LO1 - Extrinsic & Intrinsic Factors

The type of activity or sport can influence the risk of injury for example contact sports present different injury risks from gymnastic activities.

Contact sports such as football or rugby can increase risk of injury because of bad or dangerous tackles and collisions

Dangerous sports such as rock climbing or trampolining can present a higher risk of fractures due to falls.

Striking sports such as baseball, hockey or cricket can increase injury risk because of being hit by ball or sticks and associated equipment.

High impact jumping sports such as gymnastics can increase risk because of damage and stress on joints.

Coaching and supervision are extrinsic factors that can impact the risk of injury. This can cause a performer to injure themselves through applying an incorrect technique or playing the game in the wrong way or too dangerously. Factors can include:

• poor or incorrect coaching techniques for example coaching the correct tackling technique in rugby or equivalent can avoid dangerous play
• ineffective communication skills; correct instructions and messages from coaches means information is correct. If the coach is being observant and attentive they can avoid dangerous play and avoid injury.
• importance of adhering to rules and regulations; This can reduce the danger and injury by following rules. Be aware of coaches encouraging aggressive play e.g. a two-footed tackle in football.

Environmental factors include the:

• weather
• playing surface
• performance area and surrounding area
• other participants

Before and during activity the coach should check the weather conditions are suitable for example it is not too cold or hot. In extreme cold weather it could result in hypothermia or too hot and get heat exhaustion. If hot conditions there is an increased risk of dehydration which can lead to a decrease in performance and potential fainting. There is a risk of sunstroke or heat stroke and burning if too sunny. If sun gets in performers eyes there is a Risk of accidents through collision due to participants running into one another or into an object such as a goal post.

If wet weather rain could get in players' eyes resulting in blurred vision blurred and players can’t see properly, resulting in a potential collision risk. If the surface becomes wet players could slip and fall over.

In foggy conditions there is a risk that a performer cannot see clearly and collisions; with participants running into one another or running into an object such as a goal post.

Playing surface, performance area and surrounding area can effect injury risk and coaches should check the pitch is safe to play on e.g. not too wet, slippy, hard, uneven or has any objects/debris that can cause injury.

Other participants could bump into you particularly if in an overcrowded playing area. It is important to checking all items of jewellery are removed from other players, all players are wearing appropriate equipment and footwear e.g. Shin pads and studs. During matches coaches need to check players are playing to the rules e.g. no fouls.

Equipment in sport includes:

• protective equipment (e.g. shin pads in football, gum shield in boxing, helmet in cycling, goggles in skiing)
• performance equipment (e.g. hockey stick, cricket ball, rock climbing harness)
• clothing and footwear suitable for the playing surface, weather conditions and specific to the sport or activity

Performance equipment is a piece of equipment that is needed to play a particular sport or activity. Protective equipment is a piece of equipment that you are required to wear to prevent injury. It stops you getting hurt and keeps players safe which will reduce the risk of injury.

Protective equipment could cause risk by becoming injured by another player’s helmet or shoulder pad. By not wearing the correct protective equipment or by using broken/damaged and ill-fitting equipment or wearing it incorrectly such as choking on gum shield.

Performance equipment can increase risk of injury for example a performer could run into a piece of equipment (e.g. goal posts) or could get hit on the body by another player’s equipment (e.g. hockey stick). Faulty and damaged equipment can also increase injury risk.

Clothing and footwear can increase injury risk for example a player could slip and get injured due to inappropriate or incorrect footwear. They could be injured by another player’s studs on their boots. A player could get blisters if footwear does not fit properly. Clothing could snag OR get in the way, which might restrict movement.

Safety Hazards include:

• risk assessments
• safety checks
• emergency action plans

Risk assessments are completed to minimise the chances of injuries occurring, by making equipment, performer and playing area safer. It involved identifying potential hazards and dangers and assessing the possibilities of an accident occurring and the potential consequences because they take place before the activity.

A risk assessment then identifies actions to be taken to avoid and prevent the chances of accident happening. This helps you to plan an alternative safer sports activity if risks are identified.

Potential risks are classed as wither low, medium and high. The risk assessment is done to check whether activity/game is safe to go ahead.

Safety and Equipment checks should be carried out before a match eg checking pitch for litter, debris and dog faeces; and during/ongoing a match, checking if the conditions change during the game e.g. weather (snow/hail) that might cause the pitch to become dangerous. It is important to make sure the equipment is safe so that equipment does not break and cause injury. For example, goal posts should meet FA regulations and could risk collapsing on players; basketball blackboards breaking; rugby posts without padding.

Other checks include:

• Equipment
• Facilities
• Jewellery
• Weather or temperature
• Participants’ age / health / medical conditions / previous injuries
• Participants’ clothing / footwear or protective equipment
• Environment / playing surface / floor or surrounding area or litter

Emergency Action Plans - see LO3 - How to respond to injuries

Physical preparation includes:

• training
• warm up & cool down
• fitness levels
• overuse
• muscle imbalances

To participate in sports and physical activity a performer needs to be fit enought to cope with the demands of the situation/environment. Training will ensure a player is fit enough. Progressive training can allow you to build up towards being ready for performance. If you are not regularly training in preparation for the activity then you can put strain on your body that it is not able to cope with, thus causing injury.

