| ORIGINAL
PAPERSMethodological
approaches of risk factors in sport traumatology in volleyball
Elena
Taina
Avramescu, , I. Ilinca, M. Zavaleanu, D.
Enescu-Bieru
Faculty
of Physical Education and Sports, University
of Craiova
Abstract.The
volleyball becomes every year a more and more competitive game. The
strength training in the preparatory period is not optional anymore
but became a necessity. The players understood that because the
volleyball includes a combination of resistance, strength, speed,
agility and coordination is necessary to elaborate a program that
will satisfy all these necessities. Like in other sports the
development of the muscle mass in different muscle groups is
asymmetrical and unequal, conducting to decrease of performance and
trauma. Between the causes involved in a
poor physical conditioning we mention the inequality in the
development of agonist/antagonist muscular groups, the inadequate
neuromuscular coordination, flexibility and low resistance of tendons
and ligaments, low joint mobility. Reported to motor qualities the
players must work for increasing of
resistance, flexibility and strength, by using the main principles o
findividualisation, variation). Training: continuity, multilaterally,
step by step increasing, Also is important that the players will use
a variety of movements in all anatomical plans; by this reason the
programs must prepare the players to produce, reduce or stabilise
the dynamic structures involved in the movement execution for each
plan.The prophylaxis of injuries in volleyball will equally include
in the training program specific exercises addressed to he
strengthening of tendons and ligaments, along with the muscles, in
order to fortify the joints they traverse, to prevent untoward
injuries and to permit full and effective range of movement and
stability. In plus we can use massage and self-massage related to the
type of effort, training period, meteorological conditions,
protection of areas most exposed to injuries by tapping and stapping
(primary prophylaxis) and proper treatment/recovery of previous
trauma (secondary prophylaxis). We
also increased flexibility and range of joint motion. We used static
stretching exercises for general flexibility, specific warm up
procedures, weight training and resistive exercises in terms of
specific activities. We worked for the development of flexibility,
endurance and strength through the use of a carefully graded
developmental program. The
exercises were selected for assuring the warm up o all muscular
groups. The training programmes were adapted to the correspondents
training periods.
Key
words: volleyball, muscular-skeletal
traumas, rehabilitation.
Introduction
The
practice of different sport activities recognize in the late period
of time an extraordinary evolution involving more persons of
different ages and of all categories. This fact has represented a new
challenge for traumathology and for sport medicine.
Direct
consequence of generalization of sport phenomena is followed on the
medical diagram by a elevation of patients number with acute or
hiperfunctionally trauma, especially in contact sports, were the
movements are made from routine without a previously preparation (3)
.
So, the
logical conclusion that emerges from this is that the training must
be rethoughtful in terms for prophylaxis of injuries (2).
Theoretically all muscular-skeletal traumas can be prevent by an
accurate initiate and guided training, by a physical adequate
training.
Obtaining
sport performances can’t be realize only by
training; it includes a proper alimentation, medication, physical and
mental recovery, preventing and recover after injuries.
Supporting
this idea, we conceive and elaborate the present work keeping in mind
next factors:- high
incidence of
trauma in high
level volleyball;
- incomplete knowing of
some
particularly aspects of anatomy and biomechanical of involved
structures in spot trauma
- the very special role
of medical
check in the activity of physical education and sport, the role of
prophylaxis to prevent illness and the apparition of trauma.
- the very special
role
of medical
check in the activity of physical education and sport, the role of
prophylaxis to prevent illness and the apparition of trauma.
- reporting to the
complexity of
aspects appear the necessity of raise the number of persons involved in
control of physicals activities, we talk about an interdisciplinary
team that include the coach, kinetotherapist, nutrition advisor,
psychotherapist, biochemestrian, sport doctors.
- The relative role
of
kinetotherapist
in practice of sport activity is the necessity of taking over the task
in interdisciplinary team because economical conditions.
The main
purpose of this work is the realization of a prospective study in
volley trauma, by giving an precise definition of trauma, following
the dates regarding mechanism trauma and examination this traumas for
obtaining accurate informations over the mechanism and to recommend
in this way efficient prophylactic methods.
If
physical exercise represent for the majority of other profession
individuals un maintaining health factor, for high level sportsmen he
can transform occasionally in damaging factor. Causes and mechanism
of production are specifically for sport practice (predisposal,
promoting and releasing factors), depending on sportsmen, on coach,
mistakes of competitions organization, nutrition deficiency, default
on sport equipments etc.
It
is possible preventing accidents only
if the causes how determin them are known. An second objective for
the work is identification of risk factors in specific traumatology
of volleyball.
