PhysioMonkey

Back from BJC and a wonderful time was had (apart from the nasty case of tonsilitis I have).

Workshops:

1 - Injury prevention and advice - I'm now quite sure that this workshop is probably not needed.  The advice can be offered as part of other workshops.  Too much talking from me and not enough to do practically.  Would work as part of a day long session.

2 - Control and stability - Ooh this was a good one.  I enjoyed it.  The Chocfest one lasted 90 minutes.  This one ended up at 2.5 hours.  The majority stayed for most of it too.  Some interesting shoulders (one in particular) and lots of time taken to show what's going wrong.  If you were at this then I'd love some feedback on how you felt it was for you.  The responses I had afterwards were all positive.  If you didn't find it useful or interesting then I'd like to know how to improve it further.

Clinic time: Met loads of folk and gave plenty of advice out to all.  One or two odd cases and some pretty basic stuff.  If you asked me anything and want more info then get in touch.

Have fun.

[Reposted as slight changes throughout.  (Thanks to Dr Helen for the info!)]

Most injuries will be minor BUT major injury can happen even from an apparently minor incident.

[Because of increasing spam comments on this particular article I have now closed the comments section on this article only.  Sorry but if you have comments then please send me an email.  If relevant then I'll publish them on here.  Cheers.  Alan 29/5/06]

The first of the big controversies. 

Warming up is, as we all know, vital to prevent injury and prepare us for action.

Actually; no.  It's bollocks if you excuse my vernacular usage. 

I'll be more specific:  there is NO evidence to show that warming-up reduces your risk of injury.  In fact there is far more evidence to show that it's a complete waste of your time if injury avoidance is the main reason you are doing it.  But it's something that has always been done and everyone still learns and teaches it.

I've seen any number of workshops in tumbling, acro-balance, trapeze and even 3 ball juggling that have included up to 20 minutes of warming up, usually in the form of stretching everything out.  A waste of time for 90% of the participants and it's usually done incorrectly to help the remaining 10%.

Now I'll drop the real bombshell for many of you:

Stretching as a warm-up actually reduces your muscles' ability to respond as well as it could if you hadn't stretched it out.  This means that, not only does this NOT reduce your injury risk, it also drops yours performance level.  It's about a 6% loss of ballistic power.  This doesn't seem a lot but, if you're performing at the far limit of your ability, doing your hardest stuff, it can easily be the difference between success and failure.  It has been described as "the difference between winning a gold medal and not getting onto the podium".

So: so far we have:

• Warm-ups do not reduce your risk of injury.
• Stretching as a warm-up reduces your ability.

So why the hell do we do it?

There ARE benefits to a dynamic (ie not passive stretching) warming up:

• It raises your heart and breathing rates and increases core temperature.
• It gets you "in the zone".
• A set routine is more likely to get you mentally ready.

Therefore a dynamic warm-up is grand for performers.

So how do we reduce our risk of injury?

• Taking care (IE don't be stupid - follow the rules of play).
• General fitness.
• Specific fitness.

I'll talk more about specific fitness.  Sports Scientists and trainers witter on about something called "Specificity of training".  What this basically means is "to get good at something you must practice that thing".  In other words you get fit to run long distances by running a long way a lot of times.  Of course you'll start with a couple of miles only and build up as your body adapts to the new stresses that you're putting it through. Spending hours on a bike (or uni) will not really help you get good at running.  Doing both will make you more generally "fit" but the one doesn't help the other.

Relating that to us:  if you're habitually not going on a trapeze you're likely to hurt something if you try and copy a trained trapeze artist doing something quite difficult.  However much you stretch stuff out before going on the trapeze is immaterial; your body will not be fit enough to deal. 

Think about juggling; when we start to learn 5 balls we are crap at it so we practice more. We don't practise 5 balls as a whim or by accident, we practice it because we know that it's the best way to get better at it.  Getting good at diabolo will not help our 5 ball patterns.

