Palawan State University

College of Teacher Education

Unit 1: Risk Mitigation and Management

I. Risks of Musculoskeletal Injuries

Musculoskeletal injuries, also known as Musculoskeletal Disorders (MSDs), are
injuries and disorders that affect the human body’s movement or musculoskeletal system
(tendons, muscles, ligaments, nerves, discs, blood vessels, etc.)
When beginning an exercise program, it is best to progressively overload and
be aware of your body’s response. Rushing into activities for which the body is not
prepared puts you at risk for injury. You are likewise capable if you have been exercising
for a long period of time while overusing one area of the body. Even though
adherence to training principles is an effective exercise, the risk of injury is inherent in any
physical activity.

Possible injuries that might occur during Physical Activity

It is possible for you to occur acute and chronic injuries during your
participation in sports, recreation, and exercise. Acute injuries such as
sprained ankle, strained back, fractured hand, are those that suddenly occur
during an activity, while chronic injuries such as runner’s knee, jumper’s knee,
tendonitis, plantar fasciitis, patellofemoral syndrome, and iliotibial syndrome,
usually result from overuse.

1. Sprain - a stretching or tearing of ligaments occurs when joints are moved

beyond their normal range of motion and the collagen fibers within
the ligaments are pulled apart.
2. Strain - Trauma to the muscle or tendon caused by over-extension or
overstretching. It occurs as a result of fatigue, overuse, or improper use of the
muscle.
3. Fracture - a break in the continuity of a bone.
4. Tendonitis - Also called as tendinitis, is the inflammation of a tendon.

Factors that contribute to exercise-related injuries

The factors that contribute to exercise-related injuries are ( 1) body
mechanics, which is about movement and sports skill, (2) level of muscle
strength and conditioning, and (3) body’s overall condition prior to an intense
workout or game.

Techniques for reducing the risk of injury include:

1. self-myofacial release (SMR).
2. Dynamic warm-up,
3. Improving movement mechanics through mobility and stability training (e.g.
learning how to stop, change direction, pivot), and
4. Proper conditioning (e.g. developing power and strength).

Developing stability and eccentric strength or ability to land properly,

through hopping drills, which involve landing on one leg is also important area of
conditioning.
Training for movement, specifically change in direction, entails knowing the
concept of movement and timing the movement. In conclusion, training smart, which
means adhering to training principles and functional training, can reduce the risk for
injury.
II. The Exercise Program
Department of Physical Education
PATHFIT 2: Fitness Exercises
Handout 1: Risk Mitigation and Management
 1. Warm-up
Warm-up or sometimes called limbering up is always the initial phase of any
exercise program. It is a light activity aimed at increasing the body temperature to
allow a gradual increase in the blood flow to the muscles, ligaments and tendons.
Warm-up is a good take-off point for mitigating your risk for injuries. This
also has the potential of improving performance since it minimize the premature
formation of lactic acid at the start of the workout. Lactic acid is a by-product of
metabolism as one performs vigorous physical activity. Muscle fatigue is partially
attributed to the accumulation of lactic acid in the working muscles.

This consists of exercises that (1) develop single leg strength, (2) develop
dynamic flexibility, (3) increase proprioception, and (4) activate one muscle while
elongating the other.

2. Stretching and Flexibility

It is performed slowly in a sitting or standing position. It increases flexibility
and relaxes the muscles, but this does not prepare the muscles and connective
tissues for dynamic movements that occur while working out or playing your sport.
Static flexibility alone is not recommended because ‘more’ is not necessarily
better because as joint mobility increases, joint stability decreases. Same goes with
extremes of flexibility (inflexibility and hypermobility) because these are associated
with higher risks for
injury.
Stretching exercises are classified into:
a. Passive - use of external force, usually another person.
b. Static - slow increase in muscle length and holding the stretched position
for a period of time.
c. Ballistic - fast, bouncing movements aided by momentum; generally
avoided due to greater risk of injury from the high force that is generated.
d. Dynamic - distinct from ballistic stretching in that it is controlled, smooth
and deliberate. More helpful in improving functional movements used in daily
life and sports.
e. Proprioceptive neuromascular facilitation or PNF - series of contact- relax’
involving isometric contraction and static stretch that is assisted. Originally
developed as a form of rehabilitation.

Proper stretching involves holding a mild stretch for 15 to 30 seconds while

you breathe normally. Always warm up before you stretch. Like strength conditioning,
flexibility exercises should include stretching for all of the major muscle groups.

3. Strength and Endurance Exercises

The strength exercise program may combine both calisthenics and weight
training activities. Calisthenics exercises uses the weight of the body.
In performing strength and endurance exercises be sure that you include
exercise for every major muscle group, including the muscles of the arms, chest,
back, core, hips and legs.
For greater strength conditioning, add more weight and/or more repetitions,
in sets of eight to 12, when the exercise becomes easy.

