from regular physical activity include reduction of risk factors for cardiovascular disease, such as obesity, hypertension, and

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "from regular physical activity include reduction of risk factors for cardiovascular disease, such as obesity, hypertension, and"

Transcription

1 Prevention of running injuries by warm-up, cool-down, and stretching exercises WILLEM van MECHELEN,* MD, PhD, HYNEK HLOBIL,* MD, HAN C. G. KEMPER,* PhD, WIM J. VOORN, PhD, AND H. ROB de JONGH, PhD From the *Department of Health Science, Faculty of Human Movement Sciences, Vrije Universiteit, and the Central Computer Department, and the Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, University of Amsterdam, Amsterdam, the Netherlands ABSTRACT The purpose of this study was to evaluate the effect of a health education intervention on running injuries. The intervention consisted of information on, and the subsequent performance of, standardized warm-up, cooldown, and stretching exercises. Four hundred twentyone male recreational runners were matched for age, weekly running distance, and general knowledge of preventing sports injuries. They were randomly split into an intervention and a control group: 167 control and 159 intervention subjects participated throughout the study. During the 16-week study, both groups kept a daily diary on their running distance and time, and reported all injuries. In addition, the intervention group was asked to note compliance with the standardized program. At the end of the study period, knowledge and attitude were again measured. There were 23 injuries in the control group and 26 in the intervention group. Injury incidence for control and intervention subjects was 4.9 and 5.5 running injuries per 1000 hours, respectively. The intervention was not effective in reducing the number of running injuries; it proved significantly effective (P < 0.05) in improving specific knowledge of warm-up and cool-down techniques in the intervention group. This positive change can perhaps be regarded as a first step on the way to a change of behavior, which may eventually lead to a reduction of running injuries. t Address correspondence and repnnt requests to Willem van Mechelen, MD, PhD, Department of Health Science, Faculty of Human Movement Soences, Vnje Universiteit, van der Boechorststraat 7-9, 1081 BT Amsterdam, the Netherlands 711 The popularity of running as a form of exercise and recreation has grown rapidly since the 1970s, first in North America and later in Europe. Reasons for jogging include health and fitness, pleasure or relaxation, and competition or personal performance.lo>3 From a health point of view, benefits from regular physical activity include reduction of risk factors for cardiovascular disease, such as obesity, hypertension, and 5, smoking. On the other hand, runners, as any other athletes, sustain sports injuries. In the Netherlands, van Galen and Diederiks2 performed a telephone survey on sports injury incidence with a 4-week recall period. They used a representative sample of the Dutch population and included all self-reported injuries, both medically treated and not medically treated. Based on their results, calculations were made for injury incident for the total Dutch population. The total number of sports injuries was estimated at 2,700,000. In absolute numbers, running was ranked 4th for the number of injuries incurred, with 126,000 injuries per year (54,000 medically treated), behind outdoor soccer, volleyball, and indoor soccer. If running exposure was taken into account, running was ranked as the 14th injury sport, with 3.6 injuries per 1000 hours of running (44% medically treated). Most running injuries are localized to the lower extremity, with a predominance in the knee.6 1, ,31,33,37,47,48 Running injuries are of a diverse nature and vary, as outlined by Powell et al.,39 from metabolic abnormalities such as anemia, amenorrhoea, hypothermia, and hyperthermia to extrinsic hazards such as dog bites and traffic collisions. However, most running injuries are musculoskeletal injuries associated with overuse. 2,1 15,17,29,36 This is understandable since running involves the constant repetition of the same movements. According to Powell et al.,39 the etiologic factors related to musculoskeletal running injuries can be roughly divided into factors related to the runner, factors related to running, and factors related to the running environment. In relation to sports in general, some authors have sug-

2 712 gested stiffness of the muscles of the lower extremity and subsequent lack of range of motion of adjacent joints as an athlete-related etiologic factor for musculoskeletal injuries. 1,11,19, 22, 36, 41,42 In terms of the prevention of lower extremity injuries, it seems advisable to recommend stretching exercises of muscles of the lower extremity. It is known that hip flexion can be improved by such exercises. 21 In line with stretching exercises, a lack of or improper use of warm-up and cool-down techniques is mentioned as a risk factor for musculoskeletal overuse injuries of the lower extremity in sports in general22,41 and for running in particular. 35,39 Sound epidemiologic evidence for the preventive effect of warm-up, cool-down, and stretching exercises on lower extremity running injuries is scarce and contradictory. Jacobs and Berson,24 as well as IJzerman and van Galen,23 found injured runners stretched significantly more before running than noninjured runners. Jacobs and Berson reported that certain stretching exercises, such as the hurdler stretch, can lead to injury of the medial collateral ligament and to the medial meniscus. Both studies suggested that runners, who are at high risk of sustaining recurrent injury, stretch because they have previous injuries, thereby biasing research results. Walter et al. 41 found runners who &dquo;sometimes&dquo; stretch to be at greater risk for injury, in contrast to runners who &dquo;always, usually, or never stretch.&dquo; They leave this finding unexplained. Blair et al. found that frequency of stretching was not associated with running injuries. Macera et al. 32 found that stretching before running was not associated with running injuries. With regard to warmup, Walter et al. 41 found that runners who say &dquo;they never warm up&dquo; had a significantly smaller risk of running injury compared with runners who say they &dquo;always, usually, or sometimes&dquo; warm up. In the same study, regular use of cool-down exercises was not related to running injuries at all. There may be a negative, rather then a positive, relation between the above-mentioned preventive measures and the risk of lower extremity running injuries, although the findings are inconclusive. The purpose of this study was to investigate the effect of a health education intervention program by which runners were provided with information that encouraged them to perform standardized warm-up, cool-down, and stretching exercises to reduce the incidence of injuries of the lower extremity. Health education by providing information is only effective if it is put forward as a planned strategy. Kok and Bouter2 argued that such a planned strategy should be aimed at a favorable modification of the determinants of health behavior. Kok and Bouter described attitude as an important determinant of healthy behavior. They refer to attitude as the knowledge and beliefs of a person concerning the specific consequences of a certain form of behavior. An attitude is the weighing of all consequences of the performance of the behavior as seen by the individual. Consequently, this study was also aimed at the effect of the health education intervention on knowledge and attitude of runners with respect to the prevention of running injuries in general and with respect to warm-up, cool-down, and stretching exercises in particular. DESIGN AND SUBJECTS Design An experimental black-box design was chosen in which two groups of subjects, a control and an intervention group, are compared with respect to differences in running injury incidence as a direct effect of the health education intervention. Both groups were also compared with regard to differences in knowledge and attitude toward the prevention of running injuries in general and warm-up, cool-down, and stretching exercises in particular as intermediate effects of the health education intervention. We know that age and weekly running distance can be considered important predictors of running injuries.39 We therefore decided to match control and intervention subjects for these two variables. If one assumes that a health education intervention by providing information will lead to the performance of the standardized program of warm-up, cooldown, and stretching exercises, one should realize that this requires a modification of behavior. This process of behavior modification comprises a number of stages that must be completed if any modification is to be achieved.44 These stages are as follows: knowledge modification leads to attitude modification leads to intention modification leads to behavior modification. Since knowledge is the starting point in the chain of events leading to behavior modification, we decided to match control and intervention subjects for their knowledge on the prevention of running injuries as well. Subjects and matching If one assumes a yearly running injury incidence rate of 60%, and if the intervention should lead to a significant (25%) reduction of injury incidence rate,45 both the control and intervention groups should contain at least 237 subjects by the end of the experiment if a one-tailed chi-square test was to be applied.4 To recruit such a number of subjects for this study, 32,506 questionnaires were sent to all civil servants employed by the city of Amsterdam, with a request to participate in a study on running; 1057 questionnaires were returned from 982 men and 75 women. For reasons of homogeneity and because of the relatively small number of responding women, we decided to exclude all female volunteers. The responses of 463 civil servants met the criteria set to enter the study: healthy, no current injury, not home from work on sick leave, running at least 10 km/week all year-round, not performing sports as a part of their profession (police officers and firefighters were excluded), and written consent to participate in the study. Age and estimated weekly running distance for these subjects were gathered from the questionnaire. To facilitate the matching procedure, we had to first assess the level of

