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Injury prevention

To Strike or Not to Strike? That’s not the only question (for running and injury prevention)

22 Feb, 12 | by Karim Khan

Photo courtesy of Andrew Malone, Flickr CC

Running biomechanics and footwear’s (from bare feet to orthotics) relationship to injury generates lively debate.  And not just among sports clincians. A recent NY times article boldly asked – Does Foot Form Explain Running Injuries? The article profile’s the running professor, Daniel Lieberman’s (Evolutionary Biologist, Harvard) and Mr. Daoud’s (Medical Student, Stanford) research on 4 years worth of data gathered from Harvard’s cross-country running team. The researchers investigated footstrike (heel vs. toe) and rate of injury.

Beyond running style, Lieberman advocates for daily physical activity. In the BMJ podcast, Evolved to Run (that also features Steven Blair and Karim Khan), you’ll hear Lieberman say:  “we live in an abnormal world where people sit all day long.” What Lieberman positions as ‘normal,’ from an evolutionary perspective, is human bodies adaptation to having physical activity integrated into daily activities. In short – ‘the abnormality’ results from the dissonance between being ‘built to run’ and the post-industrial epidemic of sedentary behavior. You’ll hear more on the impacts of physical inactivity and the ‘ physical activity dose’ required’ to increase health from Blair and Khan on that  podcast.

Lieberman and Daoud concluded that “runners who landed on their heels were considerably more likely to get hurt,” but a forefoot running strike did not neccessarily prevent injury. Also, the researchers caution against changing your running style if you are injury-free.

And BJSM readers will know that ground/foot impact is not the only factor to take into account. What about knee and hip control? Also from Harvard, PT Professor Irene Davis illustrated that gait retraining – providing runners with feedback about landing forces – swiftly reduced anterior knee pain. Read the (free) Editor’s Choice article here.

So, while it may be premature to (run or) jump to conclusions about any one ‘superior’ approach to running, it’s clear  that 30-60 minutes of forefoot and/or heel striking is better than no strike at all.

Related BJSM Articles

RF Pinto, TR Souza, and CG Maher. 2012. External devices (including orthotics) to control excessive foot pronation. Br J Sports Med. 46:110-111.

K Mills,  P Blanch,  P Dev,  M Martin,  and B Vicenzino. 2011. A randomised control trial of short term efficacy of in-shoe foot orthoses compared with a wait and see policy for anterior knee pain and the role of foot mobility . Br J Sports Med. Published Online First: 18 September 2011

A Hirschmüller,  H Baur,  S Müller,  P Helwig, H-H Dickhuth,  F Mayer. 2011. Clinical effectiveness of customised sport shoe orthoses for overuse injuries in runners: a randomised controlled study. Br J Sports Med. 45:959-965 Published Online First: 12 August 2009

RTH Cheung, RCK Chung,  GYF Ng. 2011. Efficacies of different external controls for excessive foot pronation: a meta-analysis. Br J Sports Med 2011;45:743-751 Published Online First: 18 April 2011

Rural sport and exercise medicine in the highlands of Scotland – working with Shinty!

29 Dec, 11 | by Karim Khan

Guest blog by Dr Jonathan Hanson FFSEM


Like many doctors in sport for years I have relied upon the goodwill of colleagues and employers in the remote corner of Scotland I call home.  Last year I felt the time had come to give something back to the local sport in my region, rather than consistently abusing the goodwill to work with sports many miles away in the cities. Not that there is an extensive choice of sports for a physician to become involved in.

The reality of living and working in the North-West Highlands is that most sport is not of the organised variety – climbers, hill walkers and kayakers are the largest proportion and we already play in role  – albeit in an emergency, critical injury and primary care sports medicine role for these visiting “athletes”.

Of the organised sport out here, the extreme weather dictates that summer is outside and winter is inside. In contrast to the rest of the UK, football is a summer sport in the Hebrides and it supports a very competitive local league. A league that the winners of end up in national cup competitions. Despite being the most popular sport in Scotland by a mile, in the Highlands football remains the little brother of the real Daddy – shinty.

Describing shinty to anyone is a bit like trying to explain Cricket to Americans – until you strip in down to the most basic analogy –“imagine full contact golf”.

