Awareness of risk factors for sports injury is essential
Across the world there are millions of people involved in exercise and sport and in the process are enjoying the many advantages that are involved in being active. Encouraging young people to get involved in sport promotes a healthy lifestyle while exercise can help prevent illnesses such as heart disease and diabetes among many more. It also improves our general health and on top of the physical benefits, sport also provides us with fun, relaxation, competition, a sense of fulfillment and a social outlet. For those who reach the elite level, there are also the financial and celebrity rewards that go with it.
Injury is one of the main drawbacks
However, there can also be some risks involved in taking part in sport and without doubt injury is one of the main drawbacks. At the lowest level, sporting injuries can be nothing more than an inconvenience that keeps you out of action for a short period. However, at the other end of the scale there are the injuries that can be career-ending and even life-changing. At the elite level, injuries can see an athlete miss out on glory, and in a billion-dollar industry that is modern day sport, injuries to key individuals can have severe financial consequences for themselves along with clubs and franchises. As a result, it is not sufficient for sporting organisations to be merely in a position to wait and treat injuries when they arise. In the modern world being reactive is no longer the only solution as finding a way of reducing the risk of, or preventing injury has now become a huge part of sports science. Without a crystal ball, it can be difficult to predict when an injury is about to strike, therefore it is important to be aware of all the risk factors that could lead to injury in order that an athlete has the best possible chance to avoid such problems. It is no surprise that it is difficult to implement a method of reducing injury risk given all the factors that are involved from the type of sport, to physical traits, previous injuries and training and competition requirements.
The need for effective research
What is required is effective research into the area and the scale of this challenge is highlighted in a study conducted by Bahr and Holme entitled Risk factors for sports injuries — a methodological approach as published in the British Journal of Sports Medicine, which looks at the methodology for studies designed to investigate potential risk factors for sports injury. The study highlights the need for effective research into the area of injury prevention by noting that Scandinavian studies reveal that sport accounts for in the region of 10 to 19 percent of acute injuries in an emergency room. Also injuries are not just a short-term concern as studies have illustrated that in later years former athletes are at a higher risk of musculoskeletal disorders. Bahr and Holme acknowledge that it is a complicated process to incorporate all the variables that might put an athlete at risk of a particular injury at a particular time, and therefore having the correct methodology before undertaking research is essential. The authors stated that,
Merely to establish the internal and external risk factors for sports injuries is not enough. To establish a complete understanding of the causes, the mechanisms by which they occur must also be identified. In other words, sports injuries result from a complex interaction of multiple risk factors and events of which only a fraction have been identified
The study used the example of hamstring strains to outline some methodological issues of particular importance when studying risk factors for sports injuries. The aim was to provide some guidance on how to plan and conduct studies on risk factors for sports injuries, with special emphasis on sample size calculations.
Key points to consider for injury research studies
The authors suggest that new research needs to incorporate the many risk factors involved in sport, while the sample size is also crucial to the findings, as the authors identify the following points as key in terms of future study.
- Studies on the aetiology of sports injuries need to account for the multifactorial nature of sports injuries by including as many relevant risk factors as possible
- Risk factor studies need to be designed properly—in most cases a prospective cohort study is the appropriate model
- A multivariate statistical approach should be used, such as a linear logistic regression model or, preferably, a Cox regression model, if individual match and training participation can be recorded
- The sample size of the study needs to be considered carefully. Sample size mainly depends on the expected effect of the risk factor on injury risk, and to detect moderate to strong associations 20–50 injury cases are needed, whereas small to moderate associations would need about 200 injured subjects
- The accuracy of the methods used to measure potential risk factors and record injuries are critical factors which can influence sample size considerably
- Studies published to date on the risk factors for hamstring strains have methodological limitations, and are too small to detect small to moderate associations
What can you do to help prevent injury
From the very basic amateur teams to the top elite teams/athletes, you should be aware of the stressors and loads of your athletes. The basics cover athlete well-being, training duration and loads and their response to the training/competition that they partake in. A mix of subjective and objective is ideal but everyone has to start somewhere and starting small is infinitely better than doing nothing at all. Often time is limited and resources are few. Dr. Eamonn Flanagan, Lead Strength & Conditioning Coach at Sport Ireland Institute has written an excellent article on Monitoring, Injury Risk Factors and the 21st Century Strength Coach.
Take even simplest of training load monitoring systems – the session RPE system. With this method we log training time (minutes) and training intensity (1-10 scale) yet from this ever so basic tool we generate multiple metrics: daily and weekly training loads, training monotony and strain, training stress balance and percentage breakdown of training load per activity. We have big data before we even consider more highly involved and detailed datasets from neuromuscular fatigue tests, heart rate variability and GPS monitoring systems
He asks the questions
- How do we quickly drill down to the data that is most meaningful?
