000 AE (10, 13, 14, 15, 16).

Anatomical site of injuries and Type

Multiple Injury studies in BJJ have established that the Knee is the most commonly injured anatomical site, ranging between 20.8 to 81.1 % of all injuries occurring (5, 11, 12, 17, 18, 19, 20, 21). Two studies found hands and fingers to be the most frequent injuries in BJJ, followed by the Knee (22, 23, 24). In BJJ competitions the elbow was the most commonly injuries joint. However, the Knee had the highest incidence of medical diagnoses (11). None of the grapplers stated if injuries came from Gi-based BJJ or No-Gi BJJ. The head, neck and trunk were the leading injury sites present at American Emergency Departments for BJJ between 2008 to 2015 (25). BJJ Studies that reported injury type stated sprains as the leading diagnosis (21, 24, 26).

In several American collegiate wrestling injury surveillance studies, the Knee has been reported as the most frequent injury in competition and practice (16.7 % to 30.4 %) (3, 13, 14, 16, 27). However, this differs in American high school wrestlers, where the head/face (practices = 19.9 %, competitions = 21.4 %) and shoulder/clavicle (practices = 14.1 %, competitions = 21.0 %) were the most common injury sites (16). Data obtained from various demographics has established knee strains/sprains as the most frequent injury wrestlers (14, 28, 29).

There are still grappling arts with no research data available, such as Catch Wrestling. Others, such as Sambo and Japanese jiu-jitsu, have limited research. Blach et al. (2022) (30) Joint study of spinal injuries in Sambo reported that 53 % of all reported spinal injuries occurred in the lumbar region. In traditional Jiu-jitsu, the knee (29.4 %) (31) is stated as the most frequent injury site, while minor contusions, sprains, and muscle injuries (54 %) were the leading injury type (32). 

Greco-Roman studies often show differences in the leading injury sites varying from the Neck, Ribs and Shoulder (33, 34, 35). In competition lactations to the face are the leading injury site and type (62%) (36). Mooren et al. (2023) (37) systematic review of Injuries during Judo Tournaments stated that the majority of studies reported the Head and Neck as the leading injury site. The leading time loss injury site was the knee, and the leading injury type was joint sprains followed by contusions and lacerations. Anterior cruciate ligament (ACL) ruptures have been reported as the primary injury type for time loss with 32 % of all ACLs taking 6-9 months for grapplers to return to play (38).

The review of the available research shows that the knee is the most commonly injured site in Freestyle wrestling (3, 13, 14, 16, 27), BJJ (5, 11, 12, 17, 18, 19, 20, 21) and traditional Jiu-jitsu (31)  and the leading time loss injury in Judo (37, 38). Ligament strains were reported as the leading injury type in Freestyle wrestling, BJJ (21, 24, 26) and Judo (37) and second in traditional Jiu-jitsu (32). In Greco-Roman Wrestling and Judo competitions, the grappling sports that do not allow leg attacks, the head, neck and trunk are the leading injury sites (33, 34, 35, 36, 37). 

Mechanism of Injury (MOI)

Freestyle wrestling research is unanimous in stating that takedowns were the leading MOI, resulting in 39 % to 54.3 % of all reported injuries (10, 13, 14, 16, 27, 39). The majority of these happened during practice sparring 37.5 % to 65.1 % (10, 13, 14, 27). This was also seen in BJJ, where studies reported that 74-77.6 % of injuries happened during training (17, 21). It was also established that submissions (29.7 %) were the leading MOI, followed by takedowns (26.4 %). An opponent attempting an armbar was the leading submission to cause injury, and the triangle submission was the leading cause of injury for grapplers attempting a submission on their opponent (17). The MOI has also been shown to differ between ages with one study reporting the leading MOI for adolescents as Tumbling/ Trauma and takedowns as the lead MOI for adults and masters (40). In BJJ competitions, the armbar was the most common MOI (28.8 %), followed by takedowns (13.9 %) (11). 

Sandeep and Haridas Kuloor’s (2017) (35) study of Greco-roman wrestlers states that most injuries accrued with contact with the opponent. However, it does not go any further as to what the contact was or why it occurred. A systematic review of competition injuries in Judo found that 50 to 85.2 % of injuries happened during Tachi-waza (Standing techniques) (37). The most frequent method of MOI in standing techniques is being thrown, followed by performing a throw then grip fighting (41, 42, 43). The available research shows that takedowns and throws are the leading aetiology in all styles of wrestling and Judo, with BJJ research fluctuating between takedowns and submissions.

Risk Factors

Compared to many sports physical risk factors in grappling is under-researched. However, some studies may help the design of the IPW. In youth freestyle wrestling a relationship has been found between reduced flexibility and an increased rate of skeletal and muscular-tendinous injuries (44). A link between bone injuries and isometric strength was also established (44). In Judo and BJJ interlimb asymmetries in strength, power and flexibility in the knee, shoulder and hip have been associated with injury risk (45, 46). In Judo breakfall techniques are heavily researched (47). Although no injury incident or prevalence studies exist, ample studies show that grapplers who show incorrect falling techniques demonstrate poor collision biomechanics associated with head and neck injuries (47). Practicing correct falling techniques has been shown to lower these dysfunctions (47).

Research has highlighted multiple factors that contribute to increased injury risk. Studies have shown that injury incident rates increase with age in BJJ, Freestyle wrestling and Judo (10, 17, 37, 48, 49). Multiple BJJ studies have shown females to be at greater risk of injury (5, 40). However, studies in Freestyle and Judo have presented mixed results for gender injury incident rates (37, 50). Grappling experience and training volume have also been established as risk factors (10, 26, 40, 48). However, studies have shown that grapplers with more experience train more times a week and for longer durations (49) meaning that the increased injury incident rates in experienced grapplers may come from increased training volume.

Although research into risk factors is lacking in grappling sports the available studies suggest that strength, power, and flexibility affect injury incident and prevalence rates. The decline in these physical attributes seen with age may be the reason that injury incident rates increase with age (51, 52). An exercise selection with evidence of increasing strength, power and flexibility will be included in the IPW.

Armbars and Upper-body injury

One of the leading MOIs in BJJ is the armbar (11, 17). The armbar is a submission that involves grapplers hyperextending their opponent’s elbow joint by inflicting a posterior-to-anterior (P/A) force to the humerus and an anterior-to-posterior (A/P) force to the forearm (53, 54). Almeida et al. (2017) (54) study on the patterns and mechanisms of armbar injuries stated that force caused by the eccentric contraction of the forearm flexor muscles, leading to injury of the dynamic and static medial stabilisers of the elbow. The chances of dislocation and distal humerus shear fractures expand as the valgus moment increases when the elbow is at full extension (55, 56). Due to the level of force that can be produced, it is unlikely that the IPW will have any impact in reducing injuries from armbars; instead, sparring etiquette and the correct paring of sparring partners with similar weight and experience levels.

The head and neck are leading injury sites in Judo and Greco-Roman wrestling with the direct impact of the head on the mat being stated as a frequent MOI (47). Research in the elucidation of the causes of head injury in judo has shown that grapplers landing from unexpected throws (eyes closed) exhibited greater maximum angular acceleration of the head compared to expected throws (eyes open) (57). The delayed reaction to a push and delayed contraction of the neck muscles has also been linked to the increased risk of head injury (57). It was also seen that anterior cervical flexion strength had no impact on angular acceleration (57). Research on the Ukemi break-fall technique has shown that it can dramatically reduce peak resultant translational acceleration of the head that is associated with an acute subdural haematoma and coronal rotation that has been linked to diffuse axonal injury (58, 59, 60).

Research into neck strengthening exercises in the sport of Rugby Union and Mixed martial arts has shown a reduction in cervical muscle injuries and sports-based concussions (61, 62). Neck strength has been associated with Peak Angular Momentum of Neck Extension (PAMNE) (47). PAMNE is lower in experienced judoka when compared to novices when performing break-falls (63). As neck strength was not tested in the study it is unclear if PAMNE was lower due to better break-fall technique or from neck strength. It appears necessary to include both break-fall drills and neck strengthening exercises in the IPW. 

Leg attacks and Lower-body injury

Takedowns have been verified as the most utilised method for scoring points in competitions and are therefore practised regularly in grappling sparring and drilling (64, 65, 66). It has been established that many BJJ, freestyle, and catch wrestling takedowns, most noticeable leg attacks, involve knee torsion, lateral knee displacement and excessive force transmitted in the joint in the execution phase (67, 68, 69). Research in ACL and injuries states that the primary kinetic mechanisms are valgus forces, compressive anterior force of the quadriceps, and short axial compressive forces to the knee that cause anterior translation of the tibia (39). These variables contribute to the most frequent component of ACL strain, proximal tibia anterior shear (70, 71). The MCL is commonly injured through coronal plane impact merged with rotational forces (72, 73). The kinetic forces seen in pivoting movement, rapid deceleration, and forced hyperextension are chief mechanisms in combined knee ligament injuries (74).

These MOI align with the mechanisms of leg-based takedowns frequently performed in BJJ and Various types of wrestling. Additionally, it has been observed that freestyle wrestlers rely predominantly on leg attacks and not throws, as seen in Greco-Roman wrestling and Judo (64, 75). This is due to rulesets, as it is not permitted to grab the legs in Greco-roman wrestling and Judo. This has led to different defence strategies and postures between grappling styles that can attack the legs and those that cannot. Grappling styles that permit leg attacks, such as BJJ, freestyle and catch wrestling, demonstrate greater A/P excursion of the centre of pressure and greater knee flexion that results in significantly increased joint angles in the transverse and frontal planes at the knee and ankle due to the lowered stance needed to attack and defence the lower limbs (42, 76). This may contribute to the higher percentage of knee and lower limb injuries and higher injury prevalence rates seen in freestyle wrestling (34, 36, 77).

As suplexes are not permitted in BJJ (78), it can be presumed that the majority of takedowns are attacks to the legs and not throws, as seen in Greco-Roman wrestling and Judo (33, 37). This leads to the conclusion that grappling sports that allow leg attacks share similar MOI and can be separated from those that are not permitted to perform leg attacks. Unlike technique drilling for head injuries and coaching advisement for submission injuries there are many IPW that are designed to lower injuries to the knee joint. Research has shown that knee-focused IPW can successfully lower injuries in contact sports (79,80). Exercises from these IPW that are most relevant to grappling, can be included in the current IPW.