Shinty is a sport deeply engrained in Gaelic culture and a distant relative of the Irish sport of hurling. A bit like Aussie Rules and Gaelic football, the international version of the sport is a combined rules shinty- hurling affair between the Scots and the Irish that is played home and away each autumn.

The major cup finals (of which the Camanachd cup is the premier event) are televised on the BBC and simultaneously broadcast on national radio. A handful of seasoned campaigners have reluctantly acquired local celebrity status – but all of whom then go back to work on the croft (smallholding) or fishing boats etc.

The sports governing body – the Camanachd association, has a structure not unlike many other sports with development officers, coaching courses and an active junior section. The local papers are filled each week with photos and match reports and it is discussed passionately down the pub, just like its more widely known relations. Despite some modernisation – the sport remains the archetypal “man’s game” with traditional values which the clubs fight fervently to protect.

Injury Prevention –  medical point of view

KYLES V NEWTONMORE


From a medical point of view, living in the islands, we don’t need a comprehensive injury reporting system to note the injury prevention issues of the sport.  As a Doctor in the communities it’s hard not to be aware of club stalwarts with visual problems incurred playing the sport. Working in the emergency department, Saturday afternoons bring a steady procession of wounds around the face caused by the stick (or caman), hand fractures and the occasional hyphema or actual globe injury. Just like any other sportsman, the primary concern of the athlete is “When can I play again?”

So it was with this in mind that I thought about approaching the Camanachd association to see if I could help them in an advisory capacity. From the perspective of the organisation, the response was positive. A meeting was arranged with the lead development officer and we discussed what I thought I could offer them and what they thought they needed.

Not surprisingly the issue in the Celtic stick sports remains that of helmets and facial protection. Having seen many facial injuries, I have also learned a bit about the coaching of the sport and attitude to injury. Essentially, the good players get close enough to the attacker so that they are within his swing circle and avoid being hit. Being hit is looked down upon as something that lesser players do.

At junior level (age 14) helmets with a faceguard are compulsory and the helmets recommended are the brand specific to their hurling counterparts – so it is essentially fit for purpose. However beyond age 14 there is no compulsory regulation and given the image of the sport as a tough working mans game, very few players continue with any protection at all. Recent high profile players such as Ronald Ross have begun wearing one, but as yet this has not spread across a sport where the goalkeeper is often selected by size (and often adiposity) and chooses protection more useful against the cold (a woolly jumper) rather than against a small high velocity projectile.

I had hoped to set up an injury reporting system and look at coaching and injury prevention as well as establishing a minimum standard of first aid. A senior figure of our local club is the patron of a charity that places defibrillators (having himself had an out of hospital cardiac arrest) so the links between shinty and immediate care are strong (www.lucky2bhere.com). However, such is the suspicion around medical involvement and the perceived desire to take away traditional values of the sport by mandating helmets, that every enquiry to clubs about medical support and training, let alone collecting an injury database were either flatly ignored, or returned with aggressive questions about my motives.

Fortunately the Camanachd association have been more supportive. They are fully aware of the challenges of building medical bridges to the clubs and the value of what we were trying to do. They have taken on the F-MARC FIFA 11+ as an injury prevention strategy and introduced it to the coach education sessions. Whether or not it will make any difference to preventing injury I may never be able to measure. They are also trying to use their contacts with coaches to improve the club / medical relationship and start to quantify some of the perceived problems in the sport. Fingers crossed it continues.

Related BJSM articles

McIntosh AS, Andersen TE, and Bahr, R et al. 2011. Sports helmets now and in the future. BJSM. 45:1258-1265.

McIntosh AS, McCrory P, Finch CF, and Wolfe R. 2010. Head, face and neck injury in youth rugby: incidence and risk factors. BJSM. 44:188-193. (Editor’s choice – full text online!)

Mishra A. 2010. Management of soft tissue injury of hand wrist and elbow in sports. BJSM. 44:i3.


