Getting a leg up

A recent randomized, controlled prevention trial in Chicago high school women who play soccer and basketball has shown that the institution of a carefully planned and specialized exercise routine before practice and play reduced the incidence of a variety of lower extremity injuries, including anterior cruciate ligament (ACL) damage. The difference in specific injury rates, as compared to the control group who continued to use whatever exercise routine they may have been doing, if any, was usually statistically significant. This suggests that chance is an unlikely explanation of these striking results. (The reference is LaBella, CR, “Effect of Neuromuscular Warm-up on Injuries in Female Soccer and Basketball Athletes in Urban Public High Schools,” Arch Pediatr Adolesc Med. 2011;165 (11):1033-1040.)

It is my judgment that the introduction of this well-tested exercise routine will benefit many female athletes who play soccer and basketball at the College. By a rough estimate, at least a third, and perhaps more, of female athletes who have had surgical ACL repair will have chronic arthritis by their mid-30s. As a result of pain and reduced quality of life, many of these women will seek early knee replacement.

It appears that there is no explicit mechanism within the New England Small College Athletic Conference (NESCAC) to look systematically at the scattered athletic health literature, identify well-conducted studies that offer promise to reduce the current epidemic of athletic injury and quickly recommend these results to the attention of all administrators, coaches and trainers in the NESCAC league. The current non-system where new health information diffuses randomly (and too slowly) does not serve women athletes adequately. One must ask why NESCAC cannot be more proactive on this matter.

Nicholas H. Wright ’57, MD, MPH, lives in Williamstown, Mass.

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