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Understanding injury mechanisms: a key component of preventing injuries in sport
Open accessAbstract
Anterior cruciate ligament (ACL) injuries are a growing cause of concern, as these injuries can have serious consequences for the athlete with a greatly increased risk of early osteoarthrosis. Using specific training programmes, it may be possible to reduce the incidence of knee and ankle injuries. However, it is not known which programme components are the key to preventing knee and ankle injuries or how the exercises work to reduce injury risk. Our ability to design specific prevention programmes, whether through training or other preventive measures, is currently limited by an incomplete understanding of the causes of injuries. A multifactorial approach should be used to account for all the factors involved-that is, the internal and external risk factors as well as the inciting event (the injury mechanism). Although such models have been presented previously, we emphasise the need to use a comprehensive model, which accounts for the events leading to the injury situation (playing situation, player and opponent behaviour), as well as to include a description of whole body and joint biomechanics at the time of injury.
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“Although creatine supplementations do not appear to affect training-related plasma lactate levels, which have been correlated with muscle damage in the acute phase, little is known about the effect of an artificial increase in muscle mass on joint mechanics and core stability.44,45”
From Creatine supplementation in the pediatric and adolescent athlete-- A literature review (2023) · cites this paper as [44]
In the citing paper
“little is known about the effect of an artificial increase in muscle mass on joint mechanics and core stability.44,45”
From Creatine supplementation in the pediatric and adolescent athlete-- A literature review (2023) · cites this paper as [44]
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Hendricks, S., & Lambert, M. (2010) · doi:10.1260/1747-9541.5.1.117 · Cited by 124
Burger, N., Lambert, M., Viljoen, W., Brown, J., Readhead, C., & Hendricks, S. (2016) · British Journal of Sports Medicine · doi:10.1136/bjsports-2015-095295 · Cited by 123
van Beijsterveldt, A., Stubbe, J., Schmikli, S., van de Port, I. V. D., & Backx, F. (2015) · Journal of Science and Medicine in Sport · doi:10.1016/j.jsams.2014.02.004 · Cited by 123
Kalkhoven, J. T., Watsford, M., & Impellizzeri, F. (2019) · Journal of Science and Medicine in Sport · doi:10.31236/osf.io/vzxga · Cited by 122
Meyer, E., Baumer, T. G., Slade, J., Smith, W. E., & Haut, R. (2008) · American Journal of Sports Medicine · doi:10.1177/0363546508318046 · Cited by 121
“Many clinical studies have proposed the loading mechanisms that cause injury to the ACL; however, a precisely defined set of “injury mechanisms” has not been established.(6) In sports, noncontact ACL injuries occur more frequently than injuries involving player-to-player contact,(21,24) and the most commonly reference…”
BackgroundManaging the Risk of Injury in Sport
Fuller, C. W. (2007) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0b013e31805930b0 · Cited by 88
Hendricks, S., Till, K., den Hollander, S., Savage, T., Roberts, S., Tierney, G. J., Burger, N., Kerr, H., Kemp, S., Cross, M. J., et al. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2019-101293 · Cited by 114
Diagnosis of Acute Groin Injuries
Serner, A., Tol, J., Jomaah, N., Weir, A., Whiteley, R., Thorborg, K., Robinson, M., & Hölmich, P. (2015) · American Journal of Sports Medicine · doi:10.1177/0363546515585123 · Cited by 114
“Total examinations, n 110 105 95 Negative imaging result, n (%) N/A 23 (22) 24 (25) Injury location Adductor 73 (66) 54 (66) 45 (63) Adductor longus — 50 (93) 41 (91) Adductor magnus — 1 (2) 1 (2) Adductor brevis — 9 (17) 7 (16) Pectineus — 10 (19) 5 (11) Gracilis — 1 (2) 2 (5) Iliopsoas 28 (25) 14 (17) 13 (18) Iliacu…”
Behaviour, the Key Factor for Sports Injury Prevention
Verhagen, E. A. L. M., van Stralen, M. M., & van Mechelen, W. (2010) · Sports Medicine · doi:10.2165/11536890-000000000-00000 · Cited by 182
Meyers, M. (2010) · American Journal of Sports Medicine · doi:10.1177/0363546509352464 · Cited by 114
Serner, A., Mosler, A., Tol, J., Bahr, R., & Weir, A. (2018) · British Journal of Sports Medicine · doi:10.1136/bjsports-2018-099246 · Cited by 111
Self-citationSport injuries and illnesses during the first Winter Youth Olympic Games 2012 in Innsbruck, Austria
Ruedl, G., Schobersberger, W., Pocecco, E., Blank, C., Engebretsen, L., Soligard, T., Steffen, K., Kopp, M., & Burtscher, M. (2012) · British Journal of Sports Medicine · doi:10.1136/bjsports-2012-091534 · Cited by 111
How to Prevent Injuries in Alpine Ski Racing: What Do We Know and Where Do We Go from Here?
