Mechanisms of Upper-Limb Injuries, and Potential Preventative Strategies

In Olympic Weightlifting

Introduction

Bridging the gap between coaching practise, research, and education is vital in improving the safety of participants and the efficiency of strength

training programmes (Peterson, Rhea, & Alvar, 2004). This can be achieved in various ways, such as workshops designed to educate coaches on

the use of evidence-based practise, dose-response relationships, mechanisms underlying injuries, and preventative measures. All of which are

tools that are frequently prescribed by strength & conditioning coaches, weightlifting coaches, and personal training professionals (Rhea, 2004).

Although qualifications are available which are insightful in regards to the physiological adaptations to exercise, there is a distinct lack of

education regarding injury definitions and education, mechanisms underlying injuries, and preventative measures within these qualifications.

Even when allowing for the two largest weightlifting education organisations in the UK (the UK Strength & Conditioning Association

(UKSCA), and British Weight Lifting (BWL)), the UKSCA workshop about Olympic weightlifting is purely a technical model workshop which

“covers key technical and coaching points as well as providing the knowledge to incorporate these lifts into training programmes to improve

sports performance” (UK Strength and Conditioning Association, n.d.), has nothing on the subject of injury in any regards. BWL also run level 1

and level 2 qualifications solely focussing on Olympic weightlifting, with neither incorporate any education surrounding injury definitions, risks,

or preventative measures etc. (UKCC (1st4sport) Level 2 Certificate in Coaching Weight Lifting | British Weight Lifting, n.d.). Considering you

can attend these courses with no prior knowledge or qualifications, and then come away being able to coach Olympic weightlifting, there is a

Note: All UKSCA & BWL technical models used in this practical are referenced from official qualifications and workshop material and do not have official supporting
articles/documentation to reference in accordance to APA 6th guidelines.
need to run educational workshops such as this. Outside of performance sport there are also personal trainer qualifications (level 1, 2, and 3), all

of which do not include any reference or teaching of injury definitions, injury cause and effect, and/or preventative measures within their

syllabus (Qualifications Archive | Active IQ, n.d.).

Catering For Different Learning Styles within Pedagogy

Pedagogy is a very complex and varied, yet simple sounding task (Coffield, Moseley, Hall, & Ecclestone, 2004). Whilst many factors are to be

considered when encouraging pedagogy best-practise such as; time of day, energy levels, and mobility (Coffield et al., 2004). There are four

distinct and agreed upon ‘elements’ that encompass individual learning styles; Visual, Auditory, Kinaesthetic, and Tactile (Grabowski &

Jonassen, 1993). Within this workshop each element is carefully considered and implemented where best possible; Visual elements are included

via PowerPoint presentation including all graphs, charts, print outs and recalls; Auditory elements are included via the presenter speaking, asking

audience questions, responding to feedback, and inviting discussion; Kinaesthetic elements are included via whole body movements by means of

the weightlifting & manual therapy practical’s, which includes real-life coaching scenarios/acting; and Tactile elements are included by

encouraging attendees of the workshop to take notes on their freebie notepads throughout the workshop, as well as underlining key points and

using their hands when coaching (with permission of the participant) to be able to assist the weightlifter in moving into the correct

positions/shapes (Dunn & Dunn, 1992). Although pedagogy is still in its early years, and more integrated psychometric instrumentation and

Note: All UKSCA & BWL technical models used in this practical are referenced from official qualifications and workshop material and do not have official supporting
articles/documentation to reference in accordance to APA 6th guidelines.
models are currently being researched (Cassidy, 2004), we as practitioners must always go on current known research, this being the reasoning

for continuing to use Grabowski & Jonassen’s (1993) elements of individual learning styles within the upcoming workshop.

Critical Evaluation of Current Evidence Base

Evidence behind Introduction/Evidence for use of question and those clicker things

Research by Karpicke, (2016) highlights the use of testing and how retrieval-based learning improves learner long-term memory recall.

Although research in this areas is usually conducted over multiple retrieval/recall sessions, and with differing lengths of time between revision

and recall, the conclusion is still that amongst college-age and above students, this is the preferred method over repetitive reading ("A powerful

way to improve learning and memory", 2018).

Evidence behind doing an Olympic weightlifting practical

The use of a combination of the UKSCA and BWL Olympic weightlifting technical models was used to justify the systematic coaching process

of the practical, although appropriate APA format references were not available due to the UKSCA workshops and BWL qualifications lacking

sufficient authors, publishers, publishing dates, it is the most looked upon and credited technical model’s there are within the UK.

Note: All UKSCA & BWL technical models used in this practical are referenced from official qualifications and workshop material and do not have official supporting
articles/documentation to reference in accordance to APA 6th guidelines.
Evidence behind general injury & definition stats

Evidence used in injury definitions such as Fly et al. (1998) is more commonly used amongst weight training papers as their definition of injury, hence the

support for this research. Evidence used to support injury statistics in weightlifting such as by Kerr, Collins & Dawn Comstock (2010), although one of the

most comprehensive studies of weight training injuries to date (of which there are not many), it is exactly that, injuries in weight training, which is vastly

different in exercises, intensities, movements, participants, ability, and coaching, than Olympic weightlifting, and therefore does not accurately represent

the most common population of Olympic weightlifters. Unfortunately there are no large-scale studies on general population Olympic weightlifters, only

elite-level US Olympic weightlifters training within a 4-year ‘Olympic cycle’, which I have used later in the PowerPoint.

Evidence behind mechanisms behind the injuries

A quote from Werner & Plancher (1998) highlight the problem faced when building this workshops material, “Little scientific data regarding the wrist in

sport are available to assist the clinician”, therefore evidence and research presented in the mechanisms section, such as the YouTube clips, although

anecdotal, are from reputable physiotherapy education resources, as well as cater for the more visual learners within the group.

