Edinburgh, Scotland
Thursday 17th November 2011
I have just reviewed a paper that was brought to my attention on another website & on the face of it, I'm not sure it tells us much that we didn't already expect.  However, as far as I can recall, it is the first prospective, clustered randomised controlled trial looking at the effect that a neuromuscular warm-up conducted prior to participation in training or match-play can have on reducing the risk of lower extremity injury in football or basketball athletes.

Now, before I go any further, I just want to underline that this study is NOT looking at elite athlete populations, it is looking at high school kids in the US.  It is also using a population that consists entirely of female subjects.  Therefore, any conclusions drawn from the results must bear this in mind & cannot be extrapolated to an elite athlete population.  However, what I did like about this study is that it was looking to address the practicality of implementing warm-up strategies & as a result the warm-ups were all coach-led, which does have some relevance for those of us that liaise closely with coaches when it comes to injury prevention & rehabilitation.   

The numbers of athlete exposures were substantial (28,023 exposures with the intervention groups & 22,925 with the control groups) & the subject numbers were also high enough (coaches n = 95 & athletes n = 1,558) to give some statistically powerful data.  Coaches assigned to the intervention groups were trained to lead a 20 minute neuromuscular warm-up, whilst coaches in the control groups conducted their normal warm-ups. 

The results demonstrated that in comparison with the control groups, intervention athletes had lower rates per 1000 athlete exposures of gradual-onset lower extremity injuries (0.43 vs 1.22, P.01), acute-onset non-contact lower extremity injuries (0.71 vs 1.61, P.01), non-contact ankle sprains (0.25 vs 0.74, P=.01), & lower extremity injuries treated surgically (0 vs 0.17, P=.04). Meanwhile, regression analysis showed significant incidence rate ratios for acute-onset non-contact lower extremity injuries (0.33; 95% CI, 0.17-0.61), non-contact ankle sprains (0.38; 95% CI, 0.15-0.98), non-contact knee sprains (0.30; 95% CI, 0.10-0.86), & non-contact anterior cruciate ligament injuries (0.20; 95% CI, 0.04-0.95).

What was interesting to note is that many of the intervention coaches did not use all of the prescribed warm-up (which the authors suggest might indicate that the data is underestimating the protective effect of the warm-up) because the older, overweight & less physically fit coaches tended to omit the exercises they felt unable to demonstrate themselves.  This underlines the fact that as physios or strength & conditioning coaches, if we expect our coaches to lead warm-up sessions we have contributed to, we need to ensure that we spend adequate time demonstrating to & reviewing how the coaches are performing the exercises we want our athletes to do.

Have a read through of the paper yourself & please feel free to share your opinions in the comments box below.

blog comments powered by Disqus