Sports Medicine Research: In the Lab & In the Field: Injury Prevention for 6 Weeks = Better Landings for 6 Months (Sports Med Res)


Wednesday, February 17, 2016

Injury Prevention for 6 Weeks = Better Landings for 6 Months

The Effects of an Injury Prevention Program on Landing Biomechanics Over Time

DiStefano LJ, Marshal SW, Padua DA, Peck KY, Beutler AI, de la Motte SJ, Frank BS, Martinez JC, & Cameron KL. Am J Sports Med. Published Online First: January 20, 2016; DOI: 10.1177/0363546515621270

Take Home Message: Six weeks of a dynamic injury prevention warm-up program results in biomechanical improvements that last up to 6 months after stopping the program.  It may be important to perform these programs continually or reinforce these programs every 6 months.

Injury prevention programs successfully reduce the risk of injury in many physically active populations through improvements in movement patterns; however, it is unclear how long these improvements last after the end of the prevention program.  One theory is that prevention programs cause transient improvements, but an athlete then slides back to old patterns over time.  However, once a movement pattern is neuromuscularly reprogrammed it is possible that this should result in permanent changes.  The authors of this study aimed to investigate the immediate and long-term effects of an injury prevention program on vertical ground reaction force and landing error scoring system (LESS) scores in comparison with a standard warm up in a random sample from a randomized trial of 1104 military cadet.  Cadets had ground reaction forces and LESS assessments conducted before, after, and at 2, 4, 6, and 8 months after completion of a 6-week standard warm up or a dynamic injury prevention program.  The authors found that cadets in the dynamic injury prevention program had reduced vertical ground reaction forces at most time points post-intervention in comparison with cadets in a standard warm-up program.  Compared with before the dynamic injury prevention program, cadets had reduced ground reaction forces at 2-, 4-, and 6-months post-dynamic intervention, but not at 8-months post program. The cadets’ vertical ground reaction force gradually returned to baseline measurements over the course of the follow-up period.  LESS scores improved in both groups immediately post, and at 4 and 6 months after the programs. 

The 6-week dynamic injury prevention program resulted in cadets landing “softer” for approximately 6 months after the cessation of the program.  Hence, the injury prevention program had a biomechanical effect and improved landing mechanics but  these benefits do not last forever.  It may be interesting to see if repeating the injury prevention program would aid in creating a more lasting neuromuscular pattern and help to avoid the deterioration to initial, faultier patterns.  This study is interesting since these programs could prevent joint injuries, which in the short-term could prevent time lost to injury and in the long-term reduce the risk of osteoarthritis. To continue to benefit from these program the authors noted that “injury prevention programs may need to be performed constantly, or at least every sport season, in order for participants to maintain the protective effects against injury.” This may be most efficiently implemented by encouraging the teams we work with to incorporate injury prevention programs into their practice routine.   

Questions for Discussion:  Are there any time periods that you feel may be appropriate to reinforce these movement patterns?  How often do you think you should reinforce movement patterns until they are permanently learned?  Do you have any experience with short- and/or long-term improvements after an injury prevention program?

Written by: Nicole Cattano
Reviewed by: Jeffrey Driban

Related Posts:

DiStefano, L., Marshall, S., Padua, D., Peck, K., Beutler, A., de la Motte, S., Frank, B., Martinez, J., & Cameron, K. (2016). The Effects of an Injury Prevention Program on Landing Biomechanics Over Time The American Journal of Sports Medicine DOI: 10.1177/0363546515621270


Alexandra DeJong said...

I agree that injury prevention programs are vital to clinical practice, and this study raised interesting points about frequency of implementation. However, I am wondering if these results can be extrapolated to other types of injury prevention protocols for sports where landing is not an integral component to the movement patterns. I think it would be interesting to see how the duration of effects of injury prevention programs vary for in terms of effects of other forms of neuromuscular training, and what the cut off is for lasting effects in further reports.

Nicole Cattano said...

Hi Alexandra- thank you for your comment. It's a great point. Most injury prevention research has been in soccer players (largely a non-landing sport). But there is a large amount of potential here. Establishing cut offs for diminishing returns will be important as far as timing of
programs and refresher courses. Great points Alexandra.

Anonymous said...

I think this is interesting research. Some coaches prefer the static stretching, especially at the high school level. It is getting better, but this research can really help support the influence of a good dynamic warm-up. Another great future study could be looking at the active population who have sustained an injury, recovered, and are now back in sport and how the likelihood of soft landing mechancis is with a dynamic warm-up compared to a static or lack of warm-up. Do you think that a dynamic cool-down also plays a role in the decrease of landing mechanics?

Nicole Cattano said...

Thanks for the comment! I think the notion of static stretching pre-activity is one that there is overwhelming evidence that it doesn't provide any preventative benefit, and that it may actually hinder athletic performance. I think people static stretch after activity to try to increase tensile lengths on warmed tissue.

The anonymous comment about a dynamic cool-down is one that is interesting and I don't think anyone has looked at. Fatigue can certainly play a factor in landing mechanics, and emphasizing some of these important factors in a fatigued state may be very beneficial.

Does anyone have any thoughts about a dynamic cool-down???

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