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An injury prevention pyramid for elite sports teams
  1. Philip Alexander Coles
  1. Correspondence to Philip Alexander Coles, Performance and Medicine, San Antonio Spurs, 1 Spurs lane, San Antonio, Texas 78240, USA; pcoles{at}

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There are numerous factors that influence injury rates in elite sporting teams, and many of them are intricately related. To achieve sustained success in decreasing injury rates, we must understand not only each of those potential factors in isolation, but also the relationships that exist between them. Rarely is one session, or one event, the true isolated cause of an injury. Typically, there has been a confluence of many events over time, which has led to the pivotal point where one event then simply becomes ‘the straw that broke the camel’s back’. The ‘High Performance Unit’ should take the lead in responsibility for preventing injuries, but for them to achieve long-term success,they must collaborate closely with coaches, management and the players themselves, in creating an integrated approach to preventing injuries. While there may be significant debate about the relative influence of individual factors on injury rates, there should be little debate that each of the factors discussed in the following model will have some effect. For sustained success, it is more productive to think of each factor as a building block in a pyramid, as opposed to an independent entity. Although this does not mean that addressing one aspect in isolation cannot be effective in the short term, it recognises if you do not have the foundation blocks right, then your likelihood of achieving consistent and long-lasting success is decreased. We should also be aware, that the culture of an organisation as a whole, and the psycho-social influences on each individual player within it, can have a modifying effect on the model at every stage.1

Player recruitment / List management

The first building block in the injury prevention pyramid for elite sporting teams is player recruitment and / or list management. Ultimately, if you recruit or maintain a list of players who are either not suitable for the …

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  • Contributors There were no other contributors to this article.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.