Though it may seem like common sense that mobility and strengthening work would reduce risk of injury (we offer it in our app after all), you should never take something as a truth just because it sounds like it would be true. ALWAYS do the research. We know you’re busy, so we went ahead and did it for you.
So do “prevention exercise sessions” reduce risk of injury? Was the common sense correct after all?
It turns out…yes, yes it was. The research backs it up, for practically every joint in your body. Strengthening, improving proprioception (body awareness), and increasing mobility will help reduce your risk of future injury. BUT, things are more complicated than that.
Improving only the area of concern is often not enough to enact significant change. Instead, you need to look both above and below the area, throughout your “kinetic chain” (a fancy way of describing how body parts play roles in affecting other, farther away body parts).
For example, Arundale et al. found that “exercise-based knee injury prevention programs in women that include proximal control exercises, such as trunk/core strengthening and stability exercises, led to significantly lower ACL injury rates... In contrast, programs that did not include proximal control exercises did not reduce injury rates”.
But…why?
Sometimes injuries at one muscle or joint are the result of weaknesses across the body, not necessarily at the specified area. In order to mitigate risk injury, you need to perform a comprehensive prevention program – you ensure every muscle and joint has the appropriate strength and mobility to function accordingly.
This may be easier explained with an example.
Let’s say that over time, due to disuse and compensation, you develop weak hip abductors (the muscles on the outside of your hips). One of their main jobs is stabilizing your limb when you stand on one leg (every time you take a step) or when landing from a jump. With every step you take, your outside hip musculature works to prevent you from tipping over. If you perform athletics, you often use jumping as a tool for improvement. When you land, your hips have to work to keep your lower extremity from collapsing inward. Both of these can create a consistent and/or large amount of force for the hips to handle.
If you hips are weak you’ll get what is called a “hip drop” and “dynamic valgus”. If you watch someone walking with a hip drop, you do literally see their hips drop down with each step. In terms of jumping and landing, you’ll see the knees fall inward as the hips are unable to stabilize the femur. Most of the time an affected person has no idea it’s happening because there is no immediate pain associated with it.
The problem with the hip drop and dynamic valgus is what those actions do to your knees. Normally the knee joint is straight and aligned to create symmetric and stacked forces. If your knees are constantly falling inward due to hip weakness, they not only have to endure increased forces to pick up the slack of your weak hips, they have to do so in an abnormal and asymmetric joint position.
As you might guess, with step after step and landing after landing, a lot of stress on the knees can build up. With enough time, you’ll develop knee pain even though the root of the problem is the hips.
End example.
Now back to daily prevention programs.
More comprehensive, preventative programs are better for reducing injury risk than less comprehensive. Arundale et al. found that programs that include both strengthening and plyometrics are better than either alone for reducing ACL injury rate, and that work on proprioception also helps reduce the risk.
Thorborg et al. found that the between two programs aimed at reducing all injuries in soccer players, the more comprehensive and all-inclusive program had significant reduction in injuries whereas the less comprehensive had no effect! This is why our programs are comprehensive, even if some people don’t like it: it’s better.
Last point.
Turns out, simply doing exercises every-once-in-a-while does NOT help reduce injury.
Hammes et al. found that performing a comprehensive prevention program focused primarily on the lower extremity just one time per week did NOT reduce the risk of injuries (like hamstring strains) in soccer players. However, in a systematic review, Al et al. found that when using such programs that included eccentric hamstring strengthening (like the Nordic hamstring curl), on a more daily basis with higher compliance, hamstring injuries were cut in half. This is just one of many examples (like how Arundale et al. found that athletes who performed knee prehab and prevention exercises for a longer period of time, more times per week, and with higher compliance had significantly decreased knee ACL injuries compared to those that didn’t).
Basically: Do the work, get the results.
What does this mean for you?
One day every now and then is NOT enough. That’s why we named our Daily Prevention follow along videos just that, DAILY, and why we made everything available on an app, so you have NO excuse not to do it. All you have to do is play copycat for 10 minutes a day. But don’t waste your time thinking you are doing yourself a positive benefit and reducing injury risk if you are only going to do your exercises once a week. Commit to a healthier body, for both current you and future you.
References:
Al Attar WSA, Soomro N, Sinclair PJ, Pappas E, Sanders RH. Effect of Injury Prevention Programs that Include the Nordic Hamstring Exercise on Hamstring Injury Rates in Soccer Players: A Systematic Review and Meta-Analysis. Sports Med. 2017;47(5):907-916.
Arundale AJH, Bizzini M, Giordano A, et al. Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention. J Orthop Sports Phys Ther. 2018;48(9):A1-A42.
Hammes D, Aus der Funten K, Kaiser S, Frisen E, Bizzini M, Meyer T. Injury prevention in male veteran football players - a randomised controlled trial using "FIFA 11+". J Sports Sci. 2015;33(9):873-881.
Thorborg K, Krommes KK, Esteve E, Clausen MB, Bartels EM, Rathleff MS. Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes. Br J Sports Med. 2017;51(7):562-571.