Is Injury Prevention a Myth?

I see ads for PT and training services touting that they can “prevent injuries.” I know that it's advertising - it’s a simple claim that will draw people in. But can you really prevent injuries with PT or training? Is Injury Prevention a Myth?

The simple answer is no, you cannot 100% prevent injuries. The better term for what PT can do for athletes is to help reduce injury risk. But that doesn’t look as cool on an ad.

Wait what? Why not?

Even with the BEST of the best for injury risk reduction, you can't predict with 100% confidence what will happen in sports. For example: you fully prepared, did your ACL injury prevention program perfectly...but then someone hits your knee, there is a divot in the field, your shoe lace came untied. No amount of prep work can keep you safe from the uncontrollables in sports. The best we can do is keep our athletes strong, flexible, well fueled, and well recovered!

What does the research say?

• Generally previous injury is one of the biggest predictive factors for subsequent injuries. 

• Training volume/load is also predictive of injuries - too much training, and also too little training for a particular event increases odds of injury.

• In both running and CrossFit, more novice athletes are more likely to get injured vs more veteran athletes.

• Too little sleep (less than 7 hours a night, sustained for at least 14 days) will increase odds of injury 1.7 times.

• Low energy availability is also significantly linked to increased risk of injury. This means athletes who are not eating enough calories to balance out their energy output are at a higher risk of injury.

What about specific injuries?

• There is a significant decrease in risk of ACL tears in female athletes that participate in an exercise program that meets these criteria:

  • The program has more than 1 exercise component.

  • It includes proximal control exercises (trunk or core stability).

  • It includes both plyometric and strengthening components.

  • It’s done multiple times per week, and each session is greater than 20mins.

  • It’s included throughout the pre-season, during the season, and postseason (pre-season only doesn’t cut it!).

  • (So basically, a good strength and conditioning program!)

• There is an increased risk of ankle sprains after an initial ankle sprain if:

  • They don’t use an ankle brace or get taped.

  • There is a failure to warm up with static stretching and dynamic movement before activity.

  • The individual is lacking normal ankle range of motion (specifically dorsiflexion).

  • The individual failed to participate in a balance and proprioceptive training program after their prior injury.

How can working with a PT help reduce risk of injury?

• Addressing strength deficits and imbalances: lack of strength can result in an inability to perform a movement, control your joints, and maintain your posture. If you are trying to get up from your seat but your quads are too weak, you might end up using your back more. This can lead to overuse of your back muscles. 

• Addressing mobility deficits and imbalances: if you have poor mobility in one joint that should be moving during your chosen activity, you will make up for it somewhere else. This can result in one part of your body moving more, meaning more stress at that particular segment. If we even out the mobility, the stress is better distributed.

• Teaching better control, technique, and form: you can have the required strength and mobility, but if you don’t have the control to use it, it’s almost like you don’t have it. Working on lifting technique, sport specific form, and general body control can be important in reducing risk of injury.

• Better programming: a good PT can help you with your strength and conditioning program. Figuring out the balance between crushing yourself with too much volume, and not doing enough to get stronger can be hard on your own. This is where I see a lot of my patients get hurt, and getting back to their activities requires fixing that programming!

• First line for screening injury risk factors: PTs have knowledge of how the human body works as a whole unit (not just parts), so we take into account other factors that play into injury risk. We talk about sleep, nutrition, and stress management.

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About the author: Dr. Caitlyn Hauswirth-Varis, PT, DPT, OCS, CFMT, CF-L1

Caitlyn is board certified as an orthopedic specialist and an expert in pelvic floor physical therapy. She has helped many patients return to sports after injury, and has returned from multiple injuries to high level sports herself. She is also passionate about being truthful in advertising ;)

Disclaimer: This blog post is for informational purposes only and does not substitute for professional medical advice. Please consult with a qualified healthcare professional for personalized guidance.