Preventing lower limb injuries

Peter Reaburn, Department of Health and Human Performance, Central Queensland University

Preventing lower limb injuries: is the latest evidence being translated into the football field?

Dara Twomey, Caroline Finch, Elizabeth Roediger, David G Lloyd

The purpose of this study was to determine the knowledge, attitudes and behaviours of coaches towards lower-limb injury prevention in Australian football. The research team from the universities of Ballarat, New South Wales and Western Australia were highly experienced and respected researchers in the area of sports injury epidemiology. The project is unique in that it is bridging the gap that many might suggest exists between sport and sports science. For this, the research team need to be congratulated.

Coaches from nine first-division teams of the Sydney Australian Football League participated in the two-part project. The first part involved the completion of a survey that examined coaches’:

  • ratings of the importance of different elements of training sessions (such as warm-up, cool-down, ball handling, sprint or endurance training) with respect to team performance and lower-limb injury prevention
  • perceptions of how specific training programs could prevent these injuries
  • general attitudes to, and knowledge of, lower-limb injury risk and prevention.

Coach ratings were collected on a five-point Likert scale from ‘little importance’ to ‘utmost importance’ or ‘strongly disagree’ to ‘strongly agree’.

The second part of the project involved direct observation and analysis of two training sessions. The skills chosen for observation included warm-up, drills/set plays, ball-handling skills, kicking skills, sprinting, weight/resistance training, jumping/landing training, changing direction/side-stepping, balance training, endurance training and cool-down.

The major outcomes of the study were:

  • Accumulating scientific evidence about the importance of training programs to prevent sports injuries is not being translated into coaching or conditioning practice.
  • The coaches strongly rated warm-up and cool-down as injury-prevention strategies, but observation of the training sessions highlighted that only one of the nine clubs had a structured warm-up and six had a cool-down.
  • The coaches rated changing direction and side-stepping of little/no importance for safety. This finding was translated into training practice, with the researchers observing little or no time spent on balance, jump/landing and side-stepping techniques. This was despite increasing research highlighting poor side-stepping skills as the major cause of anterior cruciate ligament injury in Australian football, and poor jumping and landing skills leading to lower-limb injuries.
  • Only one-third of the coaches rated balance training as important for injury prevention despite increasing evidence that it helps prevent anterior cruciate ligament and other lower-limb injuries.
  • Drills, set plays, and ball-handling and kicking skills were all considered of least importance to injury prevention.

For me, this research project highlighted four points:

  • Coach attitudes and practices regarding injury prevention and conditioning have not been well examined in the research literature.
  • Both sports governing bodies and peak industry bodies in sports science and medicine need to be doing more to educate coaches, conditioners, and medical and allied health support staff on not only specific injury-prevention strategies but conditioning practices in general.
  • Coaches rank injury prevention lower than general training session needs and team performance when sports science suggests the potential is there to combine these two factors.
  • The research highlights that more needs to be done by both sports science and sport to ‘bridge the gap’ between the two. The challenge is how?
Source: Sports Coach Volume 30 Number 3