The Need for an Intervention to Prevent Sports Injuries

Abstract

Although 1.35 million children visit emergency departments for sports-related injuries each year in the United States, athletic bodies lack a systematic approach for monitoring injury risk and adopting interventions to curtail injuries. 1 Rather than using randomized clinical trials or other evidence-based approaches to evaluate interventions, the decision-making process for adopting interventions is characterized by protracted debates that overweigh subjective factors, such as how sports have traditionally been played. 2,3 The magnitude of this problem merits serious attention; more than 46.5 million children participate in team sports in the United States alone. 1 Two underappreciated factors contribute to this situation: behavioral biases that distort and delay intervention decisions and a lack of data. In this Viewpoint, we draw lessons from behavioral economics, as well as prior sports injury intervention debates, to offer prescriptions for improving the decision-making processes for sports injury prevention.The debate in the early 2000s regarding introducing protective eyewear in girls' lacrosse epitomizes the challenge of implementing changes. In the early 2000s, many coaches and administrators were opposed to mandating protectiveeyewear,arguingthatitsusewouldpromoteaggressive play and increase the risk of injury. 2 Skeptics also fearedthatadoptingeyewearprotectionwouldundermine the character of girls' lacrosse and blur the distinction between girls' lacrosse, a low-contact sport, and boys' lacrosse, a high-contact sport. 2 After years of debate, US Lacrosse mandated eyewear use for girls' lacrosse in 2005; following this change, eye injuries decreased by 84%, with noassociatedincreaseintheroughnessofplay. 2 Similardebates have occurred across youth sports. 3 In controversial changes to reduce head injuries, US Soccer recommended a ban on heading of the ball for players younger than 10 years, US Hockey banned checking for youth 12 years and younger, and Pop Warner Football limited physical contact in practices and eliminated kickoff returns, the most dangerous play in US football. 3 Despite decades of sports injury prevention efforts, both injury data and evidence of the efficacy of protective gear and other interventions are surprisingly limited. Protective gear is typically initially adopted by selfselected volunteers and followed by mandates in different jurisdictions based on subjective perceptions of risk rather than empirical evidence. Injury data are rarely compiled in a systematic way, and calls for mandatory injury reporting remain rare. 3 Compounding this problem is the challenge of compiling accurate statistics for injuries, such as concussions, that require subjective assessments for diagnosis.

Adult sports-related traumatic spinal injuries: do different activities predispose to certain injuries?

“…Understanding the mechanics that produce these injuries after impact can inform the type of protective gear needed for athletes participating in different sports. [28][29][30][31] The prevalence of TSCI varied between sporting activities, with water sports and contact sports resulting in the highest prevalence of TSCI within this cohort. Previous studies have identified diving as the primary source of water sports-related injury, highlighting how the lack of protective equipment in this activity and related sports leaves patients more vulnerable to devastating neurological injury.…”

Differences in Care Team Response to Patient Portal Messages by Patient Race and Ethnicity

“…Use of text-based health care communications is likely to continue to grow, evidenced by both traditional health care institutions, such as BMC, and the growing sector of digital-first care institutions, such as Firefly and Ginger, which often rely on text-based messaging with a health coach as a first-line triage point before patients receive clinician-based care . Additionally, while AI tools have been discussed as a means for triaging and responding to patient text-based requests, prior work has shown that AI tools can perpetuate underlying inequalities in the data that algorithms were trained on . Understanding and correcting existing disparities in care team response to patient messages will be vital for increasing equity in care today and the algorithms of the future.…”

The Effectiveness of Neuromuscular Warmups for Lower Extremity Injury Prevention in Basketball: A Systematic Review

“…In the absence of clear and unambiguous evidence about what warmup activities are effective, it is unlikely that many non-professional athletes consistently engage in warmup activities that will be optimally effective for injury prevention. This highlights the need to develop, disseminate and implement injury preventing warmups [42]. Moreover, previous studies have shown that initial benefits of a neuromuscular warmup routine decline if adherence wanes over time [43].…”