Current recommendations to reduce injury

Grindstaff & Potach (2006) (81) reviewed wrestling injuries and suggested exercises to be incorporated into a strength and conditioning (S&C) programme. This resource is useful for S&C coaches and provides a framework for a gym-based injury prevention programme. However, many of the exercise suggestions involved gym equipment that would not be possible to use for a team warm-up. However, some bodyweight exercises, such as wheelbarrow holds and bear crawls, may be adapted to fill a warm-up format. Von Gerhardt et al. (2023) (82) designed an injury-prevention warm-up for Judo called the Injury Prevention and Performance Optimization Netherlands (IPPON). It is the only published injury prevention warm-up tailored for a grappling sport. However, it focused purely on the injuries and MOIs seen in Judo. However, the IPPON intervention did not significantly reduce the overall and severe injury prevalence.

Injury prevention warm-ups have successfully reduced injury rates and precursors to injury in sports such as Football, Basketball and rugby (83, 84, 85, 86). Following a similar systematic evidence-based approach as these programs have previously, an effective injury prevention warm-up protocol for grappling arts may be designed. 

Barriers & Facilitators of introducing injury prevention warm-up

Barriers to Injury Prevention

There are some frequently reported barriers to compliance with injury prevention programmes in sport. The Minnig et al. (2022) (87) review of the barriers to the adoption of evidence-based injury prevention programmes states perceived time, financial cost, coaches lacking confidence in their ability to implement it, and the inclusion of exercises that were difficult or confusing to follow. Studies that were not included in the review stated similar barriers such as not knowing what to do, not having been previously injured, not having the correct equipment and a lack of knowledge from coaches on how to implement the programme (88, 89, 90).

Facilitators of Injury Prevention

Research on the barriers and facilitators of injury prevention programmes has stated coach education is a major contributor to improving compliance (89, 90, 91).  The British Wrestling Association (BWA) has agreed to act as a facilitator for the injury prevention programme. This encompasses embedding IPW into the British wrestling coaching course, as seen in FIFA coaching licence courses and the FIFA 11+ IPW. The BWA will also make the IPP warm-up available as an online continuous professional development course (CPD) for international grappling coaches. 

To overcome other barriers such as lack of time (87, 90), costs (92), scheduling (93), and equipment (89) the IPW is designed to last 15 to 20 mins and will take place at the start of scheduled training sessions or completions. The IPW will not need any equipment and can be implemented by coaches to minimise the cost of hiring S&C coaches or physiotherapists. It has been stated that athletes and coaches perceive performance increases as a higher motivation than injury prevention (94). Research has shown that associating injury prevention programmes with increased performance benefits increases compliance rates (95, 96, 97). Due to this, the IPW will be designed in the Raise, Activate/ Mobilise and Potentiate (RAMP) (98) structure will be used as it was designed to optimise performance preparation (98). The IPW also includes Plyometric and  Post-activation Potentiation Enhancement (PAPE) techniques that have been shown to increase athletic performance (96, 97, 99).

Appraising evidence for warm-up intervention protocols 

Duration and protocol 

A frequently reported barrier to injury prevention programmes is perceived time and scheduling (87, 90, 93), so keeping the IPW protocol compact is a requirement that may help with compliance from coaches and grapplers. A 2016 systematic review on the effect of team warm-ups by Silva et al. (2018) (100) found that a warm-up protocol of 15 minutes was the optimal period to increase explosive performance. In terms of reducing injury kinematic and kinetic dysfunctions associated with injury risk factors and reduced injury incidence, several IPWs lasting between 15 to 20 minutes have been shown to be effective (101, 102, 103, 104, 105, 106). Studies have shown a compliance rate of a minimum of 2 times a week is needed for IPW of this duration to be successful (101, 106, 107, 108).

The RAMP warm-up protocol has been successfully used in combat and contact sports such as Rugby league and boxing (99, 109). The rationale for the activities included in the IPW is formatted in the structure of the RAMP protocol.

Raise

The raise section aims to elevate body temperature, heart rate, respiration rate, blood flow, and joint fluid viscosity via low-intensity activities (98). Reviews have shown that effective warm-up protocols increase the intensity until a heart rate similar to that of a competitive environment is reached (100). Research has recorded an average heart rate of 180 to 182 bpm in grappling matches and can reach a maximum of 190 – 200 (110, 111). Exercises such as high knees, heels to glutes, and head rolls have increased dynamic mobility of the spine and peripheral joints (84). Meanwhile, rolling has been shown to increase proprioception and postural control (112, 113). Additionally, Grapplers need the ability to produce a rate of force development (RFD) and acceleration for movements such as takedowns (69). Shuffle sprints will help with the RFD (114) and aid in increasing HR.

Activate

The activate section focuses on identifying the key muscles needed for grappling and then using a selection of dynamic movements to activate them (115). The physical demands of grappling involve all major muscle groups (116, 117). This section of the IPW will start with walking lunges with trunk rotation. EMG research has demonstrated that forward lunges increased activation in the Vastus Mediali and gluteus Medius and have been used in peer-reviewed injury prevention and performance warm-ups (118, 119, 120). The lunges will be followed by bear crawls, which have been used in wrestling and functional training settings to activate the wrists, pelvis and lower limbs (121, 122). Sports-specific movements have been shown to be effective in previous injury prevention programmes (123). The wheelbarrow position mimics wrestling positions that require the grappler to support their body weight with their upper extremities (81). Research using EMG has shown that press-up variations such as the wheelbarrow exercise activated the lower trapezius and the serratus anterior (124). Press-ups have been demonstrated to increase upper body and core activation (125, 126, 127) and have been used effectively in injury prevention warm-ups (128). Hindu press-ups involve a significant degree of trunk and hip flexion that mimics the 110 degrees of trunk/hip flexion seen in the biomechanical analysis of a sprawl (129).

Much like the Hindu press-up, Hindu squats are commonly used in various wrestling styles. The squat has been successfully used to lower injury prevention and increase performance in the FIFA 11 + protocol (8, 130). The Hindu squat also allows grapplers to move into greater degrees of knee flexion needed to perform movements such as the double leg takedown (147 degrees) (129). Research has shown that many head, neck and trunk injuries in BJJ are a result of landing (25). It has been recommended that increased training in landing techniques will aid in preventing landing and fall injuries as previously demonstrated in Judo (25, 47, 63). Short-term breakfall practice has been shown to improve electromyography (EMG) activity in Stenocleidomastoid, External Oblique and Rectus Abdominis muscles (131).

Mobilise

The lack of mobility has been acknowledged as an injury precursor in grappling sports (17). Additionally, it has been shown that grappling requires athletes to exert force in large degrees of an athlete’s range of movement (ROM). This can be seen in suplexes in Greco-Roman wrestling (132), throws in Judo (47), bridges in Swiss wrestling (133) and shooting for takedowns in BJJ and freestyle wrestling (69, 129). Biomechanical analysis of Greco-roman wrestling has shown that many trajectories from throws, takedowns and presses follow Circular and Helicoidal paths, resulting in hip and spinal rotation (67). Therefore, the IPW adopts the scorpion exercise to increase ROM in these areas. Neck mobilisations are also required as research has shown that neck strengthening reduces cervical injuries in combat sports (62) as well as sports-related concussions (61).

Potentiate

The potentiate stage aims to increase activity to maximal intensity in preparation for competition (98). This often includes techniques such as PAPE (99). This technique is primarily used to improve sports performance and the focus of the IPW is to reduce athlete injury. However, it has been shown that coaches and athletes perceive performance as a higher priority than injury prevention (94). Flinch’s  (2006) (134)  proposal of the Translating Research into Injury Prevention Practice Framework (TRIPP) states that only research adopted by sports participants, their coaches, and sporting bodies can prevent injuries. By including performance aspects in the IPW, compliance levels are anticipated to increase. The potentiate section of the IPW starts with plyometric exercises. Plyometric training in adolescents has also been evidenced to increase neural drive to the agonist’s muscles, reactive strength stretches, shorting cycle efficiency, fascicle length, and Vastus Lateralis pennation angle and aid in the development of muscle activation strategies (135, 136, 137). PAPE exercises such as plyometric press-ups have shown increases (4.9 %) in peak power output (138).

This section also includes partner contact drills. Wrestling and contact drills have also been recommended as injury prevention strategies for contact injuries in Rugby League and Union (139, 140). The IPW concludes with a partner reaction drill designed by the British wrestling team’s coaching staff. This involves grapplers performing takedown defensive and attacking movements as they react to their partner’s cues. Visual processing, visual fields, and visual reaction times are essential to the performance of numerous sports and play a role in athletic injuries (141, 142). The partnered drills also allow grapplers to raise their heart rate after an anticipated drop in the mobilise section.

Conclusion

This is the first evidence-based IPW for grappling sports and may act as a resource for coaches of all grappling arts. It provides athletes and coaches with a warm-up that can be performed before grappling practice and competition. The IPW will be embedded into the British Wrestling Association’s (BWA) coaching courses and as a continuous professional development course (CPD) option for international grappling coaches. Further studies can be undertaken to verify the IPW effectiveness in reducing biomechanical injury risk factors, injury incident rates and performance benefits.

Appendix

Table 1. IPW with rationale and coaching points

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1. Introduction
2. What is Muscle Memory?
3. How does Muscle Memory Work?
4. How do you develop Muscle Memory?
5. How long does Muscle Memory last?
6. How long does it take for Muscle Memory to come back?
7. Can Muscle Memory be lost?
8. How to improve Muscle Memory?
9. How many repetitions does it take to develop Muscle Memory?
10. Conclusion

Introduction

Muscle memory is the result of a fascinating interplay between neurons, muscles, and practice—a phenomenon that transforms conscious effort into effortless mastery. It is intricately embedded in the complexities of the brain and body.  It acts as the architect enabling us to execute tasks with apparent innate precision. Think about the first time you struggled to tie your shoelaces or play a musical instrument; fast forward through practice, and those once-challenging motions become second nature. Muscle memory plays a role in these fascinating phenomena.  This article explores the marvels of muscle memory, from the firing of neurons to the reinforcement of neural pathways; join us on a journey into the depths of how the brain sculpts the blueprint for expertise through muscle memory.

What is Muscle Memory?

Muscle memory, despite its name, is not about muscle but is rather about the brain. When we learn a new skill or practice a particular movement, the brain creates neural pathways and connections that control the associated muscle groups [1, 4]. These connections become more efficient and well-coordinated through repetition, performance of the task with increased accuracy and ease [6].

Muscle memory is a complex process that involves both the brain and the body’s muscles and nervous system. It is a fascinating concept that has intrigued athletes, musicians, and professionals across various fields. It’s the reason behind the remarkable improvement in performance that comes with practice and repetition [2, 4]. This article delves into the science behind muscle memory, its practical applications, and how understanding this phenomenon can help athletes excel in their chosen pursuits [3].

How does Muscle Memory work? 

The process of muscle memory involves a series of complex neurological events within the brain, and it can be broken down into several stages. Here’s a detailed look at what happens inside the brain during the development and execution of muscle memory [3];

1. Learning Phase

Neural Pathway Formation: When a new skill or task is first learnt, the brain begins to create new neural pathways. These pathways connect regions involved in motor planning and execution. The primary motor cortex is a key player in initiating and controlling voluntary movements [5, 6].

