A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies

Abstract

Background:

A large volume of systematic reviews and meta-analyses has been published on the effectiveness of sports injury prevention programs.

Purpose:

To provide a qualitative summary of published systematic reviews and meta-analyses that have examined the effectiveness of sports injury prevention programs on reducing musculoskeletal injuries.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

We searched the PubMed, CINAHL, EMBASE, and the Cochrane databases for systematic reviews and meta-analyses that evaluated the effectiveness of sports injury prevention programs. We excluded published abstracts, narrative reviews, articles not published in English, commentaries, studies that described sports injury prevention strategies but did not assess their effectiveness, studies that did not assess musculoskeletal injuries, and studies that did not assess sports-related injuries. The most relevant results were extracted and summarized. Levels of evidence were determined per the Oxford Centre for Evidence-Based Medicine, and methodological quality was assessed using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews, revised version).

Results:

A total of 507 articles were retrieved, and 129 were included. Articles pertaining to all injuries were divided into 9 topics: sports and exercise in general (n = 20), soccer (n = 13), ice hockey (n = 1), dance (n = 1), volleyball (n = 1), basketball (n = 1), tackle collision sports (n = 1), climbing (n = 1), and youth athletes (n = 4). Articles on injuries by anatomic site were divided into 11 topics: general knee (n = 8), anterior cruciate ligament (n = 34), ankle (n = 14), hamstring (n = 11), lower extremity (n = 10), foot (n = 6), groin (n = 2), shoulder (n = 1), wrist (n = 2), and elbow (n = 1). Of the 129 studies, 45.7% were ranked as evidence level 1, and 55.0% were evidence level 2. Based on the AMSTAR-2, 58.9% of the reviews reported a priori review methods, 96.1% performed a comprehensive literature search, 47.3% thoroughly described excluded articles, 79.1% assessed risk of bias for individual studies, 48.8% reported a valid method for statistical combination of data (ie, meta-analysis), 45.0% examined the effect of risk of bias on pooled study results, and 19.4% examined the risk for publication bias.

Conclusion:

This comprehensive review provides sports medicine providers with a single source of the most up-to-date publications in the literature on sports injury prevention.

Keywords

sports injuries prevention musculoskeletal systematic review meta-analysis

In the United States, approximately 4.3 million nonfatal sports or recreation-related injuries are seen annually in the emergency department.⁸¹ The highest rates of sports injuries for both boys and girls occur in adolescents aged 10 to 14 years, which is likely due to increased participation in sports among this age group.⁸¹ The lower extremity is most commonly injured during sports participation; however, the incidence of injury to specific body parts varies by sport.^81,185,257 Owing to the influx of participants in sports and the subsequent injuries they sustain, research on sports injury prevention strategies is rapidly growing.¹²⁹ Injury prevention is important for reducing long-term health consequences, such as disability, and minimizing the economic burden of treatment.²

Injury prevention strategies typically focus on modifiable risk factors, such as rules, equipment, and physical fitness, and prevention strategies may be tailored to a specific sport or injury.² Exercise training involves learning proper exercise techniques, such as understanding the limits of range of motion of each joint and avoiding joint positions that place the anatomic structures of the joint at risk for injury.⁴⁰ Exercise training usually involves some combination of strength, proprioceptive, balance, and neuromuscular training that is important for improving athletic performance and preventing injuries.^30,107,127

The purpose of this comprehensive review was to quantify the number of systematic reviews and meta-analyses that have examined the effectiveness of sports injury prevention programs on reducing musculoskeletal injuries, evaluate the quality of each systematic review, identify the primary studies included in each review, and provide a succinct summary of this vast body of literature for easy reference. We hypothesized that the largest number of articles would (1) pertain to sports injury prevention in general (as opposed to prevention strategies for specific sports) and (2) focus on preventing knee injuries that are common in sports.

Methods

We performed a literature search in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)¹⁵¹ using PubMed, CINAHL, EMBASE, and the Cochrane databases to identify articles published in English between inception of these databases and August 31, 2020. Additional articles were found by hand searching the reference lists of included articles. The search terms were (“prevention” or “prevention programs”) AND (“sports injury” OR “musculoskeletal injury”) AND (“systematic review” or “meta-analysis”). We included systematic reviews and meta-analyses that evaluated the effectiveness of sports injury prevention programs on reducing musculoskeletal injuries. We excluded published abstracts, narrative reviews, articles not published in English, commentaries, studies that described sports injury prevention strategies but did not assess the effectiveness of these strategies, studies that did not assess musculoskeletal injuries, and studies that did not assess sports-related injuries.

The results of the entire literature search were entered into a single database, and duplicates were removed via electronic search and double-checked manually. Two of the authors (S.D.S. and M.A.K.) independently screened the results of the literature search, and 3 authors (S.D.S., J.W.K., and A.V.V.) reviewed studies that met inclusion in more detail and summarized the germane results. The articles that met inclusion criteria were summarized by 2 major topics: (1) all injuries and (2) injuries by anatomic site. Articles pertaining to all injuries were further subdivided into 9 topics: sports and exercise in general, soccer, ice hockey, dance, volleyball, basketball, tackle collision sports, climbing, and youth athletes. Articles pertaining to injuries by anatomic site were subdivided into 11 topics: general knee, anterior cruciate ligament (ACL), ankle, hamstring, lower extremity, foot, groin, shoulder, wrist, shin, and elbow. We determined the level of evidence for each systematic review according to the definitions set forth by the Oxford Centre for Evidence-Based Medicine.⁸⁸ Methodological quality was assessed using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews, revised version).²⁰⁵ The list of 129 articles was divided in half among 4 authors (S.D.S., M.A.K., J.W.K., and A.V.V.) for AMSTAR-2 assessment, and thus each study was assessed independently by 2 authors (S.D.S. and M.A.K.). Last, we tallied the number of overlapping primary studies between systematic reviews within a particular topic.

Results

Figure 1 presents the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart illustrating the literature search process. The literature search identified 507 unique articles, and of these, 129 met the inclusion criteria. Table 1 illustrates the number of included articles by topic. The majority of “all injury” articles pertained to sports and exercise in general (15.5%) and soccer (10.1%). Most of the “injuries by anatomic site” articles pertained to ACL (26.4%), ankle (10.9%), and hamstring (8.5%) injuries. Three of the 129 included articles covered >1 anatomic site. The level of evidence and the AMSTAR-2 results are shown in Table S1 (available as Supplemental Material). A total of 59 (45.7%) of the included systematic reviews were ranked as evidence level 1, and 71 (55.0%) were level 2. Based on the AMSTAR-2, 76 (58.9%) reviews reported a priori review methods, 124 (96.1%) performed a comprehensive literature search, 61 (47.3%) thoroughly described excluded articles, 102 (79.1%) assessed risk of bias for individual studies, 63 (48.8%) reported a valid method for statistical combination of data (ie, meta-analysis), 58 (45.0%) examined the effect of risk of bias on pooled study results, and 25 (19.4%) examined the risk for publication bias.

Figure 1.

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart.

Table 1

Number of Included Articles by Topic

Topic	No. of Articles
All injuries
Sports and exercise in general	20
Soccer	13
Ice hockey	1
Dance	1
Volleyball	1
Basketball	1
Tackle collision sports	1
Climbing	1
Youth athletes	4
Injuries by anatomic site
General knee ^a	8
Anterior cruciate ligament ^a	34
Ankle ^a	14
Hamstring	11
Lower extremity	10
Foot	6
Groin	2
Shoulder	1
Wrist	2
Elbow	1
Total unique articles	129

^a Categories are not mutually exclusive.

All Injuries

A total of 43 studies pertaining to prevention of all injuries were identified and are summarized by topic here. Tables S2 to S4 and Figures S1 to S3 (available as Supplemental Material) illustrate the overlapping primary studies between included systematic reviews.

Sports and Exercise in General

A number of overlapping systematic reviews^‡ have examined the effectiveness of various injury prevention strategies for sports and exercise in general. Salam et al¹⁹⁴ pooled data from 24 studies and found that sports injury prevention interventions were effective in that interventions decreased the incidence of (1) injuries in general (relative risk [RR], 0.66; 95% confidence interval [CI], 0.53-0.82), (2) injuries per hour of exposure (RR, 0.63; 95% CI, 0.47-0.86), and (3) injuries per number of exposures (RR, 0.79; 95% CI, 0.70-0.88); however, the results of their study were not stratified by type of intervention. Two meta-analyses by Lauersen et al^127,128 found that strength training was effective for reducing the risk of sports injuries, and 1 of these studies¹²⁸ also found that proprioception training (RR, 0.55; 95% CI, 0.35-0.87) and a combination of exercises (RR, 0.66; 95% CI, 0.52-0.83) were effective at reducing sports injuries. Smyth et al²¹⁴ found moderate evidence demonstrating the effectiveness of exercise and psychological interventions for reducing injuries in pre-elite athletes competing in the Olympics or professional sports, but evidence was lacking with respect to the effectiveness of equipment and nutrition-related interventions. Two systematic reviews^1,129 found that the use of insoles, external joint supports, and multi-intervention or sport-specific training programs were effective for injury prevention. Of note, several overlapping systematic reviews have found no or minimal evidence regarding the effectiveness of stretching,^§ warm-up exercises,^1,69 or prevention videos^1,129 for injury prevention. Two systematic reviews^30,107 demonstrated that balance training was favorable for reducing overall injuries (RR, 0.49; 95% CI, 0.13-1.80) and defined the optimal balance training program for injury prevention as lasting for 8 weeks and including two 45-minute training sessions per week. Three overlapping systematic reviews^77,131,239 found that psychological interventions, including cognitive behavioral therapy and stress management—based interventions, were effective at reducing sports injuries. Ernst and Posadzki⁶⁰ found conflicting results regarding the effectiveness of chiropractic interventions for preventing sports injuries in their review of 6 studies. To summarize, there are multiple systematic reviews and meta-analyses demonstrating that injury prevention programs are effective, with strength, proprioception, balance, and psychological programs being specifically beneficial.

