Principles of sports injury prevention in an athletics team with a high incidence of injuries
Sport-related injury is a cause for great concern for both the athlete and the coach as it has the potential to jeopardize the
athlete’s career. As such, principles for injury prevention hold immense value, whether it be with regard to primary, secondary or
tertiary prevention. Risk factors of injury should be identified and used to guide the development of the prevention program.
Neuromuscular training (NMT) programs have been found to reduce the incidence of (re)injury. However, buy-in from athletes
and coaches, as well as the collaboration of an interdisciplinary team is key in promoting the programme success. Finally, return
to play (RTP) assessment tools and loading principles should be used to facilitate reintegration of the injured athlete.
Levels of prevention:
Injury prevention interventions are key in promoting long-term well-being of athletes as well as enabling them to gain health
benefits associated with participation in sport (Finch et al., 2015). Injury prevention should be targeted on primary, secondary
and tertiary preventive levels. Primary prevention is largely seen as the main goal as this means the injury will not occur. E.g. all
athletes on a team compete with knee guards, even those who do not have knee injuries. As for secondary prevention, the aim
is for early diagnosis and appropriate treatment, once the injury has occurred. E.g. rest, ice, compression and elevation
immediately after a knee injury occurred. Rehabilitation post injury is the focus in tertiary prevention. Tertiary prevention adopts
RTP principles and protocols to ensure optimal recovery and aims to avoid re-injury of the body structure. For example, the
athlete would complete a rehabilitation program to strengthen stabilizing knee structures, improve balance, strength and power
before they are fit to RTP (Bahr & Meeuwisse, 2009).
Risk Factors:
An understanding of what the sport or team-position requires, and the physiological and biomechanical demands it places on
the athlete (Dhillon, Dhillon & Dhilllon, 2017) alongside an analysis of the previous season’s training and competition
programme, is vital in identifying risk factors which contributed to the team’s high injury prevalence (tertiary prevention)
(McIntosh & Bahr, 2009). When making changes to the programme it is important to make predictions regarding the efficacy of
these changes and rule out potential injury risk factors (McIntosh & Bahr, 2009). This will act as primary prevention strategies to
athletes who were not previously injured.
Risk factors may be modifiable (extrinsic) or fixed (intrinsic). Modifiable risk factors include neuromuscular control deficits,
improper functional movements (such as substitutional or compensatory movements), the level of competition, and the
components of and compliance with intervention programmes (Hewett et al., 2016). McIntosh and Bahr (2009), also included:
new types of training without adequate conditioning, suboptimal sleep, change of frequency, intensity or volume of training or
competitions, sudden RTP after a break and trial time for team selection (e.g. athlete hides symptoms of injury in case he/she is
not selected).
On the contrary, fixed risk factors could be age and sex (Hewett et al., 2016) or a change in surface (e.g. from grass to a hard
surface) or climate/altitude (McIntosh & Bahr, 2009). For example, female athletes who participate in sports which involve
pivoting and/or jumping are between two and 10 times more vulnerable to anterior cruciate ligament injury (ACLI) compared to
