HOW TO PROGRAM STRENGTH TRAINING
WITH SPORT INJURIES
Begin with a comprehensive
assessment to identify
injury-specific limitations
and contraindications.
Incorporate rehabilitation
exercises targeting the
injured area to promote
tissue healing and restore
function.
Design individualized
Gradually progress
programs focusing on non-
intensity, volume, and
affected muscle groups and
complexity while ensuring
functional movements to
exercises are pain-free and
maintain overall strength
do not exacerbate the injury.
and mobility.
Monitor progress closely,
adjust programming as
needed, and collaborate
with healthcare
professionals for optimal
recovery.
 KEY ATTRIBUTES OF MUSCLE STRENGTH AND
POWER IN SPORT INJURY READAPTATION
INDIVIDUALIZED ASSESSMENT:
every athlete's injury and recovery process
is unique. therefore, it's important to
conduct a thorough assessment of the
individual's injury, current fitness level,
and specific goals to tailor the
rehabilitation program accordingly.
BALANCE AND COORDINATION:
improving balance and coordination is
important for restoring neuromuscular
control, which is often disrupted following
an injury. balance exercises can help
retrain proprioception and reduce the risk
of re-injury.
FUNCTIONAL EXERCISES:
PROGRESSIVE RESISTANCE CORE STABILITY: developing core
incorporating functional exercises that
TRAINING: implementing a progressive stability is fundamental for overall body
mimic movements specific to the athlete's
resistance training program is essential for strength and injury prevention. core
sport helps to improve muscle strength
rebuilding muscle strength. this involves exercises targeting muscles in the
and power in a sport-specific context. this
gradually increasing the resistance or load abdomen, lower back, and pelvis can
can enhance the athlete's ability to transfer
over time to stimulate muscle growth and improve stability and support during
their rehabilitation gains to on-field
adaptation. dynamic movements.
performance.
PERIODIZATION: structuring the MONITORING AND ADJUSTMENTS:
PLYOMETRIC TRAINING: plyometric
rehabilitation program with periodization regular monitoring of progress and
exercises involve rapid stretching and
principles, including phases of adaptation, reassessment of goals are essential to track
contracting of muscles and are effective
strength development, and power improvements and make necessary
for developing explosive power. however,
enhancement, helps to optimize the adjustments to the rehabilitation program.
they should be introduced gradually and
progression of muscle strength and power this may involve modifying exercises,
progressed cautiously to avoid overloading
gains while minimizing the risk of adjusting intensity, or addressing any
injured tissues.
overtraining or reinjury. emerging issues or setbacks.
 Overuse injuries occur when tissue is subjected to repetitive
stress without adequate time for recovery => microtrauma,
REPETITIVE INJURY inflammation, and ultimately tissue breakdown.
MECHANISMS: Examples include tendinitis, stress fractures, and muscle strains.
OVERUSE OF THE Overuse injuries often result from biomechanical imbalances,
TISSUE AND ITS training errors, or insufficient rest periods, highlighting the importance
EFFECT ON THE of addressing both intrinsic and extrinsic factors in injury prevention.
CONCEPTS OF
ELASTIC Elastic hysteresis = energy dissipation within a material when
HYSTERESIS - it is subjected to cyclic loading and unloading.
STIFFNESS - In repetitive injury mechanisms, tissues (tendons and
ELECTROMECHANIC ligaments) - if the loading exceeds the tissue's capacity to recover, it
AL DELAY can lead to an accumulation of microdamage and increased hysteresis
=> energy lost within the tissue, potentially compromising its
structural integrity and predisposing it to injury.
 Overuse injuries can influence tissue stiffness, which can lead
to alterations in tissue stiffness, with potential implications for
REPETITIVE INJURY biomechanical function and injury risk.
MECHANISMS: Decreased stiffness in tendons or ligaments may compromise
OVERUSE OF THE their ability to absorb and transmit forces efficiently => increasing
TISSUE AND ITS susceptibility to injury + impairment in tissue flexibility and shock
absorption => leading to compensatory movement patterns and
EFFECT ON THE subsequent overuse injuries in neighboring structures.
CONCEPTS OF
ELASTIC
HYSTERESIS - Electromechanical delay (emd) = the time lag between
muscle activation and the generation of mechanical force.
STIFFNESS -
Prolonged or repetitive loading can disrupt the neuromuscular
ELECTROMECHANIC coordination and efficiency => alterations in EMD => compromise the
AL DELAY timely stabilization and support of joints during dynamic movements
=> increase the risk of injury.
INJURIES CAUSED BY ISOLATED LOADS

Injuries caused by isolated loads represent a

significant concern in sports and physical
activity, often resulting from sudden, high-
impact forces applied to a specific area of the
body.
Understanding the mechanisms underlying
these injuries, along with their implications
for tissue integrity and functional
performance, is crucial for devising effective
prevention and rehabilitation strategies.
Isolated loads can lead to various types of injuries depending on the
nature and magnitude of the force applied and the specific
biomechanical characteristics of the affected tissue.

