A Personal Trainer’s Guide to Preventing Injuries
For over a decade, I've been working with athletes and clients to help them build strength, recover from injuries, and achieve their fitness goals. During this time, I've commonly found that many people get hyper-focused on the small stuff regarding injury prevention. They obsess over stretching, ice baths, and the "perfect" biomechanics while overlooking more prominent factors that could make a profound difference.
In this article, we'll explore the fundamental science of injury prevention, debunking some common myths and highlighting the often overlooked elements that can empower you to take control of your body and significantly reduce your risk of injury. My aim is to give you a conceptual understanding of how many variables interplay so that you can take active steps to keep your body healthy while striving for your own physical pursuits. Understanding these principles can be a game-changer, giving you the confidence to push your limits while staying safe and healthy.
Understanding Injury Risk
It's easy to think that injuries are just a matter of bad luck or "weak" muscles. But the truth is, injury risk is far more complex. It's influenced by a multitude of factors, many of which we often overlook.
This is where it's crucial to understand the difference between injury risk and injury reduction. We can't completely eliminate the risk of injury – it's always there, lurking in the shadows like a kid’s leggo piece just waiting to be stepped on. But we can significantly reduce the probability of getting hurt. It’s all about how you play the odds. Every healthy choice you make, every proactive step you take, shifts those odds in your favor. The stricter you are about having your kid pick up their leggos, and the more observant you are when you walk, the less likely you are to catch one between the toes.
Introducing The Stress Bucket
To help visualize the concept of multiple factors blending together to create a risk profile, I like to use the analogy of a "stress bucket."
Imagine your body as a bucket that can hold a certain amount of stress. Every stressor adds to this bucket, whether it's a tough workout, a sleepless night, or even just the pressure of a big deadline. The fuller the bucket, the higher your risk of injury. When it’s overflowing, we’ve got a problem. Maybe it’s some back pain, maybe it’s poor performance, maybe it's susceptibility to a serious injury. The point is, when that bucket is full, the risk of things spilling over and making a big mess becomes much higher.
There are three main concepts you need to understand about your stress bucket and how it can illustrate your injury risk:
How your bucket gets filled
How we can get a bigger bucket
How your bucket gets emptied
Understanding each of these helps you take a more active role in preventing pain and injury. Unlike the copper bands you see on late-night infomercials, each of these concepts is actually rooted in science.
Now, let's take a closer look at some of the things that can fill up your stress bucket:
*Note: the subject of stress and stress coping can be profound and encompassing. For this article, I will stick to the aspects that overlap within my field of personal training and strength and conditioning.
Filling Up Your Stress Bucket
As I mentioned before, any and all types of stress can fill your bucket, some taking up more space than others. If you’re training hard for a marathon, that physical stress will certainly take up a decent amount. If you catch a cold, that’ll take up more still. Those are obvious, and we usually do our best to manage them, but they’re far from the most impactful.
Psychological Stressors:
You may be surprised to find psychological stress at the top of the list, but the reason is this: How an athlete or personal training client perceives an exercise, workout, or activity often dictates how much room it’s going to take up in that bucket. Think of it as an amplifier to any other stressor, and many times, as you’ll see below, other areas of mental stress can bleed over and drastically increase risk.
Academic or Job Pressure: Juggling deadlines, exams, or demanding work projects can take a toll on your mental and physical well-being, increasing your susceptibility to injury. One study found that athletes were 3.19 times more likely to have an injury restriction during times of high academic stress, such as finals or midterms, compared to times of low academic stress. To put this into perspective, when they looked at periods of extremely high physical stress and low academic stress (think training camps with 2-3 workouts a day), athletes were 2.84 times more likely to have an injury restriction than when at normal training volumes and stress levels.
Perfectionistic Concerns: Being a perfectionist in your sport or training can certainly have its advantages. However, a 2018 Meta-Analysis showed that individuals with perfectionistic concerns, a maladaptive form of perfectionism rooted in fear of making mistakes, have been shown to double their risk of injury in physical activity. This highlights the need to have a coach or personal trainer who can frame the drill or exercise appropriately without causing unnecessary fear or pressure around its performance.