Synaptic Changes: Learning involves strengthening the connections (synapses) between neurons. As movements are practiced, these synaptic connections become more efficient, allowing signals to travel more quickly and reliably along the neural pathways [5, 6].

2. Repetition and Practice

Myelination: With repeated practice, the neural pathways become more insulated with myelin, a fatty substance that speeds up the transmission of signals. Thicker myelin sheaths enhance the efficiency of communication between neurons, allowing for smoother and faster execution of movements [2, 5, 6].

Basal Ganglia and Cerebellum Involvement: The basal ganglia and cerebellum play significant roles during repetitive practice. The basal ganglia contribute to skill learning and the automation of movements, while the cerebellum refines and coordinates motor patterns, ensuring precision and timing [5, 6].

3. Automatisation

Transfer from Conscious to Automatic Processing: As the skill becomes more familiar, the process transitions from conscious, intentional control to more automatic and subconscious control. This shift involves changes in the involvement of different brain regions, with increased reliance on the basal ganglia and cerebellum for well-coordinated and efficient movements [1, 5, 6].

Reduction in Frontal Lobe Activity: The prefrontal cortex, responsible for decision-making and conscious control, may become less active as the skill is automated. This allows the skill to be performed more effortlessly and with less conscious effort [4, 5, 6].

4. Feedback and Adjustment

Sensory Feedback: The brain continuously receives feedback from sensory systems, including proprioception (awareness of body position), vision, and touch, during the execution of the skill. This feedback helps the brain make real-time adjustments to improve accuracy and consistency [5, 6].

Hippocampal Involvement: The hippocampus, involved in memory and learning, may play a role in the consolidation of motor memories during this phase, contributing to the long-term retention of the skill [5, 6].

5. Retention and Recall

Long-Term Memory Storage: The well-established neural pathways and strengthened synaptic connections contribute to the long-term storage of the skill in memory [1, 5, 6].

Retrieval Process: When the skill is later  recalled and performed, the brain efficiently retrieves the stored motor patterns and executes the movement with a high degree of accuracy, often without the need for conscious thought [5, 6].

6. Challenges and Adaptation

Neuroplasticity and Adaptability: The brain’s plasticity allows it to adapt to changes. If there are errors or bad habits in the learned skill, the brain remains adaptable, and with conscious effort and retraining, it can modify the neural pathways to correct and optimise the movement [5, 6]. 

How do you develop Muscle Memory?

Muscle memory is a complex process involving neuromuscular adaptations, motor unit recruitment, synaptic plasticity, myelin formation, muscle fibre adaptations, and a cognitive component. Repeating specific movements optimises communication between the brain and muscles, establishing neural pathways [6, 7]. Motor unit recruitment enhances coordination, while synaptic plasticity strengthens connections between neurons. Myelin formation improves nerve signal transmission, and muscle fibre adaptations include structural and biochemical changes [12]. Cognitive processes, such as conscious practice and visualisation, contribute to muscle memory. Repetition and consistency are crucial for developing muscle memory, resulting in more efficient neural pathways and improved performance over time [8].

How long does Muscle Memory last? 

Muscle memory, in the context of motor skills and physical activities, does not have a fixed duration. The term “muscle memory” is somewhat misleading because it’s not an actual memory stored in the muscles but rather a retention of motor patterns in the nervous system. The duration of muscle memory depends on various factors, including the complexity of the skill, the intensity and duration of previous training, and the individual’s overall health and fitness level [6].

Here are some key points to consider;

Retention Period – Basic motor patterns and simple skills may be retained for a shorter duration, while complex movements developed through extensive training may persist longer [6, 9].

Consistency of Practice – Regular practice reinforces and maintains muscle memory. If practice stops, associated muscle memory may gradually fade [6, 9].

Relearning Speed – Despite diminished muscle memory, relearning a skill is often faster than learning it from scratch due to the quicker reactivation of previous neural pathways [6, 9].

Skill Complexity – Intricate movements or precise coordination may require more consistent practice to maintain muscle memory [6, 9].

Individual Differences – Retention varies among individuals, influenced by factors like age, genetics, and overall health [6, 9].

Periodic reinforcement through practice is crucial for maintaining muscle memory. Neural pathways associated with skill may weaken over time without regular practice, but with renewed practice, these pathways can be reactivated, enabling faster relearning. Muscle memory’s duration is not uniform and depends on individual circumstances and the nature of the skill or activity [6, 8, 9].

How long does it take for Muscle Memory to come back?

The time it takes for muscle memory to “come back” can vary widely depending on several factors, including the complexity of the skill, the duration and intensity of previous training, and individual differences. Here are some general considerations [9, 11];

Previous Training Duration – If there was extensive training in a particular skill or activity, muscle memory for that skill may come back more quickly. The longer and more consistently a skill was  practiced in the past, the more ingrained the neural pathways associated with that skill [9, 10].

Skill Complexity – Simple motor skills may come back faster than complex movements. Basic movements that are part of daily activities or fundamental exercises might return relatively quickly, while more intricate skills may require more time and practice [9, 12].

Consistency of Practice – If  practice was consistent before taking a break, muscle memory is more likely to come back faster. Regular and repetitive practice helps reinforce neural pathways [9, 12].

Relearning Speed – Muscle memory often involves a faster relearning process compared to learning a skill for the first time. The neural pathways associated with the skill may still exist, making it easier for the body to reacquire movement [9, 12].

Individual Factors – Individual differences, such as age, genetics, and overall health, can influence the speed at which muscle memory returns. Younger individuals and those with a history of physical activity may find it easier to regain muscle memory [9, 12].

Mental Rehearsal and Visualisation – Engaging in mental rehearsal and visualisation of the skill can also contribute to the reactivation of muscle memory. While not a substitute for physical practice, mental practice can enhance the relearning process [9, 12].

It’s important to note that there is no one-size-fits-all answer, and the time it takes for muscle memory to come back can vary from person to person and from skill to skill. Consistent and targeted practice is generally the key to reactivating muscle memory efficiently. Starting with gradual reintroduction and progressively increasing the complexity and intensity of practice can be a strategic approach to facilitate the return of muscle memory [9, 11, 12].

Can Muscle Memory be lost?

Muscle memory is influenced by the frequency and duration of practice, and its effectiveness diminishes over time without regular engagement [8, 9, 12]. If a skill is not practised, the neural connections associated with it may undergo decay, leading to a decline in muscle memory. Complex skills are more susceptible to loss than simple movements. Introducing new activities can potentially interfere with existing muscle memory [1, 10].

Age and individual differences also play a role in the retention of muscle memory. The positive aspect is that weakened muscle memory can often be reactivated or relearned more quickly than initial learning through consistent practice [9, 10]. To maintain muscle memory, regular engagement is crucial, as the capacity for relearning is often greater than the initial learning process. In essence, while muscle memory is not permanently lost, its strength and efficiency diminish without consistent practice, emphasising the importance of ongoing engagement to maintain and reinforce muscle memory [3, 12].

How to improve Muscle Memory?

Improving muscle memory involves consistent and targeted practice to strengthen neural pathways [1]. Key strategies include repetitive and consistent practice, progressively increasing skill complexity, focused and deliberate practice, mental rehearsal through visualisation, starting with slow and controlled movements, maintaining correct technique, seeking feedback for analysis and adjustments, introducing practice variability, allowing sufficient rest and recovery, ensuring long-term consistency, practising in real-life contexts for transferability, and using feedback tools like mirrors or video recordings for real-time corrections [12]. Patience and dedication are essential for the gradual process of building and maintaining muscle memory across various physical activities [5].

How many repetitions does it take to develop Muscle Memory? 

The number of repetitions needed for muscle memory varies based on factors like skill complexity, individual differences, and repetition quality [14]. Simple movements may require fewer repetitions, while precise and controlled practice enhances effectiveness [15]. Factors like genetics, age, and fitness level influence an individual’s ability to develop muscle memory. Consistent and frequent practice is crucial for solidifying neural pathways.

The initial learning phase may involve a steeper curve, and introducing practice variations contributes to comprehensive muscle memory development [5][14]. Gradually increasing intensity over time and considering skill transferability also impacts repetition needs. Overall, there’s no universal repetition count for muscle memory – instead, consistent, focused, and quality practice over time is key for optimal development [12, 13, 14].

Conclusion

In conclusion, muscle memory is a remarkable phenomenon rooted in the intricate interplay between the brain and body, enabling mastery of tasks through repetitive practice. It involves complex neurological events, from the formation of neural pathways during the learning phase to the automatisation of skills and eventual retention and recall. The duration of muscle memory varies based on factors like skill complexity, consistency of practice, and individual differences, with regular engagement being crucial for maintenance.

Reactivation of muscle memory after a break depends on factors like previous training duration, skill complexity, and mental rehearsal. While muscle memory can diminish without practice, it is not permanently lost, and relearning is often quicker than initial learning. Improving muscle memory involves strategic practices, such as repetition, progressive overload, focused practice, and feedback incorporation. The number of repetitions required for muscle memory development is influenced by factors like skill complexity, individual differences, and repetition quality, emphasising the importance of consistent and focused practice over time.

When embarking on a fitness journey or recovering from an injury, it’s essential to seek the expertise of a physiotherapy clinic for guidance and assistance in building muscle memory. These professionals are trained to assess your specific needs, create personalised exercise plans, and provide hands-on techniques to optimise your muscle function. Their guidance ensures that you engage in exercises tailored to your condition, promoting effective muscle memory development and reducing the risk of injury.

The post Muscle Memory appeared first on Science for Sport.

There are myriad pain points in the high-performance sport industry but there are several strategies you can use to significantly improve your happiness, health, and job satisfaction.

By Matt Solomon
Last updated: March 1st, 2024
4 min read

Wellness in sports: Pain points and solutions

Have you struggled to find happiness in your work? Are you no longer the same person with the same verve and passion that you used to have? It happens to the absolute best of high-performance practitioners.

If you have neglected your health, happiness and wealth and want to improve those areas, you need to listen to episode 87 of the Science for Sport Podcast.
In this episode, Josh Fletcher, founder of CareerBlueprint, highlights the pain points of the high-performance sport industry and how you can make the necessary changes to significantly improve your happiness, health, and job satisfaction.

Fletcher, who worked for years in high-pressure roles including a project with a special forces unit in Romania, eventually reached a breaking point and he decided to take a step back. He realised he needed to concentrate on his wellbeing. With so many other high-performance practitioners going through similar battles, the idea of his new business was born.

