1B.4. Leading the prevention of injuries in the sporting arena
Introduction
Recently, there has been recognition within sport that more has to be done to try to prevent elite athletes from being injured. Epidemiological studies show that injuries seen by a physician, in Scandinavia, every sixth is sustained during sporting activity.1 Injuries are also expensive – the cost of emergency department treatment alone is $500 million annually in the USA9 – and common, occurring at a rate of 36 injuries per 1000 h played in soccer, for example.10 A further problem with injuries for the athlete is that it stops them from training, and this, in turn, has consequences for their performance.
The International Olympic Committee's Medical Commission, amongst others involved in sport, is now investigating prevention strategies, and how these can reduce injury.11 This is not as simple as it sounds because some injuries are intrinsic to certain sports; however, if these injuries have a specific pattern and frequency, then there is also the opportunity for reducing the injury.
This, potentially, has huge ramifications for the chiropractic profession, which often sees itself at the forefront of injury prevention. This presentation examines the current evidence relating to sporting injury prophylaxis, and this, in turn, may indicate the route the profession needs to take to secure its future involvement in this growing field.
Section snippets
Injury prevention
When considering injury prevention, we must take into consideration the demands that their level of competition places upon them, and the effect that treatment or activity modification may have on their performance.
A review of the literature on injury prevention in May 2000 produced 10,691 papers on athletic injury; however, there were only six randomised controlled trials on sports injury prevention. A similar review in December 2007 revealed that sports injury research is emerging as a new
Injury prevention research
In 1992, van Mechelen et al.2 outlined a sequence of injury prevention research (Fig. 1).
If this model is adopted, then the first step is to establish the extent of the injury problem. This is done by injury surveillance, the purpose of which is to enumerate the extent of injury in a given population. However, before this can be done, we have to define what constitutes an injury in the first place; which is not as easy as it appears. In 2006, Fuller Bahr et al.3 produced a consensus paper on
Discussion
Sports injury prevention, and the increased interest in its detection and implementation, has important implications for the medical agencies involved in providing care to athletes, none more so than the chiropractic profession. This profession often likes to see itself at the forefront of injury prevention, yet there is minimal evidence to support this role.
The chiropractic profession needs to identify where it is best suited to help with this important area. For example, if we consider injury
Conclusions
If the chiropractic profession has a role to play in the sports injury prevention forum, it has to consider where it fits into this complex multidisciplinary environment. Perhaps when we consider our research strategies in the future, we need to look at how spinal manipulation can fit into existing models.12, 2 We need to determine what, if any, intrinsic factors related to the spine predispose an athlete to back pain or poor spinal biomechanics and, indeed, all the intrinsic risk factors that
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