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Editor,—I would like to provide a brief report of a survey of sports injury prevention programmes and related research projects in the European Community between September and December 1998.
With the cooperation of partners in the Netherlands (the Netherlands Olympic Committee and the Netherlands Sports Federation), Austria (the Austrian Institute for Home and Leisure Safety), and Belgium (Flanders Red Cross) a questionnaire on sports injury prevention and related research was devised, piloted, and distributed to a sample of 368 sports, health, or safety organisations in Europe. The objective of the study was to determine the number of institutions involved in injury prevention work, and also to seek information on the nature and quality of the work being undertaken.
A total of 86 questionnaires were returned from 77 different organisations in 28 European countries. The largest number of returns was received from Austria (13 returns), Belgium (9 returns), Ireland and the Netherlands (7 returns), and Finland, Germany, and Norway (6 returns each). 87% of the organisations responding to the survey were involved primarily in either sport, safety, or education and research. The other 13% provided health care services.
Forty two out of 86 respondents (58.8% of the returns and 11.2% of the total questionnaires distributed) reported that they were currently running a programme on sports injury prevention or related research. Less satisfactorily, only 14 of the injury prevention projects (16.3% of those responding and 3.8% of the original sample) were based upon research data or had any kind of inbuilt quality control mechanism (such as an assessment of the effectiveness of the programme). Respondents were also requested to send in examples of their injury prevention materials and to provide comments on the provision of injury prevention programmes in their sport. Many of the programmes were found to consist only of warm up and stretching exercises; these were often poorly described and of doubtful value. Few of the programmes were supported by empirical evidence or addressed risk factors specific to individual sports.
Some of the comments returned with the questionnaires included the following:
“This questionnaire is not relevant to us. Our members look after their own injuries.”
“There are hardly any injuries in our sport.” (A sport known to produce a moderately high incidence of overuse injuries.)
“Injury prevention measures don't work.”
“Stretching and warm up are a waste of time.”
Reviews of the literature on sports injuries1,2 show that injury prevention measures are most effective when directed at particular sports and population groups, and that measures directed towards the extrinsic causes of sports injuries (for example, problems with the rules or with personal and playing area equipment) are often the most effective ways of reducing the incidence of sports injuries. Furthermore, a number of studies have failed to show that warm up and high levels of flexibility are effective in reducing the incidence of sports injuries.
Because of the low response rate the findings of our survey must be regarded as preliminary. However, they do suggest the following:
A significant number of sporting organisation are ignoring the problem of sports injuries.
Injury prevention programmes are often not based upon good empirical evidence and frequently do not address the risk factors specific to particular sports.
Quality control and follow up measures are rare in the context of injury prevention programmes.
The lack of appropriateness and effectiveness of some injury prevention programmes is being noticed by athletes and sports administrators.
Notwithstanding the limitations of our study, I find the results a source of concern. I would urge your readers to impress upon sporting organisations the need to take injury prevention seriously, and to do all they can to ensure that the measures adopted are based upon the results of empirical research, and that quality control measures are put in place.
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