Can injury risk category be changed in athletes? An analysis of an injury prevention system

Key points

1. 0148% of athletes (21 of 44) moved to a lower injury-risk category after the 8-week program (p=0.000; Z=-3.869).
2. 02Half of the athletes who started in the High Risk category dropped to Low Risk (16 of 32).
3. 03The biggest, statistically significant shift was Moderate Risk athletes moving down to Slight Risk: 62% (13 athletes), p<0.0001.
4. 04Athletes in the Substantial Risk category mostly did not improve, suggesting they need more formal individual assessment than a group program offers.
5. 05No control group and no follow-up, so it shows risk category is modifiable, not that injuries were actually reduced.

How it was conducted

Design

Retrospective cohort study (single group, pretest-posttest), no control group or randomization

Participants

44 female high school soccer players ages 14-17 in preseason (54 enrolled, 10 did not complete)

Intervention

8-week group program, two days/week: individualized corrective exercises (3 per athlete from FMS and YBT deficits) plus FIFA 11+ warm-up, jump, agility, and core training in progressive circuits

Outcome measure

Change in injury-risk category from the Move2Perform algorithm (Substantial, Moderate, Slight, Optimal), using FMS and Lower Quarter Y Balance Test scores

Analysis

Wilcoxon Signed Ranks Test across four categories and McNemar test across a condensed High Risk vs Low Risk threshold; significance set at 0.05

What they found

• 21 of 44 athletes improved their risk category, 2 declined, and 21 were unchanged; improvement was significant (p=0.000; Z=-3.869).
• Of 32 athletes in the combined High Risk category at pretest, 16 moved to the Low Risk category at posttest, a significant change on McNemar analysis (50%).
• 62% (13 athletes) of Moderate Risk athletes at pretest moved into the Slight Risk category at posttest (p<0.0001).
• Three athletes moved from Substantial Risk to Slight Risk, but this change was not statistically significant.
• No injuries were sustained by any participant during the program.

Limitations

• No control group and no randomization, so cause and effect cannot be established and the contribution of each program component is unknown.
• No control of co-interventions (athletes may have had personal training, weight lifting, massage, or chiropractic care).
• No short-term or long-term follow-up to show whether the lower risk category was maintained or whether actual injuries were prevented.
• Retrospective design meant full demographic data (height and weight) was not obtained, and the sample was small and limited to female soccer players.

Why it matters

For patients

A structured preseason program of individualized corrective exercises plus jump, agility, and core training may improve a young athlete's movement screening and lower their measured injury risk.

For clinicians

Clinicians can triage Moderate, Slight, and Optimal risk athletes into an individualized group program and reserve more intensive one-on-one assessment for Substantial Risk athletes who tend not to improve in a group setting.

For readers

This early single-group study shows a screening-based injury-risk category can be shifted by training, but without a control group it does not yet prove injuries are prevented.