Unit R180: Reducing the risk of sports injuries and dealing with common medical conditions

R180

Reducing the risk of sports injuries and dealing with common medical conditions The hurdler in the photo could have been injured if he fell heavily against the hurdle or on to the track. What injuries do you think he could have received from his fall? Let’s get started SAMPLE

What will you learn in this unit?

Whether you are aiming to become a personal trainer, PE teacher or sports coach, you need to know about sports injuries and how they can be prevented to ensure that your clients, students and athletes stay safe while under your care. By understanding how to reduce the risk of injury, you can make sure that you plan activities that are safe for your clients, students and performers, and do not increase the likelihood of injuries happening. In this unit you will learn about: • different factors which influence the risk and severity of injury TA1 • warm-up and cool-down routines TA2 • different types and causes of sports injuries TA3 • reducing risk, treatment and rehabilitation of sports injuries and medical conditions TA4 • causes, symptoms and treatment of medical conditions. TA5 This unit will be assessed by a 1 hour and 15 minutes written exam that is worth 40% of your overall mark. In the exam, you will be expected to show that you understand this unit by answering questions that require you to analyse and evaluate your understanding in particular sport-related contexts. How you will be assessed sports coach, you need to know about sports injuries and how they can be prevented to ensure that your clients, students and athletes stay safe while under your care. By understanding how to reduce the risk of injury, you can make sure that you plan activities that are safe for your clients, students and performers, and do not increase the likelihood of injuries happening. In this unit you will learn about: different factors which influence the risk and severity of injury warm-up and cool-down routines different types and causes of sports injuries reducing risk, treatment and rehabilitation of sports injuries and medical conditions causes, symptoms and treatment of medical conditions TA5. SAMPLE

TA1

Different factors which influence the risk and severity of injury Let’s get started The triathlon and paratriathlon events are made up of a swim, a cycle and a run. Which activity is likely to be the most dangerous? Do you think it is possible to prevent performers from getting injured? Figure 1.1: Athletes start the 3.8 km swim course Figure 1.2: Jade Hall of Great Britain competes in the during the Ironman Copenhagen triathlon, Women’s PTWC bike during the ITU Paratriathlon Denmark, 2016 World Cup, Tokyo, Japan, 2019 What will you learn? • How different sporting activities can influence the type of injury. • How extrinsic factors such as coaching, the environment and equipment may influence the risk of injury. • How intrinsic factors and the individual variables such as fitness and gender may influence the risk of injury. • How psychological factors such as aggression may cause injury, and 1 SAMPLE the reasons for aggression in sporting activities. • The mental strategies used in sporting activities.

1.1 Extrinsic factors

In every sports activity, there are factors outside the performer’s body and performance that may influence (lead to or prevent) injury. These are known as extrinsic factors. Extrinsic factors are shown in Figure 1.3. Extrinsic factors influencing the risk of injury Coaching/instructing/ leading – the knowledge, experience and actions of coaches, instructors and leaders may influence the safety of performers Type of sports activity – the nature of the sport can influence how dangerous it is, the type of injury and whether injuries are likely to be minor or major Equipment – the quality and suitability of equipment Environment – weather, playing surfaces and human interaction of other participants, officials and spectators can affect performers’ safety Figure 1.3: Extrinsic factors that may influence the risk of injury Types of sports activity No sports activity is completely safe, but some sports activities are riskier than others. The more dangerous the activity, the greater the likelihood of serious injury. A race walker may trip and sprain an ankle, for example, while a rock climber might fall and suffer fractures. • Contact sports such as rugby and Gaelic football increase the risk of injury such as bruises through tackling and collisions between players. SAMPLE • In non-contact sports such as gymnastics, performers may land poorly or fall from different types of apparatus, causing dislocations and sprains.

• Combat sports such as boxing and martial arts involve performers trying to strike each other to score points or knock out their opponent.

These sports can result in serious head injuries such as concussion as well as minor injuries including cuts and bruises. • There is a higher risk of a more severe injury in sports such as skiing and gliding, as crashes usually take place at a high speed, causing major injuries such as fractures. New safety precautions are introduced each year to help keep drivers safe in Formula 1. You will learn more about the different types of and causes of sports injuries in Section 3. Over to you! 1 Research the following categories of sporting activities to find out about the likely risk of injury: • net/wall sports • athletics – track and field • extreme sports. 2 Produce a leaflet about one sport or activity within each category. Describe how performers could be injured. 3 Rank the sports from most likely to cause injury to least likely. Coaching, instructing and leading 1 Coaches, instructors and sports leaders are responsible for the welfare of performers, both in training and during competition. An important part of their role is to keep performers safe by reducing the risk of injury. This means that coaches, instructors and leaders are expected to have skills and standards, as shown in Table 1.1. SAMPLE

Table 1.1: The skills and standards required by coaches, instructors and sports leaders to reduce the risk and severity of injury

Essential skills and standards How a coach/instructor/sports leader may reduce the risk and severity of injury Example of how the risk of injury may be reduced

Knowledge of techniques/rules/ regulations • Understand and deliver correct coaching techniques. • Know the rules and regulations of their sport. A gymnastic coach shows performers the correct way to somersault and ensures their safety by using spotters.

Experience • Be aware of factors that could cause injury. • Have the confidence to deliver safe training sessions. • Be aware of safety protocols and up-todate training methods. A cricket coach knows that a blow to the helmet can cause concussion (temporary brain injury) and follows the correct procedures for practice in nets; he removes any player with possible concussion from the game to receive medical treatment.