Example: direct blows or impacts to a joint can result in acute

traumatic injuries such as ligament sprains, muscle strains, or joint
dislocations.

These injuries often occur in sports with high contact or collision

rates, such as football, rugby, or martial arts, where athletes are
vulnerable to sudden, forceful impacts from opponents or equipment.

Isolated loads can also lead to overuse injuries when repetitive or

prolonged loading is applied to a particular tissue or structure.

Example: repetitive jumping or running activities can exert excessive

stress on the lower extremities, predisposing athletes to conditions
such as stress fractures, patellar tendinitis, or plantar fasciitis.
 INJURY MECHANISM IN MUSCLE AND TENDON
INJURIES
• Muscle injuries typically occur due to sudden, forceful contractions or excessive stretching beyond the tissue's
capacity to withstand mechanical stress.
• Common mechanisms include eccentric loading, rapid acceleration or deceleration, and direct trauma.
Eccentric contractions, in which the muscle lengthens while under tension, are particularly prone to injury due
to the high mechanical demands placed on the muscle fibers.
• Example, during a sudden change in direction or landing from a jump, the eccentric loading on the quadriceps
muscles can exceed their tensile strength, leading to strains or tears within the muscle belly.

• Tendon injuries result from repetitive overloading or degenerative changes within the tendon structure.
• Tendons transmit the forces generated by muscles to the bones, facilitating joint movement and stability.
However, when subjected to excessive tensile or compressive forces, tendons can undergo microtrauma,
inflammation, and structural breakdown.
• Common mechanisms of tendon injuries include repetitive movements, poor biomechanics, insufficient
recovery, and age-related changes in tissue quality.
• Example: Achilles tendinopathy frequently develops in runners due to the repetitive stress placed on the
Achilles tendon during repetitive heel strikes and push-off phases of gait.
 INJURY MECHANISMS INVOLVING LIGAMENTS, JOINT
CAPSULES AND INTRAARTICULAR STRUCTURES

• Flexion forces can place significant stress on ligaments and joint capsules, particularly during activities such
as landing from a jump or cutting maneuvers in sports.
• Excessive flexion loading can lead to ligamentous sprains or tears, as well as capsular injuries, due to the
stretching and deformation of these structures beyond their physiological limits.
• Repetitive or prolonged flexion loading may contribute to degenerative changes within the joint,
predisposing to conditions such as osteoarthritis and meniscal injuries.
• Torsional forces, characterized by rotational movements around the joint axis = significant risk for
ligamentous and intraarticular injuries. Sudden changes in direction or twisting motions can subject the
ligaments and menisci to torsional stress, leading to strains, tears, or avulsions.
• Shearing forces, which involve parallel sliding or displacement of joint surfaces, further contribute to the
vulnerability of ligaments, joint capsules, and menisci to injury. Shearing forces can disrupt the structural
integrity of ligamentous attachments, leading to ligament laxity or instability. Additionally, shearing forces
may cause frictional or compressive injuries to the menisci, resulting in tears or degenerative changes within
the intraarticular space.
 Risk factors associated with lack of strength
Neuromuscular Postural Stability Muscle stiffness and Hip Stabilization Periodic
Neuromuscular risk
fatigue and Core imbalance and Muscle Reassessment and
assessment
management Stabilization assessment Activation Progression

