Do Injury prevention programs work?
Apparently they do, but why are they such a tough sell? And why are the people delivering S&C services to some of our most vulnerable people (youth) so out of touch on this topic?
We know there are prophylactic effects (73.4% less change of ACL injury to be precise, Sugimoto et al., 2012) of participating in a comprehensive strength & conditioning program, especially for young female athletes who are most at risk for non-contact ACL injury.
In fact, the proposition is this simple:
About 3/4 of non-contact ACL traumas are preventable with a sound training program.
The confusing part though for parents and athletes is what types of training is best?
“Evidence suggests providing one type of exercise is not adequate to generate a prophylactic effect.”
A Comprehensive Youth S&C Program to prevent ACL Injuries
It appears a program that addresses strength training, balance training and plyometrics is the best combination. And many claim to be offering such prescriptions but perhaps not doing in a way that hones the full spectrum of physical education and literacy.
Often, compliance is the biggest issue with training programs. Athletes and parents are happy to go to practice and work on skills and attend games and tournaments for a chance to compete. Most are not doing anything outside of that and sadly, many are overspecialized, exposing their bodies to same stressors, day in and day out with little foundation to draw upon. Some youth are certainly more prepared than others to handle forces and loads associated with youth sport, but today’s youth ARE far less fit than their moms and dads likely were.
Let’s quickly talk about the differences between ‘kids today’ and ‘kids of yesterday…’
In 1985 the average child spent 30 hours per week playing outside. Today, that is just 5 hours.
So, over a year from ages 5-6 the 1985 child would have played outside for 1500 hours; today 250.
Over 10 years from ages 5-15, the difference accumulates from 15000 hours then to 2500 hours now.
So a 15 year old looking to take up sport today is already 12,250 hours behind their 1985 equivalent!
Source: Honore Hoedt (Netherlands)
If you think about playing outside, I am sure you can imagine climbing trees, balancing on rocks in the creek and sprinting from one location to the other. Talk about a great way to set up a kid’s physical potential! All boxes are checked:
Strength - pull-ups, pushing/wrestling, leaping over fences…
Balance - biking, blading, walking on ledges and over stones…
Plyometrics - sprinting, jumping, hopping…
Today’s youth are overscheduled and likely spend more time waiting in lines at practice than they do ‘free playing’ and solving movement problems.
As kids get a little older, they might also require a bit more overload (intensity) and can begin strength training more formally with weights (using free weights will build balance) and more reps of plyometrics can be followed too with a focus on body control and excellent landing mechanics. Kids will run faster once they get stronger. Let’s get them strong first. Effective strategies, using the right drills and the right progressions do not require more than 15-20 minutes a few times per week, but the drills must be coached by qualified S&C coach with training in Growth and Motor Development (typically a university course in Kinesiology).
Parents - look for coaches who incorporate these type of programs into the development of the athletes. Make sure they are not using buzz word like ‘grind’ or ‘speed ladders’ and that they understand the age and stage of development your adolescent is at. Paying attention to good form and technique and cultivating good gym habits are honed under good leadership.