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Dr Jonathan Hanson FFSEM is a Sport and Exercise Medicine Physician/Rural Practitioner. Broadford Hospital. Skye

Injury surveillance on young elite athletes participating in the 1st Winter Youth Olympic Games in Innsbruck/Austria

27 Dec, 11 | by Karim Khan

BJSM e-letter by:

Gerhard Ruedl and Wolfgang Schobersberger

E-letter for: Kathrin Steffen, Lars Engebretsen. The Youth Olympic Games and a new awakening for sports and exercise medicine. BJSM. 2011; 45: 1251-1252 (Warm up)

Photo courtesy of IYOGOC

Do we really want to see our young promising talents go through a major injury at one stage into their career?

Definitely no!

However, in competitive alpine skiing, snowboarding and freestyle, the risk to get major head and anterior cruciate ligament injuries is indeed high [1-4]. Therefore, training focussing on injury prevention should start at an early age and should go along with the athletes’ career. To implement evidence based preventive measures, however, it is of utmost importance to investigate first of all data on occurrence and severity of injuries according to the 4-step model of injury prevention research [5].

At this point of time, there is little data available concerning the injury risk of youth elite athletes competing in winter sports [6, 7]. Therefore, we will conduct a systematic injury and illness surveillance on young elite athletes participating in the 1st Winter Youth Olympic Games in Innsbruck/Austria in January 2012.  Let us work together to get meaningful data as a basis for further research on injury risk factors and injury mechanisms and finally on injury prevention strategies among young elite winter sport athletes.

We are glad to welcome you in Innsbruck!

References
(1) Pujol N, Blanchi MP, Chambat P. The incidence of anterior cruciate ligament injuries among competitive alpine skiers.  Am J Sports Med 2007; 35: 1070-4.
(2) Florenes TW, Bere T, Nordsletten L et al. Injuries among male and female World Cup alpine skiers. Br J Sports Med 2009; 43: 973-8.
(3) Florenes TW, Nordsletten L, Heir S et al. Injuries among World Cup freestyle skiers. Br J Sports Med 2010; 44: 803-8.
(4) Florenes TW, Nordsletten L, Heir S et al. Injuries among World Cup ski and snowboard atlethes. Scand J Med Sci Sports. 2010 Jun 18 [Epub ahead of print].
(5) Bahr R, Krosshaug T. Understanding injury mechanisms: a key component of preventing injuries in sport. Br J Sports Med 2005; 39: 324-9.
(6) Steffen K, Engebretsen L. The Youth Olympic Games and a new awakening for sports and exercise medicine. Br J Sports Med 2011; 45: 1251-52.
(7) Steffen K, Engebretsen L. More data needed on injury risk among young elite athletes. Br J Sports Med 2010; 44: 485-9.

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Gerhard Ruedl is a Senior Researcher at the Department of Sport Science, University of Innsbruck, Austria

Wolfgang Schobersberger is the Chief Medical Officer of Winter Youth Olympic Games in Innsbruck; Institute for Sports Medicine, Alpine Medicine & Health Tourism Innsbruck/Austria

Prevention is better than cure: SEM in the prevention of musculoskeletal injury

22 Dec, 11 | by Karim Khan

Guest Blog by Dr Sarah Davies

Sport and Exercise Medicine: The UK trainee perspective (A monthly series on the BJSM blog)

“The function of protecting and developing health must rank even above that of restoring it when it is impaired.” Hippocrates


It’s that time of year when the ghosts of Christmas past, present and future are looming, but the present fiscal climate brings little promise to the future legacy of the Olympics that we’re all hoping for, in terms of healthcare benefit.

Musculoskeletal conditions are the most common cause of chronic pain and disability.1 The prevalence of many of these increases with age and many are affected by lifestyle factors, such as obesity and physical inactivity. Increasing numbers of older people and changes in lifestyle means that the problem is set to spiral out of control in the UK.

Last week, my father turned 71. Having swam all his life, in the last 6 months he has swapped the pool for the gym in order to avoid waterlogging his new hearing aids. He has studied the theory of what, when, where and how much he should be doing in the gym (alongside chats to said SEM daughter) but he is missing the physical awareness of specific muscle groups when carrying it out.

Despite his programme at the gym, my father remains posturally challenged in a computer-hunched sort of a way, attacking the rowing machine with all the vigour of a bull in a china shop.  Suffice to say, I’m somewhat alarmed that it may be only be a matter of time before this over-enthusiasm tears his rotator cuff apart at the seams.

