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Injury prevention effects of stretching exercise intervention by physical therapists in male high school soccer players

PainSci » bibliography » Azuma et al 2020
Tags: stretch, injury, exercise, self-treatment, treatment, muscle, pain problems

One article on PainSci cites Azuma 2020: Quite a Stretch

PainSci commentary on Azuma 2020: ?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.

The abstract for this paper makes it sounds like stretching reduced injury rates. However, the researchers cherry picked their own data to arrive at that conclusion. There was no difference in traumatic injuries to report… only "disorders." There was no difference in the injury rates during competition. And there was no difference in the injury rates.

When you measure several things, there's a pretty good chance that at least one of them is going to look rosier than the others.

And finally, the effect they did detect — 32 of 64 stretchers had at least one (non-traumatic, non-competitive) injury versus 48 of 60 non-stretchers — was technically statistically significant, but also absolutely could have occurred by chance. I suspect if you studied two groups that size several times in a row you'd get quite a surprising variety of numbers.

This study could be showing a genuine injury prevention effect, unlike the body of evidence on this topic. But I doubt it. This is indeed a technically positive trial, but it’s not at all persuasive on its own.

~ 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.

We aimed to examine the prevalence of injury after physical therapy intervention for muscle tightness and injury prevention in male high school soccer players. A randomized controlled trial was conducted. Participants comprised 124 players from two high schools who competed in national tournament soccer games held from April 2018 to March 2019. Players were randomly divided into intervention (with a 12-week stretching intervention by physical therapists) and control groups (without the intervention). Players and coaches provided written information regarding injuries and daily training and match times; physical therapists visited each team weekly to collect data and review documentation. Muscle tightness and injury incidence, number, type, location, circumstances, situations, severity, and contents during the 12-week intervention period and a subsequent 40-week observation period were compared between groups. Injuries were significantly lower «sigh: how much lower? stat significance claimed without effect size» with intervention during the 40-week observation period (P < .01) but not during the 12-week intervention period (P = .44). Injury types mainly included disorder, non-contact, lower-limb/trunk, and muscle/tendon injuries. Significant interactions were observed for all tightness-test measurement items. The intervention group showed significant improvements in heel-buttock distance, and straight leg-raise and hip rotation angles (pre-intervention < 12 weeks < 52 weeks), as well as significant improvements in ankle dorsiflexion angles at 12 and 52 weeks (relative to pre-intervention values). Instructed stretching exercises, personally designed by physical therapists to address muscle tightness, improved the range of motion and trunk flexibility, with a positive effect on the injury rate in male high school soccer players, especially for non-contact disorder injuries during training.

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