Clinical guidelines for the scientific prevention of sports injuries: From health assessment to post-exercise "cooling" recovery

II. Measures to prevent sports injuries

The prevalence and risk factors of sports injuries: The incidence of sports injuries is generally high. The high proportion of sports injuries among ordinary community residents during fitness activities is also gradually attracting attention. Many factors influence the occurrence of sports injuries. Common causes include insufficient warm-up, inadequate post-injury rehabilitation (i.e., premature or inappropriate exercise, lack of or improper warm-up), lack of concentration during exercise, physical fatigue, and incorrect technique. Obesity itself is also a risk factor for sports injuries. Sports injuries vary depending on the type or activity. The location of the injury is closely related to the type of exercise, with injuries to the limbs and lower back being the most common. Generally, lower limb injuries are relatively more frequent, followed by the trunk and upper limbs, while head injuries are relatively less common. Knee injuries are the most common type of injury in mass fitness running. In obese children and adolescents undergoing exercise for weight loss, the main sites of injury are the ankle and knee joints, followed by forearm and leg muscle strains. Generally speaking, sports injuries in the general population are mostly mild, primarily soft tissue injuries, with muscle, tendon, ligament, and joint capsule injuries being the most frequent, followed by injuries to articular cartilage and rotator cuff. Furthermore, sports injuries can develop into chronic injuries due to excessive local load, accumulation of repeated minor injuries, or improper treatment of acute injuries. In addition, improper treatment or exercising while injured often leads to recurrence of sports injuries. The occurrence of sports injuries is also related to environmental conditions. The incidence of sports injuries is significantly higher in hot and cold seasons than in seasons with suitable temperatures. Insufficient light, poor ground conditions (such as uneven, hard, or slippery surfaces), and inadequate sports equipment (such as bicycle helmets) can all increase the risk of sports injuries.

Avoiding sports injuries is not just about protective measures during exercise, but should begin before developing an exercise plan. To promote health, achieve a healthy weight, and avoid sports injuries through physical activity, the following should be done: ① Assess health status; ② Assess physical activity capacity and physical fitness; ③ Develop physical activity targets and plans; ④ Ensure safety during physical activity; ⑤ Assess exercise response and adjust physical activity plans. In practice, exercise goals and exercise plans should be selected based on individual circumstances, personal interests, and living environment, and necessary protective and risk control measures should be taken during the physical activity process. (1) Prepare for exercise 1) Assess health status and exercise capacity: Before increasing physical activity to promote a healthy weight, a scientific assessment of health status and exercise capacity should be conducted. Exercise capacity is reflected in an individual's skills and physical fitness level, and is the basis for selecting physical activity content and arranging physical activity volume. The selection of activity content should be combined with existing sports skills, and the arrangement of activity volume should refer to physical fitness and existing activity level. Physical fitness assessment can refer to relevant physical fitness evaluation standards and methods, or make a rough judgment based on existing activity content and activity volume in daily life and work. 2) Develop an exercise plan after consulting with professionals: As mentioned above, a complete exercise plan and prescription include progressive exercise frequency, intensity, time and type, as well as target exercise volume and progress. The exercise plan should include endurance activities, flexibility exercises, muscle strength exercises and balance exercises. Each exercise session should include a complete warm-up and cool-down, stretching exercises, strength training, etc. As the amount of exercise increases, the rest time should be extended accordingly, and as physical fitness improves, the overall exercise load should be increased accordingly. Among them, the choice of exercise form should take into account factors such as weight, sports skill level, sports equipment, protective equipment, and climate. At the same time, proper diet also plays an important role in preventing sports injuries. (2) Perform sufficient warm-up activities before each exercise session: The purpose of sufficient warm-up activities is to warm up the body. Warm-up exercises are used to start activities that increase body temperature (such as walking or jogging). The various organs, joints and muscles of the body adapt to the exercise state, the muscles are relaxed, which is conducive to the stretching and expansion during exercise, and can reduce the chance of sports injuries. Warm-up activities usually include the following: ① Warm-up jogging: Walk or jog for at least 5-10 minutes until you are slightly sweaty. ② Specific exercises: Gradually increase the range of motion according to different sports. That is to say, the warm-up activities should include the movements that are frequently performed in the specific sports. For example, ball sports require specific footwork exercises and shoulder exercises. ③ Prepare protective gear: Choose suitable sports protective gear and sports equipment for the sports, including appropriate sports shoes and socks. Generally, shoes and socks should support the feet, absorb impact and provide adhesion friction. If necessary, simple foot orthotics can correct deformities. Protective equipment such as sports-specific protective glasses, helmets, etc. ④ Stretching activities after warm-up: After warm-up exercises, it is recommended to do necessary stretching activities to relax muscles and prevent muscle soreness the day after exercise. (3) Precautions during exercise: During exercise, pay attention to the body's sensations, environmental conditions, and sports safety. ① Concentrate: During exercise, maintain focus and pay attention to areas with sweat, debris, and other contaminants, such as scraps of paper, as these can cause slips and falls, leading to injuries. ② Be aware of the playing surface: Be aware of any potholes, bumps, and obstacles around the playing surface to prevent ankle and knee sprains. ③ Be aware of weather changes: Stay informed about weather conditions to adapt to the effects of sunny or rainy days (different humidity and temperatures) on the playing surface. Dress, wear appropriate clothing, and equipment accordingly. ④ Be prepared for falls during exercise: Be mentally and physically prepared for the risks of speed, height, and physical contact. ⑤ Avoid overexertion: Overexertion can cause muscle and joint injuries. Follow the principles of moderation and gradual progression. Moderate and regular exercise is most beneficial. If you feel fatigued, unwell, or in pain, such as fever, extreme shortness of breath, nausea, or dizziness, rest immediately. Do not force yourself to exercise, as this may lead to accidents. Seek medical attention promptly if necessary. ⑥ Pay special attention to the final stage of exercise: This is the time when injuries are most likely to occur. Because the mind and muscles are already fatigued at this time, it is easy to lose focus, so injuries often occur at this time. Remind yourself that you must concentrate before the end of the exercise to avoid injury. (4) Do cool-down exercises in the later stage of exercise: After exercise, you need time to calm down and let your heart rate return to normal. This is an active way of resting, which can make the mind, muscles and internal organs recover more evenly and improve the efficiency of physical recovery. Performing "cool-down" activities after strenuous exercise can keep the cardiovascular and respiratory systems at a high level, which is conducive to repaying the oxygen debt incurred during exercise. "Cool-down" activities relax muscles, promote the rapid decomposition and excretion of lactic acid, and avoid affecting the metabolic process due to local circulatory disorders. Jogging (5-10 minutes), breathing exercises and stretching exercises for various muscle groups after exercise are all good "cool-down" activities after exercise. They can eliminate muscle spasms, reduce muscle soreness and stiffness, and eliminate local fatigue. In this way, the body (especially the heart and musculoskeletal system) can slowly recover from a high-speed exercise state to a low-speed exercise state and then return to a resting state. It has a good effect on preventing sports injuries. In addition, it should also include manual massage, a 10-15 minute warm water bath at 40℃, changing into dry clothes in time, timely replenishment of nutrition, and sufficient sleep.