Jan 29, 2015
When the Prevention is the Cause

By Vern Gambetta

I find it ironic that as our knowledge of training has grown, injuries have actually increased, not decreased. There has been an increased emphasis on sports science, and I see more time devoted to “injury prevention” routines, sometimes to exclusion of actual training. Some of these programs are quite elaborate and “sciencey” in their appearance and rationale. So where is the disconnect occurring?

One conclusion I have come to is that many of the so-called prevention program exercises are actually causing the injuries they were designed to prevent. In an attempt to prevent injury, coaches have designed routines that put stress on the muscle group or area of the body that is susceptible to injury. Often, that area or muscle is isolated and worked extra hard and/or long, sometimes at multiple sessions in a day. The athlete is still expected to practice and play, and put together, it’s simply adding stress to stress.

The other factor is that injury prevention programs are being implemented to the exclusion of the actual physical training needed to prepare for the demands of the sport and the position. I recently watched an athletic trainer take an athlete through a prevention program at about half of game speed. The movements were on and off of a BOSU ball. This was all done because the athlete did not achieve an acceptable score on a movement screen and was not allowed to work with the team’s strength coach because of it. However, he was still expected to practice and play in the games. What’s wrong with this picture?


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Needless to say, the athlete did not make it through the season. This is not an exception–it is becoming the norm. Even if you know nothing about athletic training or rehabilitation, simple common sense should cause you to question this approach.

As an example of the prevention actually being the cause, let’s look at one of the most common injuries: hamstring pulls. One of the most popular strengthening and prevention exercises is the Nordic or Russian hamstring curl. But this exercise puts undue stress on the distal hamstring. The exercise create neural confusion because it teaches the hamstring to work differently and in some ways opposite of how it functions while sprinting. Instead, the athlete should do lunges and reaches in multiple planes, step-ups on both a low and high box. And oh, by the way, don’t forget to sprint.

If the only time the athlete is sprinting all out is in a game or match, the odds of injury are increasing significantly. They should sprint all out in practice on a regular basis. It doesn’t have to be for much distance, just enough to keep the system tuned. Also, the athlete can run curves and angles as a prevention measure. The hamstrings are stressed more on curves and coming off the curve, so practice the skill.

As a rule of thumb, thoroughly study the sport and position demands and know the qualities of the individual athlete. Then design a comprehensive training program that addresses the sport demands and takes into account the individual athlete’s strengths and weaknesses. Injury prevention should be transparent. It should be included in the athlete’s training and addressed through proper exercise selection, good training design and thorough coaching.

Vern Gambetta, MA, is President of Gambetta Sports Training Systems in Sarasota, Fla. The former Director of Conditioning for the Chicago White Sox, he has also worked extensively with basketball, soccer, and track and field athletes. He is a frequent contributor to Training & Conditioning. Vern also maintains his own blog.

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