Communication • Deliver instructions clearly and concisely. • Clearly describe technique, tactics and training drills. A basketball coach explains how to do safe stretches during a warm-up routine before a match, to reduce the risk of muscle injury.

Supervision • Continually watch performers to ensure they are following instructions and using the correct technique. • Carry out safety checks and change the environment if there are signs of danger to performers. A trampoline coach increases safety by being a spotter. They give feedback on correct technique, and check the trampoline and surrounding area is safe to use.

Ethical standards/ behaviour

• Act in an honest and truthful way, know the difference between right and wrong, and show fairness in decision making. • Treat everyone equally irrespective of their gender, age, culture, individual characteristics and background.

A kayaking instructor treats all individuals with respect, so creating a positive and safe learning environment for all performers. SAMPLE Figure 1.4: Why is it important for coaches to be able to communicate clearly?

Over to you! 2

A local volleyball team has a coach with little experience and no coaching qualification. Explain the possible risk of injury to players. Environment The sporting environment consists of the conditions and situations that can influence the risk of injury to participants (everyone taking part). Conditions need to be safe to reduce the chances of injury. The weather and temperature, playing surface and surrounding area, and any form of human interaction, all make up the sporting environment. Weather and temperature conditions Poor or extreme weather conditions can result in sports activities becoming more dangerous. For example: • Fog can reduce visibility so that performers may be unable to see other performers, participants or equipment, increasing the risk of collisions. For example, a rugby player running into another player or the flags due to poor visability. • Wind, rain and cold weather can cause both injury and medical conditions such as hypothermia (where the body temperature drops). A hill walker in wet and windy conditions has more chance of slipping and falling. Mountain climbers and fell runners may be at risk of hypothermia if weather conditions become wet, windy or cold. (You will learn more about medical conditions in Topic Area 5 of this unit.) • In bright sunshine or when the temperature is hot and humid, participants in a marathon may be at increased risk of dehydration and heat exhaustion. • Weather and temperature conditions can also affect the state of the playing surface. Football games across the UK are often called off in SAMPLE the winter because of frozen or waterlogged grass pitches that make them unsafe to play on.

Playing surface and the surrounding area

Sporting activities are performed on a range of different playing surfaces. The type of surface can influence the risk and severity of injury. • • Natural turf (grass) playing surfaces may be used for football, rugby, cricket, baseball and softball pitches. Tennis can also be played on grass courts. Natural playing surfaces need to be well maintained to reduce the risk of injury. For example, uneven grass pitches and poor drainage can result in slippery conditions, with players at risk of falling and spraining an ankle. Artificial playing surfaces may be used as all-weather sports pitches for hockey, rugby and football, on netball courts and athletics tracks. The surface may be artificial grass or synthetic. These often provide a better, safer environment for performers because the surface is flat and has better drainage. Some sports performed in the natural environment such as rock climbing and skiing may now use artificial surfaces, for example indoor ski slopes and climbing walls. This means the environment is more predictable, allowing participants to be more in control, which helps reduce the risk of injury. SAMPLE

Figure 1.5: Artificial playing surfaces can be used in all weathers

All playing surfaces must be well maintained and regularly checked for hazards such as debris or litter that could endanger safety and increase risk of injury. Many playing surfaces and courts are enclosed by a surrounding area; examples include advertising boards around rugby pitches and fencing around tennis courts. The barriers that surround any pitches or courts can increase the risk of injury, as there is a chance of players crashing into the barrier. In professional sport, players can also be at risk of colliding with photographers, who are often seated around the pitch or court. Human interaction Sports activities may involve individual performers, teams of performers from the same team and the opposition, coaching staff and officials such as referees and umpires. Sometimes, spectators or supporters may also be present. All these people may interact in different ways, which could influence the risk of injury, as shown in Table 1.2. Table 1.2: How human interactions may influence the risk and severity of injury Role Effects of human interaction Other performers and participants • May accidentally collide with performers or other participants, causing injury • May injure someone through physical contact within the rules of the game such as a fair tackle • May act aggressively in a way that causes injury to other performers or participants, for example by committing a deliberate foul • May help to calm down own team members or apologise to opponents in certain difficult situations Officials such as referees and umpires

• Check performers follow the rules of the sport, to ensure the sports activity takes place safely and to reduce the risk of possible injury • Discipline performers where their actions might cause injury to other performers and participants, for example giving players warnings for illegal and dangerous tackles • Are alert to injured performers, stopping the game if necessary so treatment can be given without delay • Check that the environment and any equipment are safe for the game to go ahead Spectators • May verbally abuse performers, officials and rival fans, which might lead to SAMPLE frustration and aggression among individual performers, teams and other spectators • May be violent and cause injury to each other, officials or performers, either when rival fans clash or when fans are unhappy with the result of the performance • May put performers, officials and other spectators at risk of injury by throwing missiles such as coins onto the playing area or by running onto the playing area

Figure 1.6: Identify the extrinsic factors in this ice hockey match Equipment Modern sports equipment is designed to help performers get the best from their performance. Manufacturers often build in safety features, but performers must check equipment for damage or faults regularly, and ensure that equipment is used correctly and safely. Figure 1.7 shows the types of sports equipment. Types of equipment

Protective equipment Performance equipmentClothing Footwear SAMPLE

Figure 1.7: Types of sports equipment

Protective equipment

Some sports require performers to wear protective equipment to reduce the risk of injury by minimising contact with the body. For example: • Helmets provide a hard covering and are designed to protect the cranium from impact in the event of a crash or fall in sports such as cycling, show jumping and motorsports. • Shinpads in hockey are worn to protect the bones of the lower legs (tibia and fibia) in case of contact with another performer’s stick or hard ball. • Swimming goggles can protect the eyes from chemicals and bacteria in swimming and freshwater pools. • Body padding is used in cricket, taekwondo and