Having good core fitness makes the body better able to cope with physical activity. Having poor or insufficient core fitness means that the body is physically less able to cope with activity. Fatigue and tiredness can also have a detrimental effect on technique which in turn can cause injury.

Each session should include a warm-up and cool-down (LO2 - Warm up/Cool Down). A suitable warm up targets relevant parts of the body and gradually prepares them for the activity ahead. Not warming up (either at all or appropriately) means that parts of the body can be unprepared for sudden use when you start the activity and this can cause injury to occur.

Effective cool down can help the body recover gradually from exercise and reduce post exercise muscle soreness.Not cooling down properly can mean that circulation drops suddenly which can lead to blood pooling and result in swelling and pain in the muscles.

Overuse Injury can be caused by repetitive actions in some activities (LO3 - How to respond to injuries), so playing too often increases the risk of these injuries by regularly placing stress on the same parts of the body

Muscle imbalances means that some muscles have to take too much strain during exercise while other associated muscles do not do enough work. Muscle imbalances can lead to injury in the muscle doing most of the work, or to the joints or parts of the skeleton being supported by the muscle group.

Individual variables that influence injuries include:

• age
• gender
• flexibility
• nutrition
• sleep
• previous/recurring injuries

Age is a factor as the older the performer then more injury prone they, as people age muscles can become weaker, bones can lose density and flexibility can reduce. Young people should be competing against people of their own age. They are more likely to be injured when playing older people. Activity must be at right level for age for example adults playing rugby alongside or against teenagers or children could cause injury.

Gender can be a factor as males and females (beyond a certain age) should not be mixed in certain sport sessions (for example contact sports), this is due to different levels of strength between genders. Males can be stronger than females or females more flexible than males.

An individuals flexibility can influence injuries for example the more flexible a person is the less chance of injury. The performers nutrition can also influence injury e.g. having the right diet allows for the correct energy levels to play safely (carbohydrates and fats), growth and repair during muscle recovery (protein) can prevent injury from weak muscles. Hydration also maintains energy levels, concentration and reduces the risk of cramps.

Sleep rates can influence injury, if a player is not getting enough sleep then fatigue and tiredness can also have a detrimental effect on technique which in turn can cause injury. Recovery from exercise and muscle growth also takes place during sleep which is important to keep performers prepared for their activity.

Understanding a performers previous or recurring injuries will ensure the activity is not going to place too much stress on an area of the body that has been or is susceptible to injury, for example too much jumping and landing in netball may cause knee pain and injury.

Performing again too soon after injury, can cause further injury for example over-working the previously injured part that has not healed yet. The injury could cause (an inherent) weakness (leading to further injury), this could cause the performer to perform differently or change to a poor technique. There might be altered posture resulting from the injury, leading to further injury.

Previous or recurring injuires are also linked to:

• Muscle imbalance
• Reduced decreased flexibility
• Psychological issues

Psychological factors related to injuries include:

• motivation
• aggression
• arousal/anxiety levels

Motivation levels could lead players to pulling out of tackles or being over motivated and tackling recklessly. This is linked to aggression (e.g. being too angry) and Arousal (e.g. over-arousal) when a player may feel they don’t care and are not safe, lack focus and cannot concentrate (eg not making safe decisions).

If a player is under aroused and lacks of control in arousal levels (or a lack of motivation) or suffers from high stress and anxiety they may lack confidence or self-esteem. This may lead to a performer being too nervous and scared in sport. They would not be ready to perform in a safe way or could cause injury by not going into a tackle properly or lack of focus from not concentrating enough. If a performer is not in the right frame of mind and unable to concentrate on the performance ahead they risk injury. Similarly too much aggression can cause a performer to go into a tackle too hard and cause injury to someone or themselves, including breaking the rules.

Posture related injuries include:

• pelvic tilt - one side of the pelvis and hips is higher than the other side. The hips not level or pelvis angled forward and back (compared to normal). One side of the pelvis higher than the other or pelvis is at different angle (than normal)
• lordosis - a forward/inward curving of the lower back/spine, so that stomach sticks out
• kyphosis - forward/inward curvature of the upper back/spine giving a hunched/ rounded appearance at the top of the spine.
• round shoulders - forward curve of the neck and hunching the shoulders forward
• scoliosis - a visibly curved spine, ‘S’ or ‘C’ shape with one shoulder higher than the other

The impact of poor posture on sport and performance includes:

• Back ache/pain
• Weaker back/spine
• Stress placed on other parts of the back
• Poor balance
• Muscular imbalance
• Poor technique/slower
• Slouching

Causes of poor posture:

• poor stance and/or gait (e.g. bending your knees or hunching your shoulders when standing)
• poor sitting positions (e.g. slumping/slouching on the sofa rather than sitting upright)
• physical defects (e.g. muscles weaken around an injured area)
• genetics (e.g. back condition/ weakness that you are born with)
• lack of exercise (e.g. lack of core muscle strength means less support, being overweight puts strain on posture). Lack of core muscle strength or weaker muscles means less support and more strain on back
• fatigue (e.g. tired muscles will be unable to support the skeleton properly) from prolonged carrying and lifting
• emotional factors (e.g. having low self-esteem/lack of confidence can influence posture) can cause someone to look down and hunch forward, this can lead to round shoulders and poor posture (in the upper body) or slouching
• clothing/footwear (e.g. wearing shoes with high heels can affect posture)
• age (risk of osteoporosis increases with age)