8 Things to Prevent a Bone Fracture

[caption id="attachment_3199" align="alignleft" width="183"] Proper landing mechanics are an essential part of injury prevention.
Are you following the NCAA basketball? Or March Madness as it is more commonly known?

I think this is one of the best sports tournaments going because it has such as great format with the 'one-and-done' arrangement. To be honest I don't spend a lot of time watching college basketball during the year. But when March rolls around I try and check out a few games.

This year is even more special as I got to go to some games. While I was down to California for a conference I managed to find some tickets on Craigslist for the games in San Jose. What a blast! What made it even more fun was the fact that I was able to keep it a secret from Megan right up until tip off at the arena.

But although the experience was once in a lifetime and a fun thing to do on the side at the conference I actually want to talk about a game we didn't see. The one where Kevin Ware, from Louisville, broke his leg. Now if you have a weak stomach don't go check it out on youtube. And sorry Jordy, but blurring your eyes when you watch doesn't prevent nightmares.

Anyways after seeing this horrifying accident I thought to myself 'I wonder if he had been doing x-y-z prior to the accident?' And I also thought this might interesting and useful for you as well. So here are 8 Things to Prevent a Bone Fracture.

1. Eccentric Training

One of the first things that comes to mind is eccentric training which is the portion of a muscular contraction when the muscle is being lengthened. This is when most injuries happen so it makes sense to prepare the body to able to reduce high levels of force safely and effectively, such as coming down from a jump.

2. Landing Mechanics

If you think about whether more injuries happen during take or landing it should seem fairly obvious that more problems happen when come back down in contact with the ground, a plyo box or another object. This is a big part of the reason we start small with our plyo training and ensure that the landing is optimal, that the body position is ideal and that forces are being dissipated appropriately.

3. Unilateral Training

It used to be that lowerbody strength training involved squats, leg press, leg extensions, leg curls, deadlifts and many other versions of these all performed on two legs. Thanks to Mike Boyle and a few other pioneers in strength & conditioning we know see the value of training one leg at a time. And if you think about most sports are they performed on two legs or one? If your sport involves performing on one leg should it make sense to train it on one as well? Not only does single leg training help in this way, resistance training causes the body to increase bone density as a result.

4. FMS

This stands for Functional Movement Screen and is a system developed by Gray Cook to look at the body's movement patterns and identify faults. For example the knees may collapse inwards during a squatting pattern suggesting possible weakness of the glutes. Or the screen may also show a difference on one side of the body compared to the other. Research from Knapic et al (1991) tells us that us that bilateral (or left and right) differences of 15% or greater are a red flag for injuries. The athlete may not report any issues prior to injury. And the lay person would not identify a problem either. An FMS would identify the issue however.

5. Proper Nutrition

We all know to drink milk to get enough calcium and vitamin D to maintain strong bones. But if the diet is swayed towards an acidic environment the body will attempt to buffer this lower pH with calcium. This calcium comes from our bones. So it may be possible for someone to eat a lot of sugar, processed foods, protein, grains, alcohol and junk food and have an overly acidic system. Calcium will be leached from the bones to attempyt to restore a more neutral pH. This causes the bones to become more susceptible to fracture.

6. Previous Injury

Have you ever suffered a sprained ankle? Any who has played basketball has probably lost count of how many times they have suffered this injury. But here's the thing about injuries. They cause us to compensate and move differently than if we were healthy and not injured. Instead of getting the heel down when we step we walk on the toes to protect the ankle. However once we are no longer aware of the pain and swelling has gone done we return to playing. Sometimes sooner. But in the meantime walking around on our toes, with our hip hiked up has caused our glutes to go to sleep. And unfortuntely the glutes play a huge role in cutting and jumping in basketball.

7. Proprioception

This is a fancy way of saying our bodies awareness of itself in three dimensional space. With injury there is a loss of proprioception. And the type of footwear we have on can enhance or impair the feedback we get from the ground. Think of walking in ski boots versus barefoot and you'll understand the difference in sensory input that feeds our proprioceptors. Some of our training and movement should be done without shoes. This can be during the warm up and for certain resistance exercises such as deadlifts but not for others such as jumping onto hard plyo boxes.

8. Avoid Early Specialization

I remember at a conference I attended where the speaker talked about the value of performing various physical tasks and demands during the developmental years. For example, it is important to let your kids play in as many different and varied sports as possible to fully develop the neuromuscular system. If they go the other route and specialize in a particular sport too early they risk not developing certain motor programs which may benefit them later. The example used at the conference was a basketball player doing only right handed lay ups in training. The brain maps out this particular region necessary to perform this task and then will 'prune' the adjacent areas not involved in the lay up. These pruned areas are then lost for future movement tasks and skills. Picture the kid who specialized in one sport very young but struggles whenever a different sport is attempted.

I don't mean to suggest this list is complete and nothing else would help minimize a fracture in sports. And it's important to note that while the title is more sexy to say prevent a fracture I will admit that we can never prevent injuries but simply help to minimize the potential of them happening. While this injury was horrific hopefully it allows you to learn some things about your own training which will help you stay healthy.

Chris [fb-like]

Knapic et al. Am J Sports Med. 1991 Jan-Feb;19(1):76-81.