Soccer

Four overlapping systematic reviews^{43,64,182,243} found mixed results for exercise-based prevention programs in soccer players, and all of these reviews were poor quality and at high risk for bias. Based on their review of 18 studies, Kirkendall et al¹²³ concluded that a structured warm-up program can be effective at reducing soccer injuries by one-third. Based on their review of 13 studies, Slimani et al²¹¹ found that psychological-based interventions were effective at reducing injury rates in soccer players. Seven overlapping systematic reviews and meta-analyses^{4,6,21,79,119,192,238} examined the effectiveness of 2 soccer injury prevention programs developed by the Federation Internationale de Football Association (FIFA). The FIFA 11 and FIFA 11+ programs combine training in both technique and balance along with neuromuscular training exercises including strengthening and plyometrics with the goal of eliminating injuries. Al Attar et al⁴ examined the combined effects of FIFA 11 and FIFA 11+ and found that overall injuries were reduced by 34% (RR, 0.66; 95% CI, 0.60 to 0.73) and lower limb injuries were reduced by 29% (RR, 0.71; 95% CI, 0.63 to 0.81). Gomes Neto et al⁷⁹ observed that FIFA 11 was associated with reduced injury risk (RR, 0.69; 95% CI, 0.49 to 0.98) and improvement in both dynamic balance (weighted mean difference, 2.68; 95% CI, 0.44 to 4.92) and agility (standardized mean difference, –0.36; 95% CI, –0.70 to 0.02) compared with controls. Two systematic reviews^21,192 demonstrated that FIFA 11+ resulted in (1) 30% to 70% fewer injuries and (2) significant improvement in many features of motor and neuromuscular performance. Two systematic reviews^6,238 directly compared FIFA 11 and FIFA 11+ and found that FIFA 11+ was associated with a greater reduction in injuries. In their review of 33 articles, Kilic et al¹¹⁹ concluded that the FIFA 11+ program and the Nordic Hamstring Exercise (NHE) program were most effective for reducing musculoskeletal injuries in adult soccer players, while FIFA 11, balance board, the Prevent Injury and Enhance Performance program, a groin program, and balance board training were not effective injury prevention programs. To summarize, the FIFA 11+ program has been shown to reduce injuries and improve neuromuscular performance in soccer.

Ice Hockey

Cusimano et al⁴⁵ identified 13 studies that examined rule changes intended to minimize aggression (eg, restriction of body-checking) during ice hockey, of which 9 studies demonstrated a decrease in penalties ranging from 1.2 to 5.9 per game and in injury rates by 3- to 12-fold.

Dance

Hincapie et al¹⁰³ reviewed 2 cohort studies and concluded that there was weak evidence for the effectiveness of injury prevention programs in dancers.

Volleyball

Kilic et al¹²⁰ found evidence from 3 studies that (1) a resistance training program, (2) a program aimed at reducing anterior knee pain, and (3) balance board training were effective at reducing musculoskeletal injuries in volleyball players.

Basketball

Based on their systematic review of 4 studies, Kilic et al¹²¹ concluded that each of the following programs was successful at reducing musculoskeletal injuries in basketball players: (1) a jump-landing technique intervention during warm-up, (2) a multistation proprioceptive exercise program, (3) a wobble board and sport-specific balance training program during warm-up, and (4) the FIFA 11+ program.

Tackle Collision Sports

Sewry et al²⁰² identified 7 studies that demonstrated that exercise-based intervention programs were successful at reducing injuries in tackle collision sports (ie, rugby union or league and American, Australian, and Gaelic football).

Climbing

Based on their systematic review of 19 studies, Woollings et al²⁶⁰ found that both taping and weight training reduced injury rates in sport climbing and bouldering. However, the authors did not find any support for stretching, yoga, using instructors, regulating equipment usage, taking supplements, heating hands before climbing, and corticosteroid injections as injury prevention measures for sport climbing.

Youth Athletes

Several overlapping systematic reviews^2,37,189,217 have examined the effectiveness of various sports injury prevention strategies in youth (ie, adolescents or teenagers aged <20 years). Soomro et al²¹⁷ pooled data from 10 studies and found a 40% reduction (injury rate ratio, 0.60; 95% CI, 0.48-0.75) in injuries for multifaceted injury prevention programs (ie, a combination of warm-up, neuromuscular strength, and proprioception training) in adolescent team sports. Abernethy and Bleakley² reviewed 12 studies and found preseason conditioning, functional training, education, balance, and sport-specific skills to be moderately effective at preventing adolescent sports injuries. However, the effectiveness of protective equipment (eg, knee pads and knee braces) was inconclusive and requires further research. Rossler et al¹⁸⁹ conducted a meta-analysis of 21 randomized controlled trials (RCTs) and found that prevention programs geared toward both specific injuries and all injuries in children and adolescents were effective. Furthermore, the authors concluded that prevention programs including jumping or plyometric exercises were more effective than programs that did not include these types of exercises. Carder et al³⁷ systematically reviewed 6 studies and found that 43% of youth athletes specialized in a single sport and these athletes were at greater risk for injury compared with youth athletes that sampled a variety of sports (RR, 1.37; 95% CI, 1.19-1.57).

Injuries by Anatomic Site

A total of 86 studies pertaining to prevention of injuries by anatomic site were identified and are summarized by topic here. Tables S5 to S10 and Figures S4 to S9 (available as Supplemental Material) illustrate the overlapping primary studies between included systematic reviews.

General Knee Injuries

Grimm et al⁸⁵ found insufficient evidence regarding the effectiveness of knee injury prevention programs in athletes based on their review of 10 RCTs; however, the authors did not distinguish among different types of injury prevention programs. Thacker et al²³⁶ found limited evidence supporting the effectiveness of neuromuscular training and conditioning programs for reducing knee injuries. On the other hand, 3 overlapping systematic reviews^51,84,99 have demonstrated that neuromuscular training programs reduced knee injuries by 27%. Ter Stege et al²³³ systematically reviewed 35 studies and found that neuromuscular injury prevention programs were effective at reducing several risk factors (ie, knee valgus moments, knee flexion angles, hamstring activation profiles, and vertical ground-reaction forces) that are associated with knee injuries in team ball sports. Three overlapping systematic reviews^179,195,236 have found that wearing a knee brace is not effective at reducing knee injuries in athletes.

ACL Injuries

All Athletes. Two systematic reviews^7,163 concluded that the available evidence was too weak to make any conclusions about the effectiveness of ACL injury prevention programs in general; however, several more recent systematic reviews^85,152,232 have found ACL injury prevention programs to be effective. Grindstaff et al⁸⁶ conducted a meta-analysis of 5 studies and estimated that 89 individuals (95% CI, 66-136) would need to participate in an injury prevention program to prevent 1 ACL injury per season. Furthermore, these authors concluded that the most important components of an ACL injury prevention program were plyometrics, strengthening, flexibility, agility, and feedback. Padua and Marshall¹⁶⁸ found moderate evidence to support the use of ACL injury prevention programs, which incorporate proprioception/balance or plyometric/agility training in athletes; however, no studies directly compared the effectiveness of multifaceted versus single exercise programs. Arundale et al¹⁵ found substantial evidence supporting the use of exercise-based prevention programs for reducing knee and ACL injuries in athletes. Several overlapping systematic reviews^∥ have found that neuromuscular training programs were effective at reducing ACL injuries by 51% to 62%, and 1 meta-analysis¹⁹³ found that neuromuscular training was more effective at reducing ACL injuries in male versus female patients. Sugimoto et al²²⁴ found that participant age (ie, training was more effective for younger athletes compared with adults), dosage of training, exercise variations, and verbal feedback were the most effective components of a neuromuscular training program. Inclusion of at least 1 of these 4 components in a training program reduced the risk of ACL injury by 18%, and if all 4 components were incorporated into the program, the risk was reduced by as much as 73%.

Benjaminse et al²⁶ concluded that when teaching motor learning, giving athletes an external focus of attention (eg, soft landing) was more effective for increasing performance and decreasing the risk of ACL injuries compared with an internal locus of attention (eg, knee flexion). Furthermore, Armitano et al¹² found that motor learning programs using augmented information improved risk factors that were associated with ACL injuries. Neilson et al¹⁵⁷ concluded that using augmented feedback with jump landing training was an effective way to reduce 2 of the major risk factors for ACL injury: maximum knee flexion angle and vertical ground-reaction force.

Female Athletes

Several overlapping systematic reviews^¶ have focused on ACL injury prevention in female athletes. Two systematic reviews^161,223 have demonstrated the effectiveness of ACL injury prevention programs in female athletes; however, there were insufficient data to determine which specific program was most effective for reducing ACL injuries. On the other hand, 3 overlapping systematic reviews concluded that plyometrics,^38,254 strengthening,^227,254 and neuromuscular exercises²⁵⁴ were the most effective components for injury prevention in female athletes. Moreover, Noyes and Barber Westin¹⁶⁰ found that both the Sportsmetrics and the Prevent Injury and Enhance Performance programs successfully reduced ACL injuries in female athletes; however, the Sportsmetrics program is very time-intensive (ie, 1-2 hours of training for 3 d/wk) and may compromise compliance. Based on their meta-analysis of 14 studies, Sugimoto et al²²⁶ found that the most effective ACL injury prevention programs in female athletes were those (1) of longer duration (>20 minutes vs <20 minutes), (2) done more frequently (multiple times versus once per week), and (3) with a higher training volume. Myer et al¹⁵⁵ found that neuromuscular training was most effective at reducing ACL injuries in female athletes aged ≤18 years compared with >18 years (odds ratio [OR], 0.28; 95% CI, 0.18-0.42). Based on their meta-analysis of 18 studies, Petushek et al¹⁷⁶ found that interventions that targeted female athletes in middle school and high school (OR, 0.38; 95% CI, 0.24-0.60) reduced the odds of ACL injury more so than interventions targeting college or professional female athletes (OR, 0.65; 95% CI, 0.48-0.89). Only 1 meta-analysis²²⁵ examined compliance with neuromuscular training in female athletes and found that high compliance was associated with a greater reduction in ACL injuries compared with low compliance (risk reduction ratio, 0.27; 95% CI, 0.07-0.80). Pfile and Curioz¹⁷⁸ concluded that both mixed leadership (RR reduction, 48.2%; 95% CI, 22%-65%) and coach-led (RR reduction, 58.4%; 95% CI, 40%-71%) injury prevention programs were successful at reducing ACL injuries in female athletes; however, the available evidence was low to moderate quality.

Ankle Injuries

Eight overlapping systematic reviews^＃ have found the use of external supports, such as ankle bracing and taping, to be effective at reducing ankle injuries. Barelds et al²⁰ conducted a meta-analysis of 6 studies and found that ankle bracing was effective for both primary (RR, 0.53; 95% CI, 0.32-0.88) and secondary (RR, 0.37; 95% CI, 0.24-0.58) prevention of acute ankle injuries; however, the available evidence was low quality. Two systematic reviews^25,50 found that external supports reduced ankle injuries by 62% to 64%; however, another review⁴⁹ found that external supports were only effective in athletes with a history of ankle injuries.