3 713 knowledge on the prevention of running injuries of each subject. This was done using a knowledge and attitude questionnaire, which was mailed to all 463 volunteers; 421 questionnaires were returned. From the questionnaire, a knowledge and attitude score was calculated, but only the knowledge score was used for matching. Subsequently, 421 subjects entered the matching procedure (Fig. 1). Classes were defined in such a way that for each variable the number of subjects in every class was approximately equal. Subjects were subdivided into three classes for estimated weekly running distance: 10 to 18 km/week (N 126), 19 to 32 km/week (N 146), and 32 km/week or more (N149). Subjects were also subdivided into 3 classes for age: born after October 1, 1953 (N 129), born between October 1, 1946 and September 30, 1953 (N 155), born before October 1, 1946 (N 137). Finally, subjects were subdivided into 5 classes depending on their score on the knowledge questionnaire. Consequently, 45 different cells (3 x 3 x 5) were filled with a minimum of 2 to a maximum of 18 subjects (Table 1). From each cell, subjects were randomly selected for the intervention (N 210) or the control group (N 211). METHODS General outline of the experiment The intervention was aimed at a change of behavior by providing information with regard to warm-up, cool-down, and stretching exercises. If such an intervention is to be effective, the &dquo;message&dquo; should meet criteria like attracting attention, simplicity, recognizability, and clarity. Also, the estimated reliability of the sender of the message is important, as well as the fact that the proposed behavior should not greatly deviate from the current behavior of the recipient of the message.26 The actual intervention was planned taking these factors into account. Figure 1. Flow chart representing the selection of subjects. TABLE 1 Distribution of subjects according to estimated weekly running distance and knowledge of prevention of running injuries&dquo; a Knowledge 1 very low, knowledge 5 very high; details. see text for After matching, all subjects from the intervention group received a booklet with written instructions on the standardized program. This booklet was specially prepared for use in this study with the help of the coach of the Dutch National Marathon team and several other experts. During each of 4 evenings, about 50 to 60 subjects were instructed by the same coach on why and how to perform the program. All exercises were practiced in a gymnasium to make sure that all subjects had understood the contents of the intervention. Then a 16-week intervention period started, which lasted from September 12, 1988 until January 1, All subjects were asked to continue running in the same way as they had done before the start of the intervention and they were asked to keep a daily diary on running distance, running time, and the occurrence of a running injury. They were also asked to record their daily compliance with the program: whether warm-up, cool-down, and stretching exercises were performed in the prescribed way. This obligation to write down daily compliance was part of the intervention strategy and can be regarded as a &dquo;cue to action.&dquo;14 Diaries covered four 4-week periods and were mailed to and from subjects. At the end of the 16-week intervention period, postintervention knowledge and attitude scores were assessed in both the control and intervention groups using the same knowledge and attitude questionnaire used to obtain the baseline scores. In addition to this questionnaire, the control group was asked to fill in a supplementary questionnaire on their warm-up, cool-down, and stretching behavior during the intervention period. To enhance continuous participation of all subjects throughout the experiment, all subjects were given a t-shirt and a subscription to the monthly magazine, Runners. Knowledge and attitude questionnaire A questionnaire measuring knowledge of and attitude toward the prevention of running injuries was constructed on the

4 714 basis of a literature survey.35 The initial knowledge questionnaire contained 79 questions that were scored on a 3- point scale (3 points for &dquo;true,&dquo; 2 points for &dquo;don t know,&dquo; and 1 point for &dquo;false&dquo;) and 45 attitude questions that were scored on a 5-point scale varying from 5 points for &dquo;total agreement&dquo; to 1 point for &dquo;total disagreement&dquo; with an attitude statement. This questionnaire was tested for validity and reliability in a pilot study 12 according to a method described by Swanborn.43 This method applies principles as described by Ebel.16 The final version of the knowledge and attitude questionnaire as it was used in this intervention study contained 56 knowledge questions and 31 attitude questions. Neither part of the questionnaire contained questions with an item-rest correlation coefficient of less than 0.20 (this means that the correlation coefficient of each item with the total score was at least 0.2). Cronbach s alpha of the knowledge part of the questionnaire was 0.89 and of the attitude part From the questionnaire, the following seven scores were calculated: 1) general knowledge of the prevention of running injuries, 2) specific knowledge of warm-up exercises, 3) specific knowledge of stretching exercises, 4) specific knowledge of cool-down exercises, 5) general attitude toward the prevention of running injuries, 6) specific attitude toward warmup, and 7) specific attitude toward cooldown. Intervention The content of the intervention, as described in the booklet and as explained during the instruction evening, was based on a literature survey.35 The intervention consisted of a warmup of 6 minutes of running exercises, 3 minutes of loosening exercises, and 10 minutes of stretching to be performed before each running session. The stretching exercises included three bouts (10 seconds each) of static stretching of the iliopsoas and quadriceps muscles, the hamstrings, and the soleus and gastrocnemius muscles. A cooldown after each running session consisted of the inverse of the warmup. Stretching exercises were performed as outlined above twice a day regardless of running performance. Injury registration A running injury was defined as any injury that occurred as a result of running and caused one or more of the following: 1) the subject had to stop running, 2) the subject could not run on the next occasion, 3) the subject could not go to work the next day, 4) the subject needed medical attention, or 5) the subject suffered from pain or stiffness during 10 subsequent days while running. Any injury that met this definition was to be noted in the daily running diary. Every injury was also to be reported by a special postage-paid reply form. Every reported injury was seen by one of the two physicians involved in the project. Location, injured structure, type of injury, and most likely medical diagnosis were noted. In case of a reported injury, a subject was excluded from reentering the study. All diary data gathered after the reported date of onset of injury were excluded from data analysis. Data analysis Incidence was calculated taking exposure into account and expressed as the number of newly sustained running injuries per 1000 hours of running. If applicable, overall differences between the intervention and control group were analyzed by applying a two-tailed t-test, a chi-square test, or by calculating a relative risk and its 95% confidence interval. Differences in baseline attitude scores between the control and intervention group were tested by applying a two-tailed t-test. The effect of the intervention was assessed by analyzing differences per cell by means of a one-tailed sign test between the control and intervention group with regard to injury incidence per exposure. The effect of the intervention was also assessed by applying the same procedure for differences between baseline and postintervention delta values with regard to knowledge and attitude scores. For all tests, P < 0.05 was considered statistically significant. RESULTS All materials (diaries and questionnaires) were returned by 168 control and 159 intervention subjects. However, at the end of the intervention 1 cell contained only 1 control subject, which made comparisons between control and intervention values for this cell impossible. For this reason, this cell and its subject were excluded from data analysis at cell level, thereby reducing the number of cells from 45 to 44. Whenever data analysis was performed at group level the results of this subject were included. Consequently, results from 167 control and 159 intervention subjects distributed over 44 cells were analyzed at cell level, and results from 168 control and 159 intervention subjects were analyzed at group level. The total drop-out rate after 16 weeks was 94/421 x 100% 22.3%. In Table 2, overall descriptive values of running performance are summarized for the control and intervention groups. None of the variables show any statistically significant (Student s t-test, P > 0.05) difference between the control and intervention groups. The average runner in this study ran about 2.7 times a week for 8.8 km per session at a speed of 12.4 km/hr. Table 3 summarizes compliance with the prescribed intervention as reported by daily diary by the intervention group. Table 4 summarizes information from the control group on the performance of warm-up, cool-down, and stretching exercises during the intervention period. This information was obtained at the end of the intervention period by questionnaire. Since the two methods of data collection with regard to the performance of warm-up, cool-down, and stretching exercises during the intervention period were different for both groups, the results from Tables 3 and 4 can only be globally compared. The tables show that in both groups a

5 TABLE 2 Mean and standard deviation of running variables as written down a by subjects during the 16-week intervention period&dquo; Differences between the intervention and control groups were tested by a two-tailed t-test. (No comparisons showed significant difference, P > 0.05.) TABLE 3 Compliance with intervention by the study group (N 159)a Data derived from daily diaries. TABLE 4 Performance of warm-up, cool-down, and stretching exercises among the control group (N 167) form of warmup and cooldown was performed by about 90% of the runners, whereas a form of daily stretching exercises was performed by about 58% of the runners. Forty-nine injuries, 23 in the control group and 26 in the intervention group, were registered in the diaries. Of these 49 injuries, 44 were also reported by means of a postagepaid injury reply form and subsequently evaluated. This means that no information on the nature and location of the injury was available from 5 subjects. From these 5 subjects, we know only the date on which they reported themselves in the daily diary as being injured. Injury incidence analysis was performed using data referring to the 49 injuries as registered in the diaries. There were no significant differences between these 2 groups (chisquare 0.45, df 1, P > 0.05). For both groups, injury incidence was calculated taking exposure into account. In the control group, 4.9 injuries per 1000 hours of running (95% confidence limit: 3.1 to 7.4) were calculated, and in the intervention group 5.5 injuries per 1000 hours of running (95% confidence limit: 3.6 to 8.0); the relative risk for injury was 1.12 (95% confidence limit: 0.56 to 2.72). To evaluate the effect of the intervention program, the injury incidence per 1000 hours of running was calculated per cell for both the intervention and the control groups. In 13 cells the injury incidence of the control subjects exceeded the injury incidence of the intervention subjects, in 14 cells the opposite was found, and in 17 cells no difference was found with regard to injury incidence between groups. By applying a one-tailed sign test, these differences proved not significant (P > 0.05). We concluded that the intervention program did not result in a reduction of the incidence of running injuries per 1000 hours of running. Differences in injury pattern between the control and intervention groups were analyzed by a chi-square test (P < 0.05 is significant) using information from the 44 evaluated injuries. No differences were found between the intervention and control groups with regard to all registered variables: location of injury, injured anatomic structure, medical diagnosis, and nature of injury (acute versus overuse and recurrence of injury). The locations of the 44 evaluated injuries are presented in Table 5. All injuries were equally distributed on the left and right sides of the body. The injured anatomic structures were: muscle (11), tendon (9), joint (9), tendon-muscle (8), tendonbone (4), bone (2), and skin (1). The distribution of the most likely medical diagnosis was as follows: strain (16), inflammation (11), sprain (3), blister (1), chondromalacia (3), miscellaneous (3), and diagnosis not clear (3). Seventy-five percent of the injuries were classified as overuse injuries that had developed over the course of hours or days; 25% of the injuries were classified as acute. Thirty percent of the runners had sustained a similar injury some time during their running careers. Mean data of both groups were calculated for six knowledge and attitude questionnaire scores. The general knowledge score is not included because the subjects were matched on this score over the control and intervention groups. Analysis by means of a two-tailed t-test proved that the differences between the intervention and the control groups were not significant (P > 0.05) concerning baseline score for which the two groups were not directly matched (baseline score general attitude, baseline score specific knowledge of warming up, baseline score specific knowledge of cooling down, baseline score specific knowledge of stretching exer- TABLE 5 Localization of 44 evaluated injuries

