Score one for warm-ups: Leg injuries reduced in teenage girls

Here’s a way to help your teenage girl patients avoid athletic injuries: During their sports physicals, tell them and their parents that coach-led neuromuscular warm-ups have been shown to significantly reduce anterior cruciate ligament (ACL) and other leg injuries in teen girls who play soccer and basketball.

Researchers report in a recent issue of the Archives of Pediatrics & Adolescent Medicine that specific coach-led warm-ups markedly reduced the incidence of lower extremity (LE) injuries among athletes compared with those who warmed up as usual. Athletes in the intervention group experienced a 35% reduction in overuse LE injuries, 44% fewer acute noncontact LE injuries, and 34% lower noncontact ankle sprains compared to controls.

Knee injuries account for up to 91% of season-ending injuries and 94% of injuries requiring surgery among female high school basketball players. Each year 20,000 to 80,000 girls suffer ACL injuries while playing high school sports, a rate much higher than that experienced by high school male athletes and prepubescent girls.

None of the athletes in the intervention group required surgery for noncontact LE injuries and all of the LE surgeries in the control group were for ACL injuries. Overall incidence of LE injury was 1.78 per thousand in the intervention group compared to 4.19 per thousand among controls.

Ninety coaches and 1,492 female basketball and soccer players in the Chicago public schools participated in the study. Teams and coaches were of mixed ethnicity and came from a predominantly low-income population. Teams competed at the varsity, junior varsity, sophomore and freshman levels.

Before the 2006-2007 season, coaches in the intervention group received 2 hours of warm-up training combined with selected tools (DVD, laminated sheet, printed materials) to use throughout the season. Coaches who went through the training reported using at least some of the prescribed warm-up exercises before about 80% of practices. Coaches in the control group typically had athletes warm up by themselves or omitted warm-ups entirely.

Researchers calculated that training 16 basketball coaches or 11 soccer coaches exposes 189 athletes to the warm-up and prevents 1 injury requiring surgery. At a cost of $80 per coach, training cost-effectively prevents ACL injuries, which cost $17,000 to $25,000 to treat surgically.

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