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Rapid Responses: Rapid Responses published:
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Overinterpretation of data
- Nick Webborn (11 February 2005)
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Comments
- pippa bennett (27 February 2005)
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Throw Away Your Shoes (sorry Nike)
- Dr. Herbert H. Nehrlich (28 February 2005)
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Use of term "warm-up" is misleading
- Paul E Jennings (28 February 2005)
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Nick Webborn, Sports Physician Sussex Centre for Sport & Exercise Medicine, University of Brighton BN20 7sn
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All the participants in this study played handball and therefore the conclusion should be "A structured programme of warm-up exercises can prevent knee and ankle injuries in young people playing handball" and not "sports". It is a huge assumption that this warm up would have the same effect in all sports. The study is also weak because it does not allow for season on season varablity in injury rates and assumes that the injury rates of the season of the study were representative of previous years. In sport we have marked variation in injury patterns in teams that are multifactorial and this is an oversimplification. Competing interests: None declared |
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pippa bennett, sports physician The Football Association 25 Soho Square London W1A4FA
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Firstly I would like to commend Dr Olsen and his team on the first RCT in this area. I believe there is to published a work by Mandelbaum and Silvers on a similar project in soccer in the States. A couple of comments. There seems to be quite a variability in the clubs and the level of training and match play and I wonder how this influenced outcome. Did the matching by playing level diminish this variabilty? Was there any problems with recall of injuries. I see that the maximum time to contact an injured player was 4 months. I agree that the focus in particular for ACL injuries needs to be prevention and more specifically we need to target our young players 10-12 year olds. This is the window of opportunity where we can make the biggest difference to their movement patterns. Competing interests: None declared |
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Dr. Herbert H. Nehrlich, Private Practice Bribie Island, Australia 4507
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While the problem of injuries to the lower limb continues to frustrate coaches and others, the little known technique for prevention is being kept in the dark Warm-up to me is like stretching, both totally unnecessary, although this won't make me many friends. Stretching and warm-up are both unnatural measures that would not be employed in our ancestral life. I have found, in 1986, that the most effective way to prevent injuries to the limbs, say hamstring tears, achilles problems and the whole bowl of knee problems etc. is simply to allow the body to once again make contact with the ground. In other words, running and doing other sports without shoes, on bare feet is the secret. Space limitations do not permit further comments but I would be glad to answer questions on the subject that has eliminated ALL my injury problems since 20 years ago. drhhnehrlich@westnet.com.au Competing interests: None declared |
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Paul E Jennings, Consultant Radiologist Ipswich Hospital
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The BMJ should take more care with its cover headlines which are most likely to be noticed by the lay press and public.
"Warm-up" to most sportsmen in this country means some light activity, which may include non-specific exercises such as stretching, immediately before a game or training session to literally warm-up the body and prepare for the main activity.
This BMJ article describes a highly structured, specific set of training excercises designed to improve body control and thus reduce injury during games. It seems quite likely that these exercises would have a beneficial effect on the participants if performed and repeated at any time and not just immediately before a game. The use of the term warm-up is thus potentially misleading and, if the full text is not studied, may be interpreted as meaning that any general "warming-up" exercise prevents injury.
Competing interests: None declared |
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