6 716 cises, baseline score specific attitude toward warming up, and baseline score specific attitude toward cooling down). We concluded that at baseline there were no differences between the intervention and control groups with respect to general attitude and specific knowledge and attitude scores. The effect of the intervention was also assessed by analyzing the difference per cell between the intervention and control groups with respect to general and specific knowledge and attitude scores. For both groups per cell the mean difference (delta score) between the baseline and postintervention scores was calculated for each questionnaire variable. In Table 6, the mean difference (delta score) between baseline and postintervention scores is summarized for each variable. From Table 6 we concluded that, except for specific knowledge scores of stretching exercises by subjects in the intervention group, all knowledge and attitude scores in both groups had improved at the end of the intervention in comparison with the score at baseline measurement. The improvement of scores of the intervention group with regard to specific knowledge about warming up, specific knowledge about cooling down, specific attitude toward warming up, and specific attitude toward cooling down was significantly greater when compared with the improvement of scores of the control group. We identified, per cell, whether this mean difference (delta score) was in favor of the intervention or the control group or whether there was no difference between both groups with respect to the mean difference (delta score) between baseline and postintervention scores. The differences in mean difference (delta score) were then analyzed for significance by means of a one-tailed sign test. The results of this procedure are summarized in Table 7. We concluded that, in comparison with the control group, the intervention program had led to a significant improvement of specific knowledge of warming up and cooling down in the subjects of the intervention group., DISCUSSION This study was aimed at a change of behavior of runners with regard to warm-up, cool-down, and stretching exercises. An important prerequisite in this study is the assumption that there is a positive relationship between preventive behavior (i.e., warm-up, cool-down, and stretching exercises) and injury prevention. If this prerequisite is valid, one must conclude that the intervention in this study has not been successful since there was no significant effect on the incidence of running injuries per 1000 hours of running at the level of the matched cells or at group level. Yet, since the study concerned a health education intervention in which the provision of information played a major role, the effect of the intervention can also be judged at the level of the matched cells from changes in knowledge and attitude of the runners with respect to the prevention of running injuries in general and from changes in knowledge and attitude with respect to the specific preventive measures related to the desired change in behavior. We can therefore conclude that the intervention has been successful, given the significant improvement of the specific knowledge scores of warmup and cooldown in the subjects of the intervention group compared with the control group. None of the other measured differences between baseline and postintervention knowledge and attitude scores showed a significant difference between the control and intervention groups. From the standpoint of health education by providing information,&dquo; this improvement of knowledge of warmup and cooldown can be regarded as a positive effect of the intervention. Some remarks with regard to the effects of the intervention must be made. Damoiseaux 13 has argued that the extent of the modifying effect of health education by providing information depends on the way in which the information is provided to the target group: on an individual (person-toperson) basis, on a group basis, or on a mass media basis (Table 8). In the present study, the information was provided on a group basis by means of a booklet and an evening of instruction. The improvement of knowledge with regard to warmup and cooldown, but not of attitude or of injury incidence, is in line with the modifications one may expect if health education information is provided on a group basis. Other factors that influence the effect of this kind of health education intervention are who provides the information and whether the provided information &dquo;appeals&dquo; to the recipients. Ooijendijk and van Agt37 conducted a study on running injury prevention. Two hundred fifty-six men and 60 women with an average age of 39 years and an TABLE 6 Mean value and standard deviation of the difference (A score) between the baseline and postintervention scores for each questionnaire variable for both the control and intervention group Small differences in numbers of subjects (N) within each group are because of missing values on some questionnaire scores not significant. b P >

7 717 TABLE 7 Comparison of A scores between the control and the intervention groups Figures given are number of cells in which the score differed. b NS, not significant. TABLE 8 Effect of modifying effecta The X indicates the maximal expected extent of the modifying effect of health education by providing information with respect to the modification of knowledge, attitude or of behavior, depending on how the subject is approached. Adapted from Damoiseaux.l3 average weekly running distance of 30 km served as subjects. These runners were asked by questionnaire if they wanted to obtain information on injury prevention and, if so, in what way and from what person. Seventy-six percent of the runners were interested in information on injury prevention: 78% wanted to obtain information from leaflets and 40% by oral instruction given by either a fellow runner (61%) or a coach (41%). In light of these results it seems valid to conclude that the way of providing information in our study (booklet in combination with an instructional group session using a well-known coach as instructor) must have appealed to our subjects, thereby not hindering the transfer of information. The aim of our study was to bring about a reduction in the incidence of running injuries by the performance of a standardized behavior concerning warm-up, cool-down, and stretching exercises. From the results as presented in Tables 3 and 4, we concluded that in both the intervention and control groups a form of warmup and cooldown was performed by about 90% of the runners, whereas a form of daily stretching exercises was performed by about 58% of the runners. On the basis of this finding, one should question whether the aim of the study in terms of a change in behavior with regard to warm-up, cool-down, and stretching exercises to prevent running injuries, was a realistic one to start if the same proportion of the control and intervention group show a more or less similar behavior. From the study of Ooijendijk and van Agt,37 we know that most runners (93%) perform some sort of warmup. In their study, 88% of the subjects performed stretching exercises as a part of the warmup, and 64% performed a cooldown. From a preventive point of view, it seems better to focus future health education intervention strategies on behavior that is not already conducted &dquo;naturally&dquo; to such an extent as warm-up, cool-down, and stretching exercises, such as the early detection of symptoms of overuse injuries, full rehabilitation after injury to avoid the recurrence of injury, and the distribution of training load (running frequency, weekly running distance, and running speed). These factors are important predictors of running injury.32,33,47 We know of only 2 large-scale prospective studies concerning running injuries. In the study by Macera et all monthly diaries were used as a method of data collection. In their 1-year study, data were analyzed on all subjects who returned 80% of their monthly diaries, including the last diary. The drop-out rate in this study was 39% (310 male subjects). In our study, with a drop-out rate of 22.3%, data were analyzed only from subjects who had all diaries and questionnaires present at the end of the study. When comparing these two drop-out rates, it should also be noted that the Macera et al. study lasted 1 year and our study lasted 16 weeks. In a 1-year prospective study by Walter et al., 47 data were collected by telephone survey 4, 8, and 12 months after the start of the study. In their study, 88% of all planned telephone contacts took place. In light of these two prospective studies, the drop-out rate in our study seems acceptable. The drop-out rate may have been influenced by the fact that the intervention took place at the end of autumn and the beginning of winter when weather condition are usually not as good as spring and summer. However, a recent national survey on sports participation conducted in the Netherlands showed that participation in recreational running is not much influenced by the season. 21 The runners in this study were all men who ran on the average about 2.7 times a week for 8.8 km per session at a speed of 12.4 km/hr. If compared with the populations of other studies, the average runner in our study can be considered as representing the recreational runner who runs for pleasure and health rather than for competition, and who participates in an organized roadrun every now and then 6,20,28,32,33,37 Although many researchers in the field of sports etiology research advise taking exposure to sports participation into account,3,7,25.30,31,34,46.49 this is seldom the case. We know of only 3 studies regarding running that calculate injury incidence per 1000 hours of running. van Galen and Diederiks2

