Sports Medicine Research: In the Lab & In the Field: For Injury Prevention it is Better to Start Young (Sports Med Res)

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Wednesday, January 31, 2018

For Injury Prevention it is Better to Start Young

Age Influences Biomechanical Changes After Participation in an Anterior Cruciate Ligament Injury Prevention Program

Thompson-Kolesar JA, Gatewood CT, Tran AA, Slider A, Shultz R, Delp DL, & Dragoo JL. Am J Sports Med. 2017; Online Ahead of Print December 27, 2017.  

Take Home Message: Pre-adolescent female soccer athletes had decreased knee valgus during a double leg landing task after participating in an injury prevention program.  Younger athletes seem to be ideal for prevention programming.

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Previous posts have highlighted authors who demonstrated that injury prevention programs are effective at reducing anterior cruciate ligament (ACL) injuries in a variety of populations (see below).  It remains unclear as to who may benefit most from prevention programs; but, some researchers have suggested that younger athletes may benefit more than older athletes.  Therefore, these authors studied 51 pre-adolescents (10 to 12 years old) and 43 adolescent (14 to 18 years old) female soccer players to see if age influences the biomechanical changes related to an injury prevention program.  The authors performed biomechanical testing in 94 female soccer players. About half in each group completed an injury prevention program and the other half served as controls.  The injury prevention program was performed about 2 times per week for approximately 8 weeks (25 min sessions). After completing the program, the investigators repeated the biomechanical testing on all participants.  The authors found that at baseline, pre-adolescent athletes had higher initial contact and peak knee valgus angles, as well as co-contraction during weight acceptance and landing tasks in comparison to adolescent athletes.  The injury prevention program improved pre-adolescent peak knee valgus during a double leg landing task in comparison to pre-adolescent controls.  The authors observed no other differences between participants who did or did not complete the prevention program.

Biomechanical improvements from an injury prevention program are primarily observed in pre-adolescent female soccer players.  This study emphasizes the importance of trying to start prevention programming early in an athlete’s motor development.  Pre-adolescent athletes had poorer movement qualities than adolescent.  This also raises a question as to whether it may be even more beneficial to introduce these programs even earlier than 10 years of age.  However, it remains unknown how long these positive changes exist.  It would be interesting to re-test these athletes a couple of months after the cessation of the program to see if there are still benefits to the program for landing and other biomechanical measures as we saw in earlier SMR posts.  There has been previous research that has shown that frequency and compliance can influence the effectiveness, therefore it would be interesting to see if increasing the frequency or monitoring the compliance of the injury prevention program further aided in the improvements.  While these authors excluded athletes with a previous knee injury, I think it would be very valuable to see what type of an effect these programs can have on already at-risk individuals.  Overall, this is another study that shows injury prevention programs should be introduced early in an athlete’s career. 

Questions for Discussion:  Are you currently incorporating injury prevention programming?  How young do you think you would target injury prevention programming?

Written by: Nicole Cattano
Reviewed by: Jeffrey Driban

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