Several overlapping systematic reviews have found evidence supporting the effectiveness of neuromuscular training,^34,35,250 proprioception and balance training,^{25,34,48,143,197} and exercise interventions^50,83 for preventing ankle injuries. Four overlapping systematic reviews^{25,48,116,197} found that proprioception or balance training reduced ankle injuries by 31% to 46%, and these training programs primarily consisted of single-leg stance challenges, wobble/balance board exercises, and sport-specific agility drills. Furthermore, Schiftan et al¹⁹⁷ found that proprioceptive training (ie, balance exercise with or without balance/wobble board or ankle disc for at least 8 weeks) was effective at reducing ankle sprains in athletes with (RR, 0.64; 95% CI, 0.51-0.81) and without (RR, 0.57; 95% CI, 0.34-0.97) a history of ankle sprain. Doherty et al⁵⁰ conducted a meta-analysis of 23 studies and found that exercise interventions reduced recurrent ankle sprains by 41% (pooled OR, 0.59; 95% CI, 0.51-0.68), and the most effective intervention was ankle disc or balance/wobble-board training for a minimum of 4 to 6 weeks. Grimm et al⁸³ conducted a meta-analysis of 10 RCTs and found that an exercise protocol focused on stretching, strength training, balance, and coordination reduced the risk of ankle injuries by 40% (RR, 0.60; 95% CI, 0.40-0.92). In summary, several systematic reviews and meta-analyses have found external supports and balance and proprioceptive training to be effective in preventing ankle injuries.

Hamstring Injuries

Hibbert et al¹⁰¹ systematically reviewed 7 studies in 2008 and concluded that hamstring lowers, isokinetic strengthening, and other strengthening were effective at reducing hamstring strains; however, the included studies were deemed low quality and none of the studies examined eccentric strengthening in isolation. Two systematic reviews, 1 by Prior et al¹⁸³ in 2009 and the other by Monajati et al¹⁵² in 2016, found low-level evidence suggesting that hamstring injury prevention programs in general may be effective at reducing hamstring injuries. Goldman and Jones⁷⁸ systematically reviewed 7 RCTs in 2010 and concluded that there was insufficient evidence regarding the effectiveness of strengthening, manual therapy, proprioception, and warm-ups/cool-downs for preventing hamstring injuries. Based on 2 systematic reviews^145,186 published in 2016 and 2013, respectively, there is inconclusive evidence regarding the effectiveness of stretching on reducing hamstring injuries. The NHE was designed to increase eccentric hamstring strength in soccer players, and 4 overlapping systematic reviews^5,80,203,245 conducted between 2015 and 2019 found that the NHE (used in isolation or combined with other interventions) reduced hamstring injuries by 49% to 65%. Two overlapping systematic reviews^80,203 published in 2015 and 2017, respectively, found that using a YoYo flywheel ergometer for eccentric hamstring strengthening was effective at reducing hamstring injuries in soccer players. In 2019, Vatovec et al²⁴⁷ conducted a meta-analysis of 17 studies and found that hamstring injuries were reduced by 51% after exercise interventions and by 50% after neuromuscular interventions.

Lower Extremity Injuries

Several overlapping systematic reviews have demonstrated that exercise programs^33,261 and neuromuscular training programs^{58,95,221,231} were effective at reducing lower extremity injuries. Emery et al⁵⁸ found that neuromuscular training reduced lower extremity injuries by 36% in youth athletes (injury risk reduction, 0.64; 95% CI, 0.49-0.84). Based on their meta-analysis of 10 RCTs, Taylor et al²³¹ found that neuromuscular training with or without lace-up ankle braces reduced the odds of lower extremity injuries in basketball players by 31% (OR, 0.69; 95% CI, 0.57-0.85). Steib et al²²¹ concluded that neuromuscular training was effective at reducing lower extremity injury risk in youth athletes, and the optimal regimen was 10- to 15-minute sessions 2 to 3 times a week. Herman et al⁹⁵ reviewed 9 studies and concluded that to be effective at reducing lower limb injuries, neuromuscular warm-up strategies should be completed for at least 3 months and should incorporate stretching, strengthening and balance exercises, sports-specific agility drills, and landing techniques. Yeung and Yeung²⁶¹ concluded that there was strong evidence suggesting that the incidence of lower extremity soft tissue running injuries can be reduced by decreasing running frequency, duration, and distance; however, the optimum training load could not be determined. There is weak or insufficient evidence regarding the effectiveness of (1) eccentric exercise, proprioception, and balance exercise for reducing lower extremity injuries in soccer players¹³⁷; (2) exercise programs for prevention of lower limb injuries in Australian football players¹⁰; and (3) lower limb injury prevention programs in high school athletes.¹³⁸ Thacker et al²³⁴ systematically reviewed 9 studies and found that using shock-absorbent orthotic inserts and a preseason conditioning regimen focused on lower extremity strength, agility, and flexibility may reduce the occurrence of shin splints in young male athletes.

Foot Injuries

Several overlapping systematic reviews found low to moderate evidence that shock-absorbing insoles may be effective at preventing stress fractures in an active military population; however, no other types of interventions (eg, reducing training volume and intensity) have been effective at reducing stress fractures, and no studies have been done in the general population.^{29,76,114,187,204} A meta-analysis of 11 studies found that foot orthoses reduced the risk of stress fractures by 41% (RR, 0.59; 95% CI, 0.45-0.76).²⁹ Peters et al¹⁷³ found limited evidence supporting the use of balance training, shoe adaptations, and hormone replacement therapy in active postmenopausal women for reducing Achilles tendinopathy, and there was no evidence to support stretching for reducing Achilles tendinopathy.

Groin Injuries

Two nonoverlapping systematic reviews^39,62 found limited evidence to support the use of hip adductor and abdominal strengthening exercises for groin injury prevention.

Shoulder Injuries

Asker et al¹⁶ identified only 1 study⁹ that examined prevention of shoulder injuries in overhead sports and found no statistically significant effects of a strength and conditioning regimen on shoulder injuries in Norwegian handball players.

Wrist Injuries

Two overlapping systematic reviews^122,191 found that the risk for wrist injury, wrist fracture, and wrist sprain was reduced by 54% to 83% in snowboarders with the use of wrist guards.

Elbow Injuries

Deal et al⁴⁷ found that injury prevention programs were effective at reducing elbow injuries in baseball players.

Discussion

This comprehensive review provides a thorough and concise summary of all systematic reviews and meta-analyses on the topic of sports injury prevention in general and for specific sports and injury types. The majority of “all injury” articles pertained to sports and exercise in general (15.5%) and soccer (10.2%). Most of the “injuries by anatomic site” articles pertained to ACL (26.4%), ankle (10.9%), and hamstring (8.5%) injuries. In line with our hypothesis, we found that most injury prevention systematic reviews pertained to sports injuries in general (as opposed to specific sports) and focused on prevention of knee injuries (both in general and specifically on the ACL). To our knowledge, this is the first comprehensive review of the systematic reviews and meta-analyses published on sports injury prevention.

Injury prevention programs are effective and can reduce injuries by at least 40% in both youth and adults.^194,217 Strength training, proprioception, balance, and psychological programs have all been shown to be beneficial, while stretching has not. Much of the research on preventing sport-related injuries in general has focused on specific sports,^{45,103,120,121,202,260} primarily soccer.^** ^†† There is substantial evidence supporting the FIFA 11+ program for preventing soccer-related injuries; however, the systematic reviews on this topic include many overlapping studies.^{4,6,21,79,119,192,238} There is limited low-quality research demonstrating that other exercise and psychological-based interventions are effective at reducing soccer-related injuries.^{43,64,123,182,211,243} Several systematic reviews have found injury prevention programs tailored toward hockey,⁴⁵ volleyball,¹²⁰ basketball,¹²¹ tackle collision sports,²⁰² and sport climbing and bouldering²⁶⁰ to be effective at reducing musculoskeletal injuries in general.

Evidence regarding the effectiveness of neuromuscular training for preventing knee injuries in general has been contradictory,^51,84,99,236 and there is currently no systematic review evidence to support wearing a knee brace for injury prevention.^7,179,236 However, there is moderate evidence to support exercise and neuromuscular training programs for ACL injury prevention,^{7,85,152,163,232} and the most effective components of these programs included plyometrics, strengthening, flexibility, agility, and feedback.⁸⁶ A number of systematic reviews have focused on ACL injury prevention in female athletes^†† and found that plyometrics,^38,254 strengthening,^227,254 and neuromuscular training²⁵⁴ were most effective in this cohort. ACL injury prevention programs were most effective in female athletes aged <18 years¹⁵⁵ and among those who were highly compliant with the programs.²²⁵ The most effective ACL injury prevention programs in female athletes were those lasting at least 20 minutes per session, with multiple sessions per week and at a high training volume.²²⁶ It should be noted that the ACL injury prevention literature may be skewed toward female athletes since most of the studies evaluated female athletes only or included more female athletes than male athletes. There is substantial evidence supporting the use of ankle bracing and taping, which can reduce ankle injuries by at least 60%.^‡‡ Neuromuscular,^34,35,250 balance,^{25,34,48,143,197} and exercise training^50,83 have also been shown to be effective for reducing ankle injuries. Exercise and neuromuscular training have been demonstrated to be effective at reducing hamstring injuries by 50%²⁴⁷; however, the effectiveness of strengthening remains uncertain,^{78,80,101,203} and there is no evidence to support stretching^145,186 for hamstring injury prevention. Lower extremity injuries can be reduced by exercise^33,261 and neuromuscular training^{58,95,221,231} programs, and the risk for stress fractures may be reduced by foot orthoses.^{29,76,114,187,204} Wrist guards have been shown to reduce wrist injuries by 54% to 83% in snow boarders.^122,191 There is limited evidence available to be able to make any conclusions regarding groin,^39,62 shoulder,¹⁶ and elbow⁴⁷ injuries and shin splints.²³⁴

There are several limitations of this study. There were a number of overlapping studies between systematic reviews and meta-analyses, which may have resulted in more weight being placed on the strength of evidence for certain topics than was truly warranted. Only 19.4% of the included reviews assessed publication bias, and 47.3% thoroughly described exclusion criteria. Thus, selection and/or publication biases may have affected the results of individual reviews. Also, only 48.8% of systematic reviews pooled their data for analysis. The remaining 50.2% did not pool data mainly because of considerable heterogeneity among included studies. Finally, this review was limited to a qualitative summary of the literature since there was too much heterogeneity between studies to warrant any pooled data analyses. However, strengths of this study include performing a thorough literature search in accordance with PRISMA and performing a thorough review of study quality and risk for bias using the AMSTAR-2.

