<h2>How can you protect your clients against injury?</h2>
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The way we exercise and work has changed in the last few generations. Our bodies were designed to be hunter/gatherers.  Our very physical make-up enables us to hunt, escape, harvest and gather by performing an almost unlimited number of movements like walking, running, throwing, bending, twisting and turning. As the technological revolution has enveloped our lives, these tasks are no longer necessary and our bodies have begun the process of de-conditioning in biomechanical terms. Problems then arise when we then ask our bodies to train in a gym in this biomechanically de-conditioned state; our bodies become adept at compensating for our biomechanical problems, like a rotated pelvis, leg length discrepancies, tight thoracic spines, stiff sciatic nerves and many others, which are significant factors in why we get pain despite being ‘fit’.
<h2>Repetitive motion</h2>
An often unrecognised problem for us is that our training programmes are by their very nature repetitive.  Where our muscles were once responsible for performing a variety of different movements throughout the day, they are now performing, semi-static, repetitive movements when we work on our laptops or larger repetitive movements when we are in the gym.   The body does not respond well to repetitive movements; nerves in particular go through a process of de-conditioning.  De-conditioning is a mechanical phenomenon where the nature of structures (in this case, nerves) actually changes and as they do, your muscles go into a protective spasm.  Remember this is while performing exercises; this is another reason for us having pain despite being fit.
<h2>Predisposition to injury</h2>
When you look at Meeuwisse’s work in 1941, he showed that the injured individual is predisposed at a number of different levels. If you apply this to your clients when lifting weights and strength training, you can see the loop that they will commonly go through from pain to returning to training (and indeed working through pain).
<h2>Injury Causation Factors</h2>
Age, Somatotype, Previous Injury, Flexibility, Intrinsic Biomechanics

Predisposed individual

Exercise

Exposure

Susceptible

Inciting event

Injury

Rehab

These same principles apply to you too.  If you do actually stop for a while to let your injury settle, even with therapy, you are still predisposed to injury if you are not correcting the biomechanical problems.

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Let’s look at some more of the specific problems with repetitive movement:
<h2>Joint loading.</h2>
If a joint is subjected to prolonged pressure when repetitive movements in your training are performed, the cartilage begins to lose its elasticity and therefore becomes vulnerable to damage, (Oleyede &amp; Broom 19942).  A biomechanically efficient joint will cope better.
<h2>Tension, stress and relaxation</h2>
Tendons are visco-elastic in nature and are therefore subject to the mechanical phenomena of preconditioning, creep and hysteresis when subjected to repeated stresses and strains.  This means they will adapt to the loads being imposed upon them, but if they are unnatural loads or the technique is performed incorrectly they will adapt to the incorrect movements and over time this will increase their risk of injury.
<h2>Muscle work</h2>
High repetition work in training can lead to muscle fatigue and in some cases, Delayed Onset Muscle soreness (DOMS) and overuse syndromes.  DOMS is associated with increase in muscle tone and faulty excitation of muscle, (Janda 19833).   This phenomenon is termed "The Calcium Paradox".  In this state the muscle is no longer able to contract and relax properly which means the muscle is in spasm i.e. it cannot relax.

In a normal individual this chronic state is avoided because we naturally move giving the muscle a normal sensory input and allowing it to relax, if however we ignore the warning signs and continue to exercise in our training, the continual irritation of the now-shortened muscle leads to physical changes within the muscle6.  Up to 40% of muscle can be replaced in a shortened muscle by connective tissue (Tardieu &amp; Tarbary).  Once this occurs normal mechanics are no longer possible without biomechanical correction (Janda 19833).  This increases your risk of injury.
<h2>Nerve tension</h2>
Nerve is visco-elastic in nature which means that the greater the velocity of stretch applied to your nerve then the less stretch is available and the greater the stress on the nerve.

It can be seen when a nerve is subjected to repeated stretching in training as it begins to react in an abnormal manner.  When a nerve is first stretched it begins to lengthen, but as the stress is removed and then reapplied, it reaches a certain point when repeated applications of stress cause no increase in nerve length.  Sometime after this point has been reached and if tension is continually removed and reapplied the nerve under stretch begins to show a greater resistance to elongation, (Barrow 19944).  This is similar to the mechanical concept of pre-conditioning found in other materials.  As the nerve becomes pre-conditioned, local muscles go into a protective spasm, which can cause pain and certainly compromises the quality of the movement you perform in your training.
<h2>So what can you do?</h2>
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There are key areas that you can work on to improve yours and your clients biomechanics:
<h2>Reduction of muscle spasm associated with repetitive movements</h2>
Muscle release exercises are designed to encourage the muscles in spasm to relax.  Studies by Ribot-Ciscar5 have established that a muscle relaxes maximally after it has been contracted sub-maximally and for a prolonged period.  So if you think one of your muscles is unduly tight or is not responding to stretching, then try low grade endurance isometric contractions of that muscle to release the spasm.  Contract the muscle for 20 seconds, using about 20% of your maximal contraction.  Repeat up to 4 times and then do this 3 – 4 times per day. iMoveFreely® will take you through this in more detail.
<h2>Prevention of postural abnormality</h2>
Many of your clients will have fundamental intrinsic biomechanical problems and these need to be addressed to have a good chance of their posture improving.  Even if they work on their posture, if they do not have the capacity to adopt and maintain good posture, that work is less likely to be effective.   Ensure they have good biomechanical foundations and their ability to adopt and hold a better posture will be enhanced.
<h2>Nerve protection</h2>
In the gym we sometimes get ‘hung up’ on what type of stretching we should be doing; static, ballistic, dynamic etc.  But it has been shown that nerves can be at least as important as muscles; as a tight nerve can cause muscle and joint injuries.  So as part of your clients warm up and cool down, it’s helpful to mobilise your clients median and sciatic nerves in particular.

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Martin Haines

Specialist Biomechanics Coach&#x2122;
<h2>References:</h2>
Meeuwisse, W.,H., 1994, Clinical Journal of Sports Medicine 4 (3) 168

Oleyede &amp; Broom.  Complex nature of stress inside loaded articular cartilage.  Clinical Biomechanics 1994.

Janda V. Muscle function testing.  London, Butterworths, 1983.

Barrow N.  Recent advances in the use of robotic dynamometry - Measurement of Neural Tension.  European Isokinetic Congress 1994

E. Ribot-Ciscar1, M. F. Tardy-Gervet1, J. P. Vedel2 and J. P. Roll1 Post Contraction Sensory Discharge.

1. Laboratoire de Neurobiologie Humaine, Université Aix-Marseille I, URA CNRS, 372, Avenue Escadrille Normandie-Niemen, F-13397 Marseille Cedex 13, France

2. Laboratoire de Neurosciences Fonctionnelles, CNRS-LNF3, 31 Chemin Joseph Aiguier, B.P. 71, F-13402 Marseille Cedex 9, France

6. Edwards RHT.   Muscle fatigue and pain.  Acta Med Scand Supplement, 1987.

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