8 718 found in their retrospective national survey an overall incidence for self-reporting running injuries of 3.6 per 1000 hours of running. Lysholm and Wiklander 31 performed a 1- year prospective study with competitive male and female runners from various disciplines: sprint, middle-distance, and marathon. They found incidences for running injuries varying from 5.8 injuries per 1000 hours of running for sprinters to 2.5 injuries per 1000 hours of running for marathon runners. Finally, Bovens et al. found, in a prospective study of 58 men (average age, 35 years), injury incidences varying with average weekly running distance from 12.1 injuries per 1000 hours of running (average weekly running distance, 24 km/week) to 7.0 injuries per 1000 hours of running (average weekly running distance, 44 km/week). The injury incidences in the present study fall within the range of incidences found in the above-cited studies. However, it should be kept in mind that these figures may be difficult to compare because of differences in definitions and research methods.3 No attempt was made to compare the injury pattern found in this study with the pattern found in other studies since potential differences between studies can be explained by differences in definitions and research methods, as well as by research outcome. 3 CONCLUSIONS 1. In a 16-week prospective intervention study in which subjects were matched for age, weekly running distance, and general knowledge regarding the prevention of running injuries, the running injury incidence was found to be 4.9 injuries per 1000 hours of running for the control group and 5.5 injuries per 1000 hours of running for the intervention group. 2. A health education intervention, consisting of providing information by means of booklet and an instructional group session aimed at a change of behavior with regard to warmup, cool-down, and stretching exercises, did not result in a reduction of running injury incidence expressed per hours of running exposure. The intervention did lead to a positive change of specific knowledge with regard to warmup and cooldown. No further knowledge or attitude changes were observed. In terms of health education by providing information, this change can be regarded as a positive effect of the intervention. 3. Regardless of the intervention, 90% of both the intervention and control group performed some form of warmup and cool-down exercises, whereas some sort of daily stretching exercises was performed by about 58% of the runners. It therefore seems advisable not to focus the prevention of running injuries by a modification of behavior a modification of with regard to these measures, but by behavior with regard to the early detection of symptoms of overuse injuries, full rehabilitation after injury to avoid the recurrence of injury, and the distribution of training load. ACKNOWLEDGMENTS This study was funded by the Dutch Ministry of Health Welfare and Cultural Affairs as the Dutch contribution to a coordinated research project of the Council of Europe: &dquo;sports for All: Sports Injuries and Their Prevention.&dquo; This study was also financially supported by the Municipal Health Authority of the city of Amsterdam and by Sportcom, publisher of Runners monthly magazine. The authors express their gratitude to Mrs. Inge Crolla, MSc, for her work as research assistant. REFERENCES 1 Agre JC Hamstring injuries Proposed aetiological factors, prevention and treatment. Sports Med , Andrews JR Overuse syndromes of the lower extremity Clin Sports Med , Backx FJG, Inklaar H, Koornneef M, et al Draft FIMS position statement on the prevention of sports injuries Geneeskunde en Sport (Special Issue) May 1990, pp Berlin JA, Colditz GA A meta-analysis of physical activity in the prevention of coronary heart disease Am J Epidemiol , Bijnen FCH, Zonderland ML, Enst GCv, et al Bewegen, fitheid en gezondheid Geneeskunde en Sport 24(6) , Blair SE, Kohl HW, Goodyear NN Rates and risks for running and exercise injuries Studies in three populations Res Q , Bol E, Schmickli SL, Backx FJG, et al Sportblessures onder de knie, NISGZ publication 38 Papendal, the Netherlands, Netherlands Institute of Sports Health Care, Bovens AMP, Janssen GME, Vermeer HGW, et al Occurrence of running injuries in adults following a supervised training program Int J Sports Med 10 S186-S190, Clement DB, Taunton JE A guide to the prevention of running injuries Austr Fam Physician , Clough PJ, Dutch S, Maugham RJ, et al Pre-race drop-out in marathon runners Reasons for withdrawal and future plans Br J Sports Med , Cornelius WL, Hinson MM The relationship between isometric contractions of hip extensors and subsequent flexibility in males J Sports Med Phys Fitness , Crolla I, Cuppens C Het meten van kennis en attitude ten aanzien van preventie van hardloopblessures: de ontwikkeling van twee vragenlijsten, doktoraalonderzoeksverslag Master s thesis Vakgroep Gezondheidkunde Faculteit der Bewegngswetenschappen, Virje Universiteit, Amsterdam, Damoiseaux V Sportblessure-preventie via massamediale voorlichting, in Rijsewijk van M, Wieberdink EAM, Zuurbier MA (eds) Voorlichting en Sportblessures Utrecht, Handelijle Centrum GVO, 1986, pp Dishman RK (ed) Exercise Adherence Its Impact on Pubhc Health Champaign, IL, Human Kinetics Books, Dressendorfer RH, Wade ChE The muscular overuse syndrome in longdistance runners Physician Sportsmed 11(11) , Ebel RL Essentials of Educational Measurement New York, Prentice Hall Inc, Eggold JF Orthotics in the prevention of runners overuse injuries Physician Sportsmed 9(3) , Eichner ER Exercise and heart disease Epidemiology of the "exercise hypothesis " Am J Med , Ekstrand J, Wiktorsson M, Oberg B, et al Lower extremity goniometric measurements A study to determine their reliability Arch Phys Med Rehabil , Galen W van, Diederiks J Sportblessures breed uitgemeten Haarlem, De Vneseborch, Hardy L Improving active range of hip flexion Res Q , Hess GP, Cappiello WL, Poole RM, et al Prevention and treatment of overuse tendon injuries Sports Med , IJzerman JC, Galen WCC van Blessures bij lange afstandlopers The Hague, The Royal Dutch Athletic Association, Jacobs SJ, Berson BL Injuries to runners A study of entrants to a 10,000 meter race Am J Sports Med , Kennedy MC, Vanderfield GK, Kennedy JR Sport Assessing the risk Med J Austr 2: , Kok GJ GVO en sportletsels, in Rijsewjjk MV, Wieberdinck EAM, Zuurbier

9 719 ZA (eds) Voorlichting en sportblessures Rijswijk, Ministry of Health, 1986, pp Kok G, Bouter LM On the importance of planned health education Prevention of ski injury as an example Am J Sports Med , Koplan JP, Powell KE, Sikes RK, et al An epidemiological study of the benefits and risks of running JAMA , Lehman WL. Overuse syndromes in runners Am Fam Physician , Loes M de, Goldie K Incidence rate of injuries during sport activity and physical exercise in a rural Swedish municipality Incidence rates in 17 sports Int J Sports Med , Lysholm J, Wiklander J Injuries in runners Am J Sports Med , Macera CA, Pate RR, Powell KE, et al Predicting lower-extremity injuries among habitual runners Arch Intern Med , Marti B, Vader JP, Minder CE, et al On the epidemiology of running injuries Am J Sports Med , Mechelen WV 25 jaar schade door sport Geneeskunde en Sport 23(5) , Mechelen WV, Hlobil H, Kemper HCG How Can Injuries Be Prevented? NISGZ publication no 25E Oosterbeek, Netherlands Institute of Sports Health Care, Mirking G The prevention and treatment of running injuries J Am Podiatr Med Assoc , Ooijendijk WTM, van Agt L Preventie van hardloopblessures Geneeskunde en Sport 23(4) , Paffenbarger RS, Hyde RT Exercise in the prevention of coronary heart disease Prev Med , Powell KE, Kohl HW, Caspersen CJ, et al An epidemiological perspective on the causes of running injuries Physician Sportsmed 14(6) , Rumke CL, With C de De grootte van groepen bij het vergelijken van twee percentages of twee kansen NTVG , Safran MR, Seaber AV, Garrett WE Warm-up and muscular injury preventon. An update Sports Med , Shellock FG, Prentice WE Warming-up and stretching for improved physical performance and prevention of sports-related injuries Sports Med 2: , Swanborn PG Schaaltechnieken, Theone en praktijk van acht eenvoudige procedures Meppel, Boom, Vent de TGM, Hlobil H, Mechelen WV Sports injuries prevention by information and education a preparative study Report No 51, Consumer Safety Institute, Amsterdam, November Vulpen AV Sport for All Sport Injuries and Their Prevention Oosterbeek, Council of Europe, Netherlands Institute of Sports Health Care, Oosterbeek, Wallace RB Application of epidemiologic principles to sports injury research Am J Sports Med 16 S22-S24, Walter SD, Hart LE, Mcintosh JM, et al The Ontano Cohort Study of running-related injuries Arch Intern Med , Watson MD, DiMartino PP Incidence of injuries in high school track and field athletes and its relation to performance ability Am J Sports Med , Wiktorsson-Moller M, Oberg B, Ekstrand J, et al Effects of warming up, massage, and stretching on range of motion and muscle strength in the lower extremity Am J Sports Med , 1983

Dropout From Exercise Programs for Seniors: A Prospective Cohort Study

Dropout From Exercise Programs for Seniors: A Prospective Cohort Study Journal of Aging and Physical Activity, 2005, 13, 409-421 2005, Human Kinetics, Inc. Dropout From Exercise Programs for Seniors: A Prospective Cohort Study Maarten Stiggelbout, Marijke Hopman-Rock, Erwin

