pre-conditioning

Pre-conditioning - or how to do the preparatory work needed to stay in tip-top training condition all year round

Imagine you had a crystal ball and could predict when you were going to get injured, and how. What if your gazing could also tell you how to prevent that injury and how to make your muscles as receptive as possible for sport specific adaptation? Wouldn’t it be great if this were possible? Well, recently several sports scientists have done the scientific ‘gazing’ on your behalf. Read on and you will be able to see into the future – and to harness strategies, techniques and drills that will enable you to avoid injury and optimise training and performance.

‘Pre-conditioning’ is a relatively new ‘buzz’ word in the world of sports training. It is about ‘training to train’ rather than training to compete; and it resembles the preparatory processes followed in numerous manufacturing industries, whereby tolerances and tests are painstakingly devised for materials and structures, so that when they are finally incorporated into the product the risks of failure are virtually nonexistent.

The start of the training year would seem an ideal time to pre-condition. Indeed, many coaches would say that’s what they are already doing by emphasising general training methods to build a foundation of strength for more specific work. In many ways these coaches are engaged in preconditioning, but in others they are not.

As a model, let’s look at how Formula 1 racing teams prepare. They work meticulously on their cars and drivers during the off-season as well as the Grand Prix season. They don’t, for example, simply fit the biggest engine they can find into their cars but rather work out just how much stress the chassis can take and what the cornering forces and breaking implications will be. A huge amount of data is generated to make this process as successful as possible.

The sports coach should adopt a similar approach for optimal pre-conditioning, determining, for example, the nature of the weaknesses in the athlete’s performances over the previous season, what injuries occurred, and when, and what the athlete’s body can handle.

Pre-conditioning should be seen as an ongoing process, operating continuously in the background of the main training programme to keep the athlete in prime training condition all year round. For example, bouts of eccentric calf training to ‘protect’ sprinters and endurance runners against Achilles strain should be used periodically throughout the training year to keep this potential injury at bay (see table 2, below).

Ultimately, pre-conditioning underpins all aspects of training. But its effectiveness depends on a broad range of determining factors.

Understanding how muscles contract to produce sporting motion is one such factor. Most sports rely on a combination of concentric and eccentric muscular actions. A concentric contraction occurs when a muscle shortens as it contracts to move a limb – eg the biceps movement during the lifting part of a biceps curl; an eccentric action occurs when a muscle lengthens as it contracts – eg the biceps movement during the lowering phase of the curl.

Damage from eccentric contractions

Eccentric contractions create more short- and long-term muscular damage than the concentric variety. Many runners will be all-too-familiar with the delayed onset of muscle soreness (DOMS) that occurs in the thighs after a workout involving downhill running. This results from the thigh muscles having to stretch on ground strike to control the speed of the descent. More serious strain injuries can also result from downhill running and similar eccentric activities.

Although the key aim of pre-conditioning is to minimise injury, if an athlete does sustain an injury it is important to understand why and take remedial steps to avoid a recurrence, and this goal will form a significant part of future preconditioning programmes. In this respect, selfdiagnostic tests can be used throughout the training period to predict potential injury (see table 1 below).

With regard to learning from previous injuries, Brockett and associates investigated hamstring injuries in elite athletes, hypothesising that those with a prior history of hamstring muscle strain were at increased risk of sustaining similar injuries in future(1). The research involved nine athletes with a history of unilateral hamstring injury and 18 uninjured subjects (controls).

Using specialised equipment, the researchers compared the torque that the hamstring muscles were able to exert. (Torque is a force that produces a twisting or rotating aspect: in a muscle, torque places increased strain on muscle fibre, creating greater potential for strains.) They found that torque peaked at much shorter muscle lengths in the injured athletes. In order to condition them against further injury, they recommended a combined programme of muscle testing and eccentric exercise.

Not all coaches have access to equipment like isokinetic machinery that is required to test muscular strength, but this should not be seen as a huge impediment to successful preconditioning (and injury prevention) as there are numerous other methods available.