Fear of Re-injury: A 2017 study showed that in ACL reconstruction patients, those with higher levels of fear were 13 times more likely to suffer a second ACL tear within two years of returning to sports than those who were less fearful. Once again, proving that to keep our athletes healthy, we need to make sure that we’re addressing the psychological perspective of how they view their bodies and exercise.
Social Stressors:
Yes, social factors can have a major impact on our stress bucket. While social outlets can serve to empty the bucket, many social environments or negative relationships can serve to fill it up.
“No Pain, No Gain” Environments: It’s been documented that having social environments that promote pushing through pain or never missing play time, no matter the cost, influence the risk and rehabilitation of sports injuries
Coaching Support: A study of 36 elite soccer teams found that low levels of coaching support led to a 23% increase in incidents of severe injuries. Athletes and personal training clients need to feel supported in their endeavors in order to thrive.
Physiological Stressors:
Physiological stressors can inhibit many of the mechanisms needed for recovery while also adding to the inflammatory load of the system. Drugs, alcohol, and sleep deprivation are the most common culprits, but anything that leads to a more inflammatory environment can contribute to the bucket.
Smoking and Alcohol: We all know that activities such as smoking and other substance use are ill-advised, but many are unaware of how far-reaching the effects may be. Smoking alone has been linked to a significant increase in exercise-related injuries and is known to increase the risk of many diseases, such as cancer, osteoporosis, rheumatoid arthritis, and many over-use injuries.
Sleep Deprivation: Skimping on sleep not only makes you feel groggy, it also shrinks your stress bucket, leaving you with less capacity to handle physical and psychological stressors. Adolescent athletes who get less than 8 hours of sleep per night have been shown to be 1.7x more likely to sustain an injury. Interestingly, they also found that the older the athlete, the higher the risk when in a sleep-deprived state, which speaks volumes for the needs of adults.
Physical Stressors:
This is more of what you were expecting this article to focus on. In most cases, physical stressors are the “straw that broke the camel’s back,” which is why they get so much attention. This does not mean that they aren’t important. Doing too much too soon or choosing forms or levels of exercise that are inappropriate for an individual can singularly fill the bucket by themselves.
Training Overload: Pushing your body too hard, too fast is a recipe for disaster. Rapid increases in training volume (more than 10% per week) have been shown to significantly increase injury risk.
Previous Injuries: If you've been injured before, that area may be more vulnerable to future problems. It's like a weak link in the chain that needs extra attention and care. Research shows that having a previous injury significantly increases your risk of future injuries primarily due to altered proprioception, strength deficits, and changes in biomechanics.
Takeaways on Filling the Bucket:
All stress is essential to consider when keeping an athlete or personal training client healthy. Until recently, most of our society focused on physical stress and biomechanics. These variables are important, especially to a good personal trainer and strength coach. However, emphasizing them as the main or only driver of injury prevention can feed fear and perfectionistic tendencies.
A good coach or personal trainer must approach them mindfully, creating a positive relationship and negating unneeded performance-related pressure. It's also important that the personal trainer or coach considers the athlete's or client's holistic stress load and injury history to yield optimal results with minimal risks.
The Stress Bucket: Making it Bigger
You can actually make your stress bucket bigger, giving you more capacity to handle life's curveballs and reducing your risk of injury. It's like upgrading from a tiny teacup to a giant bathtub – you've got more room for stress before things start to overflow.
Here are some proven strategies to expand your stress bucket and build a more resilient you:
Strength Training:
The best way to build a better bucket is through strength training. Strong muscles and connective tissues not only improve your physical resilience but also enhance your neuromuscular control, balance, and body awareness. Strength training was found to reduce sports injuries by 69% and cut overuse injuries almost in half.