More information

temperature, increase heart rate and breathing rate raising the athlete to their optimal level of preparedness for physical activity.

temperature, increase heart rate and breathing rate raising the athlete to their optimal level of preparedness for physical activity. Warm-Up & Cool-Down The warm-up and cool-down are both integral components of the ROAR session and must be completed before and after physical activity. The warmup is designed to prepare the body for the

More information

Sports causing most injuries in Hong Kong

Sports causing most injuries in Hong Kong Br J Sp Med 1993; 27(4) Sports causing most injuries in Hong Kong K. M. Chan MCh(Orth) FRCS, Yvonne Yuan MSc PCEd, C. K. Li Pg Dip Biomech, P. Chien FRCS and G. Tsang FRCS(Ed) Hong Kong Centre of Sports

More information

The Effectiveness of Injury-Prevention Programs in Reducing the Incidence of Anterior Cruciate Ligament Sprains in Adolescent Athletes

The Effectiveness of Injury-Prevention Programs in Reducing the Incidence of Anterior Cruciate Ligament Sprains in Adolescent Athletes Critically Appraised Topics Journal of Sport Rehabilitation, 2012, 21, 371-377 2012 Human Kinetics, Inc. The Effectiveness of Injury-Prevention Programs in Reducing the Incidence of Anterior Cruciate Ligament

More information

INVESTIGATION OF MANAGEMENT MODELS

INVESTIGATION OF MANAGEMENT MODELS S.K. Chen, Y.M. Cheng, Y.C. Lin, et al INVESTIGATION OF MANAGEMENT MODELS IN ELITE ATHLETE INJURIES Shen-Kai Chen, Yun-Min Cheng, Yen-Chung Lin, 1 Yu-Jue Hong, 1 Peng-Ju Huang, and Pei-Hsi Chou Department

More information

University of Groningen. The NLstart2run study: running related injuries in novice runners Kluitenberg, Bas

University of Groningen. The NLstart2run study: running related injuries in novice runners Kluitenberg, Bas University of Groningen The NLstart2run study: running related injuries in novice runners Kluitenberg, Bas IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish

More information

Planning and Organizing Track Programs and Workouts

Planning and Organizing Track Programs and Workouts Planning and Organizing Track Programs and Workouts Designing and Planning Your Program by Buzz Andrews, Track Coach, Lake Highlands H.S. To have a successful track program, track coaches have to be great

More information

Sports-related injuries in primary health care

Sports-related injuries in primary health care Family Practice 2011; 28:29 33 doi:10.1093/fampra/cmq075 Advance Access published on 5 October 2010 Sports-related injuries in primary health care Frank Baarveld a, *, Chantal A N Visser a, Boudewijn J

More information

Journal of Undergraduate Kinesiology Research

Journal of Undergraduate Kinesiology Research Chronic PNF Stretching Program 21 Journal of Undergraduate Kinesiology Research Official Research Journal of the Department of Kinesiology University of Wisconsin Eau Claire Volume 2 Number 1 December

More information

Introduction. Anatomy

Introduction. Anatomy the patella is called the quadriceps mechanism. Though we think of it as a single device, the quadriceps mechanism has two separate tendons, the quadriceps tendon on top of the patella and the patellar

More information

Can Lower Extremity Injuries be Prevented in Soccer?

Can Lower Extremity Injuries be Prevented in Soccer? Can Lower Extremity Injuries be Prevented in Soccer? Implementing the 11+ Program in Soccer: An Evidence-Informed Discussion Carolyn Emery Professor Faculty of Kinesiology & Medicine University of Calgary

More information

Neither Stretching nor Postactivation Potentiation Affect Maximal Force and Rate of Force Production during Seven One-Minute Trials

Neither Stretching nor Postactivation Potentiation Affect Maximal Force and Rate of Force Production during Seven One-Minute Trials Neither Stretching nor Postactivation Potentiation Affect Maximal Force and Rate of Force Production during Seven One-Minute Trials David M. Bazett-Jones Faculty Sponsors: Jeffery M. McBride & M. R. McGuigan

More information

Stay Strong REST AND RECOVERY

Stay Strong REST AND RECOVERY Start Running! Running improves your physical, emotional and mental health perhaps that s why its the most popular fitness activity around the world. The Ohio State University Wexner Medical Center Sports

More information

Strength and Core Stability - Handout

Strength and Core Stability - Handout Strength and Core Stability - Handout The National Physical Activity Guidelines for Australians are simple to achieve by focusing on: Thinking of movement as an opportunity, not an inconvenience. Being

More information

TRAINING FOR EXPLOSIVE POWER

TRAINING FOR EXPLOSIVE POWER TRAINING FOR EXPLOSIVE POWER How fast an athlete can generate power from a stand still. Short sprinters, offensive lineman in football and shot putters are examples of explosive athletes. An athlete s

More information

emoryhealthcare.org/ortho

emoryhealthcare.org/ortho COMMON SOCCER INJURIES Oluseun A. Olufade, MD Assistant Professor, Department of Orthopedics and PM&R 1/7/18 GOALS Discuss top soccer injuries and treatment strategies Simplify hip and groin injuries in

More information

Periodization as a philosophy of training program design

Periodization as a philosophy of training program design Periodization as a philosophy of training program design Introduction The General Adaptation Syndrome (GAS) helps us understand how a training stress improves an athlete s physiological capacity and why

More information

Chapter 20: Muscular Fitness and Assessment

Chapter 20: Muscular Fitness and Assessment Chapter 20: Muscular Fitness and Assessment American College of Sports Medicine. (2010). ACSM's resource manual for guidelines for exercise testing and prescription (6th ed.). New York: Lippincott, Williams

More information

Introduction. Coaches should leave the training with a clear understanding of the following: How to use the Special Olympics Athletics Coaching Guide

Introduction. Coaches should leave the training with a clear understanding of the following: How to use the Special Olympics Athletics Coaching Guide Introduction On behalf of Special Olympics International, THANK YOU for contributing your time and expertise. The knowledge you share with the course participants will make a significant impact on the

More information

Injury prevention: Which measures are useful? Prof. István Berkes MD., PhD

Injury prevention: Which measures are useful? Prof. István Berkes MD., PhD Injury prevention: Which measures are useful? Prof. István Berkes MD., PhD Priorities in Sports Medicine Antidoping Prevention of injuries General considerations Increasing number of active athletes and

More information

A Comparison of Plyometric Training Techniques for Improving Vertical Jump Ability and Energy Production

A Comparison of Plyometric Training Techniques for Improving Vertical Jump Ability and Energy Production Journal of Strength and Conditioning Research, 1998, 12(2), 85-89 1998 National Strength & Conditioning Association A Comparison of Plyometric Training Techniques for Improving Vertical Jump Ability and

More information

KNEE AND LEG EXERCISE PROGRAM

KNEE AND LEG EXERCISE PROGRAM KNEE AND LEG EXERCISE PROGRAM These exercises are specifically designed to rehabilitate the muscles of the hip and knee by increasing the strength and flexibility of the involved leg. This exercise program

More information

Dynamic Stretching Program augmented by self-myofascial Release on Knee Flexion

Dynamic Stretching Program augmented by self-myofascial Release on Knee Flexion Dynamic Stretching Program augmented by self-myofascial Release on Knee Flexion Passive Motion and Sprint Speed Context: Stretching techniques as well as self-myofascial release (self-mfr) have recently

More information

Fitness Intro. Freshmen PE

Fitness Intro. Freshmen PE Fitness Intro Freshmen PE Physical Fitness Are you able to get through your day easily without tiring? Does your body respond quickly when it needs to? Are you mentally alert in class? Do you feel good

More information

A Patient s Guide to Patellar Tendonitis

A Patient s Guide to Patellar Tendonitis A Patient s Guide to Patellar Tendonitis 2350 Royal Boulevard Suite 200 Elgin, IL 60123 Phone: 847.931.5300 Fax: 847.931.9072 DISCLAIMER: The information in this booklet is compiled from a variety of sources.

More information

ANKLE SPRAIN, ACUTE. Description

ANKLE SPRAIN, ACUTE. Description Description ANKLE SPRAIN, ACUTE An acute ankle sprain involves the stretching and tearing of one or more ligaments in the ankle. A two-ligament sprain causes more disability than a single-ligament sprain.

More information

Muscular Strength and Endurance:

Muscular Strength and Endurance: PE 1- Assignment #5 6 1 Name: Per: Date: Teacher: STRESS BREAK Participating in physical activities that improve your self-esteem is a great way to deal with stress. The better you feel about yourself,

More information

HOW TO USE HYDROTHERAPY TO TRAIN YOUR ATHLETES. Find out how water can help athletes condition and remain healthy.