No practitioner sets career goals of poor health, unhappiness, and fun-crushing bills. So how does it happen?
“The analogy I like to use is the world’s slowest train crash that everybody else can see coming, apart from you,” Fletcher said.

So if everyone else can see it, what are the signs to look out for? This is where athletes, coaches, colleagues and family all need to pay attention.

“Are they giving energy or taking energy, the general body language, the type of words, the language that they use, their physical appearance, the terminology they use, their availability and engagement,” Fletcher said.

The importance of a healthy environment

This is a great list, but the difficulty comes when the person in question doesn’t have a support structure they can trust. Creating this environment can be the first step to changing your health and happiness.

“You have a responsibility for yourself to create an environment where people can talk openly about these things,” Fletcher said.

So opening up to share your thoughts and feelings with trusted members of your inner circle might help remove some of the weight from your shoulders, but when it comes to really improving your situation, what are the key changes you need to make?
“Journaling is a huge way that a lot of people are looking after themselves,” Fletcher said.

This is a super interesting and cost-effective way of looking after yourself – writing your thoughts down allows you to process the information in your head. But instead of just projectile vomiting your life onto a helpless piece of A5, you’ll need to work out a structure.

“What works for Boris doesn’t work for Doris. Your wellness and your wellbeing are bespoke, and that’s why I’m encouraging people to create their own system and structure, based on some sound principles,” Fletcher said.

Three key questions you need to ask

Fletcher says there are three key questions you need to ask to help structure your thoughts and ensure you get more out of your journaling experience.

Combining the above questions with goal setting is where the magic really starts to happen
“You can combine this with basic things like goal setting. So essentially, you’re looking at short, medium, and long-term,” Fletcher said.

It would be simple to start setting goals for one week, four weeks, six months, and one year. Then look longer towards three or even 10-year goals.

This potent combination of reflective questioning and goal setting can highlight any discrepancies in your work-life balance.

The most important question you can then ask yourself is whether you are executing your decisions based on your goals.

“Are my decisions and my guiding principles in line with my short and long-term goals?” Fletcher said.

Wellness in sports – there’s no quick fixes

So there you have it – a cheap, simple, and effective way to improve your health and wellness. No shiny tricks or quick fixes, just an honest look at yourself and your situation, coupled with simple goal setting and the self-reflection to work out whether your actions are matching your goals.

If you want to hear more about how to improve your health wellness and happiness, or how you can help others around you, be sure to check out the full podcast episode using the link below.

You can download the podcast on any of the big hosting services, including Apple Podcasts and Spotify, or just use this link: https://scienceforsport.fireside.fm/87
Don’t forget to hit the subscribe button and be sure to give us a review and rating too!

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Matt Solomon

Matt is a strength and conditioning coach at Team NL (Dutch Olympic Team). He was also the Lead Academy Sports Scientist/Strength and Conditioning coach at Al Shabab Al Arabi FC. For Science for Sport, Matt works as the group manager for the Coaches Club and is the host of the Science for Sport Podcast.

More content by Matt

The post Wellness in sports: How to prioritise and maximise your mental health appeared first on Science for Sport.

Hamstring injuries can wreck an athlete’s training and performance. But when and how do they happen, how can they be prevented and how can you break the cycle if they’re already ruining your training and competing?

By Dr. Tom Brownlee
Last updated: April 25th, 2024
7 min read

Hamstring injuries – they can happen to the best of us!

In August 2017, one of sport’s true greats, Usain Bolt, stepped into London’s Olympic Stadium for his final ever race at the World Championships. Having been pipped at the post by pantomime villain Justin Gatlin in the blue riband 100m a few days earlier, the 4x100m relay was his chance to go out on a high – anchoring the Jamaican quartet in a fairytale finish to a historic, mesmerising career. Bolt received the baton in third place, about 3m off the lead. The stage was set for one final Bolt blitz in front of 90,000 adoring fans. Much like the 100m though, it wasn’t to be. This time, 30m into the final leg, Bolt pulled up clutching the back of his left leg. He had fallen victim to one of the most common injuries in sport – a pulled hamstring.

Thankfully for Bolt, many people no longer even remember this happening. And with a career like his, it’s easy for it to fade into the background behind the many world records and Olympic golds.

Relatively, Bolt had a career that was free from big injuries, especially during key events. But not all are as lucky. And for many athletes it is that same injury, the hamstring pull, that can be the cause of such torment.

Today we’re going to look at when and how hamstring injuries happen, how they can be prevented and how you might break the cycle of recurrences if they’re already ruining your training and competing. So, let’s talk about what for many is the most frustrating soft-tissue injury in sport.

Types of hamstring injuries

If we want to understand how we can avoid or treat hamstring injuries, we need to work out why they’re happening in the first place. One of the tricky things with the hamstrings is they’re what’s known as biarticular, which means they are involved in moving two joints – they extend (or move backwards) the hip as well as flexing (or bending) the knee. It is often when the hamstring is stretching, not contracting, that it is most likely to become injured. For example, a very common mechanism of injury is when, during running, the hip moves forwards and the knee straightens at the same time as we move our foot from behind us to put it back down in front of us.

The reason behind this is we are stretching the hamstring both at the knee and hip simultaneously, with great force. This is a lot to ask if our hamstrings aren’t conditioned for this, or if there are other underlying issues. And when you consider how many sports involve explosive running, jumping, changes of direction or other high-powered movements, you can see why this type of injury is so common.

Hamstring injury risk factors

Now we understand how this muscle may sustain more injuries than others, let’s think about the underlying reasons.

One thing athletes need to be aware of is the difference between overtraining and overreaching. Overtraining is ultimately when we do too much. We ask more of our body than it is able to do for a sustained period, which can lead to injury or illness. Overreaching is what we want. It’s how we create change in a good way from exercise. This occurs by pushing our body slightly beyond where it is conditioned (like moving the pin on the weights machine down one plate after a few weeks, or upping the treadmill speed slightly). When this is done over a long period, supported by adequate rest and fueling, this brings about positive adaptation.

We can think about the conditioning level of the hamstrings in a similar way. If we go and do a session with a lot of sprinting in it, which asks a lot from our hamstrings, then we are more likely to sustain an injury if we are not conditioned for it. Conversely — and this is a constant balancing act for conditioning coaches — if we don’t do enough training then we are never able to build up our tolerance to cope with higher demands when they arise, which is typically during competition, when we need it most!
As well as risk factors based on our level of and approach to conditioning, which we might think of as external factors, there are also some internal risk factors to consider. Unsurprisingly, having weak hamstrings makes them more susceptible to injury but so does having one weaker than the other – what we know as an asymmetry.

Beyond strength levels, there is also an old adage that the biggest predictor of injury is previous injury. Sadly, we can’t magic an old injury away and similarly we can’t change our age, which is also a risk factor, with older individuals experiencing more hamstring injuries. Thankfully though, we now understand some of the techniques we can employ to help us to prevent such injuries even if we do tick some of the risk factor boxes listed above.

Preventing hamstring injuries

In soccer, where hamstring injuries account for 12-16 % of all injuries, making them the most common injury, they typically occur more frequently during the later stages of each half. This suggests that strengthening the hamstrings generally to resist an accumulation of fatigue is very important.

Specifically, improving eccentric strength is important – this is the strength that is used when the muscle is lengthening. If you imagine being on a leg curl machine, or Nordic bench, eccentric strength is used if you resist the weight as your leg straightens. If you think back to our mechanism of injury section, this type of strength helps us to combat those injuries occurring during such stretches under high force when we train or compete. It can be trained specifically by simply having a slower eccentric phase of typical exercises such as squats, leg presses or leg curls. The Nordic hamstring exercise is another great one to look up for improving eccentric hamstring strength.

Minimising the asymmetries we spoke of would also be advantageous. This can be done by incorporating some single leg, or unilateral, exercises such as lunges or step ups into your program. This removes the chance for our dominant leg to take more of the load when doing double leg exercises such as deadlifts or leg presses.

Recovering from hamstring injuries

As I’ve mentioned, hamstring injuries have been shown to be more common in those who have had them previously. This suggests that perhaps people often rush back from such injuries and shows how important correct and appropriate rehab can be.

Beyond simply improving the strength of your hamstrings, another aspect that should be factored into rehab programs from hamstring injuries is improving your hip stability. Broadly the idea here is around reducing an undesirable amount of movement at the pelvis. As the pelvis is responsible for transferring forces between the spine and the lower limbs, it is thought that too much motion at this joining point can put the hamstrings under greater strain and therefore increase injury risk. This suggests a program of core and hip stability should be factored in when looking to reduce hamstring injury risk.

You may also think that hamstring flexibility might keep injuries at bay. The evidence here is a little ambiguous but it does seem that practices such as yoga can help with increasing range of motion and improve recovery time following injury,
Finally, moving forwards, it is recommended that a focus on movement quality should be sought where possible. In professional clubs this will be achieved by a structured, detailed assessment of a series of movement patterns such as how well an athlete squats, lunges, jumps etc. We should think of these movements as the foundation of a building – unless they are solid, you don’t want to build on them.

Similarly, if your fundamental movements aren’t of high quality, if you’re wobbling around all over the place for example, then no amount of increased single leg strength might save you from future injury. The reason for this importance is that sport is chaotic – we rarely move in nice straight, ordered lines like we do in the gym. This is why we need to ensure the basics are right first so when the chaos arrives we are better able to cope with it.

Although you may not be working in a professional environment, a physio or accredited strength and conditioning professional would be able to assess your movement competency and prescribe appropriate exercises to address any potential deficiencies.

Stringing it all together

Hamstring injuries certainly are best avoided. They can lead to lengthy spells on the sidelines as well as being difficult to shake without the correct rehab.

The best way to avoid them in the first place is through a mixture of overreaching of hamstring strength and sprinting in your training to bring about progressive overload while incorporating appropriate recovery periods. Specifically, eccentric hamstring strength and unilateral work is of key importance and will certainly serve you well.

If you’re unlucky enough to already be in the pattern of recurrent hamstring injuries then patience is key. Rushing back may be what you want to do but it won’t have a happy ending in the long run. Take your time, build your strength, and reap the rewards when you’re competing like Usain in his heyday!

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Dr. Tom Brownlee

Tom is an assistant professor in applied sports sciences and has worked with elite sports for over 10 years. Previous roles include working as a sports scientist at Liverpool F.C., where he completed his Ph.D., and working across a number of other sports. He is passionate about physiology, coach communication, and high-performance strategy and systems.

Tom graduated with a BSc in 2011 before undertaking an MSc at Loughborough University. He has published 25 academic papers on strength and conditioning, nutrition, and youth development in Sports Medicine, the Journal of Strength & Conditioning Research, and others. Tom also now supervises a number of his own Ph.D. students around the world embedded within sporting organisations.

