Warm-ups score in preventing high school sports injuries

Warm-ups before practice cut down on knee, ankle, and other lower extremity injuries in female high school athletes, a randomized trial showed.

Acute, non-contact, lower-extremity injuries dropped 67% among girls playing high school soccer and basketball when coaches started practice with a prescribed set of warm-up exercises for 20 minutes, Cynthia R. LaBella, MD, of Children’s Memorial Hospital in Chicago, and colleagues found.

by Crystal Phend, Senior Staff Writer, MedPage Today November 8, 2011
Similar reductions in noncontact ankle and knee sprains and anterior cruciate ligament (ACL) injuries with the prescribed warm-ups compared with standard warm-ups were reported online in the Archives of Pediatrics & Adolescent Medicine.

The number needed to treat to avoid one injury requiring surgery was 189, which would equate to training 16 basketball coaches or 11 soccer coaches, the researchers noted.

The warm-up exercises in the trial focused on neuromuscular training – strength, balance, elasticity, and agility – and taught the girls to avoid a bad knee and hip position that increases ACL injury risk. They also were taught to land jumps with flexed hips and knees to reduce ACL strain.

Many prior studies have shown benefits of a similar neuromuscular intervention in highly-motivated, elite, or suburban athlete populations, M. Alison Brooks, MD, MPH, and Timothy A. McGuine, PhD, ATC, of the University of Wisconsin–Madison, noted in an accompanying editorial.

The novel part of LaBelle’s study was showing that the warm-up worked for an underserved and disadvantaged group of girls in low-income, mixed-ethnicity, urban communities, Brooks and McGuine wrote.

And the intervention only cost about $80 per coach – which averages out to about $7 per athlete on a basketball team or $4 each on a soccer team over one season – compared with the $100 to $200 per month some commercial programs charge per individual athlete, they noted.

“The inexpensive two-hour training for coaches of an at-risk population is money well spent,” they concluded.

But it only works if you use it, they cautioned, pointing out that about two-thirds of invited coaches didn’t opt in.

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Effect of Neuromuscular Warm-up on Injuries in Female Soccer and Basketball Athletes in Urban Public High Schools–Cluster Randomized Controlled Trial, Cynthia R. LaBella, MD; Michael R. Huxford, MEd, ATC; Joe Grissom, MPP; Kwang-Youn Kim, PhD; Jie Peng, MS; Katherine Kaufer Christoffel, MD, MPH. Arch Pediatr Adolesc Med. 2011;165(11):1033-1040. doi:10.1001/archpediatrics.2011.168.

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