American football to help reduce injury from contact with performers. If protective equipment is faulty, broken or the incorrect size, this could increase the risk of injury. For example, if a boxer wears a gumshield that is too small or is split, this could result in cuts in their mouth and gums. Some sports also use protective padding around performance equipment such as netball and rugby posts to reduce the risk of injury. Netting can be used as a safety precaution in many throwing events such as the hammer. Performance equipment Performance equipment such as hockey or lacrosse sticks can cause injury by coming into contact with performers. For example, a cricket player struck directly with a fast ball may suffer an injury, and squash players may be injured if they are hit with an opponent’s racket during a rally. Some sports activities such as the javelin require the use of performance equipment that could lead to serious injury if care is not taken. Athletic throwing events need to be organised to ensure other participants, officials and spectators are kept safe when javelin, shot put, discus and hammer are thrown.

Figure 1.8: The ball strikes the batter’s helmet. How could the protective equipment the cricketer is wearing reduce the risk of serious injury? SAMPLE

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To reduce the risk of injury, it is important to: • Check performance equipment regularly for faults. The grip on a baseball bat, for example, needs to be in good condition to ensure the batter avoids getting blisters and to stop the bat from flying out of their hand and hitting another performer. • Set up performance equipment correctly. For example, hurdles need to be set in the correct position to allow them to fall if a hurdler trips. Training balls are used in some sports, such as in cricket to help develop performers’ skills and confidence without using the traditional hard ball; this also reduces the risk of injury. Clothing Clothing should always be appropriate for the activity. For example, wearing elastane (spandex or lycra) when cycling can help reduce rubbing and chafing from moving body parts. The type of clothing worn is important in reducing the risk of injury and certain medical conditions. For example, ski jackets are well insulated to give maximum protection from wintry weather conditions; this keeps the performer warm and can help reduce the risk of hypothermia (when body temperature drops well below normal). People who jog or cycle for fitness should wear high visibility clothing so they can be clearly seen by other joggers, cyclists and motorists. Footwear Many sports activities require footwear specially designed for the surface. Examples include: • Football boots are available with studs suitable for all types of playing surfaces. They ensure performers have a good grip and reduce the risk of tripping and slipping. • Running spikes for sprinting and longer distances provide grip on the track. Cross-country runners wear spikes to reduce their chances of SAMPLE slipping on grass or uneven ground. The right length spikes should be chosen and checked regularly, as the spikes can wear out, which may lead to injury. However, the spikes can also cause injury such as cuts if they come into contact with other runners.

• Road running shoes have cushioned soles designed to absorb repeated impact on the ground. • Basketball and boxing boots have extra ankle-high support and protection to reduce the risk of performers going over on their ankles and injuring themselves. Let’s get practical! Next time you take part in a sports activity, make a note of all of the extrinsic factors that can influence injury while you are playing. Produce a poster that can be displayed in the changing rooms that informs performers about the risks of extrinsic factors that can influence injury. How extrinsic factors can influence other extrinsic factors Some extrinsic factors can influence other extrinsic factors. For example, when playing golf, it is important that a golfer (human interaction in environment) shouts ‘fore’ to warn other players of a golf ball (performance equipment) that has been hit in the wrong direction and is at risk of striking them. There are also situations where extrinsic factors can influence part of the same extrinsic factor. For example, weather and temperature conditions (environment) can also affect the state of the playing surface (environment). During the summer months, natural grass pitches can become very dry and hard, increasing the risk of football players getting grazes and blisters. Players may then choose to wear moulded football boots (footwear) due to the hard conditions, to help reduce the chance of blisters. Stretch Tennis players may compete indoors and outdoors on different types of playing surface, such as grass, artificial grass, clay and hard court. a Research each type of surface to find out about the different extrinsic factors that may cause injury when playing tennis indoors and outdoors. SAMPLE b Produce a presentation that compares the different extrinsic factors that can influence injury to tennis players. c At the end of your presentation, rank the four different playing surfaces in order of risk of injury to players. Justify your rankings.

Over to you! 3

Choose a picture in this book of a team and individual sport that you have never taken part in. Using your knowledge from this chapter: a Compare and contrast how different extrinsic factors can influence the risk and severity of injury in both sports. b Describe how the following extrinsic factors can influence other extrinsic factors: • playing surfaces • appropriate footwear.

Test your knowledge

1 Identify three extrinsic factors other than coaching and equipment that can influence injury. 2 Describe three different ways in which the actions and behaviour of a coach could cause injury to performers. 3 Using an individual and team sport, list as many items as you can for the following: a performance equipment b protective equipment c clothing d footwear. 1.2 Intrinsic factors

Let’s get started 2

Identify any differences you can see between the cross-country runners.

How do you think these differences may influence injury when someone is training for an event?

1 SAMPLE

Figure 1.9: Runners in a cross-country race

Now let’s look at some further factors that can influence the risk of injury during sports activities. While extrinsic factors are external to the performer, intrinsic factors are part of the individual performer. Examples of intrinsic factors can include a performer’s fitness levels and how motivated they are. Individual variables Individual variables are unique to the performer who is taking part in the activity. Individual variables are shown in Figure 1.10. Gender Technique and ability Weight –

Medical underweight, conditions (if any) healthy weight, obese

Experience –Sleep – too little, beginner, too much intermediate, expert Nutrition (diet) and hydration (maintaining healthy levels of Fitness levels water in the body)

Age – child, adult, elderly adult Injuries – previous, current, recurring A performer’s individual variables SAMPLE

Figure 1.10: A performer’s individual variables. What are your own variables?

