The Truth About Injuries

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Ik kwam dit artikel over blessures tegen op het net. Vond het zelf wel weer een andere benadering en ik heb er wat van opgestoken. Misschien ook wat voor jullie?
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In the last year or two, one of the hottest topics in the world of strength of conditioning has been the question of whether or not to include crunches and/or other exercise that includes spinal flexion in training programs. A few experts say “yes”, most these days seem to be saying “no”, but countless articles have been written on the subject and endless discussion has taken place on training forums across the internet.
Those on either side of the debate often cite a long list of reasons why they believe doing crunches and the like is either a back injury waiting to happen and should be avoided at all costs, or why such exercises can and should be used as part of an overall core training program depending on the athlete or individual.
Originally, I planned on writing an article to give my thoughts and opinions on this topic, but the more I looked into the discussion, the more it struck me that such debates and discussions often completely overlook the big picture of injuries to begin with. Doing this not only greatly oversimplifies a vastly complex topic, it fails to give athletes and coaches the right perspective needed to take an intelligent and holistic approach to injury prevention and management.
This is because the truth that you’re not hearing is that what’s being lost amongst endless citation of research, theoretical models of spine function and dogmatic proclamations of which exercises are “good” or “bad” for everyone, is a real understanding of the most important principles of injury prevention and management.
In the real world of performance, injuries are almost always about far more than the inclusion or exclusion of an exercise, or even a particular set of exercises. It would be nice if it was just that simple and if we could solve all the lower back problems of the world by eliminating one particular movement, but unfortunately, the human body is infinitely more multifaceted and dynamic than that.
So, instead of weighing in on whether doing some crunches or sit ups or other similar exercise are like a ticking time bomb that will destroy your back one rep at a time, or if they have their place, I’m going to discuss the bigger picture of injury prevention, treatment and management.

Why Do Injuries Happen?
The best place to get started is to answer the most important question of all, “Why do we get injured to begin with?” After all, if you don’t know why injuries happen, how can you go about doing your best to prevent them?
For the purposes of this discussion, we can break injuries down into two categories: acute and chronic. An acute injury is just like it sounds, a sudden sharp shooting pain that you feel in your hamstring in the middle of a sprint or an elbow that makes a loud popping noise before your arm stops working right, for example.* Just about every athlete out there has experienced an acute injury at some point in their training career.
Likewise, most athletes have also experienced a chronic injury at some point as well – perhaps a shoulder that hurts and gets sore after every training session or a low back problem that comes and goes.
Regardless of the type of injury that we’re talking about, the fundamental mechanism that leads to it is one and the same and it’s not what most people think. Rather than the often cited causes – the wrong exercise(s) being used or used too much or not enough of the right exercises used in training – all injuries stem from the same underlying cause: too much stress.

Stress 101
The kind of stress I’m talking about is not the kind most people typically think of, the kind of stress most often associated with the feeling you get when you’ve got a big deadline coming up, a hectic family life, financial struggles, relationship drama, or any other number of issues faced in our daily lives. Instead, the kind of stress I’m talking about is biological stress – some also refer to this as “physiological stress”
While mental stress is something we talk about in terms of a feeling, biological stress is a measure of the physical demands placed on our bodies. Everything from walking around, to typing on a keyboard, to lifting weights and training, all places a measure of biological stress on our body to one degree or another.
This is because a whole lot goes into producing and supporting the production and absorption of muscular force. Our lungs have to get oxygen into our blood, our heart has to pump that blood to our working muscles, the cells in our muscles have to produce the ATP the fibers rely on to contract and relax, our fascia and connective tissue have to provide support and stability, our brain has to carefully orchestrate which muscles produce force and how much force they produce, etc.
This huge myriad of complex biochemical processes all takes place in the blink of and eye and it happens each and every time we do any sort of muscular work. Obviously, the more work we ask of our muscles, i.e. the higher the intensity and volume, the greater the demand placed on all these biological systems necessary to produce force and support movement.
Different types of biological stress
We can break down this demand into two kinds of biological stress: mechanical stress and metabolic stress. Of course the two are always inherently related to one another because metabolism supports muscle function, but mechanical stress is a measure of the force produced and absorbed by the entire neuromuscular skeletal system.
This means it includes everything from the muscle fibers themselves to tendons, ligaments, fascia, bone, etc. All of these tissues are involved in the production and absorption of force and all are placed under mechanical stress any time we put our muscles to work.
Metabolic stress, on the other hand, is a measure of the demand placed on all the tissues involved in energy production – which means it involves pretty much every major system in the body. Tissue in our heart, lungs, vascular network, muscles, brain, etc. all must work together to create the energy our working muscles need so of course the greater mechanical stress we put on our muscles, the greater the metabolic stress as well.

Adaptation
So far, all of this probably seems pretty simple and fairly obvious. Where things start to become much more complex, not to mention interesting, is when we start talking about biological adaptation. It’s the body’s fundamental ability to adapt to the demands placed on it that both keep us alive and set us up for potential injury when its limits are pushed.
You see, it all comes back to the fact that the body isn’t really a big fan of stress in general. The more stress the body is under, the harder it has to work to maintain homeostasis and the greater the stressor – whatever is placing the demands on the body – is perceived as a threat.
In the context of training, the stressor, of course, is in the form of the lifting weights, running, jumping, skill practice, etc. because all these require a ton of muscular work.
In order to try to make sure it doesn’t have to work as hard next time to same stressor is faced, and thus homeostasis is less disrupted, the body responds by making physiological changes to the mechanical and/or metabolic tissues that were stressed. These tissues are made stronger and/or more metabolically efficient and thus they become better equipped to handle the same level of mechanical and/or metabolic stress it previously was faced with.