Shoulder, elbow, knee, ankle - we all know a handball player that had an injury or had an injury ourselves .
Injuries can change careers, while some are career ending others keep you away from practicing or playing and thus hinder progress. But is it possible to prevent injuries?
WHERE ARE THESE INJURIES?
The most common injuries in handball are to the knee, ankle and hand/wrist. There are also non-contact injuries to the head that we need to watch out for, as repeated concussions can be career ending.
While many injuries are caused by contact with the opponent, teammates, or other objects (35-40%), more than 50% of all injuries occur without any action by others. It is difficult to reduce contact injuries, but we can assume that these injuries can also be reduced if we are better prepared for unusual situations.
CAN WE PREVENT INJURIES?
"Injury Prevention" is used everywhere. Unfortunately, injuries can never be completely prevented, but that's what the term suggests. Rather, it is about reducing the risk of injury, but a residual risk always remains.
In the sport of handball, you often hear the terms "prevention exercises" or "prevention training". This usually refers to 15 minutes before or after training in which special exercises are performed to reduce the risk of injury. However, this is only a very small part, if any, of prevention.
Real "prevention" means long-term athletic development, smart planning strategies, strength training, sprints, load management, nutrition, stress management, sleep, and much more. These have a huge impact.
INJURY RISK REDUCTION PYRAMID
After mythbusting the word “prevention” we like to introduce the “Injury Risk Reduction Pyramid”, a simplified model of the strategies we can use to reduce the risk of getting injured.
At the very bottom of the pyramid is “Load Management”, which we see as the single most important thing in reducing the risk of injury. And here is why:
If I tell you to do a crazy depth jump like in the video above, you probably would answer me that this is a dumb idea. And why wouldn’t you do that? Because you know that you aren’t prepared for this. It needs years of well structured training to get to the point where your body is able to withstand this crazy amount of force without getting torn to shreds. And even if you are ready to do that, how often can you handle this in a session, a week or a month? From now on, you need to understand that load management, which includes recovery strategies such as sleep or nutrition, are the foundation of any successful handball career.
The second level of the "pyramid to reduce the risk of injury" is general athletic development. The most obvious thing on this level is to become more robust through strength training. There are so many studies showing that the risk of injury decreases tremendously with more strength training. But as with everything, there is a limit. At a certain stage, it doesn't matter if you get stronger if you're very strong, or in other words, if you're very strong, you have to invest a lot more to get a little bit stronger, and that time would probably be better invested in other types of training.
Strength training is not the only thing when we talk about athletic development. There are other things, like speed training, that can make you more robust and reduce your risk of injury. Many injuries occur during high-speed movements like sprinting or jumping. It's important to understand that you can't simulate the muscle actions that occur during sprinting in the weight room. In other words, there is no substitute for sprinting. That means if you want to reduce the risk of non-contact injury while sprinting or jumping, you need to practice these things.
And you don't have to practice these things only in perfect scenarios, either. For example, if you only practice jumping in a very controlled manner, there is a good chance that you will tear your ACL in an unexpected situation where you have to react in milliseconds with a quick cutting step in a "suboptimal" position.
If you think about when injuries occur during a game, it seems clear that more injuries occur at later stages. So we can assume that the ability to maintain our strength and speed over a game, a practice, or even an entire season is endurance. Endurance in general and in particular is also something we need to improve in order to reduce the risk of injury. But as we said at the first level, we always need to keep in mind overall load management when we're working on these basic things of athletic development to make sure that we're not overloading the body so that we're getting injured because we're trying to get stronger and faster and enduring too hard and too fast.
If you're super fast and super strong, but you have a very steep decline curve during a game, that's not always an endurance problem. At least not in the direct sense. There is something we can call movement efficiency, which we think of as the third layer of the "injury risk reduction pyramid." Imagine two athletes who have exactly the same energy resources available in their bodies and can run the 20 m in exactly the same time. But if they both have to run that distance over and over again with adequate breaks in between, one of them will eventually start to slow down. And one possible reason for this could be that one of the athletes is not running with the same movement efficiency or smoothness as the other. In the first sprints, the athlete may compensate for this by using more strength, but this results in higher energy expenditure in each sprint. As a result, the athlete with the greater movement efficiency has more fuel in the tank and can run at submaximal speed to achieve the same time as the slower athlete, reducing his risk of injury. Although this is a very theoretical example, it should have clarified for you the importance of movement efficiency.
The last stage of the “Injury Risk Reduction Pyramid” is Mobility & Flexibility. How many time have you heard the following sentence? “Your muscle XY is short. You need to stretch it.” First of all, your muscles can not really shorten. This just wont happen if you are healthy. What we see is that our whole body adapt to what we do in our daily life. So if we stop moving at certain ranges, our body stops beeing used to this. Greatly simplified, our body then will always tend to avoid the ranges we aren’t used to and the nervous system will tell our body that we have to stop a movement before we get injured. And that’s one of the reasons, we aren’t as flexible as we were a few years ago.
While there are some sports like gymnastics, where you need a lot of mobility and flexibility, the majority of sports do not need excessive amounts of flexibility. In sports like handball we need the appropriate amount of mobility and flexibility. A good range can help us being able to move in different joint angles, but too much mobility can also work against our body's adaptation to a certain sport. To be clear: We're not saying you shouldn't work on your mobility and flexibility, because they have their place in the injury Reduction Pyramid and a lot of athletes lack basic mobility, especially when we look at the hip joint, but do not overestimate the impact on injury risk reduction.
At this point you know the most common injuries and what can have an impact in reducing the risk of these injuries.
Here is a list about what you can do (and what we do in our programs), starting today:
Don’t kill yourself
Load management is the key here. While we know as a player load management isn’t always in your hand, there is one part of it which you can influence more than any coaches -> Recovery. And when we talk about recovery, we do not mean recovery tools like foam rolls, massage guns or ice baths. They have their place in your recovery strategy but if you neglect the two most important things, sleep and nutrition, everything else doesn't really matter. Make sure to check our programs about nutrition and recovery if you feel like this could be a game changer for you.
Generally speaking, the stronger you are, the lower your risk of injury. And that's one of the reasons why we've developed an entire training system with our programs to both reduce your risk of injury and improve your overall athletic performance.
Get more efficient
We all know the athletes who look smooth and efficient on the field. Technical skills are underpinned by conditional skills, but are more of a coordinative skill. The same is true for speed. It is both an ability and a skill. And when you improve in these areas, your efficiency increases and your risk of injury decreases. It's best if you invest in these things like speed training to become not only faster, but more efficient.
Work on your Mobility
Yes, I know we mentioned that you shouldn't overestimate the importance of mobility in reducing the risk of injury. While this is true, it doesn't mean that you shouldn't work on it at all. For many athletes, mobility is particularly limited in the hips, ankles and shoulder joints. These are the most important parts of the body to perform basic mobility exercises on, which you can easily incorporate into your warm-up workouts, between sets in the weight room, or on recovery days. This is also the way we incorporate them into our programs.
Research and more about the topic