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Warm-up exercises prevent knee and ankle injuries

Intoduction

A new Norwegian research study published in the British Medical Journal shows that a structured programme of warm-up exercises can prevent knee and ankle injuries in young people playing sports. This study is the first randomised controlled trial among adolescents with a sufficient sample size to show that acute knee or ankle injuries can be reduced by 50% and severe injuries even more. Preventive training should be routine in training programmes for adolescents in pivoting sports.

 

Studies from Scandinavia document that sports injuries constitute 10-19% of all acute injuries seen in emergency departments, and the most common types are knee and ankle injuries. Serious knee injuries, such as injuries to the anterior cruciate ligament, are a growing cause of concern. The highest incidence is seen in adolescents playing pivoting sports such as football, basketball, and team handball. In these sports, women are three to five times more likely to contract a serious knee injury than men.

 

Previous studies indicate that it may be possible to reduce the incidence of knee and ankle injuries among adolescents, but these studies are small and mainly non-randomised with important methodological limitations. In light of that, and because of the high incidence of knee and ankle injuries in youth team handball, the Oslo Sports Trauma Research Center in cooperation with the Norwegian Handball Federation conducted a randomised controlled trial to investigate the effect of a structured programme of warm-up exercises used to prevent acute injuries of the lower limb in young people playing sports.

 

The study was carried out during the 2002-2003 season among 16-17 year olds female and male players from the central and easternNorway. A structured warm-up programme was developed by medical staff from theOsloSportsTraumaResearchCenterand coaching staff from the Norwegian Handball Federation. Half of the participants (61 clubs, 958 players) were asked to follow a 15-20 minutes programme of exercises with the ball, including the use of the wobble board and balance mat for warm up, technique, balance, and strength. Instructors from the handball federation visit the clubs at the start of the season, with an follow up midway through the season. The other half of the participants (59 clubs, 879 players) were asked to do their training as usual during the season. Ten research physiotherapists who were blinded to group allocation recorded injuries in both groups in a web based database in which all the data were coded anonymously.

 

The main observation of this study was that the incidence of knee and ankle injuries can be reduced by at least 50%, and severe injuries even more by a structured warm-up programme designed to improve awareness and knee and ankle control during landing and pivoting movements. Preventive training should be routine in training programmes for adolescents in pivoting sports. It seems reasonable to assume that the warm-up programme also could be modified to be used in other similar sports such as football, basketball, and volleyball, and in players as young as 10-12 years.

 

 

The principal investigator for this study was physical therapist Odd-Egil Olsen from the Oslo Sports Trauma Research Center, with physical therapist Grethe Myklebust, professor Ingar Holme, professor Lars Engebretsen and professor Roald Bahr.

 

 

Read more about the study, and see the warm-up programme here. 

 

Read the article here.