The
Effects of an Injury Prevention Program on Landing Biomechanics Over Time
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
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.
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.
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.
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?
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
by: Nicole Cattano
Reviewed
by: Jeffrey Driban
by: Jeffrey Driban
Related
Posts:
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
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.
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.
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?
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???