So
the present work propose achievement of an evidence of trauma and
their more frequent localisation on volleyball player, and the
evidence of eventually methodological mistakes realized in different
periods of sportsmen preparation or the anatomic-functional
equilibrium disorders in the body of sportsman, both aspects being
perfect correctable by the intervention of doctor and coach.
Excepting
pure statistic purpose, an other proposed objective consisted in
introduction in training program of some stretching exercises, who in
combination with mobilization techniques and massage to help avoiding
acute and over-use trauma.
The
prophylaxis of injuries in volleyball will include in the training
program equally specific exercises addressed to the strengthening of
tendons
and ligaments, along with the muscles, in order to fortify the joints
they traverse, to prevent untoward injuries and to permit full and
effective range of movement and stability. In plus we can use massage
and self-massage related to the type of effort, training period,
meteorological conditions, protection of areas most exposed to
injuries by tapping and strapping (primary prophylaxis) and proper
treatment/recovery of previous trauma (secondary prophylaxis).
Kinethotherapist
and coach must know very well the biomechanics of the sport for
preventing vicious attitude due to the practice of sport.
By
recording and analyzing the movement using an video and soft for
movement analyze system (SIMI Motion) will permit the biomechanical
analyze of specific tasks and techniques in volleyball and
comparation between various players with or without previous
injuries.
Materials
and methods
Taking
into account the theoretically aspects we tried to establish a more
accurate evidence of trauma and their more frequent localization on
volleyball players and also to identify the evidence of eventually
methodic mistakes in the different moments of the training process or
anatomic-functional disequilibrium, aspects perfectly correctable by
coach or doctor team intervention. We analysed the incidence of
injuries for a period of 2 years (2002-2004). The informations are
disposed in synthetics tables, regarding the frequency and
localization of injuries, previous treatments, recovery of the
traumatize segment in terms of time and regain of functional
capacities (% from functionally capacity is kept, how much time
passed until the partial or total functional recovery).
We
also registred biologically constants partial or total involved in
trauma appearance like influence factors: seric Hb, ionic and total
Ca, seric Mg, lactic acid.
Results
Traumatic
lesions occurred during volleyball games are due specially to falls,
direct contact, ball hits. So, like we demonstrate before the
locomotory system is permanently solicited mostly for the upper
limb, but also for the lower limb, the predominance of injuries on
upper limb being more then 50% of all lesions(1).
From
the performed studies came out that the rata of trauma is associated
with blocking followed by attack hit, both necessitating vertical
jumps.
A
study from 1987 on 106 traumatize volleyball players conclude that
63% of this injures are appeared after a jump.
Action
of defending was associated with a smaller number of trauma, and the
the service or passing drills were responsible with a minimum number
of trauma. Generally each player performs during the game all this
technical procedures, so in is way players are equally exposed to
the apparition of risk injuries.
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Fig.
1. The analyse attack hit in volleyball using SIMI Motion. The
graphics analyse the movement for shoulder, elbow, radiocarpian
articulation
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Over
use trauma had a bigger incidence in comparison with accidental
trauma among the
volleyball
players, consisting approximately 50%-80% (4) from all trauma
recorded.
Sport
pathology in volleyball had included the affectation of these
regions:
* complex
shoulder articulation (impingement syndrome, acute and chronic
instabilities, pathology of rotator cuff)
*
knee articulation (sprains, dislocation with lesions of collaterals
ligaments and meniscus)
*
tibiotarsian articulation (sprain by eversion or inversion,
dislocation, acute and chronic instabilities).
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Table
1. Trauma incidence
| Nr.
Crt |
Subject/year
| Trauma
| | 1
| MV/1978
| Grade
II knee sprain+lateral
collateral ligament |
|
| Achilian
tendinitis
Left
quadriceps strain
Chronic
knee pain |
| 2
| HA/1982
| Glenohumeral periarthritis
| | 3
| PA/1983
| Patellar
tendinitis
Rotator
cuff tears |
| 4
| TA/1984
| Grade
II interphalangeal sprain
finger V
Bicipital
tendinitis
Chronic
back pain |
| 5
| MB/1985
| Impingement
syndrome
| | 6
| SA/1983
| Cervical
spondylosis
Peroneal
right fracture
Osgood
Schlatter disease
Bicipital
tendinitis |
| 7
| DC/1978
| Grade I
ankle sprain
Glenohumeral
periarthritis |
| 8
| PM/ 1981
| Grade
II knee sprain+lateral
collateral ligament |
| 9
| BF/1981
| Chronic back pain
| | 10
| IG/1981
| Grade II knee sprain+medial collateral
ligament |
| 11
| BC/1981
| Left cvadriceps strain
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The
proposed prevention and conditioning programme addressed to the
strengthening of tendons and ligaments, along with the muscles, in
order to fortify the joints they traverse, to prevent untoward
injuries and to permit full and effective range of movement and
stability. We also increased flexibility and range of joint motion.
