Understanding Exercise Injury Risk Factors

A basic assumption among people when they work is out that they leave the gym in some way better than they did when they came in. For that reason, it’s important place as much emphasis on injury prevention, treatment and/or management as on the effectiveness of fitness program design.

First Things First

It is appropriate for the personal trainer to explain to any new client at the outset that are risks of injury inherent associated with all aspects of a fitness program. It is, at the same time, incumbent upon the trainer to minimize those risks.

Exercise injuries that aren’t caused from external sources (such as tripping over misplaced weights on the floor or a slip-and-fall from a slippery surface) are generally caused by either an acute trauma or overuse.

A traumatic injury is violent and sudden, such as sprains, lacerations, torn ligaments, pulled muscles, or bones broken from a fall. Immediate professional treatment is usually required.

Overuse injuries are more common and develop over a long period of time due to mild or low-grade, repeated stress.

While there are a number of categories of risk involved in exercise, they can be consolidated into 10 main injury risk factors:

1. Training Frequency: Training a specific muscle too frequently will lead to overuse injury. Working muscles require from 48 to 72 hours of rest between workouts, depending on intensity and volume of exercise.

2. Increased Intensity: An excess of applied resistance can result in acute injury to muscle- and connective tissue.

3. Sudden Changes in Direction: Quick directional changes are often referred to as “plyometric”. The greater the load during such plyometric exercises, the greater the risk of injury.

4. Excessive Activity Duration: The depletion of energy and fluids can lead to exhaustion, dehydration, and associated heat injuries.

5. Temperature Extremes: With proper attention, fluid loss through sweating can lead to heat stroke or heat exhaustion. Adequate hydration, therefore, is critical.

6. Related Health Conditions: Involving a qualified health professional can reduce the risks of a medical-related injury during, or from, exercise.

7. Muscle Weakness: Someone in a de-conditioned state requires a gradual increase in intensity, volume, and duration of exercise.

8. Flexibility Limitations: Short muscles are comparatively easier to injure. Because of this, people who are inflexible stand an increased risk of injury from exercise.

9. Age: In general, age by itself represents no particular risk. However, aging clients may be at increased risk of injury due to other factors in this list.

10. Obesity: There are factors associated with obesity that put overweight clients at risk.

Preventative Measures

Injury prevention is as important as an awareness of an attention to the foregoing risk factors. For personal trainers, that includes:

• Performing an adequate initial screening: This first step is critical in helping to identify pre-existing conditions and risk. Step-by-step initial screening instructions are provided in the National Federation of Professional Trainers’ Personal Trainer Certification Manual: The Basics (2008). These guidelines address injury risk identification and related actions on the part of the fitness professional.
• Paying attention to contraindications: It is critically important to remind the beginning client of the signs and symptoms of overexertion and the associated risk of injury. These contraindications include:
  • joint pain
  • dizziness
  • nausea
  • rapid pulse
  • excessive sweating
  • extreme muscle soreness
  • cramping
  • chest pain

A client who experiences one or more of these symptoms should cease exercising and contact the trainer. If necessary, refer him or her to the appropriate health care professional.

• Minimizing ballistic training: This measure is particularly important if the client is not experienced in proper technique and/or the trainer is not uniquely qualified in the proper technique.
• Assuring proper foot ware is worn: The proper foot ware helps to minimize shock and in some cases, provides the proper support for the ankle.
• Taking caution when training in unstable environments: It is undesirable to apply a significant load when performing exercises while unstable. The general functional fitness client will experience more risks as more joints are involved and/or when they are under load. It is important to keep in mind that the goal is to enhance coordination rather than strength in such movements.

The whole point, of course, if for people to leave the gym in better — not worse — shape than when they came in. Accidents can still happen, of course, but by paying attention to factors such as contradindications, the use of improper form, and unsafe environments, a fitness professional can cut down on the chances that they do.

References:

1. Jones, Bruce H., et al. “Intrinsic risk factors for exercise-related injuries among male and female army trainees.” The American Journal of Sports Medicine 21.5 (1993): 705-710.

2. Jones, Bruce H., David N. Cowan, and Joseph J. Knapik. “Exercise, training and injuries.” Sports Medicine 18.3 (1994): 202-214.

3. The National Federation of Professional Trainers. Personal Trainer Certification Manual. 5th Ed. Lafayette, IN: NFPT, 2008.