HOW TO USE HYDROTHERAPY TO TRAIN YOUR ATHLETES. Find out how water can help athletes condition and remain healthy. HOW TO USE HYDROTHERAPY TO TRAIN YOUR ATHLETES Find out how water can help athletes condition and remain healthy. 5 WAYS THAT HYDROTHERAPY IS EFFECTIVE FOR TRAINING AND CONDITIONING HEALTHY ATHLETES You

More information

Fitness Intro. Freshmen PE

Fitness Intro. Freshmen PE Fitness Intro Freshmen PE Physical Fitness Are you able to get through your day easily without tiring? Does your body respond quickly when it needs to? Are you mentally alert in class? Do you feel good

More information

Repetition Maximum Continuum

Repetition Maximum Continuum Parts of a Lifting Program Before putting weight on the bar, the athlete needs to know some of the basic terms used in weight training. Repetition or rep refers to the number of times you perform a movement

More information

Sports Conditioning for the Knee A guide to conditioning and knee injury prevention

Sports Conditioning for the Knee A guide to conditioning and knee injury prevention Alex Petruska, PT, SCS, LAT Sports Conditioning for the Knee A guide to conditioning and knee injury prevention This program has been developed to provide a comprehensive guide to the conditioning of the

More information

SHARKS TAKING A BITE OUT OF ATHLETIC INJURIES

SHARKS TAKING A BITE OUT OF ATHLETIC INJURIES SHARKS TAKING A BITE OUT OF ATHLETIC INJURIES Peter A. Sprague, PT, DPT, OCS Associate Professor Physical Therapy Department College of Healthcare Sciences Nova Southeastern University NSU SPORTS MEDICINE

More information

MENISCUS TEAR. Description

MENISCUS TEAR. Description MENISCUS TEAR Description Expected Outcome The meniscus is a C-shaped cartilage structure in the knee that sits on top of the leg bone (tibia). Each knee has two menisci, an inner and outer meniscus. The

More information

Posterior Cruciate Ligament Rehabilitation

Posterior Cruciate Ligament Rehabilitation Posterior Cruciate Ligament Rehabilitation Phase 6: Running program for Return to Sports : 24 Weeks after surgery onward Goals: 1. Safely recondition the injured area for the demands of sports activity.

More information

Response Tendency in a Questionnaire

Response Tendency in a Questionnaire Response Tendency in a Questionnaire without Questions J. van Heerden and Joh. Hoogstraten University of Amsterdam In a replication of an earlier study by Berg and Rapaport (1954), a questionnaire with

More information

Journal of Applied Science and Agriculture

Journal of Applied Science and Agriculture AENSI Journals Journal of Applied Science and Agriculture ISSN 1816-9112 Journal home page: www.aensiweb.com/jasa/index.html The Effects of Static and PNF Stretching on Knee Extension Range of Motion among

More information

Mechanisms of ACL Injury: Implications for Rehabilitation, Injury Prevention & Return to Sport Decisions. Overarching research theme:

Mechanisms of ACL Injury: Implications for Rehabilitation, Injury Prevention & Return to Sport Decisions. Overarching research theme: Mechanisms of ACL Injury: Implications for Rehabilitation, Injury Prevention & Return to Sport Decisions Associate Professor Co Director, Musculoskeletal Biomechanics Research Laboratory University of

More information

Pilates for Runners: Core Strength and Flexibility for Increased Efficiency and Injury Prevention

Pilates for Runners: Core Strength and Flexibility for Increased Efficiency and Injury Prevention Pilates for Runners: Core Strength and Flexibility for Increased Efficiency and Injury Prevention Helen Buehler 9/20/15 Flow Studio // Chicago // 2015 Running is the most natural and accessible form of

More information

Katie Small a, Lars Mc Naughton a & Martyn Matthews b a Department of Sport, Health and Exercise Science,

Katie Small a, Lars Mc Naughton a & Martyn Matthews b a Department of Sport, Health and Exercise Science, This article was downloaded by: [78.94.69.142] On: 19 February 2013, At: 22:06 Publisher: Taylor & Francis Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer

More information

Injury Prevention: Quadriceps Contusion (cork thigh)

Injury Prevention: Quadriceps Contusion (cork thigh) Injury Prevention: Quadriceps Contusion (cork thigh) Quadriceps contusion or a cork thigh, as it is commonly known, is the result of a severe impact to the thigh which consequently compresses against the

More information

Static Stretching and Proprioceptive Neuromuscular Facilitation Stretching within Collegiate Athletes

Static Stretching and Proprioceptive Neuromuscular Facilitation Stretching within Collegiate Athletes Static Stretching and Proprioceptive Neuromuscular Facilitation Stretching within Collegiate Athletes Shila Tolliver 1, Molly Drew 1, Korissa Kitts 1, Fred L. Miller III 1, Yenly C. Londono Calle 1 1 Department

More information

A cute hamstring strains are common injuries in sport.1

A cute hamstring strains are common injuries in sport.1 4 ORIGINAL ARTICLE Type of acute hamstring strain affects flexibility, strength, and time to return to pre-injury level C Askling, T Saartok, A Thorstensson... See end of article for authors affiliations...

More information

FMS 4/20/16. Disclosures. Functional Movement Screen and Prior Injury in National Football League Combine Athletes.

FMS 4/20/16. Disclosures. Functional Movement Screen and Prior Injury in National Football League Combine Athletes. Functional Movement Screen and Prior Injury in National Football League Combine Athletes Harris S. Slone, M.D., Spero G. Karas, M.D., Raj Shani, M.D., Megan East, M.A., L.A.T, O.T.C., William R. Barfield,

More information

Runner s Injury Prevention Program

Runner s Injury Prevention Program Runner s Injury Prevention Program www.healthfitchiro.com Comprehensive Running Analysis Report Health-Fit Chiropractic & Sports Medicine Kevin M. Christie D.C. CSCS Report Summary (Phase 1) Dear Janet,

More information

Applicant Fitness Test Cumberland County Police Testing Consortium 2018

Applicant Fitness Test Cumberland County Police Testing Consortium 2018 Applicant Fitness Test Cumberland County Police Testing Consortium 2018 This is a pass or fail test. The individual tests will be conducted in the order displayed below. 1. Vertical Jump Requirement Jump

More information

MELDING EXPLOSIVE POWER WITH TECHNIQUES IN THE LONG JUMP. Explosive Strength IS THE RATE OF FORCE DEVELOPMENT AT THE START OF A MUSCLE CONTRACTION.

MELDING EXPLOSIVE POWER WITH TECHNIQUES IN THE LONG JUMP. Explosive Strength IS THE RATE OF FORCE DEVELOPMENT AT THE START OF A MUSCLE CONTRACTION. MELDING EXPLOSIVE POWER WITH TECHNIQUES IN THE LONG JUMP Jake Jacoby Jumps Coach University of Louisville jake.jacoby@louisville.edu Explosive Strength IS THE RATE OF FORCE DEVELOPMENT AT THE START OF

More information

Marathon Runners and the Benefits of Pilates

Marathon Runners and the Benefits of Pilates Marathon Runners and the Benefits of Pilates Katie Burroughs CTTC January May 2014 South Pasadena, CA 1 ABSTRACT First-time marathon runners spend a few years preparing for a marathon. Conditioning and

More information

PELLISSIPPI STATE COMMUNITY COLLEGE MASTER SYLLABUS CARE & PREVENTION OF ATHLETIC INJURIES PHED 2335

PELLISSIPPI STATE COMMUNITY COLLEGE MASTER SYLLABUS CARE & PREVENTION OF ATHLETIC INJURIES PHED 2335 PELLISSIPPI STATE COMMUNITY COLLEGE MASTER SYLLABUS CARE & PREVENTION OF ATHLETIC INJURIES PHED 2335 Class Hours: 3.0 Credit Hours: 3.0 Laboratory Hours: 0.0 Revised: Fall 2014 Catalog Course Description:

More information

Course Catalogue (courses offered in English) Master s Programme in Sports Science and Health. 1 September June 2018

Course Catalogue (courses offered in English) Master s Programme in Sports Science and Health. 1 September June 2018 Course Catalogue (courses offered in English) Master s Programme in Sports Science and Health 1 September 2017 30 June 2018 University of Southern Denmark Contents Contents of the course catalogue... 3

More information

BSc (Hons) Sports Science and Physical Education (Top-up) - (SC 305)

BSc (Hons) Sports Science and Physical Education (Top-up) - (SC 305) BSc (Hons) Sports Science and Physical Education (Top-up) - (SC 305) 1. Introduction The Top-up programme for Sports Science and Physical Education is a 2-year s part-time course, offered by the Department

More information

Journal of Undergraduate Kinesiology Research

Journal of Undergraduate Kinesiology Research Effects of Three Different Stretching Techniques on Acceleration and Sprint Performance in Women Collegiate Soccer Players 9 Journal of Undergraduate Kinesiology Research Official Research Journal of the