Conclusion

This comprehensive review provides sports medicine providers and other interested parties with a single source of the most up-to-date published literature focused on the effectiveness of sports injury prevention and organizes the literature by anatomic site and general injury patterns.

Supplemental Material for this article is available at http://journals.sagepub.com/doi/suppl/10.1177/23259671211035776.

Supplemental Material

Supplemental Material, sj-pdf-1-ojs-10.1177_23259671211035776 - A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies

Supplemental Material, sj-pdf-1-ojs-10.1177_23259671211035776 for A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies by Samuel D. Stephenson, Joseph W. Kocan, Amrit V. Vinod, Melissa A. Kluczynski and Leslie J. Bisson in Orthopaedic Journal of Sports Medicine

Footnotes

Notes

Final revision submitted April 5, 2021; accepted May 3, 2021.

One or more of the authors has declared the following potential conflict of interest or source of funding: Departmental research funding was received from the Ralph C. Wilson Jr Foundation. L.J.B. has received research support from Arthrex, royalties from Zimmer Biomet, and hospitality payments from Prodigy Surgical. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

References

Aaltonen

Karjalainen

Heinonen

Parkkari

Kujala

. Prevention of sports injuries: systematic review of randomized controlled trials. Arch Intern Med. 2007;167(15):1585–1592.

Abernethy

Bleakley

. Strategies to prevent injury in adolescent sport: a systematic review. Br J Sports Med. 2007;41(10):627–638.

Achenbach

Krutsch

Weber

, et al. Neuromuscular exercises prevent severe knee injury in adolescent team handball players. Knee Surg Sports Traumatol Arthrosc. 2018;26(7):1901–1908.

Al Attar

Soomro

Pappas

Sinclair

Sanders

. How effective are F-MARC injury prevention programs for soccer players? A systematic review and meta-analysis. Sports Med. 2016;46(2):205–217.

Al Attar

Soomro

Sinclair

Pappas

Sanders

. Effect of injury prevention programs that include the Nordic Hamstring Exercise on hamstring injury rates in soccer players: a systematic review and meta-analysis. Sports Med. 2017;47(5):907–916.

Al Attar

WSA

Alshehri

. A meta-analysis of meta-analyses of the effectiveness of FIFA injury prevention programs in soccer. Scand J Med Sci Sports. 2019;29(12):1846–1855.

Alentorn-Geli

Mendiguchia

Samuelsson

, et al. Prevention of non-contact anterior cruciate ligament injuries in sports, part II: systematic review of the effectiveness of prevention programmes in male athletes. Knee Surg Sports Traumatol Arthrosc. 2014;22(1):16–25.

Amoroso

Ryan

Bickley

, et al. Braced for impact: reducing military paratroopers’ ankle sprains using outside-the-boot braces. J Trauma. 1998;45(3):575–580.

Andersson

Bahr

Clarsen

Myklebust

. Preventing overuse shoulder injuries among throwing athletes: a cluster-randomised controlled trial in 660 elite handball players. Br J Sports Med. 2017;51(14):1073–1080.

10.

Andrew

Gabbe

Cook

, et al.

Could targeted exercise programmes prevent lower limb injury in community Australian football?

Sports Med. 2013;43(8):751–763.

11.

Andrish

Bergfeld

Walheim

. A prospective study on the management of shin splints. J Bone Joint Surg Am. 1974;56(8):1697–1700.

12.

Armitano

Haegele

Russell

. The use of augmented information for reducing anterior cruciate ligament injury risk during jump landings: a systematic review. J Athl Train. 2018;53(9):844–859.

13.

Arnason

Andersen

Holme

Engebretsen

Bahr

. Prevention of hamstring strains in elite soccer: an intervention study. Scand J Med Sci Sports. 2008;18(1):40–48.

14.

Arnason

Engebretsen

Bahr

. No effect of a video-based awareness program on the rate of soccer injuries. Am J Sports Med. 2005;33(1):77–84.

15.

Arundale

AJH

Bizzini

Giordano

, et al. Exercise-based knee and anterior cruciate ligament injury prevention. J Orthop Sports Phys Ther. 2018;48(9):A1–A42.

16.

Asker

Brooke

Waldén

, et al. Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis. Br J Sports Med. 2018;52(20):1312–1319.

17.

Askling

Karlsson

Thorstensson

. Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload. Scand J Med Sci Sports. 2003;13(4):244–250.

18.

Bahr

. Incidence of acute volleyball injuries: a prospective cohort study of injury mechanisms and risk factors. Scand J Med Sci Sports. 1997;7(3):166–171.

19.

Barbic

Pater

Brison

. Comparison of mouth guard designs and concussion prevention in contact sports: a multicenter randomized controlled trial. Clin J Sport Med. 2005;15(5):294–298.

20.

Barelds

van den Broek

Huisstede

BMA

. Ankle bracing is effective for primary and secondary prevention of acute ankle injuries in athletes: a systematic review and meta-analyses. Sports Med. 2018;48(12):2775–2784.

21.

Barengo

Meneses-Echavez

Ramirez-Velez

, et al. The impact of the FIFA 11+ training program on injury prevention in football players: a systematic review. Int J Environ Res Public Health. 2014;11(11):11986–12000.

22.

Barrett

Tanji

Drake

, et al. High- versus low-top shoes for the prevention of ankle sprains in basketball players: a prospective randomized study. Am J Sports Med. 1993;21(4):582–585.

23.

Beaulieu

Palmieri-Smith

. Real-time feedback on knee abduction moment does not improve frontal-plane knee mechanics during jump landings. Scand J Med Sci Sports. 2014;24(4):692–699.

24.

Behm

Blazevich

Kay

McHugh

. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Appl Physiol Nutr Metab. 2016;41(1):1–11.

25.

Bellows

Wong

. The effect of bracing and balance training on ankle sprain incidence among athletes: a systematic review with meta-analysis. Int J Sports Phys Ther. 2018;13(3):379–388.

26.

Benjaminse

Welling

Otten

Gokeler

. Novel methods of instruction in ACL injury prevention programs: a systematic review. Phys Ther Sport. 2015;16(2):176–186.

27.

Bensel

. The effects of tropical and leather combat boots on lower extremity disorders among US Marine Corps recruits. Report No: TR-76-49-CEMEL. Clothing, Equipment and Materials Engineering Laboratory US Army Natick Research & Development Command, 1976. https://apps.dtic.mil/sti/pdfs/ADA025938.pdf

28.

Bixler

Jones

. High-school football injuries: effects of a post-halftime warm-up and stretching routine. Fam Pract Res J. 1992;12(2):131–139.

29.

Bonanno

Landorf

Munteanu

Murley

Menz

. Effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury: a systematic review and meta-analysis. Br J Sports Med. 2017;51(2):86–96.

30.

Brachman

Kamieniarz

Michalska

, et al. Balance training programs in athletes---a systematic review. J Hum Kinet. 2017;58:45–64.

31.

Brooks

Fuller

Kemp

Reddin

. Incidence, risk, and prevention of hamstring muscle injuries in professional rugby union. Am J Sports Med. 2006;34(8):1297–1306.

32.

Brughelli

Mendiguchia

Nosaka

, et al. Effects of eccentric exercise on optimum length of the knee flexors and extensors during the preseason in professional soccer players. Phys Ther Sport. 2010;11(2):50–55.

33.

Brunner

Friesenbichler

Casartelli

, et al. Effectiveness of multicomponent lower extremity injury prevention programmes in team-sport athletes: an umbrella review. Br J Sports Med. 2019;53(5):282–288.

34.

Burger

Dreyer

Fisher

, et al. The effectiveness of proprioceptive and neuromuscular training compared to bracing in reducing the recurrence rate of ankle sprains in athletes: a systematic review and meta-analysis. J Back Musculoskelet Rehabil. 2018;31(2):221–229.

35.

Caldemeyer

Brown

Mulcahey

. Neuromuscular training for the prevention of ankle sprains in female athletes: a systematic review. Phys Sportsmed. 2020:1–7.

36.

Caraffa

Cerulli

Projetti

Aisa

Rizzo

. Prevention of anterior cruciate ligament injuries in soccer: a prospective controlled study of proprioceptive training. Knee Surg Sports Traumatol Arthrosc. 1996;4(1):19–21.

37.

Carder

Giusti

Vopat

, et al. The concept of sport sampling versus sport specialization: preventing youth athlete injury. A systematic review and meta-analysis. Am J Sports Med. 2020;48(11):2850–2857.

38.

Chang

WD LP

. Neuromuscular training for prevention of anterior cruciate ligament injury in female athletes. Int J Athl Ther Train. 2014;19:17–21.

39.

Charlton

Drew

Mentiplay

Grimaldi

Clark

. Exercise interventions for the prevention and treatment of groin pain and injury in athletes: a critical and systematic review. Sports Med. 2017;47(10):2011–2026.

40.

Colado

Garcia-Masso

. Technique and safety aspects of resistance exercises: a systematic review of the literature. Phys Sportsmed. 2009;37(2):104–111.

41.

Coppack

Etherington

Wills

. The effects of exercise for the prevention of overuse anterior knee pain: a randomized controlled trial. Am J Sports Med. 2011;39(5):940–948.

42.

Cross

Worrell

. Effects of a static stretching program on the incidence of lower extremity musculotendinous strains. J Athl Train. 1999;34(1):11–14.

43.

Crossley

Patterson

Culvenor

, et al. Making football safer for women: a systematic review and meta-analysis of injury prevention programmes in 11 773 female football (soccer) players. Br J Sports Med. 2020;54(18):1089–1098.

44.

Cumps

Verhagen

Meeusen

. Efficacy of a sports specific balance training programme on the incidence of ankle sprains in basketball. J Sports Sci Med. 2007;6(2):212–219.

45.

Cusimano

Nastis

Zuccaro

. Effectiveness of interventions to reduce aggression and injuries among ice hockey players: a systematic review. CMAJ. 2013;185(1):e57–e69.

46.

Daneshjoo

Rahnama

Mokhtar

Yusof

. Effectiveness of injury prevention programs on developing quadriceps and hamstrings strength of young male professional soccer players. J Hum Kinet. 2013;39:115–125.