So back to warm-ups

If all you need is injury prevention - get yourself fit to do the task you are aiming for.  The warm-up won't help you suddenly be able to manage something that is novel to you.

If you are performing then you need a dynamic warm-up.

Dynamic warm-up

• Will be different for different skills/purposes and for different people.
• Generally involves getting "geared up" to do the job.
• Increases heart-rate.
• Use a set pattern to get you mentally prepared as well as physically ready.

Examples:

Jugglers

Just crack on with what you want to do.  Many folk feel that starting with easier stuff is preferable to trying your outer-limits stuff.  It's up to you.  Stretching will not stop any injuries.  Not doing stuff for too long or well beyond your physical capability will stop you injuring yourself in the normal course of things. 

For performances try practicing your basic stuff.  Make sure your body will at least manage the more physical parts of the act (eg the contortionist).  Work towards one or two runs of some hard stuff then get yourself out on that stage.

Trapezists

Make sure all your joints are managing everything they'll need to do today.  So do brief shoulder stretches just to see that the range needed is there.  Do some running on the spot or around the gym, star jumps anything to get your blood going and your heart-rate up.  Don't wear yourself out before starting to perform though.

One more thing about warming up

This is an observation after seeing something once or twice at conventions.  The most notable occurance was an acro-balance workshop.  The participants spent 20 minutes doing a wonderful series of stretches as their warm-up.  We now know that this reduced their power and didn't help prevent injury but anyway.  They then sat around (most of them) as the 2 tutors spent 15 minutes talking through and demonstrating things.  The participants were sitting quietly through this period.  At best the warm-up (done wrongly anyway) has now been completely wasted.  In fact there have been studies that show if you warm-up and then sit around doing nothing for a while then you are at MORE risk of injury than if you hadn't bothered with the warm-up in the first place. 

When you warm-up do it right (dynamic not stretchy) and finish the warm-up as close to performance as possible.

"I've heard that the cool-down is more important for reducing injury"

Not exactly true.  If you are going to pick up an injury it will already have happened by the time you get to a cool-down.  

A good cool-down was said to have helped reduce what's known as DOMS (that's "delayed onset muscle soreness). The theory being that DOMS was because of an excess in lactic acid and the massaging effect of stretching helped reduce the levels of lactate.  This is probably rubbish because a few hours after exercise the lactate levels in the tissues have been shown to return to normal levels - hence there should be no pain.  But we know in DOMS that the pain can last for 2 or 3 days.

The next theory stated that the pain was down to "micro-trauma" within the muscles.  This again may not be true but is more likely than theory 1.  A final theory states that the pain is because of the body remodelling itself because of the work you made it do.  

Some research has been done looking into this problem and how it affects sportsmen.  One such paper was Herbert RD and Gabriel M – Effects of stretching before and after exercising on muscle soreness and risk of injury: Systematic review. BMJ 2002:325:468:  This concluded with these lines

“Stretching before and after exercising does not confer protection from muscle soreness and stretching before exercise does not seem to confer a practically useful reduction in the risk of injury.”

There are more studies than that but they tend to say the same thing.  So what to do to avoid post-exercise soreness?  Simple: get yourself fit to do what you want to do.  Practice it a lot and don't go for massive leaps in effort or skill level if that can be avoided.  As you get fitter to do that you'll get fewer problems associated with over-work.  People don't like this solution as it takes longer than stretching pre- or post-exercise does a: to explain and b: to work through to get a good effect.

In brief though: You are more likely to get DOMS after unaccustomed exercise.  Again we are back to specific fitness for the job in question.  Professional trapezists will not have DOMS after doing stuff occasional workshop participants try.

In short:

• Don't bother with stretches as a warm-up.
• Warm-ups should be just that, they're to get you warm and ready to perform.
• Don't expect to suddenly be able to do new and stressful things without some soreness at best.
• Do your stretches daily if you wish to increase flexibility (but don't think they "should" be part of a warm-up).