The following general pre-conditioning advice can be used by coaches working with athletes from many disciplines:

  • Use ‘home-grown’ tests to determine muscular weaknesses and imbalances. For example, onerepetition weight training maximums (1RM) and/or plyometric (jumping) bests can be very useful pre-conditioners that can also act as periodic points of reference during conditioning. If, for example, there is a great discrepancy in strength between legs, the coach could instigate training designed to promote greater parity. In so doing, he or she will also increase an athlete’s general power expression and reduce injury risk.
  • Develop a repertoire of relevant preconditioning exercises – and know when to use them. Weight training as a pre-conditioner is covered later in this article, while selected examples of pre-conditioning exercises are offered in table 2 (below).
  • Establish ‘norms’ for required sport specific range of movement (ROM). Injury is likely if insufficient ROM is available in key muscle and tendon groups, such as the hamstrings and Achilles tendons for sprinters. This process will be subjective to some extent, particularly for novices with no training history, but the process of working out where muscular tightness could at best impair performance and at worst cause injury are key to successful pre-conditioning.
  • Analyse sporting technique. From a preconditioning standpoint, the emphasis should be on looking for muscular imbalances rather than focusing on ways to enhance performance. When filming a runner on a treadmill from behind, for example, the focus should be on hip alignment, the recovery phase of the running action, foot strike and back and shoulder position. From study of the film it may be possible to discern such problems as poor left leg hamstring and hip flexor muscle strength, identified by a ‘lazier’ lower left leg return phase during the running cycle. The coach can then design a training programme to counteract this technical deficiency in time for the start of the season.
  • Self-test for potential injury on an ongoing basis. Numerous self-diagnostic trigger point (TP) tests are available to coaches and athletes, although these should not be regarded as substitutes for sports medicine/physiotherapy interventions. TPs can flag up potential ‘problems’ before they become acute, allowing the coach to attempt to condition them out and/or seek appropriate professional help. Table 1, below, gives an example of a self-test for knee injury.
Table 1: Trigger point self-diagnostic test to identify potential ‘runner’s knee’
Injury Self-test Method
Patellofemoral pain syndrome (PFPS, or ‘runner’s knee’) See table 2, below, for a potential treatment Palpating the knee cap The coach uses his top hand to push down on the knee cap, lifting the lower pole of the patella. The thumb and forefinger of the lower hand then apply pressure to the lower borders of the inferior poles (sides) of the patella. If there is pain, it is more than likely that the athlete is suffering from/developing PFPS
Adapted from Noakes – The Lore of Running, 4th edition
  • Use eccentric training. This is recognised as a conditioning method in its own right due to its ability to recruit fast twitch muscle fibre and improve the ‘elastic’ properties of muscles. Here are some pre-conditioning suggestions:
  1. Controlled bouts of eccentric exercise to induce minimum muscular soreness – eg 4 x 100m of downhill running at 70% effort. There is much evidence to suggest that one bout of eccentric exercise will ‘inoculate’ against further eccentric muscular damage caused by the same activity for a period of up to six weeks afterwards;
  2. Eccentric pre-conditioning drills. For example, those involved in running sports could perform drop/depth jumps where the emphasis is just on the ‘landing and hold’ from the drop. Another example is eccentric weight training, where you concentrate on the lowering phase of a movement, such as controlling the weight as it is lowered to the chest during a bench press.

In terms of pre-conditioning, weight training is a must, since it can reduce the incidence of injury by strengthening soft tissue (muscles, ligaments and tendons). This is a very important consideration for endurance athletes, who may be wary of weight training because of its theoretical potential to ‘interfere’ with endurance training. However, this should not be a problem if the ‘right’ exercises are selected.

Coaches tend, quite naturally, to prefer exercises that have the capacity to develop their charges’ playing power. Invariably, they look at how power is generated – for a basketball jump shot, for example, or a tennis serve – then design a progressive conditioning programme to enhance that capacity. Although this is obviously crucial in terms of performance, thought must also be given to the muscles not directly involved in performing the relevant skill.

It is vital for a coach to gain a full understanding of the muscular dynamics of all relevant sporting actions. For example, shoulder and elbow problems often occur in racket sports players, who tend to have very powerful internal shoulder rotation muscles and much weaker external rotators – the result of years of hitting. There are numerous exercises that can be used to balance shoulder rotation strength, such as the cable or pulley external shoulder rotation described below. Whatever their sport, coaches need to consider including such ‘balancing’ in their pre-conditioning and conditioning programmes.

The cable external shoulder rotation

You’ll need a training partner to assist you and a short/medium strength dyna-band or similar rubber band type of exercise tube.