More content by Tom

The post Hamstring injuries: What can you do to avoid them? appeared first on Science for Sport.

Fascia link muscles all over the body and they seem to have a massive role in human movement, even if our understanding is still incomplete. But is it possible to train with these tissues in mind? And if we do, will it improve performance?

By Matt Solomon
Last updated: February 29th, 2024
4 min read

Fascia: What are they, and can they help improve your training?

Fun fact: Fascia link muscles all over the body. This mysterious and under-researched tissue is often overlooked, with our understanding of how it works just emerging.

So can you risk not considering it in athletic performance? Or is it just another useless piece of information you need to forget ASAP?
To answer that question, we asked Danny Foley, strength and conditioning coach at Virginia High Performance, to join us on the Science for Sport Podcast.

In episode 105, Foley describes how he uses a fascia-focused approach to get special forces personnel in top shape, ready for deployment.

What do fascia actually do?

Before we get into the nitty-gritty of training prescription, however, it’s important to work out what fascia actually are.

You might remember from an anatomy class a long time ago that fascia is a thin connective tissue that covers the muscle. But it is much more than just a turtleneck for your biceps.

“This is one integrated piece that really encompasses everything from head to toe. So we have fascia that encases muscles, nerve fibres, vessels … literally everything,” Foley said.

So fascia are all over the body, wrapping your insides, but what do they actually do?
“In addition to being a global connective tissue, it is also a major sensory and receptor network. For that reason, I think it’s probably got a little bit more importance or significance than we’ve conventionally thought,” Foley said.

The role of fascia on movement and training

So it sounds like we should be paying this more attention, but what about its influence on movement?
“It’s also a fibro-elastic connective tissue that plays a significant role with posture and movement – it’s really a dynamic tissue. The fascia network in my mind is what humanises our movement,” Foley said.

So the fascia are tissues that seem to have a massive role in human movement, even if our understanding is still incomplete. But with what we do know, is it possible to train with these tissues in mind? And if we do, will it improve performance?
Foley thinks so. But there’s no need to overhaul all of your training methods.

“It’s not a matter of doing completely different things, but rather just doing some things differently,” Foley said.

“Predominantly, we’re going to move away from bilateral stances. I think that especially as athletes continue to progress throughout their career, bilateral, symmetrical loading with high constraint and high external stability just has a really low level of return.”
So this means plenty of unilateral and split stance exercises are on the menu when Foley is cooking up a storm in the gym. The direction of movement also plays an important role in his training.

“Moving in multiple directions and emphasising omnidirectional movement is important. This is another way of saying breaking out of your traditional three cardinal planes [Sagittal, Frontal, Transverse],” Foley said.

According to Foley then, we can create fascia-focused training by stepping away from bilateral lifts, in just one plane of movement, and instead pay more attention to working on one leg, across a range of different movement vectors. But how much weight should be on the bar? Do we need to load these tissues up or do they fare better with lighter weights?
“Collectively, it’s not as much of a pursuit of maximal loading. What I’m more interested in is kind of that 65 to 85% range where we’re moving the weight with high intent,” Foley said.

The full story of fascia and sports performance

So there you have it, Foley presents a case that fascia are a super interesting albeit under-researched tissue, with loads of potential. You can train them by moving away from heavy bilateral exercises, and replacing these with lighter, unilateral variations across many planes of movement.

If you want to hear exactly how Foley programs fascia-focused training, using novel methods like offset loading, listen to the full podcast using the link below.

You can download the podcast on any of the big hosting services, including Apple Podcasts and Spotify, or just use this link: https://scienceforsport.fireside.fm/105
Don’t forget to hit the subscribe button and be sure to give us a review and rating too!

Matt Solomon

Matt is a strength and conditioning coach at Team NL (Dutch Olympic Team). He was also the Lead Academy Sports Scientist/Strength and Conditioning coach at Al Shabab Al Arabi FC. For Science for Sport, Matt works as the group manager for the Coaches Club and is the host of the Science for Sport Podcast.

More content by Matt

The post Are fascia the missing link in sport performance? appeared first on Science for Sport.

An elbow injury can often impact athletes who perform movements like the baseball pitching action, tennis shots, and golf swings, and a rehab program that is staged and structured will best prepare athletes to return to their respective sports.

By Will Ambler
Last updated: February 29th, 2024
3 min read

Elbow injury ‘epidemic’: The dangers of repetitive stress

Elbow injuries plague athletes who perform movements like the baseball pitching action, tennis shots, and golf swings. These movements place repetitive stress on athletes’ joints and the recent rise in these injuries can only be described as an epidemic, a leading performance physical therapist says.

“Year-round play and long competitive seasons are a significant reason for the epidemic of elbow injuries. Research by Leland et al., 2019, outlined that elbow reconstruction surgery, as a result of injury, has increased by 3% (2012 – 2018). The current prevalence of injury reconstruction surgery stands at 26% and 19% in Major League Baseball and Minor League Baseball athletes respectively,” leading performance physical therapist Ziad Dahdul said during his Science for Sport presentation titled ‘Elbow Injury Rehab’.

What are the common elbow injuries?

There are a number of elbow-related repetitive stress injuries seen across all levels of sports like baseball, tennis, and golf.

“These sports place repetitive valgus stress (when the forearm is angled out away from the body when the arm is fully extended and affects medial collateral ligament) from concentric and eccentric loading during their sport-specific movements. Related elbow injuries are referred to as golfer’s and tennis elbow, or to give them their scientific terms, medial and lateral epicondyle tendinopathy,” says Dahdul.

In addition to golfer’s and tennis elbow, Dahdul explains there are a number of other common repetitive stress injuries: “these include ulnar collateral ligament tears, medial apophysitis (referred to as little league elbow), olecranon bursitis, and olecranon stress fractures.”
Anatomy of elbow with lateral, posterior or anterior view vector illustration.
These all-too-common injuries occur at various parts of the elbow and recovering from them effectively is dependent upon the extent of the injury, a structured rehab program, and athletes’ rest and behaviour changes.

Rehab and recovery from elbow injuries

Designing a rehab program that is staged and structured will best prepare athletes to return to their respective sports, Dahdul said.

Dahdul’s five-step recovery plan:

1. Reduce pain, allow the athlete to rest
2. Improve strength with isometric and heavy slow resistance work
3. Build functional strength through progressing into tasks that are closer to the desired sporting motion
4. Introduce plyometrics to develop the stretch-shortening-cycle (the ‘pre-stretch’ action that is observed during explosive human movements)
5. Add sport-specific drills

Before a full return-to-play, Dahdul said: “it’s important to integrate body regions into compound movements to allow for good translation to their sport. The primary goal during repetitive stress rehab is to decrease excessive loading, improve tissue capacity, and determine the root cause of your athlete’s issues.”

Other things to consider with elbow rehabilitation

Dahdul said: “whilst focusing on the elbow and the injured area, it is also important to focus on areas outside of the injured area. The shoulder, thoracic spine, and hips play a significant role in the recovery from elbow injuries.”

Rest and improved technique are also important aspects to mitigate repetitive stress injuries or their reoccurrence during rehab.

“Each athlete is going to recover at their own pace and managing the entire human body through sleep and nutrition all play a credible part of rehabilitation,” explained Dahdul.

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Will Ambler

More content by Will

The post The elbow injury ‘epidemic’ and how to rehabilitate successfully appeared first on Science for Sport.

In recent years, there has been much-needed attention and attempts to understand the menstrual cycle and its interaction with performance for female athletes.

By Cody Roberts
Last updated: March 2nd, 2023
7 min read

Original study

Bruinvels, G., Hackney, A. C., & Pedlar, C. R. (2022). Menstrual Cycle: The Importance of Both the Phases and the Transitions Between Phases on Training and Performance. Sports Medicine, 1-4.

Click here for abstract

Background & Objective

In recent years, there has been much-needed attention and attempts to understand the menstrual cycle and its interaction with performance for female athletes (see HERE). Most importantly, a topic that was once avoided is now appreciated by coaches, and female athletes hopefully feel they too can speak up regarding symptoms (e.g. cramping, headaches, nausea) or simply changes in mood that no doubt impact their performance.

Secondly, the menstrual cycle is not something to be generalised across females. Everyone responds differently, as their body is going through drastic changes in hormones across the month. Oftentimes, these changes happen overnight, creating daily fluctuations in preparedness and adaptability.

Further, although much of the research supports a personalised approach (see HERE), there are still some who aim to over-simplify the menstrual cycle into two or three distinct phases and that seems far from appropriate as we continue to learn more through research and application.

Ultimately, the goal of this review paper was to help coaches appreciate the impact the menstrual cycle can have on females’ daily psychophysiological readiness, paying special attention to the individual nature and fluctuations across the entire process, and how it interacts with athlete preparation and performance.

What They Did

The authors outlined and addressed the topic of understanding the menstrual cycle by first highlighting the gaps in an overly basic, ‘two phase’ model (follicular and luteal phases) or even the commonly researched ‘three phase’ model (menstruation, pre-ovulation, and luteal) – both ignore hormonal shifts between phases, leaving practical application for athletes incomplete.

The authors encouraged a more complex focus – recognising menstruation, the early and late follicular phase, ovulation, as well as the early and late luteal phases – that appreciates the transitions and fluctuations in hormone levels and the psychophysiological impact it has on a female athlete on a daily basis. That said, symptoms associated with these hormone fluctuations vary between individuals and even between cycles in the same individual. Regardless, at some point, interference with psychophysiological readiness is very likely, and identifying ways to navigate them are important.

Therefore, learning and discussion need to be constant between coach and athlete regarding a female’s menstrual cycle and symptoms. This hinges on the appropriate concern (e.g. language, empathy, and respect), as well as actions, identifying sustainable interventions or modifications. Not to mention, research into various means and methods that allow females to continue to train or compete at a maximal level throughout the month without sacrificing long-term health.

What They Found

Practical Takeaways

Cody Roberts’ Comments

“The research and practice around menstrual cycle education, research, and openness is changing for the better for female athletes.  Most importantly, it should not be dismissed, and cannot be generalised. It is not a binary cycle of menstruating (having a period) and not. For coaches and athletes alike to be most successful in optimising training, they need to make an effort to learn, understand, and adapt to the psychophysiological state of the athlete.

“The menstrual cycle is a very real, constant, and ever-changing physiological state that is difficult for a male to understand. Therefore, the best thing that any coach can do (male or female) is to create a safe space for the athlete to be honest and open (transparent) about their mental and physical state. The menstrual cycle is not everything, but it is a component that at times, regardless of sleep, nutrition, or recovery, is going to interfere with performance.

“A coach should aim to build a trusting relationship with every athlete, be educated so you can shed light on what is happening inside their body, but most importantly, be ready and willing to simply listen. If you do that, performance and productivity are limitless.”

