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Sport's Injury prevention; are we measuring the right parameter?
- Per B Mahler (2 March 2005)
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Per B Mahler, MD, MPH Service de Santé de la Jeunesse, Geneva, Switzeralnd
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per.mahler{at}etat.ge.ch Per B Mahler
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Dear Editor, Having worked in sport's injury prevention with children for the last 15 years and having monitored their evolution in a representative group of about 160 adolescent girls and boys competing in various sports, I can but express a certain amount of frustration as to the results of injury prevention. Having contributed to introduce and observed changes in, nutritional and psychological counselling, stretching, interaction with coaches and clubs, school timetable adaptation and physiological evaluation, I would have expected to see at least part of the 75% injury reduction proposed by Ekstrand in 1982 [1] even though their study only concerned football players. Over the last 15 years the incidence of sport injuries in our group of adolescents has stayed constant at about 0.28 +/- .066 injuries / pupil / school year or 1.08 x 10-3 +/- 2.6 x10-4 injuries / pupil / 100 hours of sport practised. The proportion of boys and girls and the type of sports staying relatively constant through time. There was however a decrease in overuse injuries, that seems to have been compensated by non-overuse injuries. Over the same period, the mean average increase in training time was 18 min./week. Should we be finding a decrease in the incidence of injuries with preventive measures, or does prevention merely permit athletes to practice more and/or harder and reach higher levels of performance? Might it be more pertinent to monitor the increase in performance (if possible)to get an idea of the effectiveness of prevention? To measure a change in incidence, attributable to prevention, would imply that the training load and absolute performance objectives stay constant through time. This, as one imagines, is contrary to the concept of competitive sports, where the objective is to challenge our limits may they be physical, mental or other. I therefore believe that it might be difficult to measure the overall efficacy of injury prevention in a constantly changing paradigm based on performance and challenging limits. Improving records and performances over time might confirm this. References 1. Ekstrand J., A training program for the prevention of injuries to reduce soccer injuries by 75 per cent. Nord Med. 1982 Jun;97(6-7):164-5 Dr P.B. Mahler,
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