Most sports are asymmetric in nature, where the use of one side of the body is far more than the other.
These asymmetries are seen to be related to injuries. The nature of sports leads to an excessive use of one side, further leading to a disproportionate development of muscles. This not only results in a difference in strength between the two sides of the body, but also in the range of motion of joints. This affects posture and leads to an even more uneven development of either sides. As a result, you would end up using the dominant side even more, making your body more lopsided. This leaves you in a catch 22 situation; the chances of getting injured are now even higher.
Repetition of the same movement in quick succession, where the body is accelerated rapidly and stopped equally abruptly, exposes the athlete to bigger injuries. This is particularly high in tennis, golf, hockey and for fast bowlers, who get injured a lot more than spinners, batsmen or wicketkeepers. The most common injury is stress fracture of the lumbar spine (low back) on the non-dominant side. This can be career-ending if not managed properly.
Several studies have shown that fast bowlers, tennis players and golfers who complain of back pain have the greatest muscle imbalances compared to those who don’t experience any pain. So, why wait for the injury to happen? Why not prevent it?
Recognising the asymmetric nature of sports as a major reason for such injuries, coaches and trainers now recommend the use of the weaker side as well – both while one is engaged in the sporting activity and when doing strengthening and stretching. This is to reduce muscle imbalances and the uneven forces acting on joints.
As an example, playing squash would lead to a lot more wrist, elbow and shoulder injuries than back injuries. However, injuries are not limited to the upper body, but can affect the lower body as well. Thus, periodisation becomes a very important part of training as these are primarily repetitive stress injuries.
It can be divided into three phases: conditioning (preparation), pre-competition (transitional) and competition. The old adage ‘don’t race in a training run’ applies here too. You can’t be, and shouldn’t be, performing at the peak level throughout the year.
As controversial as the rotational policy is in sports, it is now being recognised as very important to prevent injuries. Even if an injury like a stress fracture of the lumbar spine happens, it is very important to take time off to not only rest but do pro-active rest. Athletes can be playing at the highest level again in 2-3 months if they are smart about it. Otherwise, it can be career-ending.
(The writer is an ultra-runner and doctor specialising in exercise and musculoskeletal medicine)