Strength Training for Injury Prevention

By Joe Heiler

Football is a high speed game of violent collisions, and with split second changes of direction. As a result, injuries to muscles and joint structures frequently occur due to the high demands placed upon them to produce, and absorb, force in an instant. Some injuries are unavoidable due to contact, but non-contact injuries can be cut dramatically using smart strength training programs.

Muscle pulls are often the result of muscles nearby not doing their job to assist or stabilize during movement. Low back strains are often the result of weak abdominals and glutes, whereas hamstring pulls are often caused by poor hip extension specifically with weakness in the glutes again.

Injuries to joint structures, such as shoulder tendinitis and ACL tears in the knee, are often the result of muscle imbalances front to back. Athletes that emphasize bench press, but ignore upper back strengthening will often experience an acute shoulder injury, or chronic pain with pressing movements in the weight room and on the field. Quadricep dominated training at the expense of the hamstrings can result in knee joint instability with deceleration and cutting, thus the common cause of many ACL and cartilage injuries.

A smart, balanced strength training program can go a long way toward preventing injury on the football field. I will give examples for some of the major joints and muscles, but remember these key points.

1. Training volume for the back of the body should match that of the front.

2. Football doesn’t just happen straight ahead. Training should include lateral and rotational movements as well. Plyometric and agility drills should address this also.

3. Don’t forget to train the trunk. This is the weakest part of the body in most athletes, but perhaps the most crucial for success.

Neck: First contact in football is often with the head and shoulders, so a strong neck and upper traps are critical for preventing neck injuries and “stingers”. Neck strengthening should be performed in all directions using a machine or resistance from a training partner. The athlete should remember to maintain good posture throughout, and not cheat with his body. The upper traps should be worked primarily with cleans, deadlifts, and the farmer’s walk. Shrugs and upright rows are traditional exercises that really just accentuate poor posture and can cause more neck and shoulder pain.

Shoulders: The shoulders have the greatest mobility of any joint, but also the least stability. The rotator cuff and scapular muscles of the upper back are responsible for joint stability especially during overhead or pressing activities. The scapular muscles are critical to maintain glenohumeral rhythm and joint space preventing impingement. This then allows the rotator cuff muscles to do their job and stabilize the shoulder joint.

The scapular musculature is recruited during pull-ups and chins, pull-downs, dumbbell or barbell rows, and deadlifts. Emphasize good posture throughout to effectively work the muscles, rather than throwing around too much weight. The rotator cuff muscles can be worked using bands or dumbbells to perform rotational movements and diagonal patterns. Using light dumbbells (3-5 pounds) to perform T’s, Y’s, L’s, and W’s are a great way to warm-up prior to lifting and will hit all the muscles of the shoulder girdle.

Lumbar Spine: The lower back is another area that is quite susceptible to injury, but can often be prevented with strengthening and attention to proper lifting technique. Keeping the low back flat during exercises like squats, deadlifts, and cleans is essential to preventing injury. Maintaining that posture against the load being lifted is also a tremendous strengthening exercise for the muscles of the entire back, even though other muscle groups are being targeted (i.e. squats for legs). Exercises like back hyperextensions and good mornings will target these muscles more throughout a greater range of motion.

Another key is abdominal strengthening to support the lumbar spine when it is under high stress. Strong abdominal muscles not only stabilize the spine, but also facilitate the transfer of power between the lower and upper body making your athletes more punishing blockers and tacklers. Explosive medicine ball throws are an excellent way to train the core musculature to stabilize the spine, and develop power at the same time.

Knees: As previously mentioned, non-contact knee injuries are often the result of muscle imbalances, specifically strong quads and weak hamstrings. Performing squats to parallel, and giving equal time to hamstring training will go a long way toward improving knee stability. Hamstring curls, glute-ham raises, and Romanian deadlifts should all be included at some point. Unilateral exercises like lunges, single leg squats, and single leg deadlifts can also be used to guard against imbalances from side to side. Lateral and rotation lunges can be used from time to time, along with agilities and plyos, to prep the knee joint structures for cutting and changes of direction.

Ankles: Ankle injuries are very common in football, and usually will occur with cutting or landing from a jump. Paying attention to strengthening the hips and trunk musculature will actually decrease ankle injuries because of improved body control with deceleration type movements. Another effective way to reduce non-contact ankle injuries is through agility and plyometric work. Stressing the muscles, tendons, and ligaments of the ankles using football specific movements will strengthen these structures, and prepare them to handle the forces placed on them in game situations. Start during the offseason and gradually build speed and increase difficulty of the drills.

As a physical therapist, the main causes of non-contact injuries I see are due to muscle imbalances, front to back and from side to side, and a lack of preparation for game-like conditions. The rehab process addresses these flaws by targeting the neglected supporting muscle groups, and stressing muscle and joint structures by incorporating sport specific movements. By applying these concepts to your training programs, many of these injuries will be avoided. That could mean fewer games missed and more wins in the Fall.

Joe Heiler PT, CSCS is a physical therapist specializing in sports medicine and orthopedics in Traverse City, Michigan. As a certified strength and conditioning specialist he has worked with athletes at all levels improving speed, power, and strength. Check out more great articles, exercise videos, audio interviews, and more from top physical therapists, athletic trainers, and sports performance coaches at

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April 30, 2008