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What are the major goals of a 'sports physical'?

Preventing Sports Injuries

Gary Brazina (Sports Medicine Physician) gives expert video advice on: What role do proper clothing and footwear play in preventing sports injuries?; Why is it important to 'stretch' before exercising? and more...

What are the major goals of a 'sports physical'?

Well, the major goal of a sports physical is actually multi-factoral. Number one is determining if the candidate fit enough to participate in that sport? If we're dealing with adolescents, we're looking for any subtle hidden abnormalities that may be present; heart murmers, high blood pressure, difficulties with kidney function, abnormalities of the extremities which would make them prone to injury. For the adult, again what we're looking for are cardiac and cardiovascular problems that could be hidden. That is why we usually recommend that a person over forty be seen by their general physician for a cardiac workup, look for their high blood pressure, check for diabetes and just a general physical examination.

What role do proper clothing and footwear play in preventing sports injuries?

Well, proper clothing and footwear, and by that we also mean protective gear, does a lot to prevent sports injuries. The most common things we see are, besides blisters from people walking too quickly, or not having proper footwear, are problems where people start to jog or walk. They're not using a good pair of jogging shoes that allow cushioning of every step. They may try to go jogging or hiking in a pair of loafers or sandals, and that is going to lead to foot, ankle and leg problems.

What is meant by the term 'training error' in sports injuries?

A training error is very common. One of the most common causes for a person to come into a Sports Medicine Physician or an Orthopedic Surgeon is an overuse injury; especially in the gym, where they will make training errors. In other words, pushing too much weight, poor technique in lifting, or poor technique in running. These training errors, are basically from not understanding the mechanics of your sport. The most common things we see are overuse injuries in the gym.

Why is it important to 'stretch' before exercising?

It's controversial whether or not stretching before working out really is helpful. What I tell my patients is, it is important to warm up first, and then stretch. Stretching cold muscles only stretches the muscle belly - what you're really trying to achieve by stretching is increase the flexibility of the muscular tendonis junction. To do that, there has to be blood flow to the area. I think it is far more important to stretch after your exercise program than before.

Why is it important to 'warm up' before vigorous activity?

Warm up is key to prevent injuries. The reason is that you want to get your muscles warm, by bringing blood flow into the area. It allows the muscles to become more flexible and it brings in blood to the muscular tendinous junction, which is a low-oxygen tension system. Once it is warmer, it is more flexible and more distensible. Also, in racquet sports for example, it builds hand-eye coordination. You get that eye-ball-racquet coordination earlier, so you're hitting the ball in a more exact fashion. So I recommend, for example for racquetball players or especially tennis players, to play what I call Mini-tennis. Stand on the service line. Hit the ball over the net gently. What it does is it gets your quickness and slowly warms you up. Same with skiers: you're not going take the toughest slope first thing on your first run. You want to warm up, get your muscles moving, get your timing down, and get your body ready for the exercise you're going to participate in.

Why is it important to 'cool down' following vigorous physical activity?

Cool down is important, as it prevents injury by allowing a slow return of your heart rate to normal, as opposed to a sudden stop. It allows the muscles to slowly divert the blood flow back to your core, and away from the vigorous muscle activity. By a slow cool down, it helps remove lactic acid, some of the metabolic by-products to be washed out of the muscles in a slow fashion

Why is it important to learn proper technique for whichever activity I am going to do?

Technique is the key to preventing injuries. Pro tennis players, for example, do not have a lot of problems with tennis elbow. For the average weekend warrior, it's a real problem because they don't have the proper technique. They're hitting the ball late on the backhand, they're using a forehand by whipping the wrist to get top spin on the ball as opposed to using their legs or changing their grip on the racket, and they have poor technique. Running, for example: if you're an avid runner, having a coach looking at you, watching your stride, watching your technique will not only decrease your running times, but will also prevent injuries to your ankle and knee.