47.

Deal

Richey

Pumilia

. Regional interdependence and the role of the lower body in elbow injury in baseball players: a systematic review. Am J Sports Med. 2020;48(14):3652–3660.

48.

de Vasconcelos

Cini

Sbruzzi

Lima

. Effects of proprioceptive training on the incidence of ankle sprain in athletes: systematic review and meta-analysis. Clin Rehabil. 2018;32(12):1581–1590.

49.

Dizon

Reyes

. A systematic review on the effectiveness of external ankle supports in the prevention of inversion ankle sprains among elite and recreational players. J Sci Med Sport. 2010;13(3):309–317.

50.

Doherty

Bleakley

Delahunt

Holden

. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med. 2017;51(2):113–125.

51.

Donnell-Fink

Klara

Collins

, et al. Effectiveness of knee injury and anterior cruciate ligament tear prevention programs: a meta-analysis. PLoS One. 2015;10(12):e0144063.

52.

Edvardsson

Ivarsson

Johnson

. Is a cognitive-behavioural biofeedback intervention useful to reduce injury risk in junior football players? J Sports Sci Med. 2012;11(2):331–338.

53.

Eils

Schroter

Schroder

Gerss

Rosenbaum

. Multistation proprioceptive exercise program prevents ankle injuries in basketball. Med Sci Sports Exerc. 2010;42(11):2098–2105.

54.

Ekstrand

Gillquist

Liljedahl

. Prevention of soccer injuries: supervision by doctor and physiotherapist. Am J Sports Med. 1983;11(3):116–120.

55.

Emery

Cassidy

Klassen

Rosychuk

Rowe

. Effectiveness of a home-based balance-training program in reducing sports-related injuries among healthy adolescents: a cluster randomized controlled trial. CMAJ. 2005;172(6):749–754.

56.

Emery

Meeuwisse

. The effectiveness of a neuromuscular prevention strategy to reduce injuries in youth soccer: a cluster-randomised controlled trial. Br J Sports Med. 2010;44(8):555–562.

57.

Emery

Rose

McAllister

Meeuwisse

. A prevention strategy to reduce the incidence of injury in high school basketball: a cluster randomized controlled trial. Clin J Sport Med. 2007;17(1):17–24.

58.

Emery

Roy

Whittaker

Nettel-Aguirre

van Mechelen

. Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis. Br J Sports Med. 2015;49(13):865–870.

59.

Engebretsen

Myklebust

Holme

Engebretsen

Bahr

. Prevention of injuries among male soccer players: a prospective, randomized intervention study targeting players with previous injuries or reduced function. Am J Sports Med. 2008;36(6):1052–1060.

60.

Ernst

Posadzki

. Chiropractic for the prevention and/or treatment of sports injuries: a systematic review of controlled clinical trials. Focus Altern Complement Ther. 2012;17:9–14.

61.

Espinosa

Poyhonen

Aramendi

Samaniego

Emparanza

Kyrolainen

. Effects of an eccentric training programme on hamstring strain injuries in women football players. Biomed Hum Kinet. 2015;7:125–134.

62.

Esteve

Rathleff

Bagur-Calafat

Urrutia

Thorborg

. Prevention of groin injuries in sports: a systematic review with meta-analysis of randomised controlled trials. Br J Sports Med. 2015;49(12):785–791.

63.

Etnoyer

Cortes

Ringleb

Van Lunen

Onate

. Instruction and jump-landing kinematics in college-aged female athletes over time. J Athl Train. 2013;48(2):161–171.

64.

Fanchini

Steendahl

Impellizzeri

, et al. Exercise-based strategies to prevent muscle injury in elite footballers: a systematic review and best evidence synthesis. Sports Med. 2020;50(9):1653–1666.

65.

Finch

Braham

McIntosh

McCrory

Wolfe

. Should football players wear custom fitted mouthguards? Results from a group randomised controlled trial. Inj Prev. 2005;11(4):242–246.

66.

Finestone

Giladi

Elad

, et al. Prevention of stress fractures using custom biomechanical shoe orthoses. Clin Orthop Relat Res. 1999;360:182–190.

67.

Finestone

Novack

Farfel

, et al. A prospective study of the effect of foot orthoses composition and fabrication on comfort and the incidence of overuse injuries. Foot Ankle Int. 2004;25(7):462–466.

68.

Foss

KDB

Thomas

Khoury

Myer

Hewett

. A school-based neuromuscular training program and sport-related injury incidence: a prospective randomized controlled clinical trial. J Athl Train. 2018;53(1):20–28.

69.

Fradkin

Gabbe

Cameron

. Does warming up prevent injury in sport? The evidence from randomised controlled trials? J Sci Med Sport. 2006;9(3):214–220.

70.

Fredberg

Bolvig

Andersen

. Prophylactic training in asymptomatic soccer players with ultrasonographic abnormalities in Achilles and patellar tendons: the Danish Super League Study. Am J Sports Med. 2008;36(3):451–460.

71.

Gabbe

Branson

Bennell

. A pilot randomised controlled trial of eccentric exercise to prevent hamstring injuries in community-level Australian Football. J Sci Med Sport. 2006;9(1-2):103–109.

72.

Gagnier

Morgenstern

Chess

. Interventions designed to prevent anterior cruciate ligament injuries in adolescents and adults: a systematic review and meta-analysis. Am J Sports Med. 2013;41(8):1952–1962.

73.

Gardner

Jr Dziados

Jones

, et al. Prevention of lower extremity stress fractures: a controlled trial of a shock absorbent insole. Am J Public Health. 1988;78(12):1563–1567.

74.

Garrick

Requa

. Role of external support in the prevention of ankle sprains. Med Sci Sports. 1973;5(3):200–203.

75.

Gilchrist

Mandelbaum

Melancon

, et al. A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. Am J Sports Med. 2008;36(8):1476–1483.

76.

Gillespie

, Grant I. Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults. Cochrane Database Syst Rev. 2000;2:CD000450.

77.

Gledhill

Forsdyke

Murray

. Psychological interventions used to reduce sports injuries: a systematic review of real-world effectiveness. Br J Sports Med. 2018;52(15):967–971.

78.

Goldman

Jones

. Interventions for preventing hamstring injuries. Cochrane Database Syst Rev. 2010;1:CD006782.

79.

Gomes Neto

Conceicao

de Lima Brasileiro

AJA

, et al. Effects of the FIFA 11 training program on injury prevention and performance in football players: a systematic review and meta-analysis. Clin Rehabil. 2017;31(5):651–659.

80.

Goode

Reiman

Harris

, et al. Eccentric training for prevention of hamstring injuries may depend on intervention compliance: a systematic review and meta-analysis. Br J Sports Med. 2015;49(6):349–356.

81.

Gottschalk

Andrish

. Epidemiology of sports injury in pediatric athletes. Sports Med Arthrosc Rev. 2011;19(1):2–6.

82.

Grace

Skipper

Newberry

, et al. Prophylactic knee braces and injury to the lower extremity. J Bone Joint Surg Am. 1988;70(3):422–427.

83.

Grimm

Jacobs

Jr Kim

Amendola

Shea

. Ankle injury prevention programs for soccer athletes are protective: a level-I meta-analysis. J Bone Joint Surg Am. 2016;98(17):1436–1443.

84.

Grimm

Jacobs

Jr Kim

Denney

Shea

. Anterior cruciate ligament and knee injury prevention programs for soccer players: a systematic review and meta-analysis. Am J Sports Med. 2015;43(8):2049–2056.

85.

Grimm

Shea

Leaver

Aoki

Carey

. Efficacy and degree of bias in knee injury prevention studies: a systematic review of RCTs. Clin Orthop Relat Res. 2013;471(1):308–316.

86.

Grindstaff

Hammill

Tuzson

Hertel

. Neuromuscular control training programs and noncontact anterior cruciate ligament injury rates in female athletes: a numbers-needed-to-treat analysis. J Athl Train. 2006;41(4):450–456.

87.

Grooms

Palmer

Onate

Myer

Grindstaff

. Soccer-specific warm-up and lower extremity injury rates in collegiate male soccer players. J Athl Train. 2013;48(6):782–789.

88.

Group OLoEW. The Oxford Levels of Evidence 2. Oxford Centre for Evidence-Based Medicine website. https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence

89.

Gulick

Kimura

Sitler

Paolone

Kelly

. Various treatment techniques on signs and symptoms of delayed onset muscle soreness. J Athl Train. 1996;31(2):145–152.

90.

Hägglund

Atroshi

Wagner

Waldén

. Superior compliance with a neuromuscular training programme is associated with fewer ACL injuries and fewer acute knee injuries in female adolescent football players: secondary analysis of an RCT. Br J Sports Med. 2013;47(15):974–979.

91.

Hammes

Aus der Funten

Kaiser

, et al.

Injury prevention in male veteran football players---a randomised controlled trial using “FIFA 11+.”

J Sports Sci. 2015;33(9):873–881.

92.

Hartig

Henderson

. Increasing hamstring flexibility decreases lower extremity overuse injuries in military basic trainees. Am J Sports Med. 1999;27(2):173–176.

93.

Heidt

Jr Sweeterman

Carlonas

Traub

Tekulve

. Avoidance of soccer injuries with preseason conditioning. Am J Sports Med. 2000;28(5):659–662.

94.

Herbert

Gabriel

. Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review. Br Med J. 2002;325(7362):468.

95.

Herman

Barton

Malliaras

Morrissey

. The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review. BMC Med. 2012;10:75.

96.

Hewett

Ford

Myer

. Anterior cruciate ligament injuries in female athletes, part 2: a meta-analysis of neuromuscular interventions aimed at injury prevention. Am J Sports Med. 2006;34(3):490–498.

97.

Hewett

Lindenfeld

Riccobene

Noyes

. The effect of neuromuscular training on the incidence of knee injury in female athletes: a prospective study. Am J Sports Med. 1999;27(6):699–706.

98.

Hewett

Myer

Ford

. Anterior cruciate ligament injuries in female athletes, part 1: mechanisms and risk factors. Am J Sports Med. 2006;34(2):299–311.

99.

Hewett

Myer

Ford

. Reducing knee and anterior cruciate ligament injuries among female athletes: a systematic review of neuromuscular training interventions. J Knee Surg. 2005;18(1):82–88.

100.

Hewson

Jr Mendini

Wang

. Prophylactic knee bracing in college football. Am J Sports Med. 1986;14(4):262–266.

101.