In today’s bleak economic landscape, employers cannot afford to treat illness rather than prevent it. If we want to improve both quality and cost-benefit of health care in this country – if we truly believe that SEM can make a difference – we must use the power of prevention.

We know the leading causes of death in our society – Hypertension, smoking, obesity, and physical inactivity – but what about the causes of preventable musculoskeletal injury and the consequent preventable pain and preventable inactivity?

This week, whilst working with the GB B1 football squad on their training camp, I noted that once a person has learned certain postural habits that are associated with being blind, they are very difficult to shake off. In contrast, if these children develop awareness at an early age, they are able to learn better physical awareness and counteract these habits.

The fact is, learning a new physical skill, especially the more ingrained the old behaviour patterns, requires repeated feedback to instil new habits.2

With SEM doctors at the interface of primary care, we are well placed in the community to identify potential musculoskeletal pathology and advise individuals how to prevent this from occurring.

It is in the prevention of illness that SEM can make a difference to the healthcare economy. SEM has the edge in diagnosing and managing musculoskeletal injuries, but SEM clout also lies in assisting the well to stay well.

Wishing you a Happy Christmas and a Healthy New Year.

References:

1. Woolf AD, Akesson K. Understanding the burden of musculoskeletal conditions. The burden is huge and not reflected in national health priorities. BMJ 2001;322:1079-80.

2. Nilsen PBourne MVerplanken B. Accounting for the role of habit in behavioural strategies for injury prevention. Int J Inj Contr Saf Promot. 2008 Mar;15(1):33-40.

Related Article

Dvořák, J. Give Hippocrates a jersey: promoting health through football/sport. BJSM 2009;43:317-322 Published Online First: 22 March 2009

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Dr Sarah Davies is an ST6 Sport and Exercise Medicine Registrar in the London Deanery, currently on a Rehabilitation and Complex Trauma placement at Headley Court Military Hospital. She also covers disability football for the FA and holds an honorary research fellow post at CXH, where she is looking into causes of pain in patients with hypermobility syndrome.


The old and the young: Ideal targets for injury prevention

8 Dec, 11 | by Caroline Finch

Guest Blog by @CarolineFinch

Cross Fertilising ‘Injury Prevention’ journal (IP) and BJSM


Photo courtesy of Maggie Osterberg, Flickr CC

The December 2011 issue of Injury Prevention, BJSM’s sister journal, highlights that musculoskeletal and activity-related injuries occur in both the old and the young. These are great targets for sports medicine professionals to ensure high quality of life through lifelong functionality and sustained active working lives. How? Through delivery of specific exercise and other interventions.
There is considerable scope for better integration of exercise and sports medicine approaches into the management of hip fracture patients. Bertram et al shows that hip fractures sustained by older people are associated with significant long-term disability. They concluded that 29% of older people who sustain a hip fracture do not reach their pre-fracture activity of daily living functionality, even one year after their fracture. Critically, this long term burden on both individuals and society could be significantly reduced if more was done to prevent the falls that lead to hip fractures from occurring in the first place. As a BJSM paper by Soo Lee and Ernst shows, delivery of exercise programs such as Tai Chi are effective for falls prevention.

In the same issue of the IP journal, Wilkinson et al describe injuries in British army infantry soldiers.The  youngest army soldiers were most at risk of injury during pre-deployment training and this was most related to participation in sport and physical training activities. As an observational study, it is not fully clear why those with a younger chronological age should be most at risk but it could be related to the fact that the younger solders had spent a shorter time in training. They were also more likely to have a lower military rank and it was possible that this may have meant that they were inherently exposed to higher risk situations in their training because of the nature of the activities they were required to undertake. Despite the high physical nature of their training activities, aerobic fitness levels were not a risk factor for the traumatic injuries in this study. There could be scope to better design some of the pre-deployment training components to reduce the risk of injury in the future.