More information

Supplementary Appendix

Supplementary Appendix Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Bayer ML, Magnusson SP, Kjaer M. Early versus delayed rehabilitation

More information

Hamstring Muscle Injuries

Hamstring Muscle Injuries Hamstring Muscle Injuries Hamstring muscle injuries such as a "pulled hamstring" occur frequently in athletes. They are especially common in athletes who participate in sports that require sprinting, such

More information

CHAPTER 2: Muscular skeletal system - Biomechanics. Exam style questions - pages QUESTIONS AND ANSWERS. Answers

CHAPTER 2: Muscular skeletal system - Biomechanics. Exam style questions - pages QUESTIONS AND ANSWERS. Answers CHAPTER 2: Muscular skeletal system - Biomechanics Exam style questions - pages 32-35 1) A Level. Warm up is considered to be an essential element of a training programme. Explain how the muscular and

More information

Knee Injuries. PSK 4U Mr. S. Kelly North Grenville DHS. Medial Collateral Ligament Sprain

Knee Injuries. PSK 4U Mr. S. Kelly North Grenville DHS. Medial Collateral Ligament Sprain Knee Injuries PSK 4U Mr. S. Kelly North Grenville DHS Medial Collateral Ligament Sprain Result from either a direct blow from the lateral side in a medial direction or a severe outward twist Greater injury

More information

The Reliability of Four Different Methods. of Calculating Quadriceps Peak Torque Angle- Specific Torques at 30, 60, and 75

The Reliability of Four Different Methods. of Calculating Quadriceps Peak Torque Angle- Specific Torques at 30, 60, and 75 The Reliability of Four Different Methods. of Calculating Quadriceps Peak Torque Angle- Specific Torques at 30, 60, and 75 By: Brent L. Arnold and David H. Perrin * Arnold, B.A., & Perrin, D.H. (1993).

More information

NATURAL DEVELOPMENT AND TRAINABILITY OF PLYOMETRIC ABILITY DURING CHILDHOOD BY KIRSTY QUERL SPORT SCIENTIST STRENGTH AND CONDITIONING COACH

NATURAL DEVELOPMENT AND TRAINABILITY OF PLYOMETRIC ABILITY DURING CHILDHOOD BY KIRSTY QUERL SPORT SCIENTIST STRENGTH AND CONDITIONING COACH NATURAL DEVELOPMENT AND TRAINABILITY OF PLYOMETRIC ABILITY DURING CHILDHOOD BY KIRSTY QUERL SPORT SCIENTIST STRENGTH AND CONDITIONING COACH The truth... Youth are not as active as they used to be, Decline

More information

Inside The Park Baseball NYO Speed-Strength / Performance Training

Inside The Park Baseball NYO Speed-Strength / Performance Training Inside The Park Baseball NYO Speed-Strength / Performance Training September 23, 2016 Presented to: Inside the Park Baseball NYO / Chastain Park 140 West Wieuca Rd. Atlanta, GA 30342 Sports Performance

More information

FIFA 11+ Reducing injury rates in soccer in Ontario

FIFA 11+ Reducing injury rates in soccer in Ontario FIFA 11+ Reducing injury rates in soccer in Ontario Rhona McGlasson PT, MBA Stella Makris RKin Chelsea Norris CSEP-CPT Matt Greenwood April 29, 2015 Agenda Review of the research What is injury prevention

More information

BACK SPASM. Explanation. Causes. Symptoms

BACK SPASM. Explanation. Causes. Symptoms BACK SPASM Explanation A back spasm occurs when the muscles of the back involuntarily contract due to injury in the musculature of the back or inflammation in the structural spine region within the discs

More information

WHAT RESEARCH TELLS US ABOUT FLEXIBILITY - I Jason Holt, Laurence E. Holt & Thomas W. Pelham Dalhousie University, Halifax, Nova Scotia, Canada

WHAT RESEARCH TELLS US ABOUT FLEXIBILITY - I Jason Holt, Laurence E. Holt & Thomas W. Pelham Dalhousie University, Halifax, Nova Scotia, Canada WHAT RESEARCH TELLS US ABOUT FLEXIBILITY - I Jason Holt, Laurence E. Holt & Thomas W. Pelham Dalhousie University, Halifax, Nova Scotia, Canada That flexibility is an important component of fitness, required

More information

CHAPTER 3 RESEARCH METHODOLOGY. In this chapter, research design, data collection, sampling frame and analysis

CHAPTER 3 RESEARCH METHODOLOGY. In this chapter, research design, data collection, sampling frame and analysis CHAPTER 3 RESEARCH METHODOLOGY 3.1 Introduction In this chapter, research design, data collection, sampling frame and analysis procedure will be discussed in order to meet the objectives of the study.

More information

ILIOTIBIAL BAND SYNDROME

ILIOTIBIAL BAND SYNDROME Dr. S. Matthew Hollenbeck, MD Kansas Orthopaedic Center, PA 7550 West Village Circle, Wichita, KS 67205 2450 N Woodlawn, Wichita, KS 67220 Phone: (316) 838-2020 Fax: (316) 838-7574 Description ILIOTIBIAL

More information

Growth cartilage in children is located at the. Age- and Sex-Related Differences and Their Implications for Resistance Exercise.

Growth cartilage in children is located at the. Age- and Sex-Related Differences and Their Implications for Resistance Exercise. C H A P T E R 9 Age- and Sex-Related Differences and Their Implications for Resistance Exercise Chapter Outline Children Female athletes Older adults Growth cartilage in children is located at the epiphyseal

More information

Platelet-Rich Plasma Compared With Other Common Injection Therapies in the Treatment of Chronic Lateral Epicondylitis

Platelet-Rich Plasma Compared With Other Common Injection Therapies in the Treatment of Chronic Lateral Epicondylitis Journal of Sport Rehabilitation, 2016, 25, 77-82 http://dx.doi.org/10.1123/jsr.2014-0198 2016 Human Kinetics, Inc. CRITICALLY APPRAISED TOPIC Platelet-Rich Plasma Compared With Other Common Injection Therapies

More information

Stretching Prior to Exercise

Stretching Prior to Exercise Croxton 1 Stretching Prior to Exercise Does pre stretching enhance an athlete s performance? Kyle Croxton Upper Arlington High School Croxton 2 Abstract The purpose of this research paper is to analyze

More information

Higher National Unit specification: general information. Prevention and Rehabilitation of Sports Injuries

Higher National Unit specification: general information. Prevention and Rehabilitation of Sports Injuries Higher National Unit specification: general information Unit code: FW67 34 Superclass: PB Publication date: October 2011 Source: Scottish Qualifications Authority Version: 01 Unit purpose This Unit introduces

More information

Unraveling the Mystery of Knee Pain #2: Client History & The 23 Injuries Common to the Knee

Unraveling the Mystery of Knee Pain #2: Client History & The 23 Injuries Common to the Knee Unraveling the Mystery of Knee Pain #2: Client History & The 23 Injuries Common to the Knee Instructor: Ben Benjamin, Ph.D. Instructor: Ben Benjamin, Ph.D. 1 Webinar Goals Understand the significance of

More information

Strength Training for Cyclist. James Herrera MS, CSCS, USAW USA Cycling National Team Coach BMX

Strength Training for Cyclist. James Herrera MS, CSCS, USAW USA Cycling National Team Coach BMX Strength Training for Cyclist James Herrera MS, CSCS, USAW USA Cycling National Team Coach BMX A type of physical exercise specializing in the use of increasing resistance to induce muscular contraction

More information

Exercise Highlight REVERSE LUNGE TO PLYOMETRIC SPRINTER-START

Exercise Highlight REVERSE LUNGE TO PLYOMETRIC SPRINTER-START Exercise highlight: Reverse lunge to plyometric sprinter-start. J. Aust. Strength Cond. 21(4)5-13. 2013 ASCA. Exercise Highlight REVERSE LUNGE TO PLYOMETRIC SPRINTER-START Ronald L. Snarr, M.Ed., CSCS,

More information

WARMING UP WARMING UP TARGETS WHY DO WE WARMING UP?

WARMING UP WARMING UP TARGETS WHY DO WE WARMING UP? WARMING UP AND COOL DOWN: WARMING UP Warming up is a set of exercises previously conducted before any physical activity or sports. First some general exercises targeting to the whole body and after them

More information

Dear Parents or Guardians,

Dear Parents or Guardians, Chandler-Newberger Community Center Robert Crown Community Center 1028 Central Street 1701 Main Street Evanston, Illinois 60201 Evanston, Illinois 60202 847-448-8252 847-448-8258 Dear Parents or Guardians,

More information

Training Manual for National Physical Fitness Award (NAPFA)

Training Manual for National Physical Fitness Award (NAPFA) Training Manual for National Physical Fitness Award (NAPFA) If you have been medically graded fit for most combat and combat support vocations (i.e. PES A/B1), you are encouraged to take the NAPFA test

More information

Response to "Berger in retrospect: effect of varied weight training programmes on strength"

Response to Berger in retrospect: effect of varied weight training programmes on strength Br J Sports Med 2003; 37: 372-373 2003 BMJ Publishing Group Ltd. & British Association of Sport and Exercise Medicine LETTER Response to "Berger in retrospect: effect of varied weight training programmes

More information

chapter Plyometric Training

chapter Plyometric Training chapter 18 Plyometric Training Chapter Objectives Explain the physiology of plyometric exercise. Identify the phases of the stretch-shortening cycle. Identify components of a plyometric training program.

