ver been to a physiotherapist or orthopedist? Every year, around 400,000 athletes are injured in sports accidents in Switzerland, over 90,000 of them in winter sports. You can't train for accidents, but you can increase your body's resistance. For top athletes, this is a regular routine. In the event of an injury, athletes receive optimal, round-the-clock care from several specialists. For a regular sports enthusiast, the situation looks quite different. One invests much less in injury prevention and preparation and needs much longer for recovery and readiness to sport. So what can you as a regular sports enthusiast do to enjoy life as pain-free as possible and save visits to physical therapists, orthopedists, and surgeons?
"Prehab," also known as prehabilitation or preventive rehab, aims to reduce the risk of injury and improve overall physical performance. That should be the goal for both, elite athletes and amateurs" - says Andreas Krüger, MD, a specialist in orthopedic surgery and musculoskeletal traumatology who supports both amateur and elite global athletes. Dr. Krüger is one of the leading specialists in post-training and post-competition recovery and is a key-opinion leader in rugby and polo and sports injuries. His core competencies include diagnostics and therapy for osteoarthritis and sports injuries, as well as knee and shoulder surgery.
By Andreas Krüger, MD
Top athletes have two goals: to perform and to prevent injuries. They must always be in condition to perform at their best. This is the goal of an athlete, their coach and the entire medical team, especially in the event of an injury. For most amateur athletes or simply sports enthusiasts, the primary goal is fun and wellbeing, whatever that means for each individual. And only second comes injury prevention, like something for the knee and shoulder. While the goals of professional athletes and amateutrs seem similar, the starting point and the "support system" is very different.
Now and then a tennis match among friends, a jogging round over lunch sometimes and for the annual skiing vacations with the family, a ride on the slopes. This is a common picture in a sports enthusiast's life. People do not train regularly and systematically. If a sport is practiced only sporadically, no sophisticated technique and well-developed neuromuscular coordination can be expected.
In athletes, injury occurs due to excessive load. In amateurs, inadequate training is the main reason they suffer from a sports injury. Many amateurs also do not know their personal performance and stress limits. They overestimate their own abilities and underestimate the risks inherent in the sports. Sports accidents result from this discrepancy.
Every year, around 400,000 people get injured while doing sports in Switzerland, over 90,000 of them in winter sports. Football with an average of 81,000, skiing including touring and cross-country skiing with about 58,000, snowboarding with 12,000, cycling with 15,000 and jogging with 13,000 injuries have the highest injury rates. Many of these could be avoided.
However, the risk of sports injuries is not only increased by inadequate preparation and misjudgement on the athletes side. Stress, lack of sleep, poor nutrition and generally too little regular exercise are the mortal enemies of the "corpore sano". Currently, we are additionally challenged by the strain of the Covid19 pandemic, not only in terms of all the social implications, but also especially due to the poor workplace ergonomics in the home office.
Our lifestyle has changed massively. We now spend most of the day sitting at home or working in front of the computer. We travel to work by public transport - also sitting down. A fully ergonomic environment for prolonged stress during this time is rarely found in a home office. After the workload, many of us seek relaxation and compensation in sports to stay physically fit. Some also need a kick to counteract the debilitating routine. True is, mental exertion and physical fatigue make us even more prone to injury.
More muscle and more strength generally means more safety and lower risk of injury. Research shows how, for example, in soccer, coordinated muscle training can reduce knee injuries by up to 50%. So for any athlete, a strong leg with a stable joint that does the right thing at the right time is less likely to injure ligaments, muscle-tendon apparatus, meniscus and bones.
But pure strength alone does not protect against injury: lack of elasticity, lack of concentration, fatigue or a nutrient-poor diet increase the risk of injury even in best trained athletes. If an injury occurs, the right recovery process is key. Having accurate strength data is super helpful here. You have a benchmark and know at any time where you are in the recovery process and when you have reached your initial performance level. How much less strength do I have in my left leg after the injury? 12%, 20% or 45%? Having access to this information makes it easier to design a rehab and safe return to sports.
In case of an injury and a break, it is of great advantage to be able to rely on a strong musculature. The latest scientific studies, such as in the case of ligament injuries in the knee, show that the healing of the ligament injury alone is not sufficient for a successful and safe return to sport. Muscle strength in all dimensions, i.e. rapid strength, maximum strength, endurance performance, must be rebuilt in such a way that, if possible, there is no longer a deficit to the uninjured opposite side.
In competitive sports, one observes all too often what happens when competition is resumed without being fully recovered and the musculature cannot yet fully compensate for the lost strength. A well-known example: Olympic skier Lindsey Vonn underestimated her knee problems. What looked like a minor injury after a 2018 fall turned out to be extensive damage to her left knee. The result: major surgery. If it had been possible to accurately measure the performance status of the musculature - so the readiness to return to sport - as is possible with the AURUM technology, further injuries might have been avoided.
Accurate data that provides the athlete and his doctor or therapist with information about their progress before and throughout rehab helps determine when the athlete is ready to perform at their top level without risking a re-injury. In addition, this objectively measured data has a positive effect on mental attitude - one feels fit and can see from the strength data on the screen that it is indeed so. This contributes to adapted risk-taking behavior, which in turn positively supports performance after injury return.
The global goal for both competitive and sports enthusiasts should be to minimize risk and maintain the body's resilience - even at an advanced age. To counteract natural ageing and degradation mechanisms in the long term, AURUM's adaptive strength training can make a big contribution to maintaining performance, fortunately in just 6 minutes once a week.
Dr. Andreas Krüger, MD
Resources:
Status 2019: https://www.suchtmonitoring.ch/docs/library/bfu_beratungsstelle_fur_unfallverhutung_0qnkr2bc5wtk.pdf
Hi, I am a guest contributor & scientific advisor for the post-injury rehabilitation at AURUM. I specialize in orthopaedic surgery and traumatology with a focus on knee and shoulder surgery & sport traumatology. I hope you enjoy my articles. Feel free to get in touch with me for a consultation or second opinion.
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