- Who are the priority athletes?
- What data should be actionable and when?
Athletes will respond to training in very different ways and some will be more injury prone than others. Eamonn identifies 6 injury risk factors that should be taken into consideration.
- Previous Injury History: Does the athlete have an extensive injury history?
- Concussion: Has the athlete had a recent concussion
- Age: How old is the athlete? How long have they been playing at this level?
- Strength: Is the Athlete Significantly weaker then his peers?
- Conditioning: Is the Athlete more poorly conditioned than their peers?
- Fiber Typing & The Explosive Athlete: Does the athlete have an explosive or fast twitch fiber type
He outlines a simple method of profiling your athletes and scoring them out of 3 in each of the risk factors and colour coding 1 as Green, 2 as Amber and 3 as Red. Simple profiling and flagging of your athletes in parallel with monitoring their wellbeing and training loads can provide you with the ‘red flags’ you need to kick start your injury prevention program.
This isn’t a foolproof system, it doesn’t prevent injury, but it may help us make slightly more effective decisions in the management of our athletes …Establishing and understanding every athlete’s individual risk factors can help us frame monitoring data in a much stronger context and enable us to make more targeted and effective decisions on load management
Dr. Joe Warne, Programme Director of Master of Science in Performance Coaching at Setanta College takes a look at the key aspects hindering identifying a valid method of training load monitoring and the need to treat players and athletes as the complex individuals they are. He sums up the difficulties inherent in trying to predict injury
The best evidence from the best research groups in the world cannot come to any agreement of a cause of injury, simply because there are TOO MANY factors involved. The factors related to injury include internal risk factors such as age, gender, body type, body composition, health, fitness, anatomy, skill level, stress, psychology, and many more. In addition, the exposure to external risk factors may come from training load, training type, surface, footwear, environment, coach decisions, pressures, the training or game situation, behaviour, or even just chance
What is Metrifit?
Metrifit helps coaches get to know their athletes, and helps athletes get ready to perform. It is a simple, intuitive and effective approach to monitoring looking at how the ‘small picture’ of an athlete’s daily habits, shapes the ‘big picture’ of match day performance.
Why not have a look at our Metrifit Ready to Perform product and gain insight on the physical and mental state of your athletes through our daily well-being questionnaire? To find out more visit our Metrifit Product Overview page or contact at for a free demo.
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Edgar K. Tham
Founder and Chief Sport & Performance Psychologist, SportPsych Consulting (Singapore, Indonesia, Philippines)
Edgar K. Tham
Founder and Chief Sport & Performance Psychologist, SportPsych Consulting (Singapore, Indonesia, Philippines)
Niall O’Driscoll
Academy Directory, SJ.B (St. Joseph’s Bray ) Academy
Niall O’Driscoll
Academy Directory, SJ.B (St. Joseph’s Bray ) Academy
Tino Fusco, B.Sc. ChPC
Head Coach, Women's Soccer, Mount Royal University (Canada)
Tino Fusco, B.Sc. ChPC
Head Coach, Women's Soccer, Mount Royal University (Canada)
Graham Williams
Athletic Development Coach, MSc ASCC
Millfield School, UK
Graham Williams
Athletic Development Coach, MSc ASCC
Millfield School, UK
Joe O’Connor
NISUS Fitness, S&C Coach Clare Senior Hurling, Horse Sport Ireland and Limerick Senior Hurling
Joe O’Connor
NISUS Fitness, S&C Coach Clare Senior Hurling, Horse Sport Ireland and Limerick Senior Hurling
"When COVID altered college athletics as we knew it, Metrifit came to the rescue. This intuitive athlete monitoring, health and well-being system provides the athlete, coach, and sports medicine staff a way to monitor and balance the physical, emotional, health and well-being of our athlete’s. Metrifit provided that calm in the middle of the perfect storm for our entire athletic department for the future. Thank you to the entire Metrifit family for assisting our department with a seamless process."
