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    How does Biology Impact Risk of Injury

      |  Jan 20, 2023

    Injuries happen to many of us, but why does it seem like some people get injured more often than others? It turns out that certain biological factors can make some individuals more susceptible to injury, and understanding these factors can help individuals take preventative measures to reduce their risk of injury.

    A big part of injury prevention is proper strength training and conditioning, as well as proper technique in those areas. The expertise of a trainer, coach, or physical therapist is crucial. This article will not focus on this area but instead will focus on biology around injury and the actions everyone can take to impact that biology 

    The Causes of Injury

    Basic Anatomy

    Most injuries happen due to a breakdown in the structure of our bones, tendons or ligaments. All three of these are composed of proteins called collagen, and it is the role of these proteins to give our joints strength, mobility, and resilience against force - such as when you suddenly change direction, or dramatically increase your speed or intensity.

    As we look at the biological basis of injury, it is no surprise that the quality of the collagen plays an important role in determining our risk for injury.

    Genetic Factors

    The first major factor influencing injury risk is genetics. Studies have shown that certain genetic variations can make individuals more susceptible to injury. For example, the COL1A1 and COL5A1 genes, which are responsible for collagen production in the body, have been linked to injury risk. Individuals with variations in these genes may have weaker connective tissues, making them more prone to injury.

    Some professional sports organizations test for these genetic variants, but testing for these genetics isn’t widely available to the public. If you are interested in getting tested, your best bet is to work with a licensed genetic counselor.

    Physiological Factors

    Our body’s internal physiology can also play a major role in influencing injury risk. In this case, glucose control and inflammation management are two key environmental factors that have been linked to injury risk.

    Blood glucose control

    It is well known that high blood glucose levels can lead to an increased risk of heart disease and stroke. Glucose can deposit into blood vessels and cause damage. However, glucose can also deposit elsewhere, including into the tissues that form our muscles, ligaments and tendons. These tendons are known as advanced glycation end products (AGEs) and in turn can weaken the tendons and increase risk of injury.

    In one research study, tendons taken from patients with diabetes, who had high glucose levels over a long period of time, were found to be significantly weaker than those from people with normal glucose control.

    Inflammation management

    Inflammation is a process in which your immune system becomes overactive and attacks healthy tissues. Inflammation can happen for many reasons, and the most common root causes of inflammation are diet, environmental exposures and stress. Inflammation is especially insidious, and low-level chronic inflammation is unfortunately very common, even among people who live healthy lifestyles such as athletes.

    Inflammation has a variety of negative impacts on our bodies, and our muscles and bones are no exception. Bone loss is a well described consequence of chronic inflammation. The mechanism by which this happens is that inflammation causes an imbalance between osteoblasts and osteoclasts, the different types of cells that make and break down bone. So chronic, low-level inflammation can lead to weaker bones, making them more prone to injury.

    Actions We Can Take

    As mentioned previously, proper strength training, conditioning, and flexibility are all essential to injury prevention. But what can we do to affect some of the other biological factors that influence our risk of injury?

    Unfortunately, there isn't anything we can do to change our genetics. However, understanding our genetic risk profile could drive us to prioritize preventative actions. But good news - the other two physiological factors - glucose control and inflammation management are things we can impact.

    Controlling blood glucose

    There are many approaches that one can take to improve glucose control, such as avoidance of refined sugars and excess carbohydrate intake. However, continuous glucose monitoring is a tool that  should be a cornerstone of any glucose control program. Continuous glucose monitoring helps to track real-time glucose levels and can provide valuable insight into how you respond to different foods and other factors in your life, allowing for changes in eating and activity levels that can lead to improved control. Truly optimal glucose control entails average glucose levels below 100mg/ml, and no spikes above 140mg/ml.

    There is also a role for supplements such as Berberine in controlling glucose. Berberine has been shown in multiple clinical studies to be effective at lowering blood glucose, so this can be an effective addition for those who struggle in this area.

    Managing inflammation

    Controlling inflammation is paramount in maintaining a healthy body and lifestyle. The most common sources of inflammation are diet, the environment, and stress, and addressing these sources is key. However, this can at times be quite difficult and take time to address. While these issues are being worked out, inflammation can be reduced more rapidly through treatments such as IV Vitamin C therapy, which has been shown to have powerful anti-inflammatory effects. For many people, this initial reduction in inflammation can kickstart their success in addressing the root causes of chronic inflammation.

    In conclusion, there are many biological factors that influence our risk of injury, and it is important to be aware of how these factors influence our health and risk of injury. While you cannot change your genetics, you can take proactive steps to control your blood glucose and manage inflammation. This will give your body the best chance of success in preventing injury and sustaining the levels of physical activity that will improve your life long term.