Some individual variables such as nutrition can be altered through lifestyle changes, but others such as age remain constant for longer periods. Some individual variables make performers better suited to participating in certain sports activities and playing positions. Table 1.3: Individual variables that can influence the risk and severity of injury Individual variable Influence on risk and severity of injury during performance Example Gender Males are generally stronger than females. Females may have more flexibility than males. Female runners are more prone to knee injury, due to the angle of the hip bone, and tend to have weaker connective tissue surrounding the joint. Male footballers are more likely to strain their hamstring than female footballers. (You can learn more about the body’s major bone groups, muscle groups and connective tissue in optional Unit R182, Topic Area 2.) Age During childhood and adolescence, the human body is continuing to grow and develop, and generally will not be as strong as during adulthood. Elderly adults are more at risk of injury, as their bones have become weaker. Sports activities for younger people are often played in age categories due to physical differences between younger and older performers. For example, there is an increased risk of injury to younger rugby players if they were to play against older players. Experience An inexperienced performer will have less practice and will have more difficulty understanding the rules and tactics of the activity. This increases their reaction time making them slower to react, which can cause injury. A cricketer who has played in few hard ball games will have little experience and not be as confident. They will have slower reaction and have an increased chance of being hit by the ball. Weight Obesity (being very overweight) can place extra stress on the joints of the body. A person who is underweight may be more at risk of injury through fragile bones.

If people are obese and attempt high impact activities such as running this may cause stresses to parts of the body such as the heart and knees. It is important that obese people follow medical advice if they want to participate in sporting activity. Weight categories in boxing are designed to make competition fairer and safer. A heavyweight boxer is able to punch with more power, and this may lead to injury to a SAMPLE lighter boxer.

Fitness levels A performer with poor fitness levels is likely to tire easily and make errors. An inexperienced runner joining an elite club may not be able to keep up with the intensity of running, which could cause an injury if they are pushing too hard.

Table 1.3: Continued

Individual variable Influence on risk and severity of injury during performance Example

Technique and ability Chronic (overuse) and acute injuries can result from actions with poor technique. (You can learn more about acute and chronic injuries in Sections 3.1 and 3.2.) Rowing with a bent back may cause an acute muscle strain injury. Tennis elbow can be caused due to the repetitive poor technique of a player’s backhand.

Nutrition and hydration A performer who has not taken on enough energy or water before a sporting activity may lose focus and concentration, leading to poor decision making. Low energy levels may cause a performer to collapse and suffer an injury. Overeating before a sporting activity may make a performer feel tired, which could increase the risk of injury. A horse rider who has poor nutrition may lack the strength to ride the horse; they may be at risk of falling off or may be slow to react to other horses around them. A beach volleyball player who has not drunk enough water during an activity is at risk of feeling unwell due to dehydration. A gymnast who has overeaten before a competition might be slower on the apparatus and be more likely to have slips or falls. (You can learn more about nutrition and hydration in Unit R183, Topic Area 2.)

Medical conditions If not managed properly by a performer, some medical conditions such as asthma and diabetes may cause the performer to feel unwell. (You can learn more about the causes, symptoms and treatment of medical conditions in Topic Area 5 of this unit.) A performer with asthma who is struggling to breathe during an activity but does not have their treatment (inhaler) with them may need to stop taking part.

Sleep A performer who is not well rested and is tired will have poor concentration. A boxer’ s decision-making may be poor if they do not get enough sleep before a competition, which may cause them to have a slower reaction and get hit.

Previous and recurring injuries Parts of the body that are injured will remain slightly weaker and at risk of the injury recurring (becoming injured again). Carrying an injury may cause the performer to overuse other parts of the body, and the additional stress could lead to further injuries.

A sprinter who has strained their hamstring will be at a greater risk of tearing it again, as the muscle has become weaker. SAMPLE

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Over to you! 4

The sports examples for each of the individual variables in Table 1.3 describe how the variable may cause injury to performers. a Choose a different sports activity for each variable and describe how the variable can be used to reduce the risk of injury to performers. b Create a table that a coach could give performers to make them aware of what they can do to reduce how the variables can cause injury. You could use a format like the one below: Individual variable Sporting activity How to reduce the risk of injury Performers may decide to change some individual variables before, during and after a sporting activity, as this can reduce the risk of injury or the onset of certain medical conditions. An example is given in the flow diagram in Figure 1.11.

Before

During

After

• A triathlete may use carbohydrate loading 2–3 days before a competition by eating pasta to fuel the body with energy. • They will drink plenty of water to ensure the body is fully hydrated at the start of the activity. • A hiker may eat nuts and seeds while walking to keep providing the body with energy. • A hiker walking all day in hot weather should drink a litre of water every hour. • 30 minutes to two hours after an intensive aerobics session, a performer should eat some protein such as chicken and fish, together with some carbohydrate such as potatoes, to help the muscles recover. SAMPLE • A performer should monitor the colour and amount of urine (pee), as a darker colour and small amounts may indicate dehydration, in which case the performer needs to drink more water to help their body recover.

