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Stretching, strengthening don’t affect knee and shin injury rates in soldiers in basic training

PainSci » bibliography » Brushøj et al 2008
Tags: stretch, IT band pain, patellar pain, shin pain, knee, exercise, self-treatment, treatment, muscle, leg, limbs, pain problems, overuse injury, injury, running, tendinitis, arthritis, aging, patellofemoral joint

Nine pages on PainSci cite Brushøj 2008: 1. Quite a Stretch2. The Complete Guide to IT Band Syndrome3. The Complete Guide to Patellofemoral Pain Syndrome4. Shin Splints Treatment, The Complete Guide5. The Complete Guide to Muscle Strains6. Strength Training for Pain & Injury Rehab7. Does Hip Strengthening Work for IT Band Syndrome?8. IT Band Stretching Does Not Work9. Can strength training prevent overuse injuries?

PainSci commentary on Brushøj 2008: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

A thousand soldiers in basic training were studied to determine whether or not an exercise program could “reduce the incidence of overuse knee injuries and medial tibial stress syndrome [shin splints].” Half participated in an exercise program consisting of stretching, strengthening or coordination exercises, and their injury rates were compared the other half that did nothing.

There were fifty injuries among those who exercised to prevent injury, but only forty-eight among those who did nothing. The researchers reasonably concluded that classic injury prevention exercises — all standard prescriptions for athletes — “did not influence the risk” of injury.

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: It is unknown whether an exercise program can prevent overuse injuries in the lower extremity. An often encountered and important risk factor for the development of lower extremity overuse injuries is an abrupt increase in activity level. HYPOTHESIS: A preventive training program based on a literature review of intrinsic risk factors, and performed concurrent with an increase in physical activity, can reduce the incidence of overuse knee injuries and medial tibial stress syndrome, as well as increase running distance.

STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.

METHODS: A total of 1020 soldiers aged 20.9 years (range, 19-26 years) undergoing 3 months of basic military training consecutively enrolled from December 2004 to December 2005. The prevention program consisted of an exercise program of 15 minutes' duration 3 times a week, including 5 exercises for strength, flexibility, and coordination; the placebo program consisted of 5 exercises for the upper body.

RESULTS: During the observation period, 223 subjects sustained an injury, with 50 and 48 of these fulfilling the study criteria for overuse knee injuries or medial tibial stress syndrome, respectively. There were no significant differences in incidence of injury between the prevention group and the placebo group (incidence, 0.22 vs 0.19; P = .162; relative risk = 1.05 [range, 0.98-1.11]). The soldiers in the prevention group had the greater improvement in running distance in 12-minute run tests (82 vs 43 m; P = .037).

CONCLUSION: An exercise program with an emphasis on muscular strengthening, coordination, and flexibility based on intrinsic risk factors identified through a literature review did not influence the risk of developing overuse knee injuries or medial tibial stress syndrome in subjects undergoing an increase in physical activity. The program increased maximal running distance in a 12-minute test.

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