Sports injury prevention is starting to take shape

[hhh]

Upon reading the article on the home page I felt compelled to comment on the hyperbole presented. You can't tell me that elite sporting teams have not been doing sports specific training, eccentric training, pre-season screening, injury surveillance and everything else presented as an abstract at the conference for at least 20 years. If not, what are we blowing our money on an Institute of Sport for? If someone reckons that this same approach can therefore reduce current injury rates in elite sports by a further 80% then I'm sorry but they are suffering the aftermath of a few too many Carlsberg's. Perhaps it should be quantified that the study spoken of was garden variety underage athletes and there is no evidence for any correlation with any other level of play. Whilst the studies stated are good science and interesting they are far from earth shattering and although I may be taking the comments out of context, are no magic bullet answer to injury prevention in elite sport.

[injuryupdate]

Agree that the 80% of injuries across the board can be prevented mentality comes from the same drawer as George Gregan's "caffeine improves your rugby game by 7%".

However, there is no doubt that sports injuries can be prevented much more than they are to date. It is equally magical to think that heart disease can be prevented and cancer can be prevented and road accidents can be prevented but that there is something special about sports injuries that means they are inevitable.

Obviously the analogy with other diseases can be continued. We certainly know HOW to prevent a lot of heart disease, but if the population sits on their collective fat butts for longer, all of the cholesterol lowering drugs in the world aren't going to cancel out the lifestyle-negative factors. In sports injuries, we could, for example, insist on depowering the scrum in rugby union, so that cervical fractures were eliminated via this mechanism. Will rugby union change the laws? Answer is perhaps eventually, when those in the sport become accountable for the rate of injuries, which currently isn't being recorded all that accurately. If for example it was compulsory for all players on the field to have $4 million insurance cover against quadriplegia or else the game couldn't go ahead, the scrum laws would change overnight (because the players wouldn't cop the high premiums).

The small decline in injury prevalence over the period of the AFL survey has shown that even at elite level some gains can be made. The trade off at elite level may be the standard of games, which needs to stay fast enough to maintain spectator interest. I wouldn't have a problem at junior levels of football if they made it illegal to have studs on the boots. Sure, every player would slip over 1 time in 6 when he tried to sidestep, but no one would ever do a non-contact ACL. The game would be a worse spectacle, but at junior levels, who would care? It sure would be nicer to have rules which didn't leave 15 year olds facing inevitable O/A of the knee after doing their ACLs.

[hhh]

I give you credit because that was a text book conference podium answer. Tell a joke, agree in part with the question, go off topic for the bulk of an answer and then provide a reference for an appropriate conclusion (sorry just teasing).

Have you done a statistical analysis of the change in injury rates in AFL with the injury surveillance? Would be interesting to see if it was statistically significant.

I think when it comes to elite sports injury prevention a quote from 7X Ironman champion Mark Allen is relevant: If you continue to do the same thing you will continue to get the same results.

[hhh]

The other text book conference podium answer is to say that the question is not in my area of expertise but Dr. Smith will be on stage later this afternoon and I'm sure he will address it for you.

And finally another good one I've heard: "if you want to meet me in the smokers area at the break I will be more than happy to discuss it with you but I don't think the remainder of the audience would want to hear me speak for 30 minutes when there is so much more we need to get through and there isn't a way for me to provide a short answer to the question"

[injuryupdate]

Out of interest, we did a lot of analysis in AFL 2003 injury report to show some statistically significant drops in injury rates over time. An advantage in the AFL is that the number of matches/length of season has stayed constant over the study period. We may have the same improvements in injury prevention and management in cricket occurring over the same time period, but the headline injury rates may not be coming down because of increased frequency of matches.

It is a circular argument to say that no funding should be devoted to sports injury prevention research because research hasn't been conducted to prove that sports injury prevention is effective. It would be highly unusual if prevention research was effective in virtually all other areas of science and medicine but didn't work at all in the field of sports.

Accept that it is misleading to take a figure like "80%" from a specific study conducted in Norway and to then claim that this is the percentage of sports injuries that can be prevented.

The old model of sports injury prevention (which many in the Australian government still adhere to) was that you can stop playing sport and then you won't get injured. The problem with this approach is that you then start getting diabetes, heart disease and cancer.

Ironically, if it is important enough to put money into prevention of diabetes, heart disease and cancer, then some of the money must actually go into preventing sport injuries. The single line of most importance in that front page article (and I admit I lifted it from a press release and don't know which study it came from) was that 1 in 4 people who give up sport do so because of injury.

I don't have any problem with an sports injury prevention policy in Australia which may recommend, for example, that if you do happen to tear an ACL playing football, that part of the rehab process might suggest you take up non multi-directional sports in order to prevent arthritis, even if you do have the ACL reco. What I have a problem with is that there is ZERO government policy on sports injuries in Australia. If you do a Google search, a Courier-Mail journo can easily find that Dr Patel had his surgical licence suspended in Oregon due to gross negligence, yet you can't use Google to find the Federal Australian government strategy on tackling sports injuries because it doesn't exist. Our government is still stuck in the days of, "why bother with sports injury prevention, if they just stopped playing sport it wouldn't be a problem?"

[injuryupdate]

BTW, isn't it time you got an avatar 'hhh'?

[Nicholas]

It is good news that sports injury prevention is startign to take shape. But when will it be working?