Want to learn more?

Then check these out…

Read this article
Watch this video
Read this infographic

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Want more research reviews like this?

Every coach understands the importance of staying up-to-date with the latest sports performance research like this, but few have the time, energy, or even enjoys spending hours upon hours searching through PubMed and other academic journals. Instead, your precious time is better-spent coaching, programming, and managing all the other more important aspects of your job.

The solution…

The Performance Digest
The Performance Digest is a monthly summary of the latest sports performance research reviewed by our team of hand-selected experts. We sift through the 1,000+ studies published in the realms of sports performance every month and review only those which are important to you. Each monthly issues contains 15 research reviews in all of the following disciplines:

This comprehensive topic base ensures you’re constantly expanding your knowledge and accelerating your career as quickly as humanly possible. The reviews are also hyper-focused, 1-page summaries, meaning there’s no jargon or wasted time. We cut right to the chase and tell you what you need to know so you can get back to coaching.

Join the thousands of other coaches who read it every, single month. Click here to get instant access for free…

Cody Roberts

Cody has been a strength and conditioning coach within NCAA Division I sports since 2008. He currently works in Olympic sports at the University of Iowa. He holds a Masters degree in Exercise Science from the University of Kansas (‘10). A former collegiate discus and hammer thrower (University of Kansas ‘07), Cody has also served as an adjunct professor within the Health & Human Physiology department at Iowa, as well a written over 200 research reviews for the Performance Digest since joining the Science for Sport team in 2019.

Cody is a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association, a Strength & Conditioning Coach Certified (SCCC) through the Collegiate Strength and Conditioning Coaches Association, and a USAW Certified Sport Performance Coach from USA Weightlifting.

The entire psychophysiological process of coaching and athletic development is what drives Cody to learn and engage others daily to best serve and develop the athletes he works with. In his role, he has numerous resources at his disposal (e.g. GPS, force plates, tensiomyography, and other testing/monitoring tools). His experience and application of these tools, implementing consistent and sustainable monitoring strategies, make him an excellent resource for all things technology and monitoring. Aiming to maximize the quest for optimal performance through a holistic and scientific approach.

More content by Cody

The post Understanding and approaching the entire menstrual cycle: A guide for coaches appeared first on Science for Sport.

Concussion is an ever-growing area of concern in many collision sports, but cutting-edge mouthguard technology is being developed in the hope of helping prevent or minimise head trauma.

By Matt Solomon
Last updated: February 29th, 2024
4 min read

Concussion technology – the mouthguards hoping to protect athletes

Massive hits are part of the adrenaline-filled entertainment package that many people love seeing in contact sports. These impacts have been par for the course in combat and field sports for many years but increasing evidence shows serious long-term effects of these impacts. Research suggests that repeated concussions can lead to issues with memory and fine motor coordination.

It is therefore imperative that clubs and organisations better measure these impacts for the health and safety of their players.

That’s why we got Chris Turner (CEO of Sport & Wellbeing Analytics) and Eoin Power (Head of Medical Services at Gloucester Rugby) on episode 95 of the Science for Sport Podcast.

Turner and Power combine years of experience in sport technology with practical advice from the top level of rugby to discuss how player health and performance can be improved with cutting-edge mouthguard technology.

It’s all about the accelerometer chips…

Until recently, a mouthguard was just a piece of plastic that many of us all swiftly spat out during PE lessons as kids. But the pros certainly don’t.

But why did Turner choose the mouthguard in an attempt to improve athlete safety? Well, it turns out this is the perfect place to insert tiny accelerometer chips.

“Previous research used sensors in helmets to try and measure collisions. But the problem you’ve got is that the skin and the hair move independently of the skull,” Turner said.

This means that what a helmet accelerometer reads, and what actually happens, can be drastically different. But cometh the hour, cometh the sport tech.

“So inevitably, that leads to a mouthguard because when you put a mouthguard in, it’s anchored to the teeth and that’s anchored into the skull. And that therefore moves as one,” Turner said.

How this technology helps the pros, and one day amateurs, too

So, what does the mouthguard actually measure? Well, there are loads of potential options, but one simplified measure is ‘contact load’, where many variables are combined to give a total load of the impacts received.

“What we’re measuring is rotational acceleration, which is measured in rads per second, which is gobbledygook to most people. But it also measures linear acceleration in G forces. So we combine those two to create something called a contact load,” Turner said.

With the help of Power, these mouthguards and metrics are transforming the way top teams monitor head impacts in both training and matches. Power gives the example of one of Gloucester’s key players, and how they have adjusted his weekly contact load.

“If we are aware that on a Saturday he’s going to achieve X amount of contacts or X amount of contact load, we’re confident we can reduce his overall contact training from Monday to Friday, to try to keep him fresh. Just exposing him to that minimum dose-response before playing that game. So that’s a really, really useful kind of metric that we use,” Power said.

READ MORE: How can you fast-track your recovery after a concussion?
It’s not only used in player monitoring throughout the week but in rehabilitation, especially after a concussion.

“This software allows us to prescribe exact quantities of contact at incremental periods and add at incremental contact loads, optimising the rehab process,” Power said.

Unfortunately, this technology is not yet available for all levels of sport but provided it’s well researched, it may well be in the future.

“We must start at the right level in a very well-regulated, managed, and monitored environment. And only then do we bring it down to the kids, much as we would love to do that right now. It’s important to take it in the right order,” Turner said.

Is this the future of fighting concussion?

So there you have it, it could be the future of fighting concussion in combat and field sports. However, for now, it’s only available to the pros. But keep your eyes peeled in the future for its release at sub-elite levels.

If you want to hear more from Turner and Power about how these mouthguards are used at the highest level, hit the link to listen to the full podcast.

You can download the podcast on any of the big hosting services, including Apple Podcasts and Spotify, or just use this link: https://scienceforsport.fireside.fm/89
Don’t forget to hit the subscribe button and be sure to give us a review and rating too!

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Matt Solomon

Matt is a strength and conditioning coach at Team NL (Dutch Olympic Team). He was also the Lead Academy Sports Scientist/Strength and Conditioning coach at Al Shabab Al Arabi FC. For Science for Sport, Matt works as the group manager for the Coaches Club and is the host of the Science for Sport Podcast.

More content by Matt

The post Concussion technology: The high-tech mouthguards trying to combat concussion appeared first on Science for Sport.

It’s very likely you’ve seen Kinesio tape being used, from the elite level of sport right down to weekend warriors, or even non-athletes needing help with their rehabilitation. Let’s explore why so many people use it.

By Matt Klayman
Last updated: February 29th, 2024
9 min read

What is Kinesio tape – and why do so many athletes use it?

What is that colourful tape many athletes have on? That is Kinesio tape. Kinesio tape has been around since the 1970s when a chiropractor by the name of Kenzo Kase invented the tape and brought it into the athletic world. It was initially invented with the intent to allow more freedom of movement for the athlete, with the same amount of support as athletic tape.

Since its inception almost 50 years ago, Kinesio tape has been popularised in the mainstream with high-profile athletes across the globe seen wearing it. Now, multiple brands have entered the market – a quick Google search for Kinesio tape reveals hundreds of unique styles and colours to choose from.

In short, Kinesio tape is a form of athletic tape which can be stretched past its original length and provide myriad proposed benefits to positively affect performance and pain levels. This is done through the stretch of the tape, which is a combination of cotton and nylon made to mimic the elasticity of our skin.

The main proposed benefits of Kinesio tape include reduction of pain, protection of weak areas, increased sensory input and improved performance. With this, Kinesio tape can be utilised by athletes and rehabilitation professionals as a potential tool in order to decrease recovery time.

So it’s very likely you’ve seen Kinesio tape being used from the elite level of sport right down to weekend warriors, or even non-athletes needing help with their rehabilitation. Let’s explore why so many people use it.

Various uses of Kinesio tape

The ‘stretch and lift’

Kinesio tape can stretch to anywhere between 100-180% of its original length. That is what really sets it apart when it comes to other tapes in sports and rehabilitation. The stretch not only allows it to contour to different body parts, but it creates a recoil of the skin. This recoil acts to pull the skin closer from the tape’s origin site to where it ends.

With this, a small lift or decompression of the skin is created which relieves pressure on the area where the tape is applied. This proposed lift may allow the associated muscles, joints and tendons to have more room for smoother contraction and stretch.

Decompression and pain

The proposed decompression of the skin can lead to a number of positive influences on it. Relief from pressure is first and foremost. Within our skin and underlying tissues, we have a multitude of receptors including those responsible for pain. By relieving the pressure in between the skin layers, we change or dampen the pain signal that goes from our skin to our brain.

Along with this, the decompression allows fluids underneath the skin like blood and lymphatic fluids (vital in the recovery process) to circulate more freely without as much interruption.

Sensory Input and Performance

The lift of the skin can change what information gets to the brain, including pain input as stated previously. This change can potentially help in decreasing the feelings of tightness in muscles or pain from associated trigger points in muscles. Along with these, some athletes believe having the tape on their skin acts as protection – knowing the tape is present on an injured area may allow some athletes to feel more confident in their abilities to overcome the injury.

Among some practitioners and rehabilitation professionals, there is a belief that Kinesio tape can also provide an actual improvement in performance. This may occur from the Kinesio tape providing support along with slight pressure to unstable joints or painful muscles. This feeling of pressure can help to facilitate muscle contraction as well and make the athlete feel stronger.

Although this may be felt from a subjective perspective, there is a lack of evidence-based research on Kinesio tape’s positive effect on performance.

Support

The same can also be said for supporting weaker areas of the body. The tape provides extra support with a joint’s normal movement – this may help to support fatigued areas and protect them from further injury or compensatory patterns.

It can also provide support for tendons, which take on the load from our bodies and forces from the ground. The patellar tendon is a common source of pain for athletes who run and jump, along with individuals who sit for prolonged periods of time. Tape can be applied to lift and support the patella, and acts similar to a patellar strap or brace.

Another common area for support taping is on the foot. With flat feet or lower arches, the navicular bone, which is located on the inside of the foot, sits lower than it should secondary to the height of the arch. A sling can be used to ‘lift’ the navicular and subsequently lift the arch. This adds support and protection to the foot.

Body awareness

Kinesio tape is applied to provide feedback on where our body and posture are situated in space. This is through proprioceptive input, which helps our bodies understand where they are positioned. Rehabilitation professionals will use the tape to cue a patient or client

to keep them in a corrective position or posture. An example of this is on the upper back and posterior shoulders – Kinesio tape is placed in an X fashion from the top of the shoulder toward the spine in a downward direction and crossed.

This will allow the tape to pull and create a feeling of a stretch when the patient rolls into a forward head/rounded shoulders position. This acts to pull the patient back to a scapular retracted and upright posture.

