Effects of an Injury Prevention Program on Landing Biomechanics Over Time

LJ, Marshal SW, Padua DA, Peck KY, Beutler AI, de la Motte SJ, Frank BS,
Martinez JC, & Cameron KL. Am J Sports
. 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.

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. 

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.   

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?

Nicole Cattano
by: Jeffrey Driban


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