July 29, 2008

Alternative Regimen Cuts Risk of Knee Injury Among Female Soccer Players

Backward running. Toe raises. Scissor jumps. Lateral hops. Bounding runs.

Sound like punishment? Hardly. All are key components of an alternative approach to warm-ups and conditioning that may help female soccer players avert a devastating knee injury, according to a study by the Centers for Disease Control and Prevention that was published this week in The American Journal of Sports Medicine.

Athletes who adhere to the regimen, known as PEP (for Prevent Injury and Enhance Performance), are 1.7 times less likely to suffer injuries to their anterior cruciate ligament than are athletes who do not, according to the study.

An ACL tear is a common injury among athletes in such sports as soccer, basketball, volleyball, and football, and it tends to occur more frequently among women than men. In most cases, it is also a season-ending injury with long-term repercussions. While it’s possible to repair the damage through surgery and months of rehabilitation, an ACL tear can increase an athlete’s risk of developing degenerative arthritis.

By improving biomechanical techniques in jumping, stopping, and turning, the alternative regimen seeks to reduce the number of non-contact ACL injuries, especially among athletes who have a history of knee injuries.

The study tracked injury rates among more than 1,400 athletes who competed on 61 NCAA Division I women’s soccer teams during the fall 2002 season. Athletes on the 25 teams who adhered to the PEP exercises avoided ACL tears altogether, while the 36 teams that stuck with their regular warm-ups incurred 15 such injuries during the course of the season. —Libby Sander

Comments

1. None of the differences were statistically significant. And, teams that adhered to PEP exercises incurred a higher rate of non-ACL knee injuries. So findings are far from conclusive.

   The biggest flaw in the study is that researchers don’t say whether the PEP was added to the warmup or substituted. Meaning, it’s very possible that the reduced ACL injuries were linked to increased warmup time regardless of the type of exercises performed, which is supported by the fact that ACL injuries were reduced for practices but not for games.

   — skeptic    Jul 29, 03:30 PM    #

2. While it does sound like there are some substantive issues of methods of conducing the study (e.g., PEP added vs. substituted), and other matters, the difference reported in the article, zero ACL breaks in a season on 25 teams vs. 15 breaks among 36 teams, just about could not be outside statistical significance under any reasonable test that I can imagine applying. Admittedly this is simplistic – I don’t have the data. But that difference comes out highly significant under any reasonable test I could see and apply. I’m skeptical of the skeptic statement, “None of the differences were statistically significant.”

   — StatsGuy    Jul 29, 05:18 PM    #

3. I’ll admit to only reading the abstract so far, but it looks like ACL injury rates during practices was significantly different (p=0.014) and ACL injury rates amongst athletes with a history of ACL injuries was significant (p=0.046)

   — Skeptical of skeptic    Jul 29, 09:05 PM    #

4. Sad that this article cannot be e-mailed and sent on to others. I don’t really care what people have to say about it in this forum. I want to share it with others – such as coaches and trainers. So please think more in terms of sharing knowledge, ok?

   — Harris Taylor    Jul 29, 11:12 PM    #

5. Harris, Article is contained in first link as a pdf.

   — Tom    Jul 30, 08:50 AM    #

6. As a women’s college soccer coach I’ve been using this program with my teams religiously for the last five years. Anecdotal but we’ve had only one non-contact ACL injury in that time. I’m a believer.

   — Todd    Jul 30, 02:53 PM    #

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