Can you predict or prevent injury?
I recently listened to a podcast by the British Journal of Sports Medicine (BJSM) in which a top academic from Norway was interviewed on the futility of screening for injury in athletes. Prof. Roald Bahr is well placed to give an opinion on the matter being Head of the Aspetar sports injury and illness prevention.
If you're in the industry I'd highly recommend a listen (to all their episodes). Here are the 3 main take aways from this one which apply to everyone:
1. The main difference between medical screening for disease and screening for injury risk in athletes (or training populations) is the present vs the future. Medical screens are designed to detect early signs of disease - things that are already present - that we know with as much certainty as possible are in themselves signs of the disease. Not risk factors that in 3 years if a particular order of events happens may lead to the disease. Bahr uses breast cancer as an example. If we remove all breasts from the world we can stop breast cancer but it is neither practical nor ethical to do so. Nor can we stop all sporting activities in order to stop sports injuries. Yes it would work but it wouldn't happen.
2. We cannot predict the future. In screening people who have no current injury we are trying to determine a risk level of future injury. It's not used as an assessment of athleticism per se, more of an indicator that something may go wrong at some point IF other factors contribute or certain things happen. Terrible movement strategies often result in injury, but not always. Luck plays far too great a role.
3. Screenings do work, but maybe not for their intended purpose. The biggest takeaway was that screening people from homogenous groups has showed success in finding ways to reduce overall injury risk. The greatest use therefore for screenings may be in the research and not in the field. In real life practical scenarios it may be more beneficial to apply the results of the researched screening and include methods and exercises that reduce injury risk across ALL players of certain sports where injuries are commonly similar.
For example, we can have all football players strengthen their hamstrings using the Nordic hamstring curl and know that we are reducing all of their hamstring tear risk. In basketball it may prove more useful to include landing mechanics drills across the whole squad. Different groups will require different interventions but to leave out athletes would theoretically be increasing (or at least ignoring) their injury risk.
Don't rush out and ditch your screening results. They're still useful and still valid. Just remember that we can't predict the future so get a good understanding of the research and established risk levels before you programme.