- Conduct - Evaluate postural

comprehensive - Implement fatigue stability and core - Assess hip stability and - Continuously
monitoring protocols strength (static and - Evaluate muscle monitor and reassess
neuromuscular muscle activation
during training and dynamic balance stiffness and joint neuromuscular
assessments to patterns using functional
competition to assessments), core range of motion function, muscle
evaluate muscle movement assessments
strength, power, and identify signs of stability tests (plank - Identify muscle (single-leg squats, strength, and
endurance using neuromuscular variations and imbalances lateral step-ups, and hip movement mechanics
validated testing fatigue (ex: decreased rotational exercises). (dominant and non- abduction/adduction to track progress and
protocols. muscle force - Implement dominant limbs, tests) identify areas for
production or altered progressive core agonist and improvement.
- Assess movement patterns) - Identify deficiencies in
stabilization antagonist muscle - Adjust training
neuromuscular hip stabilizing muscles,
- Incorporate exercises targeting groups) - through programs and
control, coordination, (gluteus medius, gluteus
appropriate rest the deep stabilizing strength testing and interventions based on
and proprioceptive maximus, and hip
periods, recovery muscles of the torso, functional movement individual needs,
acuity through rotators)
modalities, and - Incorporate analysis. performance goals,
functional movement - Develop targeted hip
tests, balance periodization functional - Develop tailored and feedback from
strategies to mitigate strength and stabilization exercises athletes and coaches.
assessments, and movements that focusing on eccentric
agility drills. the risk of challenge postural conditioning - Gradually progress
neuromuscular programs to address control, proprioceptive
control and core feedback, and exercise intensity,
fatigue and stability (lunges, muscle imbalances volume, and
overtraining. and improve overall neuromuscular
squats, and retraining to improve complexity to
- Provide education rotational muscle stiffness and challenge
joint stability. hip stability and reduce
on proper nutrition, movements) to the risk of lower neuromuscular
hydration, and sleep enhance overall extremity injuries. adaptation and
hygiene to optimize movement promote long-term
recovery and enhance efficiency and injury improvements in
neuromuscular resilience. strength, stability, and
performance. injury resilience.
 • Strength training exercises = squats, deadlifts, lunges, and bench presses, target
major muscle groups, promoting muscle hypertrophy and enhancing overall
strength and endurance.
Muscle Strength • Increased muscle strength helps to stabilize joints and support surrounding
and Endurance structures during dynamic movements, reducing the risk of strains, sprains, and
other soft tissue injuries.
STRENG
TH
TRAININ
G TO • Strength training exercises that involve multi-joint movements and functional
patterns can improve neuromuscular control and coordination = balance exercises,
REDUCE Neuromuscular plyometrics, and proprioceptive training => enhances neuromuscular feedback
THE Control and mechanisms, allowing individuals to better anticipate and react to changes in
Coordination movement dynamics => reducing the risk of falls and instability-related injuries.
RISK
FACTOR
S FOR
INJURY • Strength training programs should address muscle imbalances between opposing
muscle groups and between dominant and non-dominant sides of the body =>
Muscle target weaker or underused muscles, such as the rotator cuff muscles, hip
Imbalances and abductors, or scapular stabilizers, strength training helps to restore balance and
Symmetry symmetry, reducing the risk of overuse injuries and compensatory movement
patterns.
 • Strength training exercises that target stabilizing muscles around the joints = the core,
hips, shoulders, and ankles, can enhance joint stability and mobility.
Joint Stability and • Strengthening the muscles that support and protect the joints helps to minimize excessive
Mobility joint movement and reduce the risk of ligamentous injuries, dislocations, and other joint-
related problems.

STRENG
TH • Eccentric training = emphasizes controlled lengthening of the muscle-tendon unit, is
Tendon and particularly effective for increasing tendon and ligament strength and resilience.
TRAININ Ligament • Exercises such as eccentric calf raises, Nordic hamstring curls, and eccentric squats can
G TO Strength improve tendon stiffness and reduce the risk of tendinopathies and ligament sprains.
REDUCE
THE • Strength training has been shown to increase bone mineral density and improve bone
RISK Bone Health and
health, reducing the risk of stress fractures and other bone-related injuries.
• Weight-bearing exercises, resistance training, and impact-loading activities promote bone
FACTOR Injury Resilience adaptation and remodeling, enhancing skeletal integrity and resilience to mechanical
stress.
S FOR
INJURY
• Integrating strength training into comprehensive injury prevention programs, along with
flexibility training, movement quality assessments, and sports-specific conditioning, can
Injury Prevention maximize the effectiveness of injury prevention efforts.
Programming • Individualized programming based on specific injury risk factors, movement deficiencies,
and performance goals ensures targeted interventions and long-term injury resilience.
 EFFECTS OF STRENGTH TRAINING ON THE ELASTIC
PROPERTIES OF THE MUSCLE-TENDINOUS COMPLEX