  • Stand in a ‘ready’ position with feet shoulderwidth apart and left hand on hip;
  • Place a towel between your upper arm and side to act as a pivot and ensure the elbow is positioned directly below the shoulder;
  • Grasp the handle of the dyna-band and flex the elbow to a 90°angle, holding the grip just in front and to the left of your navel;
  • Your training partner should be positioned on your left, just behind you, with a firm grip on the other end of the dyna-band; (there must be tension in the band, so that when you externally rotate your shoulder you are pulling against a resistance);
  • Externally rotate your shoulder (ie take your hand away from your navel and out to the side) to stretch the dyna-band. Keep your lower arm parallel to the ground at all times and don’t alter your hand position.

Table 2, below, lists a selection of weight training, resistance and drill-type exercises and relates them to various sports in terms of their specific pre-conditioning benefits.

Table 2: Selected pre-conditioning exercises
Exercise Pre-conditioning relevance Applicable sports Comments/exercise pointers
Leg extension Stabilises and strengthens the knee joints All Suitable for independent left and right leg training for more balanced strength expression
Backwards and sideways running Improves agility, lower limb strength and flexibility and proprioception (the ability to perform a skill from an unstable position) All running-based sports Can be included as a regular element of a warm-up
Eccentric calf raise Strengthens Achilles tendons All running-based sports (See text below)
Cable external shoulder rotation Balances rotator cuff shoulder strength All hitting and throwing sports (See box above)
Dynamic standing leg cycling Develops concentric and eccentric hamstring strength without the impact forces associated with running All running sports Stand tall and cycle one leg underneath the body in an out-and-back running action. Stand near a wall to aid balance. Increase speed as confidence develops
Eccentric squats Develop the elastic strength of the thigh muscles and reduce injury risk All running and jumping sports Set up a Smith machine so that it allows the weight to be lowered under control
Leg press Reduces the risk of ‘runner’s knee’ (PFPS) Running sports – particularly endurance Seek expert advice if exercise causes pain

To further illustrate the role of weight training in pre-conditioning, let’s consider the use of heavy weight eccentric calf raises as a means of combating Achilles tendon injury. This and similar exercises can be used by a coach to ‘shore up’ an athlete’s body before the main training programme and to reduce the risk of injury during training.

Tendinosis is the technical term for degeneration of Achilles tendon tissue, while achilles tendinitis refers to inflammation of the soft tissue. Most Achilles pain is now believed to be a consequence of the former, particularly in athletes who are mature in training terms. Alfredson and associates discovered that heavy weight eccentric calf lowering exercises were a great treatment in research on two matched groups of 15 recreational athletes, both suffering from long-term Achilles tendinosis(2).

The first group performed the heavy calf raises with an emphasis on the eccentric phase, while the other received ‘normal’ physiotherapy treatment. At the end of the 12-week training programme, the weight training group were able to run at pre-injury levels. By contrast, the controls did not respond to physiotherapy and ultimately needed surgical treatment. The eccentric calf exercise is basically a normal calf raise, with an emphasis on the lowering phase, when the athlete lowers the weights very slowly.

As is probably becoming apparent, preconditioning is an incredibly complex phenomenon, and coaches need to have a full understanding of their sports (biomechanically, physiologically and in terms of injury risk) and match this to the abilities and limitations of their athletes. Only when completely armed with this knowledge will they be able to optimally precondition (and condition) them.

To add to this complexity, it is also more than likely that no two athletes in the same squad or team will have exactly the same specific preconditioning (and conditioning) needs.

Gender differences must also be considered. There are significant biomechanical differences between men and women that could lead to injury if not taken into account. This is not prejudice but physiological/biomechanical fact. For example, female athletes are at 4-7 times greater risk of anterior cruciate ligament (ACL) injury than their male counterparts playing at similar levels in the same sports. This is because of gender differences in hip and lower limb alignment which can lead to increased knee joint torsion in women.

Hewett and various collaborators from the Cincinnati Sports medicine and Orthopaedic Centre in Ohio have carried out a great deal of research into this vital area for pre-conditioning and, in consequence, a plyometric training programme has been devised to reduce the incidence of knee damage in female athletes(3).

In reading the above, you will perhaps have become aware (as I did while writing it!) that we athletes and coaches don’t know quite as much as we thought about training for our particular sports. It’s as if another level of knowledge has to be gained, that at first may seem somewhat peripheral. However, once you come to realise what a difference it can make, going to the trouble of implementing a pre-conditioning programme becomes a must.

John Shepherd

References

  1. Med Sci Sports Exerc, 2004, 36(3):379-87
  2. Am J Sports Med 1998;26(3):360-6
  3. Am J Sports Med 1996;24(6):765-73

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