Physical activity promotion without injury prevention is doomed to fail

Cross Fertilising Injury Prevention (IP) and the British Journal of Sports Medicine (BJSM)

Arguably two of the most pressing health behaviours that need priority attention in today’s world are those needed to reduce the risk of injury (across different settings and contexts) and those required to ensure more people are more physically active.

A long standing conundrum for me is why these are typically considered as two completely different issues, despite the fact that certain injury risks only arise when people are physically active. For example, musculoskeletal sports injuries only occur to people who actively participate in sport. Injuries to bicyclists generally only occur when people use their bicycles for recreation, fitness or general commuting, not when they are inactive.

Now a paper in the July 2012 46(9) issue of the British Journal of Sports Medicine provides strong evidence for why this situation has to change.

Bloemers and colleagues report data from a 12-month prospective cohort study involving 2208 children aged 9-12 years from 40 Dutch primary schools. The children completed self-report questionnaires from which their weekly physical activity levels were estimated. Injuries were reported by their physical education teachers. Physical activity levels were then divided into quartiles and hazard ratios for injury risk estimated from Cox regression models.

Not surprisingly, both gender and age were significant predictors of injury risk.  But so, too, was the amount of physical activity undertaken. Children most at risk of injury were those with the lowest baseline physical activity levels.

Physical activity promotion strategies are generally targeted at those who are currently most inactive. Yet, this study shows that it is precisely those who are less active who are also at increased injury risk. People who take up any form of physical activity but who are then injured are most likely to be those who then give up the activity they tried. It might also be expected that, in many cases, this could put them off trying all new physical activity altogether. Where is the long term health gain in this?

To me the link is clear. Physical activity strategies that do not include injury prevention will fail. In fact, they will probably increase injury rates!



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

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