10 Faq About Warm

10 Faq About Warm
– Written by Donald Kirkendall, USA

1. WHAT ARE WE TRYING TO PREVENT?

Before addressing the ‘what’ we should address ‘why’ we need to be so concerned about injury prevention in sports. The very best predictor of an injury is a history of that injury. Plus, some of the earliest injury surveillance studies have shown that an incompletely healed minor injury raises the risk of a more serious injury, either to the same or some other site. Thus, preventing the first injury is most critical. There are a number of reasons why we need to be very proactive about injury prevention.

Development

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A primary goal of a coach at any level should be player development. At the end of any season, every player should be better than they were when the season began. When a season ends, nearly every player has to ask two questions:

1. Do I want to play next season (and we should hope so; no sport wants players to drop out)?
2. What level do I think I can play in next season (recreational or progressively more advanced levels)?

Players who are repeatedly injured may think there are better (and safer) ways to spend their time and therefore decide to drop out. The upper level teams may never notice players in other divisions because so many never seem to get any better. In either case, the players are not developing. Players who are injured are not training. Less training means less improvement and lack of opportunity to play at more competitive levels. Pretty soon, players decide to go elsewhere. We should want our youth to keep playing football and to keep improving, which they can’t do if they are injured and not training.

Team performance

No team has three or more players at each position to select from. Most teams are lucky to have 1.5 to 2. Take one to two players out of training and competition and the team is at a distinct disadvantage. While we want every player to improve, we should also want every team to improve too. Cohesive team play is built on individual player development. Lose a couple of players and team play declines – this is seen at every level of play. And when injured players come back, they should not be considered as ready to step back into play at their previous level of performance because they may have missed weeks of training. We always hear of professional teams who do unexpectedly well because they were all healthy, while a big money team has faltered because so many days were lost to injury. Major League Baseball in the United States spends 20% of its annual salaries on injured players. This shows that at the professional level, injuries have a financial consequence.

Public health

Ever heard of FIFA’s Big Count? It’s an attempt to estimate the total number of football players around the world. The latest Big Count estimates that there are over 250 million active players. It’s almost impossible to estimate how many players get injured each year and it’s not practical to apply what is known about professionals to all lesser levels. But it should not be surprising that if 25% of this population sustains an injury that requires medical attention, there will be substantial health expenses. Reducing injuries by any degree should reduce the burden on stressed healthcare systems1.

Future health

Many disruptive injuries have longer-term consequences. Meniscal or ligamentous injury to the knee will usually lead to cartilage damage and when the cartilage is damaged, the knee has taken its first steps toward future osteoarthritis. Former athletes who have sustained cartilage damage are diagnosed with osteoarthritis at far younger ages than their uninjured peers. The same concept can be applied to the most injured joint in footballers - the ankle. And new research verifies the early onset of osteoarthritis of the hip in some players, even in the absence of an overt, obvious injury as seen at the ankle or knee. Concussions, typically from some form of accidental impact to the head, can lead to degenerative brain disease in a small number of athletes. This is an area of very active research.

Collectively, it should be obvious why prevention needs to be part of every training session that every coach conducts.

2. WE RUN AROUND A LITTLE TO BREAK A SWEAT, WE DO SOME STATIC STRETCHING ... ISN’T THAT GOOD ENOUGH?

Coaching education has long taught that every aspect of training can and should be done using the ball. Thus, teams do a little easy skill work, maybe some small group play like 5v2, and then do a variety of static stretching exercises before getting to the ‘real’ training. Programmes like this don’t address factors that are deficient in players and don’t adequately prepare them for active training and competition.

Ask any coach what part of the warm-up prevents injury and they will probably say the stretching. What is interesting is that there is no high quality research evidence that provides objective, reliable and valid support for static stretching reducing any form of injury, much less muscle injury2. In fact, there is good data to show that pre-exercise static stretching reduces speed and power output in activities that follow. Most coaches would prefer to not do anything that could impact a player’s speed and power.

On the other hand, there is data to show that dynamic stretching does help reduce injury without the performance decrements seen after static stretching. It should seem obvious to swap out static stretching and insert dynamic stretching instead.

But the kind of stretching is not the only item to consider. After looking at how injuries occur, scientists have learned that players with the best strength, endurance, balance, agility, motor control and power output are injured the least. Ideally, each of these would be addressed during training, including the warm-up.

3. WHAT ARE THE COMPONENTS OF A GOOD GENERALISED AND PREVENTATIVE WARM-UP?

The basic purpose of a warm-up is to prepare the body for the coming training or competition. At rest, our bodies unique idle keeps everything running appropriately. During exercise, all systems are operating at a higher level to support the exercise: the increased breathing rate and depth to get more oxygen into the lungs, for example. The increased output of the heart delivers more oxygen to the working muscles and removes waste products produced during the transfer of energy. The blood vessels open up to get oxygen, hormones, nutrients and more to those areas in need while also narrowing to restrict blood flow to areas of less importance. Blood vessels in the skin open to get warm blood to the skin so the extra heat produced can be eliminated. All of these and many more operate most efficiently at a temperature above that at rest and the best way to elevate the body temperature is through a gradual, progressive warm-up: start slow and work up to the harder work that precedes training or competition.

This can be accomplished simply by jogging, but that hardly prepares a footballer for the type of work, and potential injuries, that are ahead. So, when planning a warm-up, include light running exercises, dynamic flexibility, some agility work, motor control activities, strength of areas known to be a problem in footballers, some static and dynamic balance and plyometrics.

Before you go thinking that accomplishing all that will take up all the training time, consider the next question.

4. HAVE ANY SUGGESTIONS FOR GENERALISED WARM-UP PROGRAMMES ALREADY PROVEN TO BE SUCCESSFUL AT PREPARING FOR TRAINING AND REDUCING INJURY?

The research into injury prevention programmes has been of keen interest over the past 10 to 15 years and a number of programmes have been shown to reduce overall injuries by about one-third with much more dramatic reductions for specific injuries.

The 11+ is FIFA’s generalised warm-up programme. Instructions, videos and printed materials are available at www.f-marc.com/11plus/ showing how to do this 15 to 20 minute warm-up programme. Close observation of the activities show that it includes all the exercise concepts outlined in the previous question. When applied over a large number of teams, the 11+ reduced all injuries by 32%, training injuries by 32%, match injuries by 28%, severe injuries by 45% and overuse injuries by 53%. As some of those injuries can lead to extended time lost to training and competition, as well as health care expenses, everyone involved should welcome reductions like these3.

This isn’t the only proof that generalised warm-up effectively reduces injuries. From Canada comes a programme tested on girls and boys soccer that resulted in a 38% reduction in all injuries, a 43% reduction in acute injuries, 50% reduction in ankle injuries and 62% fewer knee injuries4.

Similar programmes have been reported to reduce injury in basketball, netball, team handball, Australian Rules Football and volleyball. One thi