Another example is lower back pain. Kinesio tape is placed on the muscles of the lumbar spine while the spine is flexed in order to provide feedback for people who may slump over in their chairs or while standing.

Again, the Kinesio tape is acting as a reminder to stay more upright and out of positions that can cause pain with the stretch of the tape.

Swelling

Kinesio tape can be cut and manipulated in order to promote a reduction in swelling in various areas of the body. The target for the tape is an injured area that is swollen and may be discoloured. The tape is cut in a crossover pattern with strips that mimic lymphatic channels.

The idea here is the tape provides the lift of the skin which creates space in between the layers of skin. This changes the pressure gradient in those layers of skin which enhances the flow within the lymphatic system. These channels run through our connective tissue and allow our body to deal with excess fluid.

This can be beneficial with acute and chronic injury as well as recovering from strenuous exercise and training.

Scar management

Kinesio tape can be placed on and around closed scars for a multitude of reasons such as improving aesthetics, decreasing pain and improving the pliability of the scar. Scars that are present after an injury or surgical procedure become an interruption in the skin’s layers which affects how the soft tissue in and around it contracts and stretches. This can affect your range of motion in the associated area, which can also have an effect on your strength.

Taping over and/or around a closed scar introduces a shearing or massage effect to all the layers of the scar. With this, we can also affect the surrounding tissue and have an effect on the overall movement of the associated extremity or region. The goal here is to encourage proper alignment of the tissues affected in and around the scar. It is important to know you should not place tape over open wounds or immature scars that are less than six weeks post-injury.

Nerve entrapment

Our nervous system has a unique relationship to our muscular system. For a number of reasons, a nerve can become irritated and/or compressed and impact the muscles it supplies sensory and motor function to. This can cause pain, weakness and numbness, or tingling in the leg or arm depending on the nerve affected. The tape can be applied along the length of the nerve, from its most proximal to distal point in a stretched position. Through this, the skin is lifted, allowing the nerve to glide and slide smoother in the track that it runs through.

In essence, this helps to decrease the irritation allowing for improved function. It may be difficult to perform this technique without the help of a rehabilitation professional.

What is Kinesio tape not intended for?

Kinesio tape is not intended to be used for the following conditions, due to the risk of infection, allergic reaction or blood flow changes within these conditions:

1. Open wounds
2. DVT
3. Active cancer
4. Diabetes
5. Adhesive allergy

How to use Kinesio tape?

Kinesio tape has many uses as noted above. But first of all, always consult with a physical therapist or athletic trainer who is trained in the use of the tape before using it.

When it comes to putting on the tape, there are a few helpful reminders to maximise its use.

• Clean and dry the area first. Avoid the use of lotion or oil in the area prior to taping, as these products can prevent the tape from sticking to the skin for a longer period of time.
• Trim any excess hair in the area.
• Before cutting the tape, measure the area first. The tape will stretch but it is a good idea to account for the full length of the area.
• Cut rounded corners at the ends of each strip, which helps to contour easier to the skin and allows it to stay on longer.
• Tear the back paper of the tape to use. Try not to touch the adhesive portion of the tape with your fingers.
• Take the paper off the end piece and lay it down at the desired origin. With your fingers at the base, peel back the paper and stretch the tape 50-75% while laying it onto the skin. Once the tape is stretched properly, lay the tape down but keep the end portion off the skin. Lay down the end of the tape without stretching.
• Lay down the origin piece, stretch the middle up to 50-75% and lay down the end without stretch.
• After you apply the tape, rub each end vigorously to improve the adhesive material to stick
• Additional pieces may be added for different functions. For example, a compression piece can be added at the painful point of the segment. This is used by tearing the paper at the midpoint and laying the tape down side to side with the same principles with stretch as noted above.

For a visual example of how to use Kinesio tape, check out this video.

How to use Kinesio tape for rehab and sport?

Kinesio tape can be greatly beneficial to both the rehabilitation professional and the athlete. When used correctly, it has the potential to decrease pain and swelling, provide feedback and protect injured areas. Although full conclusive evidence is lacking, Kinesio tape is a treatment that has survived and thrived in the rehabilitation world. It is primarily used by physical therapists, athletic trainers and chiropractors to help their patients and athletes return to their prior level of function.

For most practitioners, Kinesio tape has its place as a tool in the toolbox. It is not a way to completely solve the problem, but it can be used to speed up the recovery time. Just like anything in rehabilitation, it should not be used over a consistent time lasting all season. Kinesio tape is meant to be a temporary solution (lasting 3-5 days for single use) for athletes and patients when dealing with an acute injury – they cannot 100% rely on it to get them to their goal. Our bodies need to stress our systems; constant protection does not let us adapt and will not solve our injuries.

That being said, Kinesio tape has many proposed benefits. Although it may not be the correct mode of treatment for everyone, it is something that rehabilitation professionals and athletes should try.

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Matt Klayman

Matthew is a Physical Therapist and Clinic Manager at an Outpatient Orthopedic Physical Therapy clinic in Chicago, Illinois. He has worked with varied sport and orthopedic populations and has served as a Physical Therapist with the Professional Squash Association and USA Track and Field. He has recently become Board Certified as an Orthopedic Clinical Specialist (OCS) as well as certified in Dry Needling and Blood Flow Restriction Training. He has a passion for treating orthopedic and athletic injuries with a specialisation in the treatment of lower body injuries and runners.

More content by Matt

The post The benefits and uses of Kinesio tape in rehabilitation and athletic settings appeared first on Science for Sport.

When compared to the general population, athletes are more likely to be psychologically distressed. So what can they, and the people around them, do to monitor and improve their mental health?

By Dr. Will Vickery
Last updated: March 1st, 2024
9 min read

Mental health for coaches and athletes

Life over the past two years has been different, to say the least. Our day-to-day lives have changed drastically and upon reflection, it’s really been a time of learning and self-discovery. We’ve learned that working from home can be a good thing and can even help our productivity. We’ve discovered how much we (do or don’t) enjoy the company of other people. And some of us have even uncovered hidden talents through the adoption of new hobbies – I, for one, have become very good at making bad rye bread. But something we’ve collectively come to realise and appreciate is the importance of mental health and the need to better understand and look after our minds.

The pandemic has brought this importance to the surface even more than in the past, with the prevalence of mental ill health and disorders getting worse.

What is mental ill health? 

The term mental health is used a lot – whether in a news report, an email sent around to staff from HR, or in general conversation, potentially muddying the waters about what it really is. Just to make it clear, the World Health Organisation defines mental health as ‘a state of wellbeing in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community’. By extension, mental ill health would be the opposite of each of these things.

There is no way of pinpointing what leads to an individual having mental health issues – we all respond to life events and experiences in vastly different ways. But things like childhood trauma, experiencing discrimination, severe long-term stress, or experiencing significant loss, are often attributed to mental ill health among the general population.

Regardless of where we come from, mental health – notably mental ill health – is a big issue these days. Here in Australia, the most recent National Survey of Mental Health and Wellbeing (2007) reported nearly one in two people aged between 16-85 had experienced a mental disorder at some point during their life. Further, one in five of these same people experienced a mental disorder in the previous 12 months prior to this survey. With the results of an updated National Survey of Mental Health and Wellbeing due to be released sometime in the next 12 months, it’s likely we will see a rise in these numbers.

Mental health among athletes

At the end of the day, athletes are human beings and are just as susceptible to experiencing mental ill health as everyone else. The difference between an athlete and the mid-management employee who has a small family, a mortgage, various bills to pay, and other everyday life stressors, is the athlete might have these same issues in addition to sport-specific stressors. Those of us in the general population don’t really have to worry about the impact of long-term injuries, the constant attention from the public and media, or pressure of constantly having to be at the top of our game.

It’s no wonder then that when compared to the general population, athletes are more likely to be psychologically distressed.  Furthermore, more than half of Australian athletes have experienced some form of mental health problem like depression, eating disorders, or social anxiety. We see more and more stories these days of just how much mental ill health is impacting top-performing athletes, think most recently of Naomi Osaka and Simone Biles.

Now it’s unlikely that mental ill health will ever disappear, particularly within the athletic environment, but clearly, athletes need help when it comes to dealing with their mental health. Further still, athletes may not even recognise they are suffering from mental ill health. Again, they’re still human and most of us have trouble admitting we need help or why we need it. Although many clubs and organisations employ mental health professionals, some athletes may not take up the offer of these individuals. It might be that an athlete is much more comfortable bringing this up with their coach.

The question is then, what role does the coach play in the mental health of an athlete?

The role of the coach in preventing mental ill health among their athletes

Without question, the coach is one of the most influential individuals in an athlete’s lifetime, and therefore they have a significant role in an athlete’s mental health. This has been the topic for many a conversation within academic and practitioners’ environments for some time, and there is a lot of information out there that offers guidance.

What should I be looking for?
Given that many athletes often don’t, or are reluctant to, directly communicate their mental health issues to anyone, coaches need to be more knowledgeable about when their athletes have mental health concerns. In many cases, coaches spend just as many, if not more, hours in the week with the athlete than their loved ones, so they are in a really good place to recognise how their athletes are mentally.

Some of the common issues surrounding mental ill health and its lifecycle that coaches should know about and may find useful include:

1. The early warning signs that players consider to be the potential root of their mental ill health. This might include stressors linked to performance like not living up to expectations, or being away from loved ones and feeling isolated for long periods of time.
2. Fluctuations of mental health which might include some of the early stressors combined with additional ones that negatively (e.g., views of the media, long international tours) or positively (e.g., enjoying playing the sport, being given some on-field responsibility) impact their mental health.
3. The build-up to a severe incident which is characterised by an impactful and key period of time that was the precursor to the negative effect on their mental health. The authors highlighted this might include a death in the family that coincides with being away on tour.
4. The severe incident or key event. This is where the athlete appears to be at their lowest point with regards to their mental health. It’s the point where they can no longer suppress their feelings or where it becomes much more public. There is no one way in which this can be characterised and it could be triggered by even a minor incident. Players are often quoted as saying things like “by far the worst [experience of my life]” and “[being] vulnerable and exhausted”. This incident could also signal the end of an athlete’s playing career.
5. The recovery process is all about how the players dealt with the severe incident that led to their mental ill health. This is likely to differ depending on the individual, but one of the common examples used in this study was speaking with a professional such as a psychologist. 
6. Each player experienced some form of relapse of mental ill health, in some cases after attempting to restart their playing career at the highest level but ultimately led to their retirement.  

What can I do to support my athletes?

There is no one specific way or intervention that will lead to positive mental health. It is about knowing your athlete/s and fine-tuning your behaviours and the environment to their needs and how you think they’ll best respond. It’s important coaches are aware of the different contexts their athletes might find themselves in with regards to their mental health (e.g., the early warning signs, fluctuations, recovery after mental ill health), so they can create an effective environment that promotes positive mental health. Below are some examples of what this might include, but I would strongly encourage you to have a read through this article to get the full picture.

