Intellectuals solve problems; geniuses prevent them.
The 2000s saw a remarkable acceleration in the focus on sports injury prevention; athletes in the second decade of this century benefit from the knowledge that interventions can prevent major knee and ankle injuries. Improving uptake remains a challenge, as in all areas of preventive health.
In this book, we use the term “prevention” synonymously with “primary prevention.”1 Examples of primary prevention include health promotion and injury prevention among those who have never had an injury (e.g. ankle braces being worn by an entire team, even those without previous ankle sprain). “Secondary prevention” refers to early diagnosis and intervention to limit the development of disability or reduce the risk of re-injury. We refer to this as “treatment” (e.g. early RICE treatment of an ankle sprain, see Chapter 13). Finally, “tertiary prevention” is the focus on rehabilitation to reduce and/or correct an existing disability attributed to an underlying disease. We refer to this as “rehabilitation” (Chapter 15); in the case of a patient who has had an ankle sprain, this would refer to wobble board exercises and graduated return to sport after the initial treatment for the sprain. The proactive clinician will initiate injury prevention strategies, give prevention advice during consultations where treatment is being sought, and devise in-season strategy planning sessions with coaches and during screening of athletes (Chapter 62).
This chapter begins with a widely-used model of how sports injuries occur. This is a very useful guide to ways to prevent sport injuries in a systematic matter. From there, we direct the reader to review the importance of correct biomechanics of sports for injury prevention as outlined in Chapter 8. Then, we discuss other important factors that may assist in the prevention of injury:
taping and bracing
Systematic injury prevention
Willem van Mechelen et al.2 provided the now classic conceptual model for prevention of sports injuries (Fig. 9.1). First, identify the magnitude of the problem and describe it in terms of the incidence and severity of sports injuries. If you are responsible for a team, this involves recording all injuries within the squad, as well as training and match exposure. Second, identify the risk factors and injury mechanisms that play a part in causing those sports injuries. For the practitioner, this involves systematic examination of sportspeople and their training and competition program (see below). The third step is to introduce measures that are likely to reduce the future risk and/or severity of sports injuries, based on the etiologic factors and the injury mechanisms identified in the second step. Finally, the effect of the measures must be evaluated by repeating the first step. In the research setting, preventive efforts are best evaluated using a randomized ...