Note: All UKSCA & BWL technical models used in this practical are referenced from official qualifications and workshop material and do not have official supporting
articles/documentation to reference in accordance to APA 6th guidelines.
Evidence behind preventative strategies

Evidence presented in this section of the workshop was taken from throwing/overhead-sport athletes, such as work by Chu, Jayabalan, Kibler & Press

(2016), as unfortunately there are no studies on the mechanisms to injury specific to Olympic weightlifters, as a result the transferability from

throwing/overhead athletes was deemed the closest available.

Evidence behind practical manual therapy

Much of the manual therapy testing comes from physiotherapy backgrounds, again from throwing sports, but the principles behind the common injury sites

and early-identification of shoulder, elbow, and wrist injuries still apply to Olympic weightlifters, hence the inclusion of this section within the workshop.

Evidence behind the final slide Preventative Measures Part 2

High intraclass correlation coefficiencies were used and reported within this section, by Borg (1998) regarding his RPE scale. The research

behind this RPE scale, although focused more on team sport feedback, has been shown to be reliable enough to be used across all sports, with

research such as (Kraemer et al., 2002) suggesting the use of RPE to be the only accurate form of feedback there is when it comes to

weightlifting sports/training.

Note: All UKSCA & BWL technical models used in this practical are referenced from official qualifications and workshop material and do not have official supporting
articles/documentation to reference in accordance to APA 6th guidelines.
PEDro Scores

See Table 1 in appendix for PEDro scores.

Conclusion

Although references were used regarding throwing athletes, research is limited on Olympic weightlifters, with only one large study to date, an

American elite-level Olympic weightlifting analysis completed during a US Olympic training camp “using very high training volume and

intensities” (Calhoon, & Fry, 1999). This does not accurately reflect the more general and most common population of Olympic weightlifters,

nor does it reflect the clients and athletes of the coaches that may attend this workshop, is it simply the most comprehensive study regarding

specifically Olympic weightlifting injuries to date.

Implications for Further Research

This workshop highlights the need for longitudinal research on the injury rates, causes, effects, and preventative measures of those who utilise

Olympic weightlifting movements and derivatives within their training.

Note: All UKSCA & BWL technical models used in this practical are referenced from official qualifications and workshop material and do not have official supporting
articles/documentation to reference in accordance to APA 6th guidelines.
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articles/documentation to reference in accordance to APA 6th guidelines.
 Appendix

Table 1

PEDro Score For a Randomly Allocated Selection of References

Reference Criteria 1 2 3 4 5 6 7 8 9 10 11 Relevance Notes

Foam rolling is a key tool Small sample size (18). Although inconclusive evidence
Cavanaugh et utilised by S&C coaches, was found in support of muscular activation, there is
al. (2017)       weightlifting coaches, and supporting evidence in regards to the use of foam rolling
personal trainers. as a positive warm up strategy.
One of the largest and few
Although elite-level Olympic weightlifters were used,
studies to date reviewing the
Fry et al (1998)       injuries of Olympic
data gathered over a four year period can assist in
identifying trends regardless of experience.
weightlifters
Number of participants of each study was not
standardised, giving some of the results data less value
A good injury comparison
Keogh & than if all sports had even or similar participation levels.
between all sports that evolve
Winwood       around weight lifting in some
And although all athletes’ levels were similar, there
(2016) were mixed male and females within all studies; it
capacity
would have been helpful to separate the genders to
enable trends to be identified, if any.
Olympic weightlifting can The definitions of injury were all so that every injury
only be participated within a was classified as a ‘weight training-related’ injury, even
gym environment, therefore if it was simply by dropping a weight on ones foot.
Kerr (2010)     many gym-related injuries Although applicable to a gym scenario, not the type of
must be acknowledged, to evidence that could not be simply avoided by proper
then be prevented. supervision.
Exactly the research needed to
justify the need for this Although this research is dated and sample sizes may
workshop, to back up the not be large enough to draw upon conclusions for the
Kulund et al. claims made in the workshop, whole Olympic weightlifting population, the evidence
(1978)
     and to encourage further shown in this piece is still strong, and supports the
research in the area of argument for the need for further and continued research
Olympic weightlifting within Olympic weightlifting,
injuries.
Pierce et al.     RPE has been shown to be Lactate and heart rate are not of a great concern to

Note: All UKSCA & BWL technical models used in this practical are referenced from official qualifications and workshop material and do not have official supporting
articles/documentation to reference in accordance to APA 6th guidelines.
 (1993) one of the most effective weight lifting coaches, due to the relatively low aerobic
monitoring solutions within contributions Olympic weightlifting demands.
weight lifting training
programmes. This study
supports that notion and gives
evidence and
recommendations to exercise
prescription to suit different
levels of reported RPE.
Analysis was on team sports only. And although most
Injury prevention programmes
injury prevention strategies can be implements by sports
are useful for all sports and
coaches, more intimate strategies such as massage
Soomro et al. for athletes of all ages.
(2016)      Especially young athletes, as
therapy or clinical assessments must be conducted by
qualified and licensed practitioners, something most
they may partake in multiple
grass-root clubs will not have, or have the money to pay
sports.
for.
The age bracket within the
eligibility criteria is perfect
for the participants of this
Nothing new was found, only supporting evidence that
workshop, as well as the
Su et al. (2017)      recent drive of British Weight
foam rolling is more effective than static or dynamic
stretching in increasing ROM about the knee and hip.
Lifting’s youth development
programmes. Good sample
size (30)

Note: All UKSCA & BWL technical models used in this practical are referenced from official qualifications and workshop material and do not have official supporting
articles/documentation to reference in accordance to APA 6th guidelines.