Gradual and Appropriate Conditioning:
Understanding the physical needs and demands of a sport or activity is imperative to create a safe plan to develop an individual’s abilities. A well-designed training program that gradually increases stress will help your body adapt and become more resilient over time while keeping the risk of overtraining or injury low. It's like slowly stretching out that stress bucket, giving it more and more capacity.
Mindset
One study found that individuals who had an underlying belief that high amounts of stress were inherently bad for their health reported regularly having more stress and had an increased risk of premature death. Regularly reappraising your stress and viewing it as an adaptive response from which you can get better noticeably improves your physiological response. It’s important for a good coach or personal trainer to always help athletes and clients see the opportunity in their situations and cultivate a growth mindset.
Takeaways on Creating a Bigger Bucket
You may notice that there are significantly fewer options for making a bigger bucket than there are for filling it up. Staying strong, keeping in good aerobic shape and keeping our heads on our shoulders seem to be the best ways to become more resilient. Just because it’s simple, don’t let it fool you to how far-reaching the effects can be.
The Stress Bucket: Emptying the Bucket
Just as life and training can dump stress into your bucket, stress reduction, and recovery techniques can help drain it out. The thing is, there aren’t that many proven strategies to improve the rate of recovery beyond the basics. Let’s jump in:
Relaxation Techniques
It shouldn’t come as a surprise that relaxation techniques help to counteract stress, but many would be surprised that they have been shown to reduce injury rates. This further supports my point that systemic stress should be viewed as one of the main culprits of injury.
Sleep:
Sleep is your body's overnight pit crew. While you rest, your body gets busy repairing tissues, regulating hormones, and consolidating memories. It's also crucial for managing inflammation and adapting to stress. Skimping on sleep is like sending your pit crew home early—you're not giving your body the time it needs to recover and prepare for the next challenge.
Mindfulness
Learning to manage stress through techniques like breathing exercises and meditation can be a game-changer. These techniques drastically reduce and alleviate stress. It's like installing a pressure release valve on your stress bucket, preventing it from overflowing, especially if the client or athlete learns to become autonomously reactive in their employment when they feel their bucket getting full.
Nutrition:
Nutrition is important for everyone, but it’s especially true for athletes and personal training clients who are very physically active. Your body needs the nutrients necessary to recover. Ensuring that you have adequate calories, protein, carbohydrates, fat, and micronutrients is extremely important.
Takeaways on Emptying the Bucket
You may notice that there are also not a lot of ways to empty the bucket. Unfortunately, when it comes to recovery, time, sleep, relaxing, and good food seem to be the only things that have any noticeable impact. I want to iterate that simplicity in emptying the bucket is a good thing as it should simplify what you have to focus on to recover.
Stress Bucket Summary
My main point is that health, and specifically preventing injury, is extremely complex and multifactorial, when it comes to factors that add to our risk. There are numerous factors that can fill our bucket up, yet only a handful can empty it or make it bigger, which leads me to my final point:
TRUE INJURY RISK MANAGEMENT IS ABOUT MANAGING WHAT GOES INTO THE BUCKET MORE THAN IT IS ABOUT COUNTERACTING THEM
The factors that can add stress are indefinite, while the factors that reduce it are finite and heavily temporal. It’s easy for the filling up of the bucket to outpace the emptying of it, which is why many traditional recovery or injury prevention strategies outside what I mentioned have not held up in the research to prevent injuries (I’ll get into this later).
If I were to summarise the best thing for an athlete or personal training client to do to stay healthy and reduce their risk of sustaining an injury, it’d be the following:
Sleep. Like a lot.
Stick to an intelligent training plan that progresses slowly and can be adapted in times when you’re feeling run down.
You need to strength train.
Focus on fueling your body and maintaining a well-rounded diet. Macronutrients are vital, but also don’t skimp on the fruits and vegetables.
Be mindful of what stress you experience outside of your training and attempt to be reactive with stress-reducing strategies when it is high.
Maintain a growth mindset and always try to reframe the stressful situations you’re in as opportunities to grow and test yourself.
