Strategies to prevent injury in adolescent sport: A systematic review. British Journal of Sports Medicine, 41, 627-638

Musgrave Park Hospital, Belfast, Northern Ireland.
British Journal of Sports Medicine (Impact Factor: 5.03). 11/2007; 41(10):627-38. DOI: 10.1136/bjsm.2007.035691
Source: PubMed


This systematic review set out to identify randomised controlled trials and controlled intervention studies that evaluated the effectiveness of preventive strategies in adolescent sport and to draw conclusions on the strength of the evidence. A literature search in seven databases (Medline, SportDiscus, EMBASE, CINAHL, PEDro, Cochrane Review and DARE) was carried out using four keywords: adolescent, sport, injury and prevention (expanded to capture any relevant literature). Assessment of 154 papers found 12 studies eligible for inclusion. It can be concluded that injury prevention strategies that focus on preseason conditioning, functional training, education, balance and sport-specific skills, which should be continued throughout the sporting season, are effective. The evidence for the effectiveness of protective equipment in injury prevention is inconclusive and requires further assessment.

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Available from: Chris Bleakley, Aug 22, 2014
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    • "Technical skills can be developed at ages as young as 7–9 years (Branta et al., 1984; McMorris, 1998). Although the majority of the technical instructions at this level will be explicit, emphasis on correct technique and safety in the tackle should start from a young age and increase as the player gets older (Abernethy and Bleakley, 2007; Van Tiggelen et al., 2008). Accordingly, national injury prevention programs, such as those mentioned earlier, generally try to encompass learning of proper techniques for injury prevention at all levels of play (from under-6 to senior adult level). "
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    ABSTRACT: The tackle event in rugby, places both ball-carrier and tackler at a high risk of injury at all levels of play. To reduce this risk of injury, risk factors need to be identified. Attitude and behaviour have been identified as risk factors for injury in other sports, and probably also have a role in rugby. The purpose of this study was to assess the attitude and behaviour of players in training and match play with regards to safety and performance. A questionnaire was designed to assess attitude (importance) and behaviour (frequency and quantity) among junior (under 19) players on a 5-point Likert Scale. Questionnaires were handed out to 220 players (10 schools) at a tournament and 75% (9 schools, n=164) were returned for analysis. During training and match play, players’ mean ratings were higher for improving performance than for injury prevention. However, a level of importance was evident for injury prevention. When executing a tackle the aim is to dominate the contact situation and prevent the ball-carrier from gaining territory and retaining the ball. Therefore, players, coaches and administrators need to find the most suitable balance between injury prevention and performance during training within their team setting. This process may be facilitated by modifying the current equipment and training drills used to train the tackle, and the time of season during which tackle technique training occurs. Equally important, players should learn proper tackle technique at a younger age, with the importance of safety emphasised from all information sources.
    Safety Science 02/2012; 50(4). DOI:10.1016/j.ssci.2011.08.061 · 1.83 Impact Factor
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    • "Finally, an economic limitation would be the cost associated with upgrading all playing facilities to meet a pre-determined safety standard when compared to the cost of treating the injuries sustained due to poor-quality playing facilities. Several systematic reviews on sports injury prevention strategies have been published and some conclude that there are a range of interventions that can be effective even though the methodology is generally poor to moderate (Aaltonen, Karjalainen, Heinonen, Parkkari, & Kujala, 2007; Abernethy & Bleakley, 2007; Gilchrist, Gitanjali, & Marshall, 2009; Junge & Dvorak, 2004; Parkkari, Kujala, & Kannus, 2001). A number of models have also been developed to identify sports injury risk factors and establish preventive strategies (Bahr & Holme, 2003; Finch, 2006; van Mechelen, Hlobil, & Kemper, 1992). "
    International Journal of Injury Control and Safety Promotion 03/2010; 17(1):69-72. DOI:10.1080/17457300903524896 · 0.67 Impact Factor
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    • "The strategies could be divided into prophylactic devices, functional training, technique training, change of game rules, and education. [177]. "
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    ABSTRACT: This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing - a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms). Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60-90 ms). The failure supination or inversion torque is about 41-45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative. Immobilization should not be used as it results in joint stiffness, muscle atrophy and loss of proprioception. Traditional Chinese medicine such as herbs, massage and acupuncture were well applied in China in managing sports injuries, and was reported to be effective in relieving pain, reducing swelling and edema, and restoring normal ankle function. Finally, the best practice of sports medicine would be to prevent the injury. Different previous approaches, including designing prophylactice devices, introducing functional interventions, as well as change of games rules were highlighted. This paper allows the readers to catch up with the previous researches on ankle sprain injury, and facilitate the future research idea on sport-related ankle sprain injury.
    Sports Medicine Arthroscopy Rehabilitation Therapy & Technology 08/2009; 1(1):14. DOI:10.1186/1758-2555-1-14
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