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Caroline Finch is an injury prevention researcher from the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP) within the Monash Injury Research Centre, Monash University, Australia. She specialises in implementation and dissemination science applications for sports injury prevention. She is the Senior Associate Editor for Implementation & Dissemination for the British Journal of Sports Medicine and a member of the Editorial Board of Injury Prevention; both journals are published by the BMJ Group. Caroline can be followed on Twitter @CarolineFinch

Methods for identifying repeat treatment episodes and adjusting for risk factor transient exposures

2 Dec, 11 | by Caroline Finch

Guest Blog by @CarolineFinch

Cross Fertilising ‘Injury Prevention’ journal (IP) and BJSM

Tejvanphotos, Flickr cc

Sports injury epidemiologists with a methodological bent will benefit from two papers published in the October issue of the BJSM’s sister journal, Injury Prevention.
In the first paper, Davie et al. discuss how to identify re-admissions for the same injury from hospital discharge data. Although only the tip of the iceberg for sports injury occurrences, hospital admissions data can be a good source of information about severe sports injuries. Some people get admitted to hospital for injury several times within a specified period of time and this could indicate either (i) recurrent injuries (each new episode of care is for treatment of a new occurrence of the same type of injury), (ii) people at risk of multiple injuries (new episodes of care for different injuries sustained in different injury events, because of the inherent risks and hazards they are exposed to) or (iii) previous treatment failure/incomplete rehabilitation (leading to episodes of care relating to ongoing treatment of the same injury). The paper concludes that to identify-readmissions properly it is important that injury data collections routinely record a unique person identifier and the date of injury, as well as the admission and discharge dates for the episodes of care.

In the sports medicine context, it is alarming how few sports injury data collections collect all this information and our modelling of sports injury incidence rates in the future would benefit from attention to these issues.

The second paper I highlight is a study protocol for a case-crossover design to better understand the link between bicyclists injuries and the cycling environment by Harris et al. In case-crossover studies are particularly useful for adjusting for exposures to risk factors that are transient (i.e. differ) over time and place but which are also associated with distinct acute events. In injury research, this study design has most commonly been applied to road crash studies in which cases are injured road users and people serve as their own controls where the control condition (i.e. with no injury) is at a different point in time when the road conditions are different (e.g. traffic density, weather conditions, earlier in the day, on a different part of the route, etc). The majority of epidemiological risk factors studies in the sports injury area do not consider transient risk factors, but rather assess injury risk in relation to baseline factors. There could be an opportunity to consider how risk factors themselves might vary over a playing season if case-crossover study designs were considered. This paper gives one example of how this approach could be included into a study.

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Caroline Finch is an injury prevention researcher from the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP) within the Monash Injury Research Centre, Monash University, Australia. She specialises in implementation and dissemination science applications for sports injury prevention. She is the Senior Associate Editor for Implementation & Dissemination for the British Journal of Sports Medicine and a member of the Editorial Board of Injury Prevention; both journals are published by the BMJ Group.

Follow Caroline on Twitter @CarolineFinch

Moneyball: Rewarding excellent sports medicine care. But check your indemnity limit. You may need more if treating elite professional athletes.

27 Nov, 11 | by Karim Khan

UKsem was the first conference to have a ‘Moneyball’ panel session; attendees voted with their feet that this should happen again. What’s ‘Moneyball’? The unabridged term refers to Michael Lewis’ book of that name. It’s about a baseball team who performed much better than they should have by recruiting cheap players who didn’t have the ‘look’ of top draft picks but whose statistics were impeachable. The implication is that an astute statistician may help to recruit this type of player whereas a ‘sport expert’ might be fooled by intangibles – the style, the charisma, pedigree – but in the end things that don’t predict success as well as the carefully analyzed data. The concept was in the news in Australia just today.

In the sports medicine setting, Dr John Orchard raised raised the concept in 2009. He’d read the book (didn’t wait for the Brad Pitt movie) and figured that team physios and team sports physicians could augment team performance. This appreciation, literally valuing of the sports medicine / fitness team would lead to great salaries for those individuals. At the conference Moneyball session, Liverpool Football Club’s Peter Brukner estimated that many soccer/football clubs in the English Premier League have annual player salaries over 100 million GBP but pay less than 0.5% of that for ‘maintenance’ – the sports medicine team. Seems crazy and I suspect that in Formula 1 the investment in the ‘asset’ would be much higher.

