By Tom Fontana, MSPT
In terms of car safety, is it better to be a nimble, but light, Lamborghini that can better AVOID an accident, or a plodding (compared to a Lamborghini!) but stout Humvee that can better WITHSTAND an accident? There are arguments for either side.
The question is not only a good one to ask for automobiles but also for human bodies. Is it better to “float like a butterfly” to avoid injuries or to be built like a tank to withstand whatever comes your way? As with the car question, there are arguments for either side. Undoubtedly, the only good injuries are the ones you never suffer, so avoidance is HUGE. But, for an athletic population in particular, there is no such thing as keeping yourself out of every possible injurious situation so you need to be built to last.
For much of the 20th century, physical therapy and athletic training focused on building tanks. As the field has grown, however, research has shown injuries often leave lingering effects on the nervous system and this may account for the large amount of reinjury that athletes experience (the number one predictor of an athletic injury is a previous athletic injury!) even when strength has been normalized. This often takes the form of decreased balance or delayed time in getting muscles to fire and sometimes a millisecond makes all the difference in the world in terms of lifting your foot if it is about to roll over or firing a muscle to prevent it from doing so. More evidence is piling up that AVOIDING injury may be more important.
To illustrate, have you ever walked down the stairs and missed the last step? You can turn your ankle. You can hyperextend your knee. Any number of terrible things can happen. Events like this, where what you experience is different from what you were expecting and you have little time to react, can end up in a world of hurt, regardless of how strong you are. This begs the question: is the reason you can walk around during the day, go up and down stairs, maneuver objects with your arms, etc. and not get hurt all the time because you’re built like a tank everywhere or because you are moving your limbs where they belong at the right time with the right force, etc?
Fortunately, unlike a car, you don’t have to choose to be one kind or the other—you can be both (wow, a Humvee handling like a Lamborghini—who wouldn’t want that?)! Improving your sense of balance, coordination and reaction time not only prevents injuries but also makes your movements more efficient and synchronized. This is why we work on these whether during your physical therapy, fitness training after PT, or in our athletic performance program.