Figure 1.11: When a performer might change an individual variable such as nutrition and hydration

Case study

World heavyweight boxer Anthony Joshua’s training programme It is important for boxers to be prepared before a fight. Boxers will attend training camps for a few weeks before their fight. This helps them prepare both physically and mentally. Boxers such as Anthony Joshua have developed strenuous training programmes that may include: • eating between 4000 and 5000 calories a day, including fish, chicken, rice and vegetables • drinking 5 litres of water a day • getting up at 6.30 a.m., getting at least 10 hours of rest a day and not staying up late • three gym sessions a day with cardio work such as eight sets of running 900 metres in 3 minutes followed by 1 minute’s rest • sparring that focuses on footwork and different punches such as jabs, hooks and uppercuts. A boxer needs to make the weight category they are competing at, but they will then try to put on additional weight to make their punches more powerful. It is important not to put on too much weight; otherwise the boxer may tire during the later rounds of the contest, which will put them at greater risk of injury. Check your understanding 1 Identify the individual variables covered by the training programme. 2 Identify the individual variables that are not covered in the training programme. Describe how these can be added to the training programme and explain how they may help to reduce injury. Figure 1.12: Anthony Joshua (right) punches Andy Ruiz Jr during the IBF, WBA, WBO and IBO World Heavyweight Title Fight, Saudi Arabia, 2019 SAMPLE 3 Compare the individual variables between the two boxers in the photograph.

Explain who you think is at most risk of injury. Justify your responses.

Psychological factors

Let’s get started 3

Some people believe that sport is played with the body but won in the mind. How do you think these boxers in Figure 1.13 could use their thoughts to help them stay safe in the fight? Psychological factors are to do with the performer’s mind. Many elite performers and teams employ sports psychologists to help prepare them mentally before and during the sports activity, so as to enable them to boost performance levels. Table 1.4 shows how psychological factors can influence the risk of injury. Table 1.4: Psychological factors and how they can influence the risk of injury Psychological factor Definition Example of psychological factor that may influence risk of injury Motivation Having the drive to succeed • Being over-motivated may result in a football player performing a reckless tackle that could result in injury either to themselves or another player. • Being undermotivated may cause a rugby player to not fully commit themselves in a tackle and pull out. Arousal Feeling excited or alert in a sporting context • High arousal can lead to higher levels of excitement, which could cause a gymnast to perform a vault that is too complex and land awkwardly due to poor technique. • Low levels of arousal may cause a canoeist to make a poor decision that causes their canoe to capsize. Anxiety Feeling of unease such as worry or fear An American football player who is anxious about getting hurt during a game may react slower when being charged at and fail to dodge the tackle in time. Stress Feeling unable to cope with pressure A dancer who feels high levels of pressure before a performance may stumble and trip when linking parts of their routine. Confidence A person’s self-belief in their ability and that they can succeed

A batter in cricket who does not have the confidence to face a fast bowler may have slower reactions and get hit with the ball. Figure 1.13: Beatriz Ferreira of Brazil, left, and Kellie Harrington of Ireland during their women’s lightweight final bout at the Tokyo 2020 Olympic Games. SAMPLE Aggression (direct and channelled) The deliberate intention to harm an opponent. Channelled aggression involves playing within the rules but with the aim of harming performers on the opposing team. • Direct aggression: A lacrosse player deliberately punching another player may result in injury. • Channelled aggression: An ice hockey player may try to win the puck in a hard check against the boards, in the hope that the opposing player will become injured.

A performer who is unable to control psychological factors can be at more risk of injury to themselves and other performers. The level of each factor will vary between performers and depends on their personality and the situation. Reasons for aggression • Level of performance: a performer may become frustrated because they are performing poorly, while other performers may be playing well. This frustration may build up until the performer needs to release it through an act of aggression. For example, a basketball player might push over an opponent as an outlet for making too many mistakes. • Retaliation: if a performer has been illegally tackled (fouled) in a game, they may seek revenge themselves by committing a foul against the other performer. For example, a Gaelic football player might trip up an opponent who had fouled them earlier in the game. • Pressures to win: there are many pressures to do well in sport, and this can sometimes result in aggression that leads to foul play. Spectators can also add to the pressure during the game by encouraging performers to try harder, which may lead to over-arousal and loss of control. For example, a tennis player who is playing in a final may hit the ball aggressively away because they lost the point. • Decisions of officials: performers may get frustrated when officials, referees and umpires appear to make wrong decisions that go against them. For example, a water polo player may throw the ball at an opponent in frustration at the opposing team being awarded a penalty foul. • Performance enhancing drugs: anabolic steroids are performance enhancing drugs used to increase muscle mass and improve athletic performance; some weightlifters and bodybuilders use anabolic steroids. As well as several physical side SAMPLE effects, the misuse of anabolic steroids by performers can cause psychological and emotional side effects, including mood swings and aggression.

Mental strategies

Many professional teams and elite performers employ sports psychologists to help performers develop mental strategies and techniques to control their emotions on the field of play. This should lead to less aggression and so reduce the risk of injuries. Mental strategies (Figure 1.15) include: • Mental rehearsal: this involves a performer visualising a sports skill to give them a clear picture in their head before they perform it. This can lead to higher levels of confidence. For example, a golfer mentally rehearsing their swing may result in a better technique. • Imagery: this requires the performer to create a mental image of the environment they will be performing in. This helps decrease anxiety, maintain focus and improve confidence. For example, a hockey player may imagine the kit they are wearing, holding the stick, the conditions of the pitch as they are dribbling the ball, etc. • Selective attention: this involves a performer blocking out unwanted distractions such as spectators watching the game or performance.