Hibbert

Cheong

Grant

Beers

Moizumi

. A systematic review of the effectiveness of eccentric strength training in the prevention of hamstring muscle strains in otherwise healthy individuals. N Am J Sports Phys Ther. 2008;3(2):67–81.

102.

High

Howley

Franks

. The effects of static stretching and warm-up on prevention of delayed-onset muscle soreness. Res Q Exerc Sport. 1989;60(4):357–361.

103.

Hincapie

Morton

Cassidy

. Musculoskeletal injuries and pain in dancers: a systematic review. Arch Phys Med Rehabil. 2008;89(9):1819–1829.

104.

Holme

Magnusson

Becher

, et al. The effect of supervised rehabilitation on strength, postural sway, position sense and re-injury risk after acute ankle ligament sprain. Scand J Med Sci Sports. 1999;9(2):104–109.

105.

Hölmich

Larsen

Krogsgaard

Gluud

. Exercise program for prevention of groin pain in football players: a cluster-randomized trial. Scand J Med Sci Sports. 2010;20(6):814–821.

106.

Huang

Jung

Mulligan

CMS

Norcross

. A majority of anterior cruciate ligament injuries can be prevented by injury prevention programs: a systematic review of randomized controlled trials and cluster-randomized controlled trials with meta-analysis. Am J Sports Med. 2020;48(6):1505–1515.

107.

Hübscher

Zech

Pfeifer

, et al. Neuromuscular training for sports injury prevention: a systematic review. Med Sci Sports Exerc. 2010;42(3):413–421.

108.

Hupperets

Verhagen

van Mechelen

. Effect of unsupervised home based proprioceptive training on recurrences of ankle sprain: randomised controlled trial. BMJ. 2009;339:B2684.

109.

Ivarsson

Johnson

Anderson

Fallby

Altemyr

. It pays to pay attention: a mindfulness-based program for injury prevention with soccer players. J Appl Sport Psychol. 2015;27(3):319–334.

110.

Jamtvedt

Herbert

Flottorp

, et al. A pragmatic randomised trial of stretching before and after physical activity to prevent injury and soreness. Br J Sports Med. 2010;44(14):1002–1009.

111.

Jłrgensen

Fredensborg

Haraszuk

Crone

. Reduction of injuries in downhill skiing by use of an instructional ski-video: a prospective randomised intervention study. Knee Surg Sports Traumatol Arthrosc. 1998;6(3):194–200.

112.

Johansson

Lindström

Sundelin

Lindström

. The effects of preexercise stretching on muscular soreness, tenderness and force loss following heavy eccentric exercise. Scand J Med Sci Sports. 1999;9(4):219–225.

113.

Johnson

Ekengren

Andersen

. Injury prevention in Sweden: helping soccer players at risk. J Sport Exerc Psychol. 2005;27(1):32–38.

114.

Jones

Thacker

Gilchrist

Kimsey

Jr Sosin

. Prevention of lower extremity stress fractures in athletes and soldiers: a systematic review. Epidemiol Rev. 2002;24(2):228–247.

115.

Junge

Rosch

Peterson

Graf-Baumann

Dvorak

. Prevention of soccer injuries: a prospective intervention study in youth amateur players. Am J Sports Med. 2002;30(5):652–659.

116.

Kalirtahinam

Ismail

Singh

TSP

Saha

Hashim

. Does neuromuscular exercise training improve proprioception in ankle lateral ligament injury among athletes? Systematic review and meta-analysis. Sci Med. 2017;27(1):1–8.

117.

Kerr

Goss

. The effects of a stress management program on injuries and stress levels. J Appl Sport Psychol. 1996;8(1):109–117.

118.

Kiani

Hellquist

Ahlqvist

, et al. Prevention of soccer-related knee injuries in teenaged girls. Arch Intern Med. 2010;170(1):43–49.

119.

Kilic

Kemler

Gouttebarge

. The “sequence of prevention” for musculoskeletal injuries among adult recreational footballers: a systematic review of the scientific literature. Phys Ther Sport. 2018;32:308–322.

120.

Kilic

Maas

Verhagen

Zwerver

Gouttebarge

. Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: a systematic review of the literature. Eur J Sport Sci. 2017;17(6):765–793.

121.

Kilic

Van Os

Kemler

Barendrecht

Gouttebarge

. The “Sequence of Prevention” for musculoskeletal injuries among recreational basketballers: a systematic review of the scientific literature. Phys Sportsmed. 2018;46(2):197–212.

122.

Kim

Lee

. Snowboard wrist guards---use, efficacy, and design: a systematic review. Bull NYU Hosp Jt Dis. 2011;69(2):149–157.

123.

Kirkendall

Junge

Dvorak

. Prevention of football injuries. Asian J Sports Med. 2010;1(2):81–92.

124.

Kolt

Hume

Smith

Williams

. Effects of a stress-management program on injury and stress of competitive gymnasts. Percept Mot Skills. 2004;99(1):195–207.

125.

LaBella

Huxford

Grissom

, et al. Effect of neuromuscular warm-up on injuries in female soccer and basketball athletes in urban public high schools: cluster randomized controlled trial. Arch Pediatr Adolesc Med. 2011;165(11):1033–1040.

126.

Larsen

Weidich

Leboeuf-Yde

. Can custom-made biomechanic shoe orthoses prevent problems in the back and lower extremities? A randomized, controlled intervention trial of 146 military conscripts. J Manipulative Physiol Ther. 2002;25(5):326–331.

127.

Lauersen

Andersen

. Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis. Br J Sports Med. 2018;52(24):1557–1563.

128.

Lauersen

Bertelsen

Andersen

. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med. 2014;48(11):871–877.

129.

Leppänen

Aaltonen

Parkkari

Heinonen

Kujala

. Interventions to prevent sports related injuries: a systematic review and meta-analysis of randomised controlled trials. Sports Med. 2014;44(4):473–486.

130.

Lewis

. A systematic literature review of the relationship between stretching and athletic injury prevention. Orthop Nurs. 2014;33(6):312–32 2.

131.

Chen

. Effects of psychological interventions on the prevention of sports injuries: a meta-analysis. Orthop J Sports Med. 2020;8(8):2325967120928325.

132.

Lim

Lee

Kim

, et al. Effects of sports injury prevention training on the biomechanical risk factors of anterior cruciate ligament injury in high school female basketball players. Am J Sports Med. 2009;37(9):1728–1734.

133.

Longo

Loppini

Berton

, et al. The FIFA 11+ program is effective in preventing injuries in elite male basketball players: a cluster randomized controlled trial. Am J Sports Med. 2012;40(5):996–1005.

134.

Machold

Kwasny

Eisenhardt

, et al. Reduction of severe wrist injuries in snowboarding by an optimized wrist protection device: a prospective randomized trial. J Trauma. 2002;52(3):517–520.

135.

Maddison

Prapavessis

. A psychological approach to the prediction and prevention of athletic injury. J Sport Exerc Psychol. 2005;27(3):289–310.

136.

Mandelbaum

Silvers

Watanabe

, et al. Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. Am J Sports Med. 2005;33(7):1003–1010.

137.

McCall

Carling

Davison

, et al. Injury risk factors, screening tests and preventative strategies: a systematic review of the evidence that underpins the perceptions and practices of 44 football (soccer) teams from various premier leagues. Br J Sports Med. 2015;49(9):583–589.

138.

McGuine

. Sports injuries in high school athletes: a review of injury-risk and injury-prevention research. Clin J Sport Med. 2006;16(6):488–499.

139.

McGuine

Brooks

Hetzel

. The effect of lace-up ankle braces on injury rates in high school basketball players. Am J Sports Med. 2011;39(9):1840–1848.

140.

McGuine

Hetzel

Wilson

Brooks

. The effect of lace-up ankle braces on injury rates in high school football players. Am J Sports Med. 2012;40(1):49–57.

141.

McGuine

Keene

. The effect of a balance training program on the risk of ankle sprains in high school athletes. Am J Sports Med. 2006;34(7):1103–1111.

142.

McHugh

Tyler

Mirabella

Mullaney

Nicholas

. The effectiveness of a balance training intervention in reducing the incidence of noncontact ankle sprains in high school football players. Am J Sports Med. 2007;35(8):1289–1294.

143.

McKeon

Hertel

. Systematic review of postural control and lateral ankle instability, part II: is balance training clinically effective? J Athl Train. 2008;43(3):305–315.

144.

Michaelidis

Koumantakis

. Effects of knee injury primary prevention programs on anterior cruciate ligament injury rates in female athletes in different sports: a systematic review. Phys Ther Sport. 2014;15(3):200–210.

145.

Michalis AH, Stergioulas

Hamstring strains in football: prevention and rehabilitation rules. Systematic review. Biol Exerc. 2016;12(1):121–148.

146.

Mickel

Bottoni

Tsuji

, et al. Prophylactic bracing versus taping for the prevention of ankle sprains in high school athletes: a prospective, randomized trial. J Foot Ankle Surg. 2006;45(6):360–365.

147.

Milgrom

Finestone

Shlamkovitch

, et al. Prevention of overuse injuries of the foot by improved shoe shock attenuation: a randomized prospective study. Clin Orthop Relat Res. 1992;281:189–192.

148.

Milgrom

Giladi

Kashtan

, et al. A prospective study of the effect of a shock-absorbing orthotic device on the incidence of stress fractures in military recruits. Foot Ankle. 1985;6(2):101–104.

149.

Mjolsnes

Arnason

Osthagen

Raastad

Bahr

. A 10-week randomized trial comparing eccentric vs. concentric hamstring strength training in well-trained soccer players. Scand J Med Sci Sports. 2004;14(5):311–317.

150.

Mohammadi

. Comparison of 3 preventive methods to reduce the recurrence of ankle inversion sprains in male soccer players. Am J Sports Med. 2007;35(6):922–926.

151.

Moher

Liberati

Tetzlaff

Altman

; the PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.

152.

Monajati

Larumbe-Zabala

Goss-Sampson

Naclerio

. The effectiveness of injury prevention programs to modify risk factors for non-contact anterior cruciate ligament and hamstring injuries in uninjured team sports athletes: a systematic review. PLoS One. 2016;11(5):e0155272.

153.

Mundermann

Stefanyshyn

Nigg

. Relationship between footwear comfort of shoe inserts and anthropometric and sensory factors. Med Sci Sports Exerc. 2001;33(11):1939–1945.

154.

Munro

Herrington

. The effect of videotape augmented feedback on drop jump landing strategy: implications for anterior cruciate ligament and patellofemoral joint injury prevention. Knee. 2014;21(5):891–895.