Spörri, J., Kröll, J., Gilgien, M., & Müller, E. (2016) · Sports Medicine · doi:10.1007/s40279-016-0601-2 · Cited by 109
“the events leading to injury situations and injury mechanisms) must also be identified [1, 4].”
BackgroundSoccer Injuries in Players Aged 7 to 12 Years
Rössler, R., Junge, A., Chomiak, J., Dvořák, J., & Faude, O. (2016) · American Journal of Sports Medicine · doi:10.1177/0363546515614816 · Cited by 109
“data on incidence and characteristics of soccer injuries in children should be gathered.(2,6,46) Population-based descriptive data from presentations to emergency departments are available for sport-related injuries in children and players under 19 years of age in several sports,(17) including soccer.”
BackgroundHulme, A., & Finch, C. F. (2015) · Injury Epidemiology · doi:10.1186/s40621-015-0064-1 · Cited by 135
“Closer to home, in the sports injury literature, there have been a number of examples that discuss or illustrate causality from a general prevention perspective (Meeuwisse 1994a, b; Gissane et al. 2001; Bahr and Holme 2003; Bahr and Krosshaug 2005; McIntosh 2005).”
BackgroundInfluentialWilkerson, G., Giles, J., & Seibel, D. K. (2012) · Journal of athletic training · doi:10.4085/1062-6050-47.3.17 · Cited by 108
Sundemo, D., Hamrin Senorski, E., Karlsson, L., Horvath, A., Juul-Kristensen, B., Karlsson, J., Ayeni, O. R., & Samuelsson, K. (2019) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2019-000620 · Cited by 108
Dingenen, B., Malfait, B., Nijs, S., Peers, K., Vereecken, S., Verschueren, S., & Staes, F. (2015) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2015.06.013 · Cited by 107
Tackle characteristics and injury in a cross section of rugby union football.
McIntosh, A., Savage, T., McCrory, P., Fréchède, B., & Wolfe, R. (2010) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181c07b5b · Cited by 107
McLean, S. G., Huang, X., & van den Bogert, A. J. (2008) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2008.03.072 · Cited by 88
“Data from such studies continue to govern and refine current neuromuscular training strategies aimed at targeting and subsequently preventing these high-risk control manifestations ( Bahr and Krosshaug, 2005; Hewett et al., 1999; Mandelbaum et al., 2005).”
BackgroundHead, face and neck injury in youth rugby: incidence and risk factors
McIntosh, A., McCrory, P., Finch, C., & Wolfe, R. (2008) · British Journal of Sports Medicine · doi:10.1136/bjsm.2007.041400 · Cited by 107
“These would contribute to a study of the ‘‘inciting event’’ and ‘‘internal risk factors’’ as proposed by Bahr and Krosshaug.(31)”
Concussion biomechanics, head acceleration exposure and brain injury criteria in sport: a review
Tierney, G. J. (2021) · Sports Biomechanics · doi:10.1080/14763141.2021.2016929 · Cited by 106
“The combination and interaction between internal (individual-related) and external (environmental-related) risk factors are believed to play a role when assessing injury causation (Bahr, 2005; Van Mechelen et al., 1992).”