This allows the performer to focus on the important aspects of the performance. For example, a high jumper ignoring the crowd and focusing on the height of the bar will help them to clear the set height. Mental strategies

Lessen anxiety Increase confidence Improve focus Control emotions

Figure 1.14: Performers use imagery to create the most realistic picture possible in their head. How could this performer use imagery?SAMPLE Figure 1.15: How a performer may use mental strategies

Over to you! 5

Produce a short presentation that informs performers about three mental strategies you will be using with them and how each one can help control their aggression in a game. How some individual variables can influence other individual variables Some individual variables can also influence other variables. For example, a javelin thrower who has developed a rotator cuff injury in the shoulder may alter their technique when throwing. It is also possible for some individual variables to influence more than one variable. For example, a basketball player who is obese (overweight) may only be able to play for short periods of time (fitness) and may be at more risk of developing diabetes (a medical condition).

Over to you!

Choose a team and an individual sport that you have never taken part in. (You could use two sports shown in the photos in this book.)

Using your knowledge from this chapter: a Compare and contrast how different intrinsic factors can influence the risk and severity of injury in both sports. b Describe how the following individual variables can influence other individual variables: • weight of a participant • fitness levels. c Using your knowledge of extrinsic factors, explain how a coach may influence the following individual variables: • medical conditions • injury.

6 SAMPLE

Review your learning

Test your knowledge

2

1 For each of the following sporting scenarios, state whether they are extrinsic or intrinsic factors: a A snowboarder with a recurring knee injury b A jockey trying to lose 1.5kg in a sauna before a race meeting c A hockey player wearing a face mask on a short corner d A cricket player developing their spin bowling in training 2 Identify three extrinsic factors and three intrinsic factors that can influence injury. 3 Using practical examples, describe how a national governing body of taekwondo reduces the risk of injury through rules that focus on individual variables. See section • Describe how different sporting activities can influence the type of injury 1.1 • Describe how extrinsic factors such as coaching, the environment and equipment may influence the risk of injury 1.1 • Describe how intrinsic factors and individual variables such as fitness and gender may influence the risk of injury 1.2 • Define and describe how psychological factors such as aggression may cause injury and the reasons for aggression in sporting activities 1.2 • Describe the mental strategies used in sport 1.2 What have you learnt? SAMPLE

TA2

Warm-up and cool down routines

Let’s get started The cricket players in Figure 1.16 are using resistance bands to warm up before the match. How do you think this will help the players prepare for the game? Figure 1.16: Sri Lankan cricketers warm up ahead of their first Test match against Bangladesh, Sri Lanka, 2021 What will you learn? • The different components of a warm-up and cool down. • The physiological and psychological benefits of warming up. • The physiological benefits of cooling down. 2.1 Key components of a warm-up 1 SAMPLE Before you take part in a sports activity, you should complete a warm-up. A warm-up is an exercise routine that will help to improve performance and reduce the risk of injury.

A warm-up consists of four components, or stages, as shown in Figure 1.17.

Start warm-up with: Pulse raising Mobility Dynamic stretching Skill rehearsal Performer is now ready to begin training or activity

Figure 1.17: The key components of a warm-up The four components of a warm-up are described in Table 1.5. Table 1.5: The four components of a warm-up. Each component should be completed in order. Warm-up component What the warm-up does Examples of warm-up activity Pulse raising • Gradually increases the performer’s heart rate and the temperature of their muscles • Increases the amount of oxygenated blood in the working muscles • A cross-country runner jogging for a few minutes • A mountain biker cycling a short distance before their race Mobility • Increases the range of movement around the joints (where two bones meet) of a performer (To learn more about joints and the role of the musculo-skeletal system during exercise, see Unit R182, Topic Areas 2 and 3.) • A bowler in cricket performing shoulder rotations • A golfer carrying out hip circles before play Dynamic stretching • Stretching the muscle while moving during exercise • Focuses on different muscles in the body that will be mainly used during the activity • May be similar to the movements about to be performed, such as a football player kicking a leg across a body and other types of leg swing exercises • A hockey player carrying out a groin walk • A netball player performing lunges before the game Skill rehearsal • Allows the performer to use movements and techniques that will be similar to those needed while performing • May involve the use of performance equipment and drills or tactics that will be used in the game. For example, professional football players will usually play ‘keep ball’ with no goals as part of their practice. • The intensity of the drills and practices used should take the performers close to the physical demands of the sporting activity

• A tennis player practising their serve and smash before a match • A boxer sparring on the pads before their bout SAMPLE

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Figure 1.18 shows a typical example of a warm-up for a tennis player.

Pulse raising –10 minutes • Forwards, backwards and sideways skipping and jogging around the court • Knee lifts and butt kicks Mobility –5 minutes • Shoulder rolls • Arm circling • Trunk twists Dynamic stretching –5 minutes • Lateral lunges • Squats • Arm and leg swings across body

Skill rehearsal –10 minutes • Serving • Forehand and backhand shots Figure 1.18: Example of a warm-up routine for a tennis player SAMPLE

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Case study

Warm-up routines for professional tennis players Professional tennis players such as Emma Raducanu and Daniil Medvedev will take part in strenuous warm-up routines to help prepare them both physically and mentally before playing a match. In the warm-up area before going onto the court they will complete exercises such as jogging followed by a series of footwork drills that require them to change speed and direction. They may then perform exercises such as heel flicks, high knees, shoulder rotations and hip circles before using resistance bands and mimicking different movements and strokes. Tennis players may also use headphones and listen to music during their warm-up routine to help prepare them psychologically. When on court, just before they start the match, they will then spend time practising their serve, volleys, forehand and backhand shots. Check your understanding 1 Identify the different components of a warm-up that can be used by professional tennis players. Describe some exercises they can perform for each component. 2 Which muscles and joints of the body could be targeted in the mobility and dynamic stretching components of a tennis warm-up? (For details of muscles and joints of the body, see Unit R182, Topic Area 2.) 3 Why do some tennis players choose to wear headphones and listen to music before a game? 4 What tennis strokes could be practised in the skill rehearsal component of the warm-up? Figure 1.19: Emma Raducanu of Great Britain takes part in a warm-up session during the 2021 US Open SAMPLE

In Topic Area 1, you learnt about different factors that may influence the risk of injury. The individual variables of performers will influence the type of warm-up and level of intensity. For example: • A tennis player who is obese, recovering from an injury or is over the age of 50 may require a less intense warm-up than a younger and fitter adult. • Young children learning to play tennis may need a more fun-based and less intense warm-up. This will help to keep them motivated. • Elite tennis players will warm up for longer and will put their body through a hard and demanding routine; their warm-up may last over 30 minutes. Some of the components may start in the practice area in the changing rooms and finish with practice on the court.