Security sit - ready for action - at Liverpool vs. Chelsea, November 20, 2011

Also in the UKsem session was power lawyer Mary O’Rourke, QC, who is clearly a pre-eminent sports lawyer in the UK. She emphasized the risk that sports physicians are at when taking care of players who might be earning over 100,000 GPB per week. Is your personal liability insurance in place for the 40 million GPB or so you might be sued for?  I didn’t realize that as Dick Steadman operates in Colorado, the legislation in that stats caps any medicolegal claim at $10 million. In the UK, there is no cap. Food for thought for both players, and physicians. Lots of players have value greater than $10 million.

There was also an introduction to the idea of clincians using agents to help them get better deals in this new world. Clinicians valued more = larger contracts = need for help with negotiation and for digging out the good gigs. Makes sense.

A great idea for future conferences in the UK and beyond. I can see it traveling very well at AMSSM in Atlanta 2012, the VSG (Netherlands), Australia, Switzerland, South Africa, and among the ECOSEP member countries.

For a detailed movie review and background to Moneyball click here please.

And on the subject of Liverpool Football Club, it seems like Brad Pitt is a fan!

Fitness and health of children through sport: the context for action – Guest Blog Caroline Finch

20 Oct, 11 | by Karim Khan

(follow Caroline Finch on Twitter — @CarolineFinch)

This relates to:

Micheli, L, Mountjoy, M, and Engebretsen, L et al. 2011. Fitness and health of children through sport: the context for action. BJSM. 45:931-936

photo: owenfinn16 via Flickr cc

I read, with great interest, the paper by Micheli et al [1]in the September Injury Prevention and Health Promotion issue of the BJSM,because it outlined  different policy contexts for action.  These contexts are generally consistent with the ecological levels of sports delivery we outlined in the Sports Setting Matrix as a framework for the implementation and evaluation of programs delivered through sport.[2]  It is also consistent with our previous argument that the sports delivery and policy contexts need to be more aligned for global sports safety.[3]

Given that injury is one of the major barriers towards participating in sport,[4] it is surprising that no international policy link for addressing this key factor in children’s sports participation was named in the article.  Many of the organisations named in the paper (e.g. the World Health Organization) have divisions that are concerned with injury prevention as well as NCD (non-communicable disease) prevention, for example. A major way forward to ensuring lifelong participation in sport would surely be to bring together the policy bodies for physical activity/sport promotion together with those concerned with reducing or removing injury risk in such activities.

Whilst there is no doubt that having global policy is a key driver of action and priority attention given to health issues, it is largely practitioners at a more local level who need to implement those policies and to translate them into appropriate acceptable and sustainable programs.  In the sports injury context, we have found a mismatch between what the policy makers want and what the practitioners or implementers need.[5] Moreover, just because there is an international policy/guideline/directive one cannot assume that the desired practice or action at the grass roots level of participation, even at a low level, is achieved.[6]  No matter how much evidence-base there is for a new policy, the end-users will have their own perspectives that will directly influence their readiness to act according to the desired policy result.[7]

Having global, national and local policy responses to fitness and health (including injury prevention) will be crucial for ensuring lifelong participation in sport well into the future.  But not less so than also ensuring both an adequate informed workforce of practitioners to deliver associated programs and end users who are fully receptive to the messages that have been appropriately targeted to reach them.

References

1.         Micheli L, Mountjoy M, Engebretsen L, et al. Fitness and health of children through sport: the context for action. Br J Sports Med. 2011;45:931-6.

2.         Finch CF, Donaldson A. A sports setting matrix for understanding the implementation context for community sport. Br J Sports Med 2010;44:973-8.

3.         Timpka T, Finch CF, Goulet C, et al. Meeting the global demand of sports safety – the role of the science and policy intersection for sports safety. Sports Med. 2008;39:795-805.

4.         Siesmaa E, Blitvich J, Finch CF. Chapter 1. A systematic review of the factors that are most influential in children’s decisions to drop out of organised sport.  In: Farelli A, editor. Sport participation: health benefits, injuries, and psychological effects: Nova Science Publishers Ltd; 2011. p. 1-45.