Jennifer McIntosh
Head Athletic Trainer, Colorado School of Mines
Jennifer McIntosh
Head Athletic Trainer, Colorado School of Mines
Richard Deuchrass
Lincoln University Athletic Performance Manager
Richard Deuchrass
Lincoln University Athletic Performance Manager
Tommy Mooney
Strength and Conditioning Coach at DCU Sport and with Dublin Minor GAA
Tommy Mooney
Strength and Conditioning Coach at DCU Sport and with Dublin Minor GAA
Dan Rickaby
Assistant S&C Coach, Tulane University
Dan Rickaby
Assistant S&C Coach, Tulane University
Brijesh Patel
Quinnipiac University, Head Strength and Conditioning Coach
Brijesh Patel
Quinnipiac University, Head Strength and Conditioning Coach
Michael Torres
CEO, Shift Performance, Miami
Michael Torres
CEO, Shift Performance, Miami
Kevin Schultz
Associate Director of Strength & Conditioning
Director of Olympic Strength & Conditioning
University of Wisconsin
Kevin Schultz
Associate Director of Strength & Conditioning
Director of Olympic Strength & Conditioning
University of Wisconsin
Emma Hawke, PhD Exercise Physiology
Coach - Sweden Climbing, Olympic Offensive - Female Coach Swedish Olympic Committee, Senior Lecturer - Coach education programme (Sweden)
Emma Hawke, PhD Exercise Physiology
Coach - Sweden Climbing, Olympic Offensive - Female Coach Swedish Olympic Committee, Senior Lecturer - Coach education programme (Sweden)
Yvonne Treacy
Nutritionist, Wexford Camogie
Yvonne Treacy
Nutritionist, Wexford Camogie
Eamonn Fitzmaurice
Kerry Senior Football, Manager
Eamonn Fitzmaurice
Kerry Senior Football, Manager
Robert Karlsson, Professional Golfer
Robert Karlsson, Professional Golfer
Dr. Dale Richardson
CEO Achieve Total Performance Pty Ltd
Dr. Dale Richardson
CEO Achieve Total Performance Pty Ltd
Erik Helland
Director of Strength & Conditioning and Head Strength Coach Men’s basketball, University of Wisconsin
Erik Helland
Director of Strength & Conditioning and Head Strength Coach Men’s basketball, University of Wisconsin
Paul Cremin
Head Physiotherapist, Cornish Pirates Rugby Club
Paul Cremin
Head Physiotherapist, Cornish Pirates Rugby Club
Aaron Mansfield
Head Coach, LMU Lions, Loyola Marymount University
Aaron Mansfield
Head Coach, LMU Lions, Loyola Marymount University
Brian Clarke
Head Strength and Conditioning Co-ordinator,Noblesville High School
Brian Clarke
Head Strength and Conditioning Co-ordinator,Noblesville High School
Cian O’Neill
Kildare Senior Football Manager
Cian O’Neill
Kildare Senior Football Manager
Dave Passmore
Head Coach, Irish Hockey
Dave Passmore
Head Coach, Irish Hockey
Kari Thompson
Head Volley Ball Coach, Southern Illinois University
Kari Thompson
Head Volley Ball Coach, Southern Illinois University
Jason McGahan
Sports Scientist, Kildare Football, PhD Sports Science Researcher
Jason McGahan
Sports Scientist, Kildare Football, PhD Sports Science Researcher
Dan Horan
Head of Fitness for International Football/Fitness Coach Men's Senior Team
Football Association of Ireland
Dan Horan
Head of Fitness for International Football/Fitness Coach Men's Senior Team
Football Association of Ireland
Lee Stutely
Team Manager and Athlete Support Services Coordinator at Great Britain Wheelchair Rugby
Lee Stutely
Team Manager and Athlete Support Services Coordinator at Great Britain Wheelchair Rugby
Ryan Osborn
Head Basketball Coach, Carmel High School
Ryan Osborn
Head Basketball Coach, Carmel High School
J.B. Belzer
Head Coach, Women's Soccer at Regis University
J.B. Belzer
Head Coach, Women's Soccer at Regis University
References
Risk factors for sports injuries — a methodological approach by R Bahr, I Holme
Monitoring Injury Risk Factors and the 21st Century Strength Coach by Dr. Eamonn Flanagan
Fast and Slow Twitch Muscle Fibers: Does muscle fiber type determine sports ability?
Recognize the factors that contribute to sport injury risk by Susan Kay Hillman
The Role of Sports Specialization in Overuse Injury | Metrifit
Mind Your Head: Concussion in Sport | Metrifit
The curse of the ACL injury | Metrifit
Edgar K. Tham
Founder and Chief Sport & Performance Psychologist, SportPsych Consulting (Singapore, Indonesia, Philippines)
Edgar K. Tham
Founder and Chief Sport & Performance Psychologist, SportPsych Consulting (Singapore, Indonesia, Philippines)
Niall O’Driscoll
Academy Directory, SJ.B (St. Joseph’s Bray ) Academy
Niall O’Driscoll
Academy Directory, SJ.B (St. Joseph’s Bray ) Academy
Tino Fusco, B.Sc. ChPC
Head Coach, Women's Soccer, Mount Royal University (Canada)
Tino Fusco, B.Sc. ChPC
Head Coach, Women's Soccer, Mount Royal University (Canada)
Graham Williams
Athletic Development Coach, MSc ASCC
Millfield School, UK
Graham Williams
Athletic Development Coach, MSc ASCC
Millfield School, UK
Joe O’Connor
NISUS Fitness, S&C Coach Clare Senior Hurling, Horse Sport Ireland and Limerick Senior Hurling
Joe O’Connor
NISUS Fitness, S&C Coach Clare Senior Hurling, Horse Sport Ireland and Limerick Senior Hurling
"When COVID altered college athletics as we knew it, Metrifit came to the rescue. This intuitive athlete monitoring, health and well-being system provides the athlete, coach, and sports medicine staff a way to monitor and balance the physical, emotional, health and well-being of our athlete’s. Metrifit provided that calm in the middle of the perfect storm for our entire athletic department for the future. Thank you to the entire Metrifit family for assisting our department with a seamless process."