Surround yourself with individuals who promote a healthy view of exercise, and be weary of anyone who seems to regularly use negative feedback or create anxiety around your performance and exercise.
Re-evaluating Popular Injury Prevention Strategies
By now, you’re probably wondering why I haven’t mentioned things like stretching, ice baths, and other traditionally used interventions for injury reduction and recovery. While there are many popular strategies for reducing injury risk, research suggests that some might be less impactful than we once thought. Let's take a closer look at a few of them:
Stretching: You better stretch so you don’t pull a muscle, right? Wrong (and also more likely to create a toxic belief system, as we mentioned earlier). Stretching has been studied at length (get it?), and thus far, no research has shown that static stretching does anything to noticeably prevent injuries. Dynamic stretching, however, can make a great warm-up to better prepare for many activities, as we’ll get into later.
Ice Baths: Those icy plunges might be a popular post-workout ritual, but their effectiveness in preventing injuries is questionable at best and counterproductive to training at worst. If you’re curious to learn more, you should check out my previous article on the subject.
Foam Rolling: While many athletes swear by foam rolling, the research on its benefits for injury prevention is sparse. It might feel good and offer some temporary relief from muscle soreness, but it hasn't been definitively proven to prevent injuries. This doesn’t mean it’s not useful: Foam rolling before your workout offers some small acute performance advantages.
"Perfect" Biomechanics: While good form is certainly important, I’ve already mentioned the downfall of obsessing over achieving "perfect" biomechanics. Our bodies are adaptable and resilient, and variations in movement are often normal. What constitutes "good" biomechanics can vary significantly from person to person, depending on factors like anatomy, limb length, and movement history. This is why the literature has struggled to find form or technique to be predictive of injury in many sports or forms of exercise. You’ll never hear me say that biomechanics or exercise technique don’t matter- if I see an ugly squat in my weight room, I’m going to address it. It’s that this concept should be implied when it comes to training and that athletes and personal training clients should focus on moving well and feeling comfortable rather than striving for an unrealistic ideal.
Warm-ups: Now, this one is important! But not all warm-ups are created equal. A proper warm-up should be specific to the activity you're about to do. If you're going for a run, your warm-up should include movements that prepare your legs and cardiovascular system for running. If you're lifting weights, your warm-up should focus on the muscles and joints you'll be using during your workout. Having a structured warm-up that helps to expose the joints and energy system gradually to the activity that you’re preparing for can reduce your risk of injury during that workout. As I said earlier, this is where dynamic (never static) stretches can play a useful role, especially on the court or field.
Putting Injury Risk Reduction into Practice
At NOVA Strong, we have become a go-to source for many athletes or personal training clients who want to break the repetitive injury cycle and get back to making PRs and seeing progress. We know that injury prevention is about more than avoiding certain exercises or stretching until you're a human pretzel. It's about understanding your body, managing stress, and building a foundation of strength and resilience.
Our approach considers all the pieces of the puzzle:
Individualized Programming: We design training programs that are tailored to your specific needs, goals, and injury history.
Progressive Overload: We gradually increase the demands on your body, allowing it to adapt and grow stronger over time and we pull back when need to.
Stress Management: We incorporate mindfulness techniques and stress-reduction strategies to help you build mental resilience and manage the demands of training and life.
Nutritional Guidance: We provide nutrition coaching to ensure you're fueling your body with the nutrients it needs for optimal performance and recovery.
Constant Support: Our personal trainers and coaches all understand how important it is to be a pillar of support, especially one that helps to promote many of the mental aspects covered in this article.
We believe that a holistic approach to injury prevention empowers you to take control of your health and achieve your goals safely and sustainably.
If you're ready to work with someone who gets it and take your injury prevention strategy to the next level, we're here to help. At NOVA Strong, we offer personalized training programs, nutrition coaching, and expert guidance to help you achieve your goals safely and sustainably.
Schedule a free consultation today, and let's start building a stronger, more resilient you!