5.         Poulos R, Donaldson A, Finch C. Towards evidence informed sports safety policy for NSW, Australia: assessing the readiness of the sector. Inj Prev. 2010;16:127-31.

6.         Hollis S, Stevenson M, McIntosh A, et al. Compliance with return-to-play regulations following mild traumatic brain injury in Australian schoolboy and community rugby union players. 2011;On line First, published on June 24, 2011 as 10.1136/bjsm.2011.085332.

7.         Donaldson A, Leggett S, Finch CF. Community perceptions of a draft policy and training structure for Australian football sports trainers at the community level: a qualitative analysis. 2011;In press. Published online 16 September 2011 as DOI: 10.1177/1012690211422009.

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Caroline Finch is an injury prevention researcher specialising in implementation and dissemination science applications for sports injury prevention.  She is the Senior Associate Editor for Implementation & Dissemination for the British Journal of Sports Medicine and a member of the Editorial Board of Injury Prevention; both journals are published by the BMJ Group.  Caroline can be followed on Twitter @CarolineFinch

Learning from Injury Prevention Researchers

11 Oct, 11 | by Caroline Finch

Image source: www.spotflick.com

The August 2011 issue of Injury Prevention (sister journal to the BJSM ) included an editorial from me with my views on an apparent unfortunate divide between sports medicine and injury prevention researchers.   The two groups rarely meet at the same conferences or read the same journals and so there is somewhat of a lack of knowledge about relevant research across the two sectors. I have vowed to help reduce this gap by establishing cross-journal Blog posts to directly alert readers of one journal about relevant research in the other, and vice versa.  Of course, my hope is that this will not be necessary in the long-term and that cross-fertilisation of ideas becomes the norm.

In this first IP to BJSM  cross-Blog, I’d like to alert injury researchers to several papers describing methodological issues of relevance, also published in the August IP issue.

One paper by Lawrence discusses the use of the controlled vocabularies of the commonly-used literature search engines PubMed/MEDLINE and PsycINFO for finding articles on injury prevention and safety promotion.  It highlights specific indexing problems that could impact on the quality of literature search strategies that rely solely on those methods to identify papers to include in reviews.

Another paper by Khan et al focuses on the statistical issue of how to best model injury count data, when there are excess zeroes. This is a common occurrence in injury studies where most people sustain no injuries, many only one or two injuries and fewer people sustain more injuries.  Such data should not be analysed by traditional Poisson counts and more appropriate statistical modelling applied instead.

Finally, Cryer et al present a new theoretical definition of injury death, which should overcome the short falls of current surveillance systems which are known to under-enumerate injury deaths.  Even though deaths in sport are rare compared to those in other settings, these new definitions are relevant to anyone who uses routine mortality data to monitor injuries.

Caroline Finch is an injury prevention researcher specialising in implementation and dissemination science applications for sports injury prevention.  She is the Senior Associate Editor for Implementation & Dissemination for the British Journal of Sports Medicine and a member of the Editorial Board of Injury Prevention; both journals are published by the BMJ Group.  Caroline can be followed on Twitter @CarolineFinch

New editoral from Prof. Finch- Updating the international research agenda for sport injury prevention

26 Jul, 11 | by Karim Khan

Professor Caroline Finch is a leading advocate for decreasing the divide between the science and practice of injury prevention through greater cross-fertilization in the fields of injury and sports medicine research.

In the June 24, 2011 edition of  BJSM’s sister journal Injury Prevention, Prof Finch offers a concise summary: Updating the international research agenda for sport injury prevention. She contextualizes and highlights key discussions from the IOC’s World Congress on Prevention of Injury and Illness in Sport (Monaco, April 2011) (See related BJSM Blog June 06, 2011  View Top Lectures Online: IOC World Congress of Prevention of Injury & Illness in Sport).

Prof Finch also comments on her own IOC Keynote address – the status of implementation and dissemination research in sports injury prevention. Turning research into action – a major BJSM theme for 2012. Read the article online now to learn more about how certain frameworks and strategies can dramatically improve uptake. See her Editor’s choice editorial in the current BJSM issue too (August 2011)!

In closing her Injury Prevention article, Prof Finch notifies readers that she will be making more guest contributions on both the Injury Prevention and BJSM Blogs…stay tuned!

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