Some personal info: I am MD and a specialist in sports and exercise medicine, have long experience in clinical work related to sports injuries, have published 150+ scientific papers related to physical activity, sports and health in international peer-review journals, have worked since 2004 as a professor of sports and exercise medicine in the University of Jyväskylä.
Abstract
Sports injuries are common and preventive strategies are needed. Ideal steps in injury prevention include:
• The extent of the problem as well as the specific mechanisms and factors involved should be identified in each sport • Measures likely to reduce the risk of injury should be introduced and their effect monitored
There are different strategies to prevent sports injuries. On one hand, population strategy may focus on giving general information to all using public media, and, on the other hand, teaching individuals (trainers, coaches, team physiotherapists & physicians) have a challenge how to identify injury-prone athletes and to tailor their training and rehabilitation programs. First, just a sound knowledge of risks is likely to have a preventive effect. Secondly, giving advice how to prevent the injury is likely to increase the preventive effect.
A resent study on top-ranking Finnish athletes showed that the most common specific problem among swimmers was overuse injury in the shoulder, 40% of athletes having a shoulder problem during the 12 month study period (Ristolainen et al. unpublished data). Another interesting finding was that acute injuries in the swimmers occurred mainly (68% of the injuries) when practising another sport, while overuse injuries occurred mainly when swimming.
Historically changes in rules and equipment/protective equipment/supports have been shown to change the injury profile among athletes most clearly.
A resent systematic review of the effects of randomized controlled interventions to prevent sports injuries (Aaltonen et al. 2007) shows evidence that interventions of various kinds may prevent sports injuries: On the basis of five trials including six different comparisons (2446 participants) either custom-made or prefabricated insoles compared to no insoles reduced lower limb injuries in military recruits (risk reduction ? 50% in four comparisons). All seven studies investigating external joint supports (10300 participants) showed a tendency to prevent ankle, wrist or knee injuries (risk reduction ? 50% in five studies). Additionally, all six multi-intervention preventive training programs (2809 participants) were effective in preventing sports injuries (risk reduction ? 50% in five studies). However, it is to note, that there may be many effective means of preventing sports injuries, which have not been studied using randomized designs, such as a rule change and the use of protective equipment. The systematic review focused only on interventions studied in randomized trials.
The future research should focus to commonly practiced and high risk sports including modern sporting trends. Additionally, in future studies, issues concerning the acceptability, compliance, cost-effectiveness, and long-term adherence of the preventive measure should be well evaluated.
We need more sports-specific scientific data on how to prevent injuries. However, many preventive measures can be done on the basis of current clinical and scientific knowledge. The following are ten general guidelines to start injury prevention:
- Choose a safe sport as well as a proper place and surface
- Treat and rehabilitate your old injuries
- Start all new training modalities progressively
- Learn the techniques and train so that you are fit enough to participate
- Remember warm-ups, recovery, rest and proper diet
- Use proper equipment including protective equipment and supports
- Follow the rules (including no doping!) and control your nerves
- Do not participate when you are sick or injured
- Remember that injury risk is higher during competition than training, but journey to training court is more dangerous than sports when only catastrophic accidents are considered
- Concentrate in what you are doing and do not go over the limits of your skills
References/additional reading:
Aaltonen S, Karjalainen H, Heinonen A, Parkkari J, Kujala UM. Prevention of sports injuries. Systematic review of randomized controlled trials. Arch Intern Med 2007;167:1585-1592.
McMaster WC, Troup J. A survey of interfering shoulder pain in United States competitive swimmers. Am J Sports Med 1993;21:67-70. Parkkari J, Kujala UM, Kannus P. Is it possible to prevent sports injuries? Review of controlled clinical trials and recommendations for future work. Sports Med. 2001;31:985–995.
