What Happens After Injury Prevention Programs: The Need for Ongoing/Seasonal Implementation

Warmup
Chinese wrestlers warm-up before strength training.

Injury prevention is always a hot topic in sports given the common goals to maximize performance and minimize playing time lost. To date, there have been a number of studies completed that look at the implementation of different warm-up programs and their effects on injury risk (one of my favorites being the famous FIFA 11+ study). And while the literature is robust in support of the effectiveness of these programs, they generally lack information on length and retention.

However, coming soon to print in the American Journal of Sports Medicine is an article that talks about just that – how long the effects of an injury prevention program last. The study, titled The Effects of an Injury Prevention Program on Landing Biomechanics Over Time, looked at two randomly assigned groups of military recruits: one to a traditional warm-up and another to a 10 minute Dynamic Integrated Movement Enhancement (DIME) injury prevention program. The program was carried out for 6 weeks, after which the recruits were monitored every 2 months for 8 months post-intervention for jump ground reaction forces and injury rate. Authors DiStefano et al found that the recruits that participated in the DIME program had significantly decreased jump ground reaction forces at the 2, 4, and 6 month follow-ups but no significant difference at the 8 month follow-up. In addition, there was an overall downward trend, but lack of statistical significance, for injury risk that also dissipated by the 8 month follow-up.

This study is important in understanding the need for ongoing injury prevention programs. For our sports teams, it’s telling them that these programs must be carried out at least once every season. However, what does it mean for our patients?

I’ve written before on the topic of injury being the greatest risk factor for re-injury. However, I’ve always considered this to be a reflection of a flawed rehabilitation model – indications of room for improvement in both our treatment techniques as well as our return to play criteria. But this article suggests that perhaps testing out of the best return to play measure may still leave you at risk for re-injury if poor patterns also return 6 months post movement re-education. I’m not sure whether the answer is further rehabilitation into the return to play period, or periodic check-ins for the athletic lifespan; all I know is that the story doesn’t end at discharge.

** Not surprisingly, DIME injury prevention program elements look at lot like FIFA11+, such as the side hop, jump squat, and side plank. See the full list of exercises for both injury prevention programs here – DIME & FIFA11+.


Resources:
http://ajs.sagepub.com/content/early/2016/01/20/0363546515621270.full.pdf+html
http://bjsm.bmj.com/content/49/9/577.full

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