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Can Coaches Can Play a Vital Role in Preventing Lower Extremity Injuries?

female athletes in a huddle

By Tara Martinez, 
Athletic Trainer, 
Douglas County High School

As the fall season begins and my Athletic Training room begins to flood with athletes, I mentally prepare myself for common injuries that can occur during the fall season. One of the most common injuries seen during this season is the sprain or tear of the Anterior Cruciate Ligament (ACL). The prevalence of ACL injuries amongst athletes is on the rise, with a 10­fold increase in high school sports and a 5­fold increase in collegiate sports over the last 30 years (NCAA, 2002; NFHS, 2009). Typically, ACL injuries are noncontact and are often the result of poor biomechanics during pivoting, running, and landing maneuvers (Kirkendall & Garrett, 2000). ACL tear injuries result in extensive sport participation time lost, high cost of reconstructive surgery and subsequent rehabilitation, and potential long­term debilitation (Hewett, Ford, Hoogenboom, & Myer, 2010).

As a result of this surge in ACL injuries, researchers have identified the various components associated with ACL failure (Fong, 2011; Hewett, 2010; Padua, 2012) which lead to the creation of the LESS test, a valid and reliable lower extremity movement screening tool (Padua et al., 2009) and the emergence of injury prevention programs (IPPs) in the hopes of decreasing this epidemic in the athletic population. The question arises, how can this be useful to the Athletic Trainer who is already covering a variety of fall sports, and may not have time to do various IPPs?

There is a growing body of evidence supporting the effectiveness of lower extremity IPPs in significantly reducing lower extremity injuries (Pryor, 2017; Sadoghi, 2012; Steffen, 2013). Although the Athletic Trainer may play a leading role in executing these IPPs, studies have shown that coaches who implement these IPPs have shown favorable outcome in reducing lower extremity injuries within their team. After all, coaches play a vital leadership role, influencing each player and promoting team involvement. It is vital to get a coach involved in an IPP because their approach and attitude towards IPPs directly impact how well a team will adhere to such a program.

According to Twomey and colleagues (2014), educating the coaches on lower extremity injury is primarily the work of a club or district’s medical support staff, primarily speaking, the ATC. Awareness of the prevalence of lower extremity injuries needs to be incorporated into coaches’ training, which could take place leading up to each season. Norcross et al. (2015) suggests a multifaceted educational approach targeted at coaches, athletes, and parents, which aims to reduce previously conceived misunderstandings of what causes lower extremity injuries and what constitutes IPPs. The club, district medical support staff, or Athletic Trainer needs to work hand in hand to disseminate the latest injury prevention strategies to the coaches.

In summary, due to the rise in ACL injuries, it is important to get coaches involved in injury prevention. Coaches play a vital leadership role, influencing each player and promoting team involvement, therefore, the Athletic Trainers can educate their coaches on sport specific exercises so they may utilize them to help execute and get their players involved in IPPs.



1. Frank, B. S., Register­Mihalik, J., Padua, D. A. (2015). High levels of coach intent to integrate a ACL injury prevention program into training does not translate to effective implementation. Journal of Science and Medicine in Sport, 18, 400­406.
2. Hewett, T. E., Ford, K. R., Hoogenboom, B. J., Myer, G. D. (2010). Understanding and preventing ACL injuries: Current biomechanical and epidemiologic considerations­ update 2010. North American Journal of Sports Physical Therapy, 5(4), 234­251.

3. Kirkendall, D. T., Garrett Jr., W. E. (2000). The anterior cruciate ligament enigma: Injury mechanisms and prevention. Clinical Orthopaedics and Related Research, 372, 64­68.
4. National Collegiate Athletic Association. (2002). NCAA injury surveillance system summary. Indianapolis, IN.
5. Norcross, M., Johnson, S., Bovbjerg, V., Koester, M., Hoffman, M. (2015). Factors influencing high school coaches’ adoption of injury prevention program. Journal of Science and Medicine in Sport, 19, 299­304.

6. Padua, D. A., Marshall, S. W., Bolling, M.C., Thigpen, C. A., Garrett, W. E., Beutler, A. I. (2009). The landing error scoring system (LESS) is a valid and reliable clinical assessment tool of jump­landing biomechanics. American Journal of Sports Medicine, 37(10), 1996­2002. doi:10.1177/0363546509343200.

7. Pryor, L., Root, H., Vandermark, L., Pryor, R., Martinez, J., Trojian, T., Denegar, C., DiStefano, L. (2017). Coach­led preventative training program in youth soccer players improves movement technique. Journal of Science and Medicine in Sport,1­6.
8. Sugimoto, D., Mattacola, C. G., Bush, H. M., Thomas, S. M., Barber Foss, K. D., Myer, G. D., Hewett, T. E. (2017). Preventive neuromuscular training for young female athletes: Comparison of coach and athlete compliance rates. Journal of Athletic Training, 52(1), 58­64. doi: 10.4085/1062­6050­51.12.20.

9. Twomey, D., Finch, C., Roediger, E., Lloyd, D. (2009). Preventing lower limb injuries: Is the latest evidence being translated into the football field? Journal of Science and Medicine in Sport, 12, 452­456.


September 11, 2017 | By CSilberman | Category: Athletics and Activities

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