Over to you!

Using the example of the tennis warm-up in Figure 2.3, design a warm-up routine for a sporting activity of your choice.

Remember to include each of the four components: pulse raising, mobility, dynamic stretching, skill rehearsal. Amateur performers often plan and carry out their own warm-up routine. Professional sports teams employ fitness coaches to prepare players for training and matches. Use of equipment during a warm-up Some warm-up routines include the use of equipment, such as: • agility ladders and poles for players to run in and out of during a rugby warm-up • cones that mark the space for certain drills to be played, for example 3 vs 1 in football • resistance bands for stretching in cricket. Any equipment used during a warm-up needs to be checked to ensure that it is in good working order – broken equipment could increase the chances of injury. Players should be made aware where cones and poles are, to help avoid accident and injury caused by tripping over them.

1 SAMPLE

Let’s get practical! 1

1 With a partner, demonstrate a mobility exercise. Mirror the exercise they are demonstrating. a State the name and type of joint involved. b Name the muscles and bones around the joint. c What sports would that particular mobility exercise be useful for? 2 Demonstrate a dynamic stretch to your partner that could be used during a warm-up. Mirror the stretch they are demonstrating. Identify the muscles being stretched. (For details of muscles and joints of the body, see Unit R182, Topic Area 2.) 2.2 Physiological and psychological benefits of a warm-up Physiology refers to the way our bodies work. Psychology refers to the way the human mind works and how it can influence what we do (our behaviour). In this section, you will understand how a warm-up benefits both the body and the mind. Physiological benefits A warm-up prepares the body physically for sporting activity and reduces the risk of injury such as sprains and strains. The different components of the warm-up make changes to the body’s systems – the musculoskeletal system (muscles, bones, joints and connective tissues) and the cardio-respiratory system (heart, blood vessels and lungs). In this way, a warm-up provides physiological benefits for all performers. (To learn more about the role and functions of the cardio-respiratory and musculoskeletal systems, see Unit R182, Topic Areas 1 and 2.) SAMPLE Some physiological benefits of a warm-up are shown in Figure 1.20. (To learn more about the short-term physiological effects of exercise and warming up, see Unit R182, Topic Area 3.)

Physiological benefits

Pulse raising • Increase in heart rate • Increase in muscle temperature • Increase in blood flow and oxygen to working muscles Mobility • Increase in speed of muscles contracting • Increase in flexibilty of muscles and joints • Increase in pliability (an increased range of movement around the joint due to the ligaments and tendons having increased elasticity when warmed up) Dynamic stretching • Increase in flexibility of muscles and joints • Increase in pliability of ligaments and tendons • Increase in speed of muscles contracting

Skill rehearsal • Practising the techniques that will be used by the performer in the game Figure 1.20: Some physiological benefits of the warm-up Over to you! 2 1 Identify which component of the warm-up has the greatest benefit on the cardio-respiratory and musculo-skeletal systems. 2 Using Figure 1.20, explain whether the main physiological benefit of the warm-up is for the cardio-respiratory or musculo-skeletal system, or a combination of both. SAMPLE

Psychological benefits

A warm-up has many psychological benefits, including allowing performers to prepare their mind before they take part in sporting activity. Using the warm-up to ‘get in the zone’ may help performers to raise their performance levels and reduce the risk of injury. Figure 1.22 shows some of the psychological benefits of a warm-up. Heighten or control arousal Cyclist being alert to what might happen such as another rider turning into their path Psychological benefits Increase confidence Increase motivation A boxer believing they A rugby player being fully will be able to defend committed to a tackle themselves against an opponent’s punches

Mental rehearsal Improve concentration A kayaker practising a A golfer using selective difficult part of the course in attention to focus on the their head to get them better correct technique when prepared for the event driving and putting

Figure 1.21: Basketball player Luka Doncic getting ‘in the zone’ before a game. How could he be doing this? SAMPLE Figure 1.22: The psychological benefits of a warm-up – some practical examples

Over to you! 3

Mental rehearsal is when a performer creates an image in their head. The more real the image, the better the benefits will be. Using the senses of sight, hearing, touch, smell and taste, imagine one different sporting scenario for each sense. For example, for touch: a swimmer may feel the water on their skin. Possible negative effects of no warm-up Failure to carry out a warm-up may put the performer at a greater risk of injury because they will fail to get its physiological and psychological benefits. • In the musculo-skeletal system, the connective tissue of muscles, tendons and ligaments will remain cold, so will have no flexibility or pliability. This may mean the performer is more likely to strain a muscle. • In the cardio-respiratory system, there will be no increase in heart rate. This means there will be no increase in oxygenated blood going to the working muscles, so the body will not be ready to perform the activity. • The performer’s mind may be less focused, and they may find it harder to concentrate. They will also not be as motivated in preparation for the sports activity, and they may find it harder to control their arousal levels. Subsequently their confidence may remain at a lower level. This will increase the risk of injury, as their decision-making and reaction times will be slower. Test your knowledge 1 1 Consider the benefits of warming up, and list as many as you can. 2 Describe how psychological benefits help reduce the risk of injury. SAMPLE

