Neuromuscular Warm-Up May Reduce Lower Extremity Injuries in Adolescent Female Athletes

Female high school athletes who participated in neuromuscular warm-up before sports practice had a reduced risk of lower extremity injuries, according to a study in the November issue of Archives of Pediatrics & Adolescent Medicine.

“In girls’ high school sports, injury rates per 1,000 athlete exposures are highest in soccer (2.36) and basketball (2.01),” the authors wrote as background information in the study. “Knee injuries are the most common cause of permanent disability in female high school basketball players, accounting for up to 91 percent of season-ending injuries and 94%of injuries requiring surgery.”

Ninety coaches and 1,492 athletes from Chicago Public schools participated in the study, led by Cynthia R. LaBella, MD, of the Feinberg School of Medicine, Northwestern University, Chicago, and colleagues. Coaches were randomly assigned to either the neuromuscular warm-up group or a control group, who maintained current warm-up procedures.

Coaches in the intervention group attended a 2-hour training session 2 weeks before the start of the 2006-2007 sports season. During the session, coaches were taught how to implement a 20-minute neuromuscular warm-up before every practice and an abbreviated version before each game. Neuromuscular training included progressive strengthening, balance, plyometric and agility exercises. Coaches also promoted safe jumping and landing techniques designed to help avoid strain on the anterior cruciate ligament.

There were 737 athletes in the intervention group and 755 athletes in the control group. The intervention group had 50 lower extremity injuries compared with 96 lower extremity injuries in the control group. Two athletes in the intervention group and thirteen athletes in the control group sustained two lower extremity injuries. All athletes with noncontact lower extremity injuries that required surgery were in the control group.

Intervention coaches reported using the prescribed warm-up before practice for a mean 80% of practices, and only six of the 53 intervention coaches reported using the prescribed warm-up for less than 50% of practices. No control coaches were observed using any prescribed practices, and most omitted a warm-up or had athletes jog or warm-up by themselves.

“Coach-led neuromuscular warm-up reduces noncontact lower extremity injuries in female high school soccer and basketball athletes from a mixed-ethnicity, predominantly low-income, urban population,” the authors said in the study. “These findings suggest that neuromuscular training should be routine in girls’ high school soccer and basketball.”

For more information:

  • Effect of neuromuscular warm-up on injuries in female soccer and basketball athletes in urban public high Schools: Cluster randomized controlled trial.
    LaBella C. Arch Pediatr Adolesc Med. 2011;165[11]:1033-1040.

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