Sports injury prevention
Sports participation is important from a public health perspective. There is no longer any doubt that regular physical activity reduces the risk of premature mortality in general, and of coronary heart disease, hypertension, colon cancer, obesity, and diabetes mellitus in particular. The question is whether the health benefi ts of sports participation outweigh the risk of injury and long-term disability, especially in high-level athletes? A study from Finland has investigated the incidence of chronic disease and life expectancy of former male worldclass athletes from Finland in endurance sports, power sports, and team sports (Sarna et al., 2000). The overall life expectancy was higher in the high-level athlete compared to a matched reference group (75.6 versus 69.9 years). They also showed that the rate of hospitalization was lower for endurance sports and power sports compared to the reference group (Kujala et al., 1996). This resulted from a lower rate of hospital care for heart disease, respiratory disease, and cancer. However, the athletes were more likely to have been hospitalized for musculoskeletal disorders. A follow-up study revealed that former team sport athletes had a higher risk of knee OA, and other studies have documented an increased risk of hip and knee arthritis among former football players. Thus, the evidence suggests that although sports participation is beneficial, injuries are a significant side effect. To promote physical activity effectively, we have to deal professionally with the health problems of the active patient. This does not only involve providing effective care for the injured patient, but also developing and promoting injury prevention measures actively.
Why is injury prevention in sports important?
Injury prevention is a complex process. To prevent injury, scientists must fi rst correctly identify one or several risk factors, the mechanisms of injury, devise an effective intervention to modify it, implement the intervention with suffi cient compliance, and study the outcome of the intervention with a method that is sensitive enough to detect reductions in the injury rate which are clinically meaningful. When prevention is successful or fails, it may not always be clear which step in this chain of events was defi cient. This complexity makes injury prevention difficult, but not impossible. A number of interventions have shown a reduction in injury rates, that is, ACL injuries in team handball and soccer; ankle injuries in soccer, basketball and volleyball; head injuries in hockey and skiing; wrist injuries in snowboarding; and hamstrings injuries in Australian Rules football and soccer. The list is increasing year by year for the benefit of the athlete and the sports.
The future of injury prevention
Do we need to further develop prevention programs in the future? Year by year we seem to have more information about risk factors and their relative roles. If the relative additional risk of having specifi c risk factors is known, some individuals should probably be advised against participation in certain sports where the risk factor cannot be eliminated. On the contrary, if the effect of eliminating one risk factor after another is known, individuals may be able to participate in sports with low risk if they are compliant with their specifi c training program. The goal must be to reach a stage where the risk factors are known and where we can assign a relative risk of an injury to individuals. During the preseason examination, individuals with risk factors can then be assigned training programs that have been validated. Even at this stage, future research in this fi eld is necessary. The nature of sports is always changing—becoming faster and generally more demanding. Just think of the difference in alpine skiing over the last 25 years. In almost any sports the same increase in pace is seen. Thus, research on risk factors
and injury mechanisms must be ongoing and intervention studies crucial. In an evolving fi eld such as this, international cooperation is critical the broadest defi nition of injury would be any event occurring as a result of participation in sport (Fuller et al., 2006). Injury was then further classifi ed into medical attention injuries; those that required assessment or treatment by a medical practitioner. A further sub-division was timeloss injuries; those causing a player to miss one or more practices or games or sessions
Risk factors for injury (distant from outcome)
Injury mechanisms (proximal to outcome)
Intrinsic risk factors:
• Age • Gender • Body composition (e.g., body weight, fat mass, BMD, anthropometry) • Health (e.g., history of previous injury, joint instability) • Physical fitness (e.g., muscle strength/power, maximal O2 uptake, joint ROM) • Anatomy (e.g., alignment, intercondylar notch width) • Skill level (e.g., sport specific technique, postural stability)
Inciting event:
• Playing situation • Player/opponent “behavior” • Biomechanical characteristics
Exposure to extrinsic risk factors:
• Human factors (e.g., team mates, opponents, referee) • Protective equipment (e.g., helmet, shin guards) • Sports equipment (e.g., skis) • Environment (e.g., weather, snow and ice conditions, floor and turf type, maintenance)
INJURY
Predisposed athlete
Susceptible athlete
Pre-crash Crash Post-crash
Athlete Technique, Neuromuscular function
Training status, Falling techniques
Rehabilitation
Surroundings Floor friction, Playing rules
Safety nets Emergency medical coverage Equipment Shoe friction Tape or brace, Ski bindings, Leg padding First-aid equipment, Ambulance
Prevention of ankle injuries
- factors
Previous ankle sprain
Gender
Range of ankle
Height and weight
Foot type, foot size, and anatomic alignment of the lower extremity
Limb dominance
Ankle joint laxity and generalized joint laxity
Muscle strength
Play setting
Playing position
Shoe type
Taping
Probably the most well known and already widely preventive measures against ankle sprains are tape and braces.
Taping is a form of strapping that attaches tape to the skin in order to physically maintain a certain joint position. Taping of the ankle is the earliest prophylactic measure used to prevent ankle sprains.
What one also does is stimulate additional nerve receptors on the ankle surface and to avoid any excessive ankle movements leading to an ankle sprain.
One of the greatest benefits of taping is that one can adjust the method of taping to the needs of the athlete. This starts with the preparation of the skin. The most common preparation is to clean and dry the lower leg, ankle, and foot. A layer of pre-wrap is applied to the ankle. Some athletes prefer to shave the hair around the ankle, and to have the tape applied directly to the skin.
Braces
The concept of ankle bracing evolved from ankle taping. Braces are currently being used instead of traditional taping by many athletes at all levels of competition. They offer several advantages in that they are self-applied, reusable, and readjustable.
Braces come in three different basic varieties
- Ankle sleeves
- Non-rigid ankle braces
- Semi-rigid braces:
Leave a Reply