As much attention should be given to injury prevention and treatment as is given to the effectiveness of the overall fitness program. There are numerous considerations regarding injuries. In this post, I’ll try to create a guide to injury risk identification, prevention of injury, and minor treatment.

Everything from seemingly harmless stretching to advanced ballistic training places the trainee at risk. Below is a list of injury risk factors, along with a brief explanation of each.

Injury Risk Considerations

• Training frequency: training a specific muscle too often will result in overuse injury. Depending on intensity and volume of the session, the recovering muscle requires between 48 to 72 hours of rest.
• Activity too long in duration: energy and fluid depletion may result in exhaustion, degydration, and related injuries.
• Increased intensity: acute injury to muscle and connective tissue (ligaments or tendons) may result from excessive applied resistance.
• Muscle weakness: a deconditioned individual requires a more gradual increase in intensity, volume, and duration.
• Limited flexibility: short muscles are more easily injured.

Injury Prevention Measures

Remaining aware of the symptoms of overexertion and risk of injury can safeguard from the likelihood of overuse injuries. In addition to the above risk factors, the below list should be noted:

• Attention to contraindications: joint pain, dizziness, nausea, rapid pulse, excessive sweating, extreme muscle soreness, cramping, or chest pain. When one or several of these symptoms are experienced, activity should be stopped.
• Incorporating strict form technique: because every movement requires the involvement of multiple muscle groups (primary, secondary, and stabilizer), attention must be paid to form technique. Improper form will cause an imbalance of how the load is distributed among the muscle groups involved, which can easily result in an overuse injury to one of the smaller muscles.
• Improperly maintained equipment: this is the #1 cause of reported injuries.
• Warm-ups: properly executed warm-ups play a crucial role in injury prevention.

Minor Injury Treatment

PRICE is the acronym for Protection, Rest, Ice, Compression, and Elevation. When a body part is injured, the injured person should immediately take steps to prevent the injury from worsening. PRICE is recommended by the NFPT.

An injury in the acute phase generally has 4 signs or characteristics. These characteristics are called the “cardinal signs” and they are dolor, calor, rubor, and turgor. In English, they translate to pain, warmth, redness, and swelling respectively. Acute injuries develop the 4 signs over a period of time, and if the injury is more severe, the cardinal signs also become more intense. As the injury heals the cardinal signs become less pronounced, and a return to normalcy is experienced.

This topic can go much deeper, as muscle and ligament injuries can be classified on a 3 point scale. Understanding this scale helps to identify the type of injury, as well as the appropriate treatment method. Because this is entirely too complex, I won’t go into detail on these aspects in this post (maybe another one down the road, if anyone is interested).

Chronic injuries may develop quickly from acute injuries, or they may develop subtly over time without the telltale presence of the cardinal signs. Chronic injuries lack all 4 cardinal signs but pain and loss of function may occur.

In a situation where the cardinal signs have become pronounced, the injured person should stop activity and employ PRICE before the signs progress and loss of function occurs.

How does PRICE work?

Protection: prevents the muscle fibers or ligaments from tearing further. Protection also prevents excessive muscle contractions or stresses on ligaments by keeping weight off of the injured body part, so that capillaries are not encouraged to bleed into the injured tissues.

Rest: essential to allow the normal healing after an injury. This doesn’t mean sit on your ass all day.. Rest means tha the injured body part or tissue is rested while you can still continue to exercise other parts of the body.

Ice (or cryotherapy): cools the injured tissues, slows bleeding in the injured tissues, prevents additional swelling, and reduces the pain of injury. Be careful not to overdo it here. Icing for too long can cause injury. Recommended that this period be between 15-30 min every 2-4 hours. Ice is not necessary after normal exercise, and it may not be necessary during chronic injuries.

Compression: useful during the acute phase, as it increases the pressure inside the injured tissue, thereby slowing down bleeding and swelling. Gently pressure is usually sufficient. Remember, you’re not applying a tourniquet. You should still be able to feel the body part, and the limb must not turn blue from lack of circulation. Compression can be applied for 30 min or more with elastic bandages.

Elevation: elevating the body part is useful by reducing the blood flow to the limb, thereby reducing the amount of bleeding. Elevating the limb 6-12 inches above the heart is usually sufficient.

Injury prevention is your first line of defense. When injuries happen, assess for cardinal signs, assess function, and incorporate PRICE before function is lost. If the injury is too severe, see your doctor.

A side note: Stretching As Injury Treatment

Stretching movements should be performed mildly in the absence of injury because tendons are not elastic, they are soft tissues, and the intense stretching can result in microscopic tears to the tendons of insertion. It is also important to note that you should NEVER stretch an injured tendon until you are well into the rehab phase.