Jennifer McIntosh
Head Athletic Trainer, Colorado School of Mines
Jennifer McIntosh
Head Athletic Trainer, Colorado School of Mines
Richard Deuchrass
Lincoln University Athletic Performance Manager
Richard Deuchrass
Lincoln University Athletic Performance Manager
Tommy Mooney
Strength and Conditioning Coach at DCU Sport and with Dublin Minor GAA
Tommy Mooney
Strength and Conditioning Coach at DCU Sport and with Dublin Minor GAA
Dan Rickaby
Assistant S&C Coach, Tulane University
Dan Rickaby
Assistant S&C Coach, Tulane University
Brijesh Patel
Quinnipiac University, Head Strength and Conditioning Coach
Brijesh Patel
Quinnipiac University, Head Strength and Conditioning Coach
Michael Torres
CEO, Shift Performance, Miami
Michael Torres
CEO, Shift Performance, Miami
Kevin Schultz
Associate Director of Strength & Conditioning
Director of Olympic Strength & Conditioning
University of Wisconsin
Kevin Schultz
Associate Director of Strength & Conditioning
Director of Olympic Strength & Conditioning
University of Wisconsin
Emma Hawke, PhD Exercise Physiology
Coach - Sweden Climbing, Olympic Offensive - Female Coach Swedish Olympic Committee, Senior Lecturer - Coach education programme (Sweden)
Emma Hawke, PhD Exercise Physiology
Coach - Sweden Climbing, Olympic Offensive - Female Coach Swedish Olympic Committee, Senior Lecturer - Coach education programme (Sweden)
Yvonne Treacy
Nutritionist, Wexford Camogie
Yvonne Treacy
Nutritionist, Wexford Camogie
Eamonn Fitzmaurice
Kerry Senior Football, Manager
Eamonn Fitzmaurice
Kerry Senior Football, Manager
Robert Karlsson, Professional Golfer
Robert Karlsson, Professional Golfer
Dr. Dale Richardson
CEO Achieve Total Performance Pty Ltd
Dr. Dale Richardson
CEO Achieve Total Performance Pty Ltd
Erik Helland
Director of Strength & Conditioning and Head Strength Coach Men’s basketball, University of Wisconsin
Erik Helland
Director of Strength & Conditioning and Head Strength Coach Men’s basketball, University of Wisconsin
Paul Cremin
Head Physiotherapist, Cornish Pirates Rugby Club
Paul Cremin
Head Physiotherapist, Cornish Pirates Rugby Club
Aaron Mansfield
Head Coach, LMU Lions, Loyola Marymount University
Aaron Mansfield
Head Coach, LMU Lions, Loyola Marymount University
Brian Clarke
Head Strength and Conditioning Co-ordinator,Noblesville High School
Brian Clarke
Head Strength and Conditioning Co-ordinator,Noblesville High School
Cian O’Neill
Kildare Senior Football Manager
Cian O’Neill
Kildare Senior Football Manager
Dave Passmore
Head Coach, Irish Hockey
Dave Passmore
Head Coach, Irish Hockey
Kari Thompson
Head Volley Ball Coach, Southern Illinois University
Kari Thompson
Head Volley Ball Coach, Southern Illinois University
Jason McGahan
Sports Scientist, Kildare Football, PhD Sports Science Researcher
Jason McGahan
Sports Scientist, Kildare Football, PhD Sports Science Researcher
Dan Horan
Head of Fitness for International Football/Fitness Coach Men's Senior Team
Football Association of Ireland
Dan Horan
Head of Fitness for International Football/Fitness Coach Men's Senior Team
Football Association of Ireland
Lee Stutely
Team Manager and Athlete Support Services Coordinator at Great Britain Wheelchair Rugby
Lee Stutely
Team Manager and Athlete Support Services Coordinator at Great Britain Wheelchair Rugby
Ryan Osborn
Head Basketball Coach, Carmel High School
Ryan Osborn
Head Basketball Coach, Carmel High School
J.B. Belzer
Head Coach, Women's Soccer at Regis University
J.B. Belzer
Head Coach, Women's Soccer at Regis University