Are you hitting roadblocks with your injury prevention efforts?

A True Tale of Two Teams: Team #1

A soccer team wanted to reduce injuries. Well, not exactly.  The real passion for injury prevention came from a local physical therapist who wanted to reduce injuries on this particular soccer team. The PT volunteered his time and implemented the FMS and Lower Quarter Y Balance Testing for this group. The first year it was a challenge simply to get the testing scheduled and completed. But each year, the testing got easier and eventually, the Upper Quarter Y Balance Test was added.

Every year, the players received their Move2Perform reports with the risk category (Lehr et al), as well as 3 corrective exercises to perform. There was little buy-in from coaches and athletes, little follow up, and no re-testing occurred. After the 4th year, the athletic trainer was exceptionally frustrated as the injury rate was still sky high. He told a colleague, “The FMS doesn’t work.  Players who score a 16 are still getting hurt!  We need to do more and different screening.”

Fortunately, the testing data was kept and it was analyzed. Over the past four years, 17 athletes with preventable, time loss lower-extremity injuries were identified. Their Move2Perform category was then examined and these results showed that 13 of the 17 players were in the moderate or substantial risk category at the start of the season in which the injury occurred. Remember the players who scored above 14?  Yes, but those players have 0s and 1s which placed them at higher risk of injury.

Was the problem that the tests were not identifying the players who were at risk?  No. The problem is that the athletes who were identified as being at substantial or moderate risk for injury did not receive appropriate intervention strategies and re-testing.

Team #2  

A baseball team wanted to reduce injuries. Well, not exactly.  The entire sports medicine and performance team wanted to revamp their injury prevention system. They wanted something stable, reliable, and scalable. They hired a consultant to systematize their injury prevention. After working with the consultant, they elected to do the FMS and Y Balance Test and categorize athletes using the Move2Perform software. They created a mission statement and goals. After testing, they developed a strategy for each player to address the deficits found. They had a re-testing schedule and organizational accountability for the outcomes.

At the end of the season, they had one of the lowest injury rates in their history as well as one of the lowest injury rates among their peers. They found that if a player entered the season with deficits (in the higher risk Move2Perform categories), they were 4 times more likely to get injured. If they were able to improve the deficits in the pre-season and get the player into a lower risk category, they did not get injured. The next year, they had a plan to improve their testing, intervention strategies, and outcomes.

Both teams used testing for injury prevention.  Why was only one team successful?

Here are a few of my observations of the successful team:

• They started with Why: One team recognized that the best way to improve player performance was to keep them on the field in the first place (prevent injury). Each staff member from lowest level to highest level gave the same answer to the question:     Why are we doing this?

 “Last year, we had too many injuries that kept key players from performing their best.

We are doing this so everyone can stay on the field with top notch performance.”

• They had entire organizational buy-in from coaching, strength and conditioning, rehabilitation, and medical staff. They owned and internalized the process. The system became part of their culture.
• They analyzed their current state: What was their historical injury rate? What were they currently doing? What was working, what wasn’t? What tests or screens were providing meaningful information? What things were they collecting because of tradition?
• They had a written mission statement and objectives. They effectively communicated why, how, and what they were doing.
• They used multiple risk factors and categorized their team members by systematically weighing those factors. They didn't rely on a single risk factor for their risk identification and intervention strategies.
• They financially invested in the system. When things are free, people don’t see as much value in them as when they purchase them.
• After testing, they had clearly written intervention strategies that were communicated among all involved parties.
• They monitored their outcomes and developed strategies for improvement.
• And finally, the successful team had a checklist throughout the continuum of care and across disciplines.

Bottom line: The successful team improved player performance by implementing systematic injury prevention.  Future posts will expand upon each of the characteristics and describe implementation strategies.