It seems there are two types of people who fit the pandemic injury-prone profile. There are those over-doing it in a valiant effort to escape the house (essential exercise, anyone?) and gym-goers turned couch-potato by forced fitness closures.

Perhaps that's an over-simplification. But, according to podiatrist Emily Braidwood fitness business closures coupled with exercise being the only legitimate reason to avoid cabin-fever has significantly increased injuries.

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"People significantly increased their walking and running cardio exercise, leading to an overload of soft tissue and bone.

"We've noticed a spike in acute cases of plantar fasciitis, stress fractures and tendinopathies with each patient reporting a similar exercise history.

"I believe the general public is not well versed in progressive load management strategies, nor are they aware of the consequences of exercise overload, until it's too late."
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The critical message to avoid injury, according to Ms Braidwood, is 'if you don't use it, you lose it!

"If you haven't lifted weights, engaged in HIIT training, run or swam for more than a month, you will need a 'return to exercise' program.

"This involves starting at an easy level and working on your distance, reps, pace, or weight - but not at the same time.

"By building each component up by 10 per cent each week, you will safely allow the body to adapt and the tissues to condition.

"It's also important to add sessions gradually, starting with one to two sessions a week with rest days between," said Ms Braidwood. 

Physiotherapist Tim Dettmann agreed, stating that research showed a 400 per cent increase in Achilles tendon ruptures after a 12-week forced break.

"Dropping weights by 20 to 30 per cent, adjusting for age, training experience and injury will safeguard you from injuries.

"Physiotherapists should expect to see an influx of injuries three to four weeks after gyms have re-opened and community sport returns," said Mr Dettmann.

Did you know?

Mr Dettmann shared the following sobering statistics on sport and injuries.

• Community sports results in 60,000 hospitalisations in Australia each year
• In the first weeks of soccer returning in Germany, injury rates are up 300%
• When the NFL had a 14-week lockout in 2011 injury rates of Achilles injuries went up 400%
• Contact sports such as AFL, NRL and Rugby Union have the highest injury rate in Australia - relevant for both parents of school children and adults returning to games next week.
• Males account for 75% of hospitalisations.

Why the spike in injuries?

CSIRO research shows that two in five of us put on weight, and two-thirds of us had our exercise negatively affected during the lockdown. So, our physical health deteriorated, and we're at increased injury risk.

"To understand why we expect to see a rise in injuries, it's easiest to consider what protects us from injury. As a physiotherapist, the two standout preventative measures for me are strength training and consistent, specific training."

"Gyms were closed for 80 plus days in most states, and we know that a good strength training program will reduce sporting injuries by 30 to 50 per cent.

"Given most people couldn't replicate the load and specificity of the best strength training program at home, it's reasonable to assume we will see a minimum 30 per cent rise in injuries based of this factor alone.

"The reason consistent, specific training protects us is that our body is very good at adapting to load. When we train our muscles get stronger, our tendons stiffen, and our joints take on new movements."

As a result, people perform better and become protected from injury.

During the lockdown, however, the training involved less jumping, landing, balance, throwing, kicking and reaction-based activities. Basically, people played less, explained Mr Dettmann.

"As team sports re-start, we are throwing a huge number of environmental variables back into exercise very quickly.

"To the simple activity of running, we are adding jumping, catching, changing direction, new shoes, uneven surface, crowd noise and teammates. And not having trained in this environment will increase the risk of injury."

Common injuries on return to sport

The issues most likely to present after a return to sport include soft tissue, contact and overuse injuries.

Soft tissue injures due to lack of conditioning

Soft tissue injures are part of competitive sport, and they occur at the community level even after a well-planned pre-season.

"We've been deprived of a proper pre-season this year, so we expect to see an increase in hamstring tears in running sports and 'back sprains' in ball sports like golf and tennis."

Contact injures due to lack of 'play'

"It takes a lot of concentration to catch a ball, pivot and pass in AFL, netball and other ball sports.

"Throwing an opponent into the equation might overload our ability to coordinate our movement and result in more contact related injuries."

Overuse injuries

"Most of us have experienced pain related to starting an activity too quickly. Tendons, in particular, hate rapid increases in load. So, if you haven't run for ten weeks, don't start with a 10 km this weekend!"

Avoiding injuries post-lockdown

The best way to avoid injuries includes strength training, easing back into exercise slowly and training for four weeks before returning to sport, but don't waste time stretching advises Mr Dettmann.

Strength training

Strength training will reduce injuries by 30-50 per cent, so get back into lifting weights as soon as possible for four to six weeks before returning to sport.

Start slowly (literally)

Speed of movement is an influencing factor in many injuries. Lift slowly, run slowly, train slowly, hit the tennis ball slowly – do your regular activity but slow it down.

Train for four weeks

Restrictions have caused a decrease in 'conditioning'. So, train for four weeks before returning to sport to regain conditioning.

"There's no evidence that stretching helps prevent injuries – so in a world where time is our most precious resource, don't waste your time!"

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