Simplifying Injury Prevention

Too often I see soldiers approaching 30 blaming their musculoskeletal ailments on “getting old.” I typically reply with a comment about some professional athletes not hitting their prime until 30. So why do so many of us feel like we are breaking down while these athletes continue to excel? Yes, genetics and lifestyle are big components. However, programming is a large factor and is easily modifiable.

You can break down overall physical fitness into many components. For example, CrossFit teaches the ten general physical skills: power, speed, endurance, coordination, agility, etc. When speaking to soldiers and patients about injury prevention, I simplify it to three: Stability, Mobility, and Control. Visually, they form the points of a performance triangle:

Each of these points encompass multiple components of physical fitness, but often it’s best to use the KISS method (Keep It Simple, Stupid). “Stability” here includes such traits as strength, endurance, and power. “Mobility” is a combination of muscular flexibility and joint range of motion. The final corner of “Control” consists of motor control, coordination, and agility.

An athlete with a well-designed program will have a good balance of these three elements and find themselves near the middle of the triangle (the “X” represents the athlete).

When programming changes, key aspects of physical fitness often become emphasized while others neglected. This should not be news to anyone. Using our visual, the person (the “X”) will migrate away from the center. For example, if an athlete focuses on strictly strength training and power lifting, their X will slide towards the Stability corner.

This athlete is no longer balanced. They certainly have Stability and some Control, but they move further away from Mobility, now increasing their injury risk. If given a task to move a heavy load within their available range of motion, they are golden. However, the injury risk is high if given a task placing them outside their mobility limitations. This is very common in the military, especially with males in combat units.

The same can be said for stereotypical “yogis” who can contort their bodies into many shapes. Their range of motion is phenomenal, but they lack the strength to support their range of motion under load. Hence why hypermobile athletes are challenging to coach.

Let’s look at the desk jockey who plays soccer on the weekends. He or she likely migrates heavily towards the Control corner of the performance triangle. They can start, stop, turn, accelerate, move laterally, and dribble a ball, exhibiting overall control of their bodies. However, decreased ankle stability and shortened hamstring mobility significantly increase their chances of injury.

“I know…. I’m not 18 anymore” is a common statement made by my patients in conjunction with “getting old”. Well, yes, this is true. But what else is different now compared to when they were 18? The answer in training. Likely, they played sports in high school and were required to spend dedicated time in the weight room. This combination of training gave them the balanced skills to remain centered in our performance triangle. As they became older, their training changed and more specialized, oftentimes unintentionally, dragging them out of the center.

Just like everything else in life, balance is key. If you or your athlete are constantly injured, refocus your training to strengthen your neglected weaknesses. Again, this concept is not new, but hopefully this visualization can help simplify the issue. I witness a lot of “aha lightbulb moments” with my athletic patients after taking the time to discuss this performance triangle.

Thanks for reading.


Bonus Material: A Balanced Life

I can use one word to summarize this post: balance. Human optimization and injury prevention is balance between stability, mobility, and control. The balance concept is also critical in other aspects of life. “Work-life Balance” is a popular term used to describe the time, energy, and resources spent between an individual’s professional and personal life. “Professional life” is driven by a person’s occupation and actions related to it. I would include stay-at-home parents raising children into this category. “Personal life” contains multiple spheres including family, social connections, hobbies, health, and spirituality. Oftentimes, personal life takes a backseat to professional life with spirituality and health being the most neglected. We need to our resources to keep our these buckets full as this allows us to pour better versions of ourselves into the other areas of life and other people.

Having an empty spiritual bucket is similar to having an empty gas tank. Good luck progressing through your journey if you’re constantly running on fumes…. Take the time to refill your tank through whatever means most advantageous to you and your beliefs: church, Scripture, meditation, prayer, etc. Our biggest non-renewable resource we have is Time, so it’s imperative to allocate it to the right thing at the right time. Remember, as the verse below reminds us, there is a time for everything:

Ecclesiastes 3:1-8 (ESV)

For everything there is a season, and a time for every matter under heaven: a time to be born, and a time to die; a time to plant, and a time to pluck up what is planted; a time to kill, and a time to heal; a time to break down, and a time to build up; a time to weep, and a time to laugh; a time to mourn, and a time to dance; a time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing; a time to seek, and a time to lose; a time to keep, and a time to cast away; a time to tear, and a time to sew; a time to keep silence, and a time to speak; a time to love, and a time to hate; a time for war, and a time for peace.

#physicaltherapy #injuryprevention #crossfit

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