• Strength training exerts significant effects on the elastic properties of the

muscle-tendinous complex, influencing both stiffness and elastic hysteresis.
• structured resistance exercises and progressive overload principles, strength
training stimulates adaptive responses in muscle and tendon tissues, leading to
improvements in stiffness, which refers to the resistance of the tissue to
deformation, and elastic hysteresis, which reflects the energy absorption and
release during loading and unloading cycles.
• Eccentric loading enhances tendon stiffness and modulate elastic hysteresis
properties. These adaptations contribute to enhanced mechanical efficiency,
force transmission, and injury resilience, ultimately improving athletic
performance and reducing the risk of musculoskeletal injuries.
• Understanding the effects of strength training on the elastic properties of the
muscle-tendinous complex provides valuable insights for designing effective
training programs, optimizing performance, and promoting long-term
musculoskeletal health and function.
 CHRONIC TENDINOPATHIES AND STRENGTH
TRAINING

• Chronic tendinopathies present significant challenges for athletes, often leading to persistent pain,
functional limitations, and reduced performance.
• Strength training plays a crucial role in both the prevention and rehabilitation of degenerative tendon
injuries by targeting key underlying factors contributing to tendinopathy development and progression.
• = structured resistance exercises, progressive loading protocols, and eccentric training modalities, strength
training promotes tendon adaptation, collagen synthesis, and remodeling, enhancing tendon resilience and
reducing the risk of degeneration.
• + strength training improves muscular support and biomechanical efficiency around the affected tendon,
alleviating stress and optimizing movement mechanics to mitigate further injury risk.
• Integrating strength training into comprehensive prevention and rehabilitation programs empowers
athletes to effectively manage chronic tendinopathies, restore function, and return to sport with improved
performance and reduced recurrence rates.
 MUSCLE INJURIES AND STRENGTH TRAINING

• Muscle injuries are common in athletes, often resulting from sudden, forceful movements or
overexertion during sports and physical activity.
• Strength training plays a pivotal role in both the prevention and rehabilitation of acute muscle
injuries by targeting key aspects of muscle function and tissue adaptation.
• = progressive resistance exercises, plyometric training, and eccentric loading protocols, strength
training enhances muscle strength, power, and resilience, thereby reducing the risk of injury
occurrence.
• + strength training promotes tissue remodeling, collagen synthesis, and neuromuscular
coordination, facilitating optimal healing and readaptation following acute muscle injuries.
• By incorporating strength training into comprehensive injury prevention programs and
rehabilitation protocols, athletes can enhance muscular support, improve biomechanical efficiency,
and minimize the likelihood of muscle injuries, enabling a safe and expedited return to sport with
enhanced performance and reduced recurrence rates.
 JOINT INJURIES – ACL INJURY AND THE ROLE OF
STRENGTH TRAINING ON NEUROMUSCULAR
CONTROL OF THE KNEE
• Joint injuries, such as anterior cruciate ligament (ACL) tears, are debilitating injuries commonly
encountered in sports, leading to instability, functional limitations, and increased risk of osteoarthritis.
• Strength training plays a critical role in improving neuromuscular control of the knee and reducing the
risk of ACL injuries.
• target muscle imbalances, enhancing proprioception, and optimizing movement patterns, strength training
helps to stabilize the knee joint and mitigate excessive forces during dynamic activities.
• Ex: exercises focusing on strengthening the quadriceps, hamstrings, hip abductors, and core musculature
contribute to better knee alignment, joint stability, and injury resilience.
• + plyometric drills, balance exercises, and agility training enhance neuromuscular coordination,
proprioceptive feedback, and dynamic joint control, further reducing the risk of ACL injuries.
• Integrating strength training into injury prevention programs and rehabilitation protocols empowers
athletes to optimize knee stability, improve athletic performance, and minimize the likelihood of joint
injuries, facilitating a safe and sustainable return to sport.
 ANKLE LIGAMENT INJURIES AND THE ROLE OF
STRENGTH TRAINING AS A STABILIZING ELEMENT OF
THE JOINT
• Ankle ligament injuries, such as sprains, are common occurrences in sports and physical activity, often
resulting from sudden movements or improper landing mechanics.
• The strength of the surrounding muscles plays a crucial role in stabilizing the ankle joint and preventing
ligamentous injuries.
• target strength training exercises focusing on the muscles of the lower leg, including the calf muscles,
peroneals, and intrinsic foot muscles, athletes can enhance joint stability and proprioception, reducing the
risk of ankle sprains.
• Improve muscular support around the ankle joint, strength training helps to compensate for any laxity or
weakness in the ligaments, providing additional stability during dynamic movements.
• + incorporate balance drills, plyometric exercises, and agility training into strength programs enhances
neuromuscular coordination and dynamic joint control, further reducing the likelihood of ankle ligament
injuries.
• Overall, strength training serves as a critical component in the prevention and rehabilitation of ankle
ligament injuries, empowering athletes to maintain joint stability, optimize performance, and minimize
the risk of recurrence.
 PREVENTING GROIN INJURIES IN SOCCER PLAYERS:
Proper Warm-
Strength Flexibility and Technique Gradual Monitoring and
up and Cool-
Training: Mobility: Correction: Progression: Rehabilitation:
down:
• Targeted • Incorporating • Dynamic • Coaches • Gradually • Regular
exercises to stretching and warm-up should increasing monitoring of
strengthen the mobility routines before emphasize training players' fitness
adductor exercises for training and proper kicking intensity and levels and
muscles, as the groin, hip matches help and movement volume can addressing any
well as the flexors, and prepare the mechanics to help players signs of fatigue
core, hips, and hamstrings can muscles for minimize adapt to the or discomfort
pelvis, can improve activity, while stress on the demands of the can prevent
improve flexibility and cooldowns and groin muscles sport and injuries from
stability and reduce strain stretching and ligaments. reduce the risk worsening.
reduce the risk on the muscles. afterward aid of overuse • +rehabilitation
of injury. in muscle injuries. programs
recovery and should focus
flexibility. on restoring
strength,
flexibility, and
function
following a
groin injury.
 HOW TO PROGRAM DIFFERENT MANIFESTATIONS
OF STRENGTH IN STAGES OF READAPTATION
AFTER INJURY
Intermediate Maintenance
Early Stage: Advanced Stage:
Stage: Stage:
• Focus on • Gradually • Implement • Sustain strength
foundational increase complex and gains through
movements with resistance and sport-specific regular strength
low intensity and intensity while movements at training sessions
high repetitions incorporating near-maximal while
to rebuild muscle functional loads to simulate emphasizing
endurance and exercises to game-like injury prevention
motor control. restore strength conditions and exercises and
and prepare for return continued
neuromuscular to play. monitoring of
coordination. progress.
 PROGRAMMING STRENGTH TRAINING WITH
CHRONIC TENDINOPATHIES