155.

Myer

Sugimoto

Thomas

Hewett

. The influence of age on the effectiveness of neuromuscular training to reduce anterior cruciate ligament injury in female athletes: a meta-analysis. Am J Sports Med. 2013;41(1):203–215.

156.

Myklebust

Engebretsen

Braekken

, et al. Prevention of anterior cruciate ligament injuries in female team handball players: a prospective intervention study over three seasons. Clin J Sport Med. 2003;13(2):71–78.

157.

Neilson

Ward

Hume

Lewis

McDaid

. Effects of augmented feedback on training jump landing tasks for ACL injury prevention: a systematic review and meta-analysis. Phys Ther Sport. 2019;39:126–135.

158.

Noh

Morris

Andersen

. Psychological intervention programs for reduction of injury in ballet dancers. Res Sports Med. 2007;15(1):13–32.

159.

Nouni-Garcia

Carratala-Munuera

Orozco-Beltran

Lopez-Pineda

Asensio-Garcia

Gil-Guillen

. Clinical benefit of the FIFA 11 programme for the prevention of hamstring and lateral ankle ligament injuries among amateur soccer players. Inj Prev. 2018;24(2):149–154.

160.

Noyes

Barber Westin

. Anterior cruciate ligament injury prevention training in female athletes: a systematic review of injury reduction and results of athletic performance tests. Sports Health . 2012;4(1):36–46.

161.

Noyes

Barber-Westin

. Neuromuscular retraining intervention programs: do they reduce noncontact anterior cruciate ligament injury rates in adolescent female athletes? Arthroscopy. 2014;30(2):245–255.

162.

Olmedilla-Zafra

Rubio

Ortega

Garcia-Mas

. Effectiveness of a stress management pilot program aimed at reducing the incidence of sports injuries in young football (soccer) players. Phys Ther Sport. 2017;24:53–59.

163.

Olsen

Scanlan

MacKay

, et al. Strategies for prevention of soccer related injuries: a systematic review. Br J Sports Med. 2004;38(1):89–94.

164.

Olsen

Myklebust

Engebretsen

Holme

Bahr

. Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial. BMJ. 2005;330(7489):449.

165.

Onate

Guskiewicz

Marshall

, et al. Instruction of jump-landing technique using videotape feedback: altering lower extremity motion patterns. Am J Sports Med. 2005;33(6):831–842.

166.

Onate

Guskiewicz

Sullivan

. Augmented feedback reduces jump landing forces. J Orthop Sports Phys Ther. 2001;31(9):511–517.

167.

Owoeye

Akinbo

Tella

Olawale

. Efficacy of the FIFA 11+ warm-up programme in male youth football: a cluster randomised controlled trial. J Sports Sci Med. 2014;13(2):321–328.

168.

Padua

Marshall

. Evidence supporting ACL-injury-prevention exercise programs: a review of the literature

Athl Ther Today. 2006;11:11–23.

169.

Parsons

Alexander

. Modifying spike jump landing biomechanics in female adolescent volleyball athletes using video and verbal feedback. J Strength Cond Res. 2012;26(4):1076–1084.

170.

Pasanen

Parkkari

Pasanen

, et al. Neuromuscular training and the risk of leg injuries in female floorball players: cluster randomised controlled study. BMJ. 2008;337:A295.

171.

Paszkewicz

Webb

Waters

Welch McCarty

Van Lunen

. The effectiveness of injury-prevention programs in reducing the incidence of anterior cruciate ligament sprains in adolescent athletes. J Sport Rehabil. 2012;21(4):371–377.

172.

Perna

Antoni

Baum

Gordon

Schneiderman

. Cognitive behavioral stress management effects on injury and illness among competitive athletes: a randomized clinical trial. Ann Behav Med. 2003;25(1):66–73.

173.

Peters

Zwerver

Diercks

Elferink-Gemser

van den Akker-Scheek

. Preventive interventions for tendinopathy: a systematic review. J Sci Med Sport. 2016;19(3):205–211.

174.

Petersen

Thorborg

Nielsen

Budtz-Jørgensen

Hölmich

. Preventive effect of eccentric training on acute hamstring injuries in men’s soccer: a cluster-randomized controlled trial. Am J Sports Med. 2011;39(11):2296–2303.

175.

Petersen

Braun

Bock

, et al. A controlled prospective case control study of a prevention training program in female team handball players: the German experience. Arch Orthop Trauma Surg. 2005;125(9):614–621.

176.

Petushek

Sugimoto

Stoolmiller

Smith

Myer

. Evidence-based best-practice guidelines for preventing anterior cruciate ligament injuries in young female athletes: a systematic review and meta-analysis. Am J Sports Med. 2019;47(7):1744–1753.

177.

Pfeiffer

Shea

Roberts

Grandstrand

Bond

. Lack of effect of a knee ligament injury prevention program on the incidence of noncontact anterior cruciate ligament injury. J Bone Joint Surg Am. 2006;88(8):1769–1774.

178.

Pfile

Curioz

. Coach-led prevention programs are effective in reducing anterior cruciate ligament injury risk in female athletes: a number-needed-to-treat analysis. Scand J Med Sci Sports. 2017;27(12):1950–1958.

179.

Pietrosimone

Grindstaff

Linens

Uczekaj

Hertel

. A systematic review of prophylactic braces in the prevention of knee ligament injuries in collegiate football players. J Athl Train. 2008;43(4):409–415.

180.

Pope

Herbert

Kirwan

. Effects of ankle dorsiflexion range and pre-exercise calf muscle stretching on injury risk in Army recruits. Aust J Physiother. 1998;44(3):165–172.

181.

Pope

Herbert

Kirwan

Graham

. A randomized trial of preexercise stretching for prevention of lower-limb injury. Med Sci Sports Exerc. 2000;32(2):271–277.

182.

Porter

Rushton

. The efficacy of exercise in preventing injury in adult male football: a systematic review of randomised controlled trials. Sports Med Open. 2015;1(1):4.

183.

Prior

Guerin

Grimmer

. An evidence-based approach to hamstring strain injury: a systematic review of the literature. Sports Health. 2009;1(2):154–164.

184.

Ramirez

Baldwin

Franklin

. Prevention of anterior cruciate ligament rupture in female athletes: a systematic review. JBJS Rev. 2014;2(9):e3.

185.

Roberts

Stallard

. Emergency department evaluation and treatment of knee and leg injuries. Emerg Med Clin North Am. 2000;18(1):67–84, v-vi.

186.

Rogan

Wust

Schwitter

Schmidtbleicher

. Static stretching of the hamstring muscle for injury prevention in football codes: a systematic review. Asian J Sports Med. 2013;4(1):1–9.

187.

Rome

Handoll

Ashford

. Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults. Cochrane Database Syst Rev. 2005;2:CD000450.

188.

Ronning

Gerner

Engebretsen

. The efficacy of wrist protectors in preventing snowboarding injuries. Am J Sports Med. 2001;29(5):581–585.

189.

Rossler

Donath

Verhagen

, et al. Exercise-based injury prevention in child and adolescent sport: a systematic review and meta-analysis. Sports Med. 2014;44(12):1733–1748.

190.

Rovere

Haupt

Yates

. Prophylactic knee bracing in college football. Am J Sports Med. 1987;15(2):111–116.

191.

Russell

Hagel

Francescutti

. The effect of wrist guards on wrist and arm injuries among snowboarders: a systematic review. Clin J Sport Med. 2007;17(2):145–150.

192.

Sadigursky

Braid

De Lira

DNL

, et al. The FIFA 11+ injury prevention program for soccer players: a systematic review. BMC Sports Sci Med Rehabil. 2017;9:18.

193.

Sadoghi

von Keudell

Vavken

. Effectiveness of anterior cruciate ligament injury prevention training programs. J Bone Joint Surg Am. 2012;94(9):769–776.

194.

Salam

Arshad

Das

, et al. Interventions to prevent unintentional injuries among adolescents: a systematic review and meta-analysis. J Adolesc Health. 2016;59(4)(suppl):S76–S87.

195.

Salata

Gibbs

Sekiya

. The effectiveness of prophylactic knee bracing in American football: a systematic review. Sports Health. 2010;2(5):375–379.

196.

Scase

Cook

Makdissi

Gabbe

Shuck

. Teaching landing skills in elite junior Australian football: evaluation of an injury prevention strategy. Br J Sports Med. 2006;40(10):834–838 .

197.

Schiftan

Ross

Hahne

. The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: a systematic review and meta-analysis. J Sci Med Sport. 2015;18(3):238–244.

198.

Schwellnus

Jordaan

. Does calcium supplementation prevent bone stress injuries? A clinical trial. Int J Sport Nutr. 1992;2(2):165–174.

199.

Schwellnus

Jordaan

Noakes

. Prevention of common overuse injuries by the use of shock absorbing insoles: a prospective study. Am J Sports Med. 1990;18(6):636–641.

200.

Seagrave

III Perez

McQueeney

, et al. Preventive effects of eccentric training on acute hamstring muscle injury in professional baseball. Orthop J Sports Med. 2014;2(6):2325967114535351.

201.

Sebelien

Stiller

Maher

. Effects of implementing Nordic hamstring exercises for semi-professional soccer players in Norway. Orthop Pract. 2014;26:90–97.

202.

Sewry

Verhagen

Lambert

, et al. Exercise-based interventions for injury prevention in tackle collision ball sports: a systematic review. Sports Med. 2017;47(9):1847–1857.

203.

Shadle

Cacolice

. Eccentric exercises reduce hamstring strains in elite adult male soccer players: a critically appraised topic. J Sport Rehabil. 2017;26(6):573–577.

204.

Shaffer

Uhl

. Preventing and treating lower extremity stress reactions and fractures in adults. J Athl Train. 2006;41(4):466–469.

205.

Shea

Reeves

Wells

, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:J4008.

206.

Sherry

Best

. A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. J Orthop Sports Phys Ther. 2004;34(3):116–125.

207.

Shrier

. Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. Clin J Sport Med. 1999;9(4):221–227.

208.

Silvers-Granelli

Mandelbaum

Adeniji

, et al. Efficacy of the FIFA 11+ injury prevention program in the collegiate male soccer player. Am J Sports Med. 2015;43(11):2628–2637.

209.

Sitler

Ryan

Hopkinson

, et al. The efficacy of a prophylactic knee brace to reduce knee injuries in football: a prospective, randomized study at West Point. Am J Sports Med. 1990;18(3):310–315.

210.