We used static stretching exercises for general flexibility, specific
warm up procedures, weight training and resistive exercises in terms
of specific activities.
We
worked for the development of flexibility, endurance and strength
through the use of a carefully graded developmental program that
included:
Warm-up.
The subjects started
with 10 minutes of running,
followed by static stretching exercises for general flexibility (back
stretch, trunk stretch, shoulder stretch, hamstring stretch, lateral
stretch and gastrocnemius stretch). Each position was hold for 60
seconds.
Non-specific
conditioning
exercises: Squat thrust, abdominal
curl with trunk twisting, touching the right elbow to the left knee,
arm flinging (10 repetitions of each). Gradually we increased the
number of executions to 30.
Specific
warm - up exercises:
arm circling, ski stretch,
ankle supper, pectoral stretching, push-ups, shoulder roll, anterior
shoulder stretch (10 repetitions for each).
Weight
training and resistive
exercises. This program was
performed once a week and included isotonic exercises (military press,
two-arm curl, half squat, supine benc press, rowing exercise, side arm
raises – prone and supine; 3 series of 10 repetitions);
isometric
exercises (straight arm lift, shoulder arm tensor, wall press; 2 series
of 15 repetitions). We also used weight training in terms of specific
activities: passing drills with a medicine ball (4-6 pounds), finger
strengthening, supination-pronation with a 20 pound dumbbell; 3 series
of 10 repetitions.
Tapping
and strapping.
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Fig.
2. Warming up exercises. Back, trunk ,
shoulder, hamstring, lateral and gastrocnemius stretch
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After
a year of using the proposed programme the trauma incidence showed a
decrease of 37% in acute injuries. Measurements of muscular force of
the upper limb by dynamometry and joint mobility by goniometry showed
slight improvements at the end of the programme in some cases, but
not significant increases. The technique amd movement analyse showed
significant improvement.
Discussions
and conclusions
From
our anterior research results the fact that lately more authors
recognise as first cause of sport trauma an inadequate conditions of
sportsmen. The right conclusion is trauma can be prevent by an
adequate physical preparation on training process.
Our
research propose to redefine sport training for reaching and
maintaining an good physical condition, suggesting and using an
assemble of exercise special adjust for the training period and for
the objectives already mentioned for prophylaxis of trauma.
We
evoke that among the causes of trauma that are attribute to a
inadequate physical condition are the inequality of developing of
antagonist and agonist group of muscle, not concordance movements
due to inadequate neuromuscular coordination, reduce flexibility and
resistance of the tendons, ligaments, muscular elasticity, reduce
flexibility and articular mobility
For
this reason the present work draw the attention on necessity of
continuous developing and adapting training methodology keeping in
mind the principals of modern physiology and of sport biomechanical.
We
must recognise that lack of physical fitness is one of the prime
causes of athletic injury. These injuries can be obviated by proper
and through physical conditioning. Physical conditioning is herein
defined as the role played by exercise in getting prophylactic
results in trauma incidence. Muscular imbalance, improper timing
because of poor neuromuscular coordination, a lack of ligamentous or
tendinous strength, lack of flexibility are among the causes of
injury attributable to insufficient or improper physical
conditioning.
In
this way the methodology of training must be continuously developing,
taking into consideration the achievements of modern physiology and
biomechanics of sport activity.
Bibliography
1.
Kontonopoulou I.,
Xidea-Kkemeni A.(2004). Musculoskeletal
Injuries and the Parameters that Contribute to their Appearance in
Professional Athlets or in Athlets of High Level, the 13 th Balkan
Sports Medecine Congress, Drama.
2.
Mechelen W. van,
Evert A.L.M., Verhagen M, Wieke de Vente M. (2001). The effect of
preventive Measures on the incidence of ankle sprains – Proc.
The 17-th
International Jerusalem Symposium on sports medecine.
3. Mariani P.P.,
Camillieri G., Maresca G., Adriani E., Margheritini F.(1999). New
perspectives in sports traumatology, Proc 4-th
An. Cong. Europ. College
Sport Sc, Roma.
4. Rinderu
ET. Ilinca
I, Kesse AM (2004). The role of physical conditioning for prevention of
sports injuries in a volleyball team, he
13 th Balkan Sports Medecine Congress, Drama.
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