More information

Objectives. Sprains, Strains, and Musculoskeletal Maladies. Sprains. Sprains. Sprains. Physical Exam 5/5/2010

Objectives. Sprains, Strains, and Musculoskeletal Maladies. Sprains. Sprains. Sprains. Physical Exam 5/5/2010 Objectives, Strains, and Musculoskeletal Maladies Robert Hosey, MD University of Kentucky Sports Medicine Define sprains and strains Systematically evaluate and manage joint / muscle injuries When to refer

More information

ELECTRICAL MUSCLE STIMULATION (EMS) IMPLEMENTATION IN EXPLOSIVE STRENGTH DEVELOPMENT

ELECTRICAL MUSCLE STIMULATION (EMS) IMPLEMENTATION IN EXPLOSIVE STRENGTH DEVELOPMENT Zoran Đokić, Bojan Međedović Fakultet za sport i turizam, Novi Sad UDK:796.012.11:615.84 ELECTRICAL MUSCLE STIMULATION (EMS) IMPLEMENTATION IN EXPLOSIVE STRENGTH DEVELOPMENT 1. INTRODUCTION Research on

More information

Hip Strains. Anyone can experience a hip strain just doing everyday tasks, but strains most often occur during sports activities.

Hip Strains. Anyone can experience a hip strain just doing everyday tasks, but strains most often occur during sports activities. Hip Strains A hip strain occurs when one of the muscles supporting the hip joint is stretched beyond its limit or torn. Strains may be mild, moderate, or severe, depending on the extent of the injury.

More information

Biomechanics of Skeletal Muscle and the Musculoskeletal System

Biomechanics of Skeletal Muscle and the Musculoskeletal System Biomechanics of Skeletal Muscle and the Musculoskeletal System Hamill & Knutzen (Ch 3) Nordin & Frankel (Ch 5), or Hall (Ch. 6) Muscle Properties Ø Irritability Ø Muscle has the capability of receiving

More information

Sul Ross State University KES: 3303 Care and Prevention of Athletic Injuries Fall 2016 Syllabus

Sul Ross State University KES: 3303 Care and Prevention of Athletic Injuries Fall 2016 Syllabus Sul Ross State University KES: 3303 Care and Prevention of Athletic Injuries Fall 2016 Syllabus Instructor: Charles Lynn Office Phone: 837-8241 Class Time: MWF 11:00 11:50 Location: GPC 107 Email: clynn@sulross.edu

More information

Knee Conditioning Program

Knee Conditioning Program Prepared for: Prepared by: Purpose of Program After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle. Following

More information

Homework Linear Regression Problems should be worked out in your notebook

Homework Linear Regression Problems should be worked out in your notebook Homework Linear Regression Problems should be worked out in your notebook 1. Following are the mean heights of Kalama children: Age (months) 18 19 20 21 22 23 24 25 26 27 28 29 Height (cm) 76.1 77.0 78.1

More information

NORDIC HAMSTRING PROGRAM

NORDIC HAMSTRING PROGRAM NORDIC HAMSTRING PROGRAM Injury Prevention Sport Med 18 January 26 Dave Wright CAT(c) University of Guelph Hamstring Injury Prevention Injury Prevention: Evidence Based Literature Hamstring injuries are

More information

CHAPTER 8: THE BIOMECHANICS OF THE HUMAN LOWER EXTREMITY

CHAPTER 8: THE BIOMECHANICS OF THE HUMAN LOWER EXTREMITY CHAPTER 8: THE BIOMECHANICS OF THE HUMAN LOWER EXTREMITY _ 1. The hip joint is the articulation between the and the. A. femur, acetabulum B. femur, spine C. femur, tibia _ 2. Which of the following is

More information

THE SUFFERFEST: YOGA FOR CYCLISTS PROGRAMME

THE SUFFERFEST: YOGA FOR CYCLISTS PROGRAMME THE SUFFERFEST: YOGA FOR CYCLISTS PROGRAMME WE PUT THE YOGA IN AGONY Exclusive to Sufferfest App Subscribers IWBMATTKYT 1 About The Sufferfest s Yoga Videos When looking for a yoga partner for The Sufferfest

More information

Comparative Effect of Three Modes of Plyometric Training on Leg Muscle Strength of University Male Students

Comparative Effect of Three Modes of Plyometric Training on Leg Muscle Strength of University Male Students European Journal of Scientific Research ISSN 1450-216X Vol.31 No.4 (2009), pp.577-582 EuroJournals Publishing, Inc. 2009 http://www.eurojournals.com/ejsr.htm Comparative Effect of Three Modes of Plyometric

More information

Move Well, Live Well September Newsletter

Move Well, Live Well September Newsletter Move Well, Live Well September Newsletter September 15, 2016 Volume 4, Number 9 In This Issue: Eccentric Strengthening to Improve Flexibility Complete Rehab for Ankle Sprains Living with Chronic Pain:

More information

ANKLE SPRAINS. Explanation. Causes. Symptoms

ANKLE SPRAINS. Explanation. Causes. Symptoms ANKLE SPRAINS Explanation Ankle sprains occur when ligaments in the ankle are partially or completely torn due to sudden stretching, either laterally or medially, or when the ankle is suddenly twisted

More information

Applied Exercise and Sport Physiology, with Labs, 4e

Applied Exercise and Sport Physiology, with Labs, 4e Applied Exercise and Sport Physiology, with Labs, 4e hhpcommunities.com/exercisephysiology/chapter-10-aerobic-exercise-prescriptions-for-public-health-cardiorespiratory-fitness-and-athletics/chap Chapter

More information

DEVELOPING PHYSICAL CAPACITIES IV - STRENGTH MUSCLE TYPES

DEVELOPING PHYSICAL CAPACITIES IV - STRENGTH MUSCLE TYPES DEVELOPING PHYSICAL CAPACITIES IV - STRENGTH The muscular system is made up of around 650 muscles and account for around half of the weight of our body. The muscular system of the body is what allows humans

More information

Athletics Merit Badge Workbook

Athletics Merit Badge Workbook Merit Badge Workbook This workbook can help you but you still need to read the merit badge pamphlet. This Workbook can help you organize your thoughts as you prepare to meet with your merit badge counselor.

More information

NSW Country Rugby League Academy

NSW Country Rugby League Academy Name: NSW Country Rugby League Academy Weight Training Guidelines 2007/08 Prepared by: The Department of Exercise Science and Sport Management Southern Cross University Contents Page Introduction 1 Weight

More information

MENTOR METHOD OF TRAINING

MENTOR METHOD OF TRAINING MENTOR METHOD OF TRAINING When trying to improve performance on the field of play or on the court, whatever your sport, it is important that you understand where it all begins. For an athlete there are

More information

EXERCISE AND SPORT SCIENCE (EXSS)

EXERCISE AND SPORT SCIENCE (EXSS) EXERCISE AND SPORT SCIENCE (EXSS) 1 EXERCISE AND SPORT SCIENCE (EXSS) EXSS 50. First-Year Seminar: Discrimination and Sport. 3 This course will examine the American ethos by looking at those who have been

More information

Game Shape FAST. total female hockey

Game Shape FAST. total female hockey total female hockey 2008 1 TABLE OF CONTENTS SECTION PAGE Game Shape FAST Program Outline...4 Daily Workouts...5 Week 1 Day 1...5 Day 2...6 Day 3...7 Week 2 Day 4...8 Day 5...9 Day 6...10 Week 3 Day 7...11

More information

WRIST SPRAIN. Description

WRIST SPRAIN. Description WRIST SPRAIN Description Other sports, such as skiing, bowling, pole vaulting Wrist sprain is a violent overstretching and tearing of one Poor physical conditioning (strength and flexibility) or more ligaments

More information

Physical Therapy for the Lower Extremity: What You and Your Patient Should Expect from Rehab

Physical Therapy for the Lower Extremity: What You and Your Patient Should Expect from Rehab 1 Physical Therapy for the Lower Extremity: What You and Your Patient Should Expect from Rehab Thomas Clennell, PT, DPT, SCS Physical Therapist UCSF Benioff Children s Hospital Oakland Sports Medicine

More information

Coaching Applications

Coaching Applications Coaching Applications The effects of ten weeks block and reverse periodization training on swimming performance and body composition of moderately trained female swimmers. Arroyo- Toledo, J.J. 1 Clemente,

More information