Sitler

Ryan

Wheeler

, et al. The efficacy of a semirigid ankle stabilizer to reduce acute ankle injuries in basketball: a randomized clinical study at West Point. Am J Sports Med. 1994;22(4):454–461.

211.

Slimani

Bragazzi

Znazen

, et al. Psychosocial predictors and psychological prevention of soccer injuries: a systematic review and meta-analysis of the literature. Phys Ther Sport. 2018;32:293–300.

212.

Small

McNaughton

Matthews

. A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury. Res Sports Med. 2008;16(3):213–231.

213.

Smith

Walter

Jr Bailey

. Effects of insoles in Coast Guard basic training footwear. J Am Podiatr Med Assoc. 1985;75(12):644–647.

214.

Smyth

Newman

Waddington

Weissensteiner

Drew

. Injury prevention strategies specific to pre-elite athletes competing in Olympic and professional sports---a systematic review. J Sci Med Sport. 2019;22(8):887–901.

215.

Söderman

Werner

Pietilä

Engström

Alfredson

. Balance board training: prevention of traumatic injuries of the lower extremities in female soccer players? A prospective randomized intervention study. Knee Surg Sports Traumatol Arthrosc. 2000;8(6):356–363.

216.

Soligard

Myklebust

Steffen

, et al. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. BMJ. 2008;337:A2469.

217.

Soomro

Sanders

Hackett

, et al. The efficacy of injury prevention programs in adolescent team sports: a meta-analysis. Am J Sports Med. 2016;44(9):2415–2424.

218.

Stasinopoulos

. Comparison of three preventive methods in order to reduce the incidence of ankle inversion sprains among female volleyball players. Br J Sports Med. 2004;38(2):182–185.

219.

Steffen

Emery

Romiti

, et al. High adherence to a neuromuscular injury prevention programme (FIFA 11+) improves functional balance and reduces injury risk in Canadian youth female football players: a cluster randomised trial. Br J Sports Med. 2013;47(12):794–802.

220.

Steffen

Myklebust

Olsen

Holme

Bahr

. Preventing injuries in female youth football---a cluster-randomized controlled trial. Scand J Med Sci Sports. 2008;18(5):605–614.

221.

Steib

Rahlf

Pfeifer

Zech

. Dose-response relationship of neuromuscular training for injury prevention in youth athletes: a meta-analysis. Front Physiol. 2017;8:920.

222.

Stevenson

Beattie

Schwartz

Busconi

. Assessing the effectiveness of neuromuscular training programs in reducing the incidence of anterior cruciate ligament injuries in female athletes: a systematic review. Am J Sports Med. 2015;43(2):482–490.

223.

Stojanovic

Ostojic

. Preventing ACL injuries in team-sport athletes: a systematic review of training interventions. Res Sports Med. 2012;20(3-4):223–238.

224.

Sugimoto

Myer

Barber Foss

, et al. Critical components of neuromuscular training to reduce ACL injury risk in female athletes: meta-regression analysis. Br J Sports Med. 2016;50(20):1259–1266.

225.

Sugimoto

Myer

Bush

, et al. Compliance with neuromuscular training and anterior cruciate ligament injury risk reduction in female athletes: a meta-analysis. J Athl Train. 2012;47(6):714–723.

226.

Sugimoto

Myer

Foss

Hewett

. Dosage effects of neuromuscular training intervention to reduce anterior cruciate ligament injuries in female athletes: meta- and sub-group analyses. Sports Med. 2014;44(4):551–562.

227.

Sugimoto

Myer

Foss

Hewett

. Specific exercise effects of preventive neuromuscular training intervention on anterior cruciate ligament injury risk reduction in young females: meta-analysis and subgroup analysis. Br J Sports Med. 2015;49(5):282–289.

228.

Sugimoto

Myer

McKeon

Hewett

. Evaluation of the effectiveness of neuromuscular training to reduce anterior cruciate ligament injury in female athletes: a critical review of relative risk reduction and numbers-needed-to-treat analyses. Br J Sports Med. 2012;46(14):979–988.

229.

Surve

Schwellnus

Noakes

Lombard

. A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the Sport-Stirrup orthosis. Am J Sports Med. 1994;22(5):601–606.

230.

Tate

Milner

Fairbrother

Zhang

. The effects of a home-based instructional program aimed at improving frontal plane knee biomechanics during a jump-landing task. J Orthop Sports Phys Ther. 2013;43(7):486–494.

231.

Taylor

Ford

Nguyen

Terry

Hegedus

. Prevention of lower extremity injuries in basketball: a systematic review and meta-analysis. Sports Health. 2015;7(5):392–398.

232.

Taylor

Waxman

Richter

Shultz

. Evaluation of the effectiveness of anterior cruciate ligament injury prevention programme training components: a systematic review and meta-analysis. Br J Sports Med. 2015;49(2):79–87.

233.

Ter Stege

Dallinga

Benjaminse

Lemmink

. Effect of interventions on potential, modifiable risk factors for knee injury in team ball sports: a systematic review. Sports Med. 2014;44(10):1403–1426.

234.

Thacker

Gilchrist

Stroup

Kimsey

. The prevention of shin splints in sports: a systematic review of literature. Med Sci Sports Exerc. 2002;34(1):32–40.

235.

Thacker

Gilchrist

Stroup

Kimsey

Jr . The impact of stretching on sports injury risk: a systematic review of the literature. Med Sci Sports Exerc. 2004;36(3):371–378.

236.

Thacker

Stroup

Branche

, et al. Prevention of knee injuries in sports: a systematic review of the literature. J Sports Med Phys Fitness. 2003;43(2):165–179.

237.

Thacker

Stroup

Branche

, et al. The prevention of ankle sprains in sports: a systematic review of the literature. Am J Sports Med. 1999;27(6):753–760.

238.

Thorborg

Krommes

Esteve

, et al. Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes. Br J Sports Med. 2017;51(7):562–571.

239.

Tranaeus

Ivarsson

Johnson

. Evaluation of the effects of psychological prevention interventions on sport injuries: a meta-analysis. Sci Sports. 2015;30(6):1–9.

240.

Tranaeus

Johnson

Engstrom

Skillgate

Werner

. A psychological injury prevention group intervention in Swedish floorball. Knee Surg Sports Traumatol Arthrosc. 2015;23(11):3414–3420.

241.

Tropp

Askling

Gillquist

. Prevention of ankle sprains. Am J Sports Med. 1985;13(4):259–262.

242.

van Beijsterveldt

van de Port

Krist

, et al. Effectiveness of an injury prevention programme for adult male amateur soccer players: a cluster-randomised controlled trial. Br J Sports Med. 2012;46(16):1114–1118.

243.

van Beijsterveldt

van der Horst

van de Port

Backx

. How effective are exercise-based injury prevention programmes for soccer players? A systematic review. Sports Med. 2013;43(4):257–265.

244.

van der Horst

Smits

Petersen

Goedhart

Backx

. The preventive effect of the Nordic hamstring exercise on hamstring injuries in amateur soccer players: a randomized controlled trial. Am J Sports Med. 2015;43(6):1316–1323.

245.

van Dyk

Behan

Whiteley

. Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes. Br J Sports Med. 2019;53(21):1362–1370.

246.

van Mechelen

Hlobil

Kemper

Voorn

de Jongh

. Prevention of running injuries by warm-up, cool-down, and stretching exercises. Am J Sports Med. 1993;21(5):711–719.

247.

Vatovec

Kozinc

Sarabon

. Exercise interventions to prevent hamstring injuries in athletes: a systematic review and meta-analysis. Eur J Sport Sci. 2019:1–13.

248.

Verhagen

van der Beek

Twisk

, et al. The effect of a proprioceptive balance board training program for the prevention of ankle sprains: a prospective controlled trial. Am J Sports Med. 2004;32(6):1385–1393.

249.

Verhagen

Bay

. Optimising ankle sprain prevention: a critical review and practical appraisal of the literature. Br J Sports Med. 2010;44(15):1082–1088.

250.

Verhagen

van Mechelen

de Vente

. The effect of preventive measures on the incidence of ankle sprains. Clin J Sport Med. 2000;10(4):291–296.

251.

Verrall

Slavotinek

Barnes

. The effect of sports specific training on reducing the incidence of hamstring injuries in professional Australian Rules football players. Br J Sports Med. 2005;39(6):363–368.

252.

Vescovi

VanHeest

. Effects of an anterior cruciate ligament injury prevention program on performance in adolescent female soccer players. Scand J Med Sci Sports. 2010;20(3):394–402.

253.

Waldén

Atroshi

Magnusson

Wagner

Hägglund

. Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial. BMJ. 2012;344:e3042.

254.

Webster

Hewett

. Meta-analysis of meta-analyses of anterior cruciate ligament injury reduction training programs. J Orthop Res. 2018;36(10):2696–2708.

255.

Wedderkopp

Kaltoft

Holm

Froberg

. Comparison of two intervention programmes in young female players in European handball---with and without ankle disc. Scand J Med Sci Sports. 2003;13(6):371–375.

256.

Wedderkopp

Kaltoft

Lundgaard

Rosendahl

Froberg

. Prevention of injuries in young female players in European team handball: a prospective intervention study. Scand J Med Sci Sports. 1999;9(1):41–47.

257.

Wedmore

Charette

. Emergency department evaluation and treatment of ankle and foot injuries. Emerg Med Clin North Am. 2000;18(1):85–113, vi.

258.

Weldon

Hill

. The efficacy of stretching for prevention of exercise-related injury: a systematic review of the literature. Man Ther. 2003;8(3):141–150.

259.

Wester

Jespersen

Nielsen

Neumann

. Wobble board training after partial sprains of the lateral ligaments of the ankle: a prospective randomized study. J Orthop Sports Phys Ther. 1996;23(5):332–336.

260.

Woollings

McKay

Emery

. Risk factors for injury in sport climbing and bouldering: a systematic review of the literature. Br J Sports Med. 2015;49(17):1094–1099.

261.

Yeung

. A systematic review of interventions to prevent lower limb soft tissue running injuries. Br J Sports Med. 2001;35(6):383–389.

262.

Yoo

Lim

, et al. A meta-analysis of the effect of neuromuscular training on the prevention of the anterior cruciate ligament injury in female athletes. Knee Surg Sports Traumatol Arthrosc. 2010;18(6):824–830.

263.

Zouita

Kebsi

, et al. Strength training reduces injury rate in elite young soccer players during one season. J Strength Cond Res. 2016;30(5):1295–1307.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

1.63 MB