Athletes may be more likely to suffer leg injuries when they’ve had injuries in the past - even those involving other parts of the body, a recent study suggests.
It’s well known that athletes often re-injure the same part of their body more than once, researchers note in the British Journal of Sports Medicine. But their new study shows that physical therapy and injury prevention efforts need to take into account the risk other injuries pose for subsequent leg injuries.
The researchers examined data from 12 previously published studies and found many types of previous injuries, including concussions, were associated with higher odds of a lower limb injury.
“When we are injured we generally only focus on the body part that is being rehabilitated, yet it is just as important to keep the non-injured parts of your body healthy and injury free,” said lead study author Liam Toohey of La Trobe University in Bundoora, Australia, and the Australian Institute of Sport in Canberra.
When athletes miss components of their normal training regimens due to injury, they may have a reduced fitness level and be in less than top condition when they resume participation in practices or competitions, Toohey said by email.
“During rehabilitation, it is common for the injured body site to be strengthened and conditioned, but often other body sites are not trained as much as they were before the injury,” Toohey added. “So when an athlete is ready to return to full training and competition, the other areas of their body may not be as conditioned as they need (to be) to withstand the demands of the sport - where they may then go on to sustain an injury at a different site.”
For example, one of the most common knee injuries, an anterior cruciate ligament (ACL) sprain or tear, was associated with a more than doubled risk of a subsequent hamstring injury, Toohey and colleagues found.
A previous muscle injury in the hamstrings, quadriceps, adductors and calves was tied to higher odds of a muscle injury in a different part of the lower limb, the study also found.
Back injuries were also connected to an increased risk of leg injuries in the future, as was a history of concussion and a variety of joint injuries.
One limitation of the analysis is that it examined data from only a small number of previously published studies, the authors note. It’s also possible that other things such as the intensity or duration of play, nutrition, or psychological factors might influence the odds of lower limb injuries, the authors note.
Even so, the findings add to evidence suggesting that injured athletes need to consider the potential for future injuries, said Lauren Fortington of the Australian Centre for Research into Injury in Sport and its Prevention in Ballarat.
“Many research studies to date have focused on recurrent injuries of exactly the same type, for example a right ankle sprain followed by another right ankle sprain,” Fortington, who wasn’t involved in the study, said by email. “The problem is greater than that - previous injury of any type may increase the risk for lower limb injuries.”
To minimize the risk of leg injuries in the future, rehabilitation of other injuries must account for what parts of the body carry most of the load in an athlete’s particular sport, said Isabel Moore, a sports and health sciences researcher at Cardiff Metropolitan University in the UK.
Psychological factors also need to be addressed, Moore, who wasn’t involved in the study, said by email.
“Stress, anxiety and fear of re-injury are all known to influence the chances of sustaining an injury,” Moore said.
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