The role of the athlete in managing their mental ill health

Although coaches can – and should – be supporting their athletes and any mental ill health issues they might have, at some point the athletes will need to address and manage these issues themselves.

As I mentioned earlier, athletes are just human beings and they are exposed to many of the same potential traumatic events that can lead to mental ill health as the rest of us – they just have the pressures of sport to deal with as well. This means how they deal with and manage their mental health is not really any different to the general population, and the best way is to get out in front of it. In other words, the sooner an athlete recognises and intervenes with any mental ill health they might be feeling, the sooner and easier it can be in avoiding any long-term and severe mental health disorders.

Getting on top of mental issues as soon as possible was recognised by the International Olympic Committee Mental Health Group, who, one could argue, have the best interest of all athletes in mind. With that being the case, this group offered up a number of ideas on how athletes can identify and cope with any mental ill health issues they might have. These are just a few to consider: 

What does this all mean?

As coaches, we know our athletes are going to experience periods of pure joy as well as sadness, and for the most part, we cannot always control this to nurture a positive mental health status. What we can do, though, is have a better understanding of the various contexts and situations that might have the biggest impact on the mental health of our athletes and modify the environment and our own behaviours accordingly.

As athletes, we may not always have the confidence to speak up when we have mental ill health concerns, but recognising what might trigger a negative reaction to our mental health is the first step in managing this. Trust that your coach has your best interests at heart and they are more than just someone to offer advice about your forehand.

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Dr. Will Vickery

Will is a Lecturer of Sport Coaching at Deakin University, Australia. Prior to this he has worked with Cricket NSW and Cricket Australia in an array of roles ranging from a sport scientist, development coach and a strength and conditioning coach. He completed his PhD at the University of Newcastle, Australia within the area of practice design.

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Early specialisation is one of the hottest debates in youth development circles. But what is all the fuss about, and which path is preferable?

By Tom Green
Last updated: March 1st, 2024
8 min read

Early Specialisation in youth athletes: What’s all the fuss about?

So, you want to be a professional athlete? Who doesn’t!
In society, you are taught that if you want to get better at something, you must repeat the process until mastery is achieved. School, employment, even relationships require deliberate practice to develop and maintain them. However, this can also backfire.

Take a talented mathematician in school as an example – should they just focus on math at the expense of science and English? No. Parents, teachers and students would understand that their holistic education is really important.

So why do we do the opposite when it comes to sport? Sit back, pause that podcast, and enjoy.

Specialisation case study

This is Tim.

Tim wants to be a professional football player. His parents take him to every training session, buy him all the new gear and pay for the top coaches to develop his football skills in hopes that it will improve his chances of success.

When Tim’s parents take him out, they are always boasting to their friends about how he is going to be a professional football player. By the ripe age of 10, Tim is never seen out of a football kit. He pretends his bike is a Range Rover and even rocks the Jack Grealish hair band at school – as you can see, he looks good.

Tim’s best friend, Rob, also plays football but is encouraged by his teachers and parents to play rugby and cricket as well. He also dabbles in a bit of casual swimming on the weekends with his other friends. Rob’s support network knows that intensive training, coupled with inadequate strength and conditioning provision and nutrition, is a recipe for disaster (see what I did there?). In addition, they know that focusing on one sport may negate the many benefits associated with multi-sport participation.

Fast forward six years, Tim and Rob are both playing on the same team at the same level, and their coaches are thinking about who is going to progress through the system.

Tim is really good, but keeps picking up small injuries throughout the season and has a limited repertoire of skills.

Rob, on the other hand, is robust and is socially more rounded from participating in other sports (e.g., rugby). Rob is an example of a late-specialisation athlete who has focused on a sport a bit later on, allowing him to refine and hone his technique through a variety of activities.

Rob has been filling his toolbox with a variety of tools (i.e., movements and skill sets), whereas Tim has simply sharpened the one tool he has. Tim has fallen victim to the early specialisation conundrum, which impacts so many youths in various systems.

Some of the negative consequences of specialising too early in one sport have been briefly demonstrated above. Put simply, Tim has made football his identity.

Let’s go down a path where Tim isn’t selected for an elite team. To Tim, this may feel like a criticism of everything he stands for, and although that’s not the case, as a young athlete, it can certainly be hard to deal with. None of us enjoy the feeling of rejection.

Tim is also going through adolescence, where he will experience significant alterations in hormonal status, physical growth, and social and cognitive processes. Now he’s not just lost his identity (“I know Tim, that’s the guy who wants to be the footballer”), but is also going through one of the biggest physical, emotional, and cognitive transitions of his life (adolescence). What a tough time.

Remember those pesky little injuries Tim kept getting? Well, youth athletes who specialise early are more prone to growth-related injuries (e.g., Osgood Schlatter’s disease), fractures, rotator cuff injuries, and ACL injuries – which are more prevalent in females. These can all be classified as overuse injuries, which are mostly due to repeated physical stress from performing similar movement patterns over and over again. In addition to these injuries, Tim has missed some parts of his childhood, which has contributed to him feeling somewhat out of touch with his peers.

Tim, like many, faces a conundrum created by society’s desires for immediate gratification, opportunities for social recognition and scholarships, and most frequently, adults imposing their own dreams and wishes on their child.

Is this always the case?

Okay, so I’ve sent you down one pathway (which admittedly was a little grim), now let’s go down another. Some sports, such as gymnastics, tennis, or ballet must be pursued from a young age, as these athletes can compete professionally from as young as 15. In addition, the skill sets required to be successful are often refined and honed over time to develop high levels of proficiency.

Take a look at this video of Simone Biles competing for the USA in gymnastics. Could you start this at 16? Of course. But in order to develop the strength, mobility, flexibility and skill required to do so, it would take years of expert coaching. Furthermore, by 16 years of age, you’ve likely already developed a whole host of bad movement habits (e.g., limited thoracic extension from excessive sitting), which make a back handspring look like something that should be in a Marvel movie, not the gym.

Specialising early in a sport can certainly have some advantages. For instance, participating within one environment (e.g., rugby) makes an individual very familiar with the language, culture, and tactics adopted within a club or sport. In return, coaches may perceive these individuals to be more receptive to the “way things are done” and treat them as a safe investment.

Early specialisation can and does work, but allowing athletes to sample other movements, for example, placing a tennis player into a game of football, would not harm the development of their primary sport skills – their tennis serve in this case. Instead, it can aid the development of other relevant performance characteristics – such as their footwork and ability to speed up (accelerate) and slow down (decelerate).

What can you do?

Early specialisation can increase the likelihood of burnout and overtraining, so it’s important players engage in a variety of sports to avoid tedium. Here are my top four tips to avoid some of the issues associated with early specialisation:

Think of a gymnast who at 15, decides that gymnastics is no longer for them. Which of their existing skills lend to other sports? They may have spent the last 10 years in static positions, with minimal focus on landing with their feet apart, evading, accelerating, throwing and catching – so, their skillset is clearly very specific to gymnastics. Therefore, it may be time to change it up and play some tennis, engage in a bit of parkour, or develop a new skill (e.g., rugby pass) in your free time. This will help keep you well-rounded whilst combatting some of the overuse risks discussed above.

Coaches shouldn’t make you feel bad or feel as though it will impact your selection in the future. If they do, it could be time to find a new one. In addition, playing sports should be fun, so it’s more than okay to want to play for your school team as well as your chosen club. If your coach understands what’s best for you, they may even excuse you from training if you’ve had a busy sports schedule – they should respect your need to rest and recover.

Do you actively create an environment that celebrates and encourages sport diversity? When a teammate does really well in another sport, celebrate it with them, their parents, the club, and the coach. This will foster a culture where everyone feels like they can, and should, play other sports to develop their skill set.  

Jump a stream, climb a tree and learn to fall. These are invaluable athletic skills that we must develop outside of sport. Your internal fear gauge (e.g., concluding “I simply cannot jump that height”) is a pretty good indicator of how safe a task is. This advice is not just for the ‘young’ however – you are never too old to go out and discover what your body can do!

Am I specialising?

It all comes down to this question. Even after reading this, you may feel like early specialisation is really bad – it isn’t. But, taking small steps that allow younger athletes to sample different movement patterns, personalities, and skills can be the difference between reaching success and struggling to unlock their potential.

This small graphic below, adapted from Myer et al. (2015), is a fantastic guide for players, parents and coaches to determine whether they, their child or their athlete, are in the realm of early specialisation.

Figure 1: (Adapted from Myers et al., (2015), p2).
If by the end of this process you are in the green box on the right, you might like to think about engaging in a basic level strength and conditioning program – focusing on movements such as the squat, hinge, and lunge patterns, push and pull variations, and bracing (e.g., planks). This will reduce your likelihood of serious injury and prevent those annoying little niggles from occurring (e.g., rolling your ankle).

If you arrive in the orange box, you should consider the above advice too, but more specifically, focus on some key injury prevention exercises such as Nordic hamstring curls, thoracic mobility, hip strength, and trunk control. You are approaching the status of early specialised athlete and need to monitor your schedule. Any additional stress (i.e., exams, increased fixture demands, or poor sleep) will elevate your risk of injury.

Find yourself in the red box? Time to seriously reconsider your weekly schedule. You are an early specialised athlete. If you answered yes to all three questions on the left, you could be at a high risk of injury, both general and overuse, which could mean missing a lot of time from your sport. Consider engaging in other sports and think about seeking the help of a strength and conditioning coach who focuses solely on youth.

Final comments

In simple terms, early specialisation may be defined as practice with high levels of domain specificity, focusing on one sport only. Late specialisation occurs when an individual enters the sport “late” – after sampling a variety of sports skills beforehand. Both have benefits but are largely context-dependent (e.g., based on the requirements of the sport).

In most cases, intense training in one sport at the exclusion of others should be delayed until middle to late adolescence, as early diversification is more likely to lead to success. For example, when the backgrounds of 300+ female intercollegiate athletes were investigated, it was discovered the majority had their first organised experiences in other sports. On the contrary, only 17 percent had exclusively participated in their current sport. This typifies the risk of early specialisation in youth, where the misconception that “more is better” doesn’t always ring true. However, it is important to acknowledge that early specialisation can work if the sport/education provider considers the risk of single-sport participation by ensuring that practice is diverse and many transferable sport skills are involved.

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Tom Green

Tom Green is currently the Head of Athletic Development at St Peters RC High School in England. Tom has extensive experience in a range of sports at varied levels. He holds a BSc and MSc in Strength and Conditioning, is a qualified teacher, and sits on the UKSCA board for S&C in Schools.

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