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Department of Physical Education
PATHFIT 2: Fitness Exercises
Handout 1: Risk Mitigation and Management
 The following are the suggested calisthenic and weight training exercises that
develop the major muscles of the body.

The following are Cardiovascular Endurance Training Activities that you can do with
regards to FIT principle of training:
(Frequency: 3 to 5 days per week, Intensity: 60% - 90% maximum
heart rate, Time: 20 - 60 minutes of continuous aerobic activity)

These are sample cardiovascular endurance training activities that you can perform
at home following the FIT principle of training.
1. Continuous running
2. Prolonged Brisk walking
3. Fartlek
4. Stationary Bicycling
5. Aerobic dancing
6. Continuous swimming
7. Rope skipping
8. Rowing

4. Cool-down
Cool-down gradually returns the body to resting state and promotes effective
recovery (e.g. removal of lactic acid). Activities are of low-to-moderate intensity but
gradually diminishes so as to bring breathing, heart rate, and metabolism back to
baseline levels. This controlled ‘slow-down’ is important for the heart so as to avoid
cardiac abnormalities such as negative and abrupt changes in heart rhythm.
In addition, it prevents the sudden pooling of blood in the lower extremities
and ensures the adequate circulation to the skeletal muscles, heart, and the brain.
This reduces the tendency of dizziness and fainting from a sudden drop in blood
pressure.
Lastly, cool-down aids in preventing or relieving spasms or cramps in fatigued
muscles through static stretching. Since your muscles are warm from the workout,
they are more pliable and it is best to perform static stretching at this time.
Stretching as part of the cool-down can help improve extensibility of the muscles and
connective tissues, and the range of motion around the joint.

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Department of Physical Education
PATHFIT 2: Fitness Exercises
Handout 1: Risk Mitigation and Management
III. Management of Injuries
The following are signs of an injury:
a. Deformity - abnormal shape compared to an uninjured part on the other side
of the body.
b. Open wounds - there is a break in the skin and bleeding.
c. Tenderness or pain - sensitive to touch and usually the individual can point the
site.
d. Swelling - area is larger than usual because of fluid from inflammation and/or
bleeding/s.
When an acute injury to the muscle, bone or joint occurs, the standard
treatment is rest, ice, compression, and elevation, or RICE of the affected body part.
While using RICE method, taking nonsteroidal anti-inflammatory medications, such
as ibuprofen or naproxen may help to reduce swelling and pain.

The RICE method:

1. REST
Rest and protect the injured or sore area. Stop, change, or take a break from
any activity that may be causing your pain or soreness.

2. ICE
Cold will reduce pain and swelling. Apply an ice or cold compact right away to
prevent or minimize swelling. Apply the ice or cold compact for 10-20 minutes,
3 or more times a day. After 48-72 hours, if swelling is gone, apply heat to
the area that hurts. Do not apply ice or heat directly to the skin, place a towel
over the cold or heat pack before applying it to the skin.

3. COMPRESSION
Compression, or wrapping the injured or sore area with an elastic bandage,
will help decrease swelling. Don’t wrap it too tightly, because this can cause
more swelling below the affected area.
Loosen the bandage if it gets too tight. Signs if the bandage is too tight
include numbness, tingling, increased pain, coolness, or swelling in the area
below the bandage.
When there are obvious deformities (possibly a fracture or dislocation), splint
the injured area in order to stabilize against movement.
Do a quick check of circulation, sensation, and movement (CSM) for injuries
to the extremities to guard against limb loss, because the tissues of arms and
legs cannot survive for more than three hours without blood circulation.
a. Circulation: For an injury, feel for the radial pulse; for a leg injury,
feel for the posterior tibial pulse located between the Achilles tendon
and inside ankle bone.
b. Sensation: Lightly touch or squeeze the finger or toes to determine
the presence of sensation. Loss of sensation indicates possible nerve
damage.
c. Movement: Check for nerve damage by wiggling the fingers or toes,
only if they are not injured. If you observed any disruption in
circulation, sensation, and movement, seek immediate medical care.

4. ELEVATION
Elevating the injured area decreases the blood flow and minimizes swelling.

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Department of Physical Education
PATHFIT 2: Fitness Exercises
Handout 1: Risk Mitigation and Management
 An injury is fully healed when there is no longer pain, swelling, and limping (favoring
the uninjured side of the body) or instability.

Symptoms and care for common injuries are listed below:

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Department of Physical Education
PATHFIT 2: Fitness Exercises
Handout 1: Risk Mitigation and Management
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Department of Physical Education
PATHFIT 2: Fitness Exercises
Handout 1: Risk Mitigation and Management