• Prioritize exercises with low-to-moderate intensity and high repetitions to improve

tissue elasticity and endurance without exacerbating symptoms.
• Incorporate isometric holds and slow, controlled eccentric movements to build
strength while minimizing tendon stress.
• Gradually introduce higher intensity exercises focusing on maximum muscle power
and explosive strength, using proper technique to avoid excessive strain on tendons.
• Implement plyometric and ballistic exercises to enhance explosive strength,
gradually increasing intensity and volume to improve endurance while minimizing
fatigue.
• Emphasize rest and recovery between sessions, monitoring symptoms closely and
adjusting programming as needed to manage fatigue and prevent overuse injuries.
 PROGRAMMING STRENGTH TRAINING AFTER
ACL INJURY

• Initially focus on low-impact exercises to improve endurance and maintain elasticity in surrounding muscles
and connective tissues.
• Progressively introduce resistance training with light loads and higher repetitions to promote muscular
hypertrophy and strength, while avoiding excessive strain on the injured knee.
• Incorporate exercises targeting maximum muscle power, such as plyometrics and agility drills, to increase
speed and dynamic stability, with emphasis on proper landing and deceleration mechanics.
• Gradually integrate explosive strength exercises, like box jumps and medicine ball throws, to maximize
efficiency and power production while minimizing joint stress.
• Implement interval training and circuit workouts to improve explosive strength endurance, emphasizing
quality of movement and technique to delay fatigue and optimize performance.
I CONSIDER THE CONCEPTS CHOSEN IMPORTANT BECAUSE:
• knowledge about muscle tendon injuries in sports is essential for prevention,
early recognition, treatment planning, optimal recovery, performance
enhancement, and long-term musculoskeletal health. It empowers athletes,
coaches, trainers, and healthcare professionals to mitigate risks, promote safety,
and support the well-being of individuals participating in sports and physical
activity.
• strength programming is important in the context of sport injuries because it
supports rehabilitation, prevents future injuries, enhances performance, improves
resilience, provides psychological benefits, and promotes long-term health and
fitness. It is a crucial component of comprehensive injury management and
sports performance optimization strategies.
• understanding the differences between strength programming in chronic
tendinopathies and ligament injuries is essential for developing effective
rehabilitation strategies that address the unique characteristics and requirements
of each condition. By tailoring strength training programs to the specific needs of
the individual and their injury, healthcare professionals can optimize outcomes
and facilitate a safe return to sport or activity.