Ask Dr. Geier – Injury Prevention Programs

A couple weeks ago I passed the six-month anniversary of my blog. All of the posts I have written have led to many opportunities to write for other media outlets and sports organizations – The Post and Courier, STOP Sports Injuries, the Department of Health and Human Services, and the Family Circle Tennis Center – to name a few.

My 100th post is rapidly approaching. (If I count the injury posts on the Sports Injury Locator, I would total over 150.) I have truly enjoyed the blog, and I never would have imagined that I would enjoy connecting with readers interested in sports medicine around the world.

Therefore, I want to make the 100th post special. I have been receiving questions for months about me personally. “What’s your favorite sport/athlete to treat?” “Why did you decide to go into sports medicine?” “What’s Albert Pujols like?” Well, I decided to devote the 100th post to answer them and give readers a glimpse of what I’m like. If there is anything you would like to know, ask. Go to the Contact form and send your questions. I can’t guarantee that I will answer them all, but I’ll do the best I can.

David

Reta in Mtubatuba, South Africa asks:

Good Morning,

My son has never have any form of injury. Do you think that he needs to go on a proprioception program?

Kind Regards,
Reta

I am going to start with my thoughts. I also asked this question of Michael J. Barr, PT, DPT, MSR, a physical therapist and sports medicine coordinator of MUSC Sports Medicine. Our program has been active in teaching an ACL injury prevention program to sports teams for years, but Mike is helping to design a lower extremity injury prevention program to try to decrease a number of potential injuries and improve performance.

Injury prevention programs have gained attention in recent years as sports medicine has evolved into a field not only dedicated to treating injuries in athletes but also trying to prevent them. The programs that have gained the most headlines lately have been those aiming to prevent ACL tears. These programs have traditionally focused on preventing these injuries in female athletes, as females have a much higher risk of the injury. It is believed that neuromuscular factors such as quadriceps/hamstring strength and balance as well as tendencies for females to land and turn with their knees fully extended contribute to the increased risk. These programs teach females to land and turn with increased knee flexion and better balance and control, and early data has at least shown a tendency to reduce the rate of the injury.

Recently programs have been designed to try to prevent other lower extremity injuries such as ankle sprains and hip and groin strains. It has been suggested that athletes with a prior history of these injuries, especially ankle sprains, should use these exercise programs to lessen the chance of a new injury.

I am not an athletic trainer or physical therapist, but it seems to me that while preventing reinjury in athletes is a good use for such programs, they potentially benefit all athletes – male or female, no prior injury or history of multiple injuries. Exercises that can be incorporated into a daily warmup routine and therefore do not increase overall practice time would be best and most likely to be continued. Learning to land and turn with proper mechanics is critical to decrease the chances of any lower extremity injury. If an athlete can learn the proper mechanics ahead of time so that they become second nature, they would seem to be much less likely to use poor mechanics out on the field. Improving proprioception (a joint position sense) and balance and strengthening the muscles that surround a joint hopefully would also decrease the chance that the force from an injury tears the ligaments or tendons around that joint.

Barr agrees and adds, “Proprioception training involves balance and stabilization exercises. It is basically a combination of strengthening through co-contractions surrounding a joint. All athletes would benefit from this type of training to improve their joint stability and increase strength and muscular endurance. The stronger the surrounding musculature of a joint is the more stable the joint will be and will be at less risk for injury.”

Exercise programs can never completely eliminate the risk of injury, as sports often involve traumatic events. However, if we can decrease the risks of even one injury, that is potentially a young athlete who might play uninjured for an entire season instead of sitting on the bench watching.

Tags: ACL prevention Ask Dr. Geier injury prevention michael barr MUSC Sports Medicine proprioception