2.3 Key components of a cool down

Let’s get started

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The performers in Figure 1.23 have finished their exercise workout and are cooling down. Why do you think a cool down may be just as important as the warm-up? Figure 1.23: Ice hockey players stretching as part of their cool down routine You should always perform a cool down after sporting activity. A cool down consists of gentle exercises such as slow jogging and stretches. It is important to cool down in order to reduce pain and muscle stiffness. The components of a cool down allow the performer to continue being active but at a lower intensity. The low intensity exercises of a-cool down enable the musculo-skeletal and cardio-respiratory muscles to recover from the sporting activity and gradually return the body to a resting state. The two components of a cool down are: • Pulse lowering: light exercises and easy movements compared with the physical activity, for example players in a hockey team slowly jogging round the pitch following the end of the game. SAMPLE • Stretching: different types of stretches for different muscles in the body. Stretches help with flexibility and range of motion, for example a water polo player stretching their deltoid and latissimus dorsi in the changing room after training.

Types of stretching

The different types of stretching that performers use during a cool down are described in Table 1.6. An example of a cool down routine for an ice hockey player is shown in Figure 1.24. Table 1.6: Different types of stretching that can be used during a cool down Type of stretching Description Maintenance stretches • Returns the muscle back to its pre-exercise state • Helps maintain range of motion around a joint and muscle flexibility after hard exercise • Involves holding each stretch for 15 seconds before moving onto the next Static stretches • Involves holding a stationary position for a period of 15–30 seconds

Proprioceptive neuromuscular facilitation (PNF)

• Progressive stretching that involves contraction and relaxation of the muscle group Leg stretching – 5 minutes • Hamstring • Quadriceps Arm stretching – 5 minutes • Biceps • Triceps Pulse lowering – 10 minutes • Slower skating around the ice rink Figure 1.24: This cool down routine for an ice hockey player includes static stretches after a game. Proprioceptive neuromuscular facilitation (PNF) stretching PNF stretching improves flexibility and increases the range of motion of a performer. To perform PNF stretching the muscle needs to contract before the stretch, so that it can benefit from maximum muscle relaxation. To carry out PNF stretching: • The player moves slowly into the stretch position until they feel the stretch sensation on the targeted muscle group. • Another player or coach holds the limb in this stretched position SAMPLE (see Figure 1.25) or the player uses a resistance band to hold the leg. • The player pushes against resistance for around 10–15 seconds. • The player stops pushing and relaxes the muscle.

• The player moves their limb a little further into the stretch until they feel it in the muscle again. • The player repeats the previous steps until the muscle is fully relaxed.

Figure 1.25: A runner performs PNF stretching

Let’s get practical!

a Complete the following stretch: 1 Sit on the floor with your knees bent. 2 Extend your right leg. 3 Lean forwards over your waist.

4 Reach towards your right foot. 5 Hold the stretch for 30 seconds. 2 b Identify the muscle being stretched. c Research other stretches that target other muscle groups. Write your own set of instructions for different stretches that a coach could use as part of their cool down routine. You could use diagrams to go with your instructions. SAMPLE

2.4 Physiological benefits of a cool down

Like the warm-up routine, completing a cool down has many physiological benefits for the musculo-skeletal and cardio-respiratory systems. A cool down will also help the body recover for the next workout. The physiological benefits of a cool down are shown in Figure 1.26. Gradually lowers heart rate

Removes waste products such as lactic acid from the muscles Gradually reduces Helps prevent breathing rate blood pooling

Circulates blood and oxygen around the body Gradually lowers body temperature Reduces risk of Delayed Onset of Muscle Soreness (DOMS) Physiological benefits of a cool down Figure 1.26: The physiological benefits of a cool down Prevention of blood pooling Blood pooling is where blood remains in the lower legs, ankles and feet. If exercise stops immediately, it is difficult for the blood to be returned to the heart. The low intensity exercise of a cool down helps blood to be SAMPLE returned to the heart. If the blood remains in the legs, a performer may start to feel dizzy.

Removal of lactic acid

Lactic acid is a waste product that is produced in muscles during intense sporting activity. It can cause pain and discomfort to the performer. A cool down maintains circulation of oxygenated blood, which helps in the removal of lactic acid. This helps reduce muscle soreness and stiffness. Reduces Delayed Onset of Muscle Soreness (DOMS) Delayed Onset of Muscle Soreness (DOMS) is caused by tiny tears in muscle fibres during exercise and can last for 2–3 days. The more you exercise, the more the muscle will grow and repair itself. Once muscles are used to the demands of the activity, DOMS will occur less. Stretch Performers may choose other ways to cool down after exercise, such as ice baths, compression bandages and foam rolling. Produce a table that compares these other techniques and how they can help a performer recover after exercise. Possible negative effects of no cool down A coach, sports leader or instructor that does not encourage performers to perform a cool down after lessons could be putting them at risk of some negative effects. For example, a skier who stops skiing immediately without performing some slower turns and stretching their arm and leg muscles may experience more pain in their muscles. This muscle soreness may continue when they ski again over the next couple of days. Other negative effects of no cool down can include dizziness and feeling light-headed. Failure to perform a cool down can also increase the risk of injury. Test your knowledge 2 SAMPLE 1 Name the two components used during a cool down. Give a practical example for each named component. 2 Identify the different physiological benefits of cooling down.