Sports Medicine Research: In the Lab & In the Field: Injury Prevention Warm-Up Has Immediate Benefits (Sports Med Res)


Wednesday, November 25, 2015

Injury Prevention Warm-Up Has Immediate Benefits

Landing Technique and Performance in Youth Athletes After a Single Injury-Prevention Program Session

Root H, Trojian T, Martinez J, Kraemer W, DiStefano LJ. J Athl Train. Published Online First: November 2, 2015; DOI: 10.4085/1062-6050-50.11.01

Take Home Message: An injury prevention program warm-up helped immediately improve landing mechanics in a youth population without compromising performance measures. 

Several Sports Med Res posts have discussed the benefits of injury prevention programs (see below).  Unfortunately, many athletic programs have yet to incorporate injury prevention programs into practices. If these programs have immediate short-term benefits compared with “traditional” warm-up activities then coaches and athletes may be more likely to adopt injury prevention programs as a warm-up.  Therefore, the authors of this randomized trial investigated the immediate effects on landing techniques and performance measures of 3 warm-up protocols: static warm-up (jog followed by traditional stretching of major muscle groups), dynamic warm-up (functional activities that were gradually increased in intensity), and injury prevention warm-up, which was similar to a dynamic warm up with plyometrics and balance activities added. Eighty-nine youth participants between 5th and 9th grade performed performance tasks (i.e., vertical jump, long jump, shuttle run, and jump-landing task) prior to randomly completing one of the 3 warm-up protocols.  The participants then completed the performance tasks again within 10 minutes of finishing their randomized warm-up protocol.  The participants were unaware of which program was the injury prevention warm-up. The evaluators were blinded to time (pre or post) as well as to what warm-up the participants completed.  The injury prevention warm-up resulted in a greater improvement in landing techniques (as assessed by the Landing Error Scoring System) in comparison to the dynamic and static warm ups protocols.  There were no differences in changes in any of the performance variables (i.e., vertical jump height, long jump distance, shuttle run time) among the 3 groups. 

The authors of this study discovered that an injury prevention program can improve landing mechanics immediately post program while not altering performance in a youth population.  An improvement in landing mechanics immediately after a 12 minute warm-up could be part of the reason that injury prevention programs successfully reduce the risk of injuries. These programs may place an athlete in more optimal landing positions.  It was interesting that these authors found no improvements in performance post dynamic warm-up or that there were no decreases in performance post static warm-up despite previous research findings.  It is exciting to see that there are such positive results in a younger cohort.  Future research should focus on long-term implications within this age group, since they are developing neuromuscular patterns.  This could help decrease their risk for injury as they get older if they develop more optimal neuromuscular patterns.  It may also be interesting to know how the athletes “felt” in regards to physical and mental preparation after these types of warm-up programs.  Athletes are often accustomed to dynamic or static stretching as part of their pre-activity routines.  This deviation from the “norm” may take time to educate athletes about these programs and help them feel more comfortable with the new warm-up.  Clinically, the authors provide more evidence to support replacing our traditional warm-up programs with an injury prevention program. 

Questions for Discussion:  Are there any concerns that you have heard from athletes regarding injury prevention programs?  What has your experience been with trying to integrate an injury prevention program?

Written by: Nicole Cattano
Reviewed by: Jeffrey Driban

Related Posts:

Root H, Trojian T, Martinez J, Kraemer W, & DiStefano LJ (2015). Landing Technique and Performance in Youth Athletes After a Single Injury-Prevention Program Session. Journal of athletic training PMID: 26523663


Stephan Bodkin said...

This article does a great job not only addressing the effectiveness and importance of an injury prevention warm-ups, but also the challenges that are present to make it highly used. We've seen from many articles that these warm-ups make a difference; however, most used secondary schools where coaches and athletes are accustomed to their usual warm-up routine. I feel like using a younger cohort will implant this "different" routine at an earlier age, and hopefully we will see an increase of teams implementing injury prevention warm-ups in the future. I also agree that another advantage of using a younger cohort is developing proper neuromuscular firing patterns. Very important and often overlooked! Great Article!

Nicole Cattano said...

Great point Stephan! I think that years ago, the "dynamic" warm up was a shift in the mindset and culture of the warm up. So hopefully we will see early integration of these programs (which has been shown to have greater impact in injury reduction) which will lead to less resistance to these "new" warm-ups.

Caroline L. said...

This article clearly states the design’s limitations in only evaluating acute outcomes and although more long term outcomes are not focused on in this research design, the improved LESS scores indicates promising results for similar progams. Because research has indicated an increased risk of injury at the end of games, it would be useful to evaluate if the athletes maintain improved LESS scores after competition, practice or other such fatiguing exercises. I agree that applying this program into an athlete’s warms up is a creative way to encourage coaches to incorporate an injury prevention program into a team's basic routine. In my personal experience, I have found it difficult to convince coaches to change or incorporate different injury prevention techniques in a team’s daily routine. However, because this program includes similar dynamic warm up exercises, it may only seem like a small change to coaches so they are more receptive to using it. The program also includes an element of education for proper landing techniques. Directing education of proper landing techniques towards youth athletes consistently and beginning at a young age may have implications for reducing unsafe landing patterns as they age over time. This article provides a solid base for future research in regards to injury prevention programs.

Nicole Cattano said...

I think Caroline made a great point. While there are immediate benefits, it would be interesting to see what the effects are after being fatigued by their sport activity. I had similar concerns from the coaches that I work with, but there was a smooth transition since parts of their "traditional" warm up included some of these components.

Kyle Murray said...

I think with these results it is hard to really argue against using these injury prevention programs, yet I feel as though coaches may still object due to being stuck in old habits, which is frustrating as a healthcare provider. I do think that showing coaches that these injury prevention programs could influence them by saying that these programs contain many similar exercises that they are already accustomed to using during the traditional dynamic warm up. I think that showing the coaches the results on decreased injury risk should hopefully be more than enough incentive for them to make the transition.

Nicole Cattano said...

I agree Kyle! I also think that approaching a coach earlier is better to help them get the idea in their head for a season that is still a couple of months away.

Perhaps present them with some facts from their most recent season. For example, "there seemed to be a lot of ankle sprains this past season..."

Best of luck trying to get them on board!

Chris Donner said...

I agree with Kyle with the fact that it is very hard to convince coaches to change their ways. Many coaches are of the mindset "Why should I spend my practice time doing this?" especially when there are no proven results. As bad as it may sound, it may take a traumatic injury where a player misses significant time to convince a coach to implement an injury prevention program. That is somewhat the case at my high school. Last year, there were several traumatic injuries with significant time missed on the girls basketball team. This year, the coach has agreed to implement an injury prevention program.

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