InfluentialGrassi, A., Smiley, S., di Sarsina, T. R., Signorelli, C., Muccioli, G. M., Bondi, A., Romagnoli, M., Agostini, A., & Zaffagnini, S. (2017) · European Journal of Orthopaedic Surgery & Traumatology · doi:10.1007/s00590-017-1905-0 · Cited by 105
Energy Flow Analysis During the Tennis Serve
Martin, C., Bideau, B., Bideau, N., Nicolas, G., Delamarche, P., & Kulpa, R. (2014) · American Journal of Sports Medicine · doi:10.1177/0363546514547173 · Cited by 105
“Two parameters, magnitude and quality of energy transfer, are usually considered to be risk factors for injury in sports.(3,22,26) Concerning the magnitude of energy transfer, it is believed that injuries occur when mechanical energy is transferred or absorbed by the joints in amounts or at rates that exceed the thres…”
BackgroundCools, A., Maenhout, A., Vanderstukken, F., Declève, P., Johansson, F., & Borms, D. (2020) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2020.03.009 · Cited by 101
eSports: A new window on neurocognitive expertise?
Campbell, M. J., Toth, A. J., Moran, A. P., Kowal, M., & Exton, C. (2018) · Progress in brain research · doi:10.1016/bs.pbr.2018.09.006 · Cited by 136
Injury Prevention in Child and Adolescent Sport: Whose Responsibility Is It?
Emery, C., Hagel, B., & Morrongiello, B. (2006) · Clinical Journal of Sports Medicine · doi:10.1097/01.jsm.0000251179.90840.58 · Cited by 99
Seshadri, D. R., Thom, M. L., Harlow, E. R., Gabbett, T. J., Geletka, B. J., Hsu, J. J., Drummond, C. K., Phelan, D. M. J., & Voos, J. E. (2021) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2020.630576 · Cited by 117
“The nature of injury in sport is more complex, as injury exposure may occur with different intrinsic and extrinsic risk factors (Bahr and Krosshaug, 2005) or as a result of multiple participations without permanent removal from participation (Meeuwisse et al., 2007).”
BackgroundAllen, N., Nevill, A., Brooks, J., Koutedakis, Y., & Wyon, M. A. (2013) · Clinical Journal of Sports Medicine · doi:10.1097/jsm.0b013e3182887f32 · Cited by 98
The reliability of musculoskeletal screening tests used in cricket
Dennis, R. J., Finch, C. F., Elliott, B. C., & Farhart, P. J. (2007) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2007.09.004 · Cited by 88
“All rights reserved. sp.2007.09.004 ing author. ess: rebecca.dennis@unsw.edu.au (R.J. Dennis). why an athlete may be predisposed to injury (Bahr & Krosshaug, 2005; Finch, 2006).”
BackgroundInfluentialBeato, M., Maroto-Izquierdo, S., Turner, A. N., & Bishop, C. (2021) · International Journal of Sports Physiology and Performance · doi:10.1123/ijspp.2020-0862 · Cited by 95
Takahashi, S., Nagano, Y., Ito, W., Kido, Y., & Okuwaki, T. (2019) · Medicine · doi:10.1097/md.0000000000016030 · Cited by 95
“Recently, prevention has been especially focused on sports medicine and sports-related injury prevention models generally contain 4 steps in the research design.([7,8]) This model has been used for assessing many sports-related injuries, especially in ACL injury prevention.”
MethodHaaland, B., Steenstrup, S., Bere, T., Bahr, R., & Nordsletten, L. (2015) · British Journal of Sports Medicine · doi:10.1136/bjsports-2015-095467 · Cited by 95
Self-citationFor Debate: Consensus Injury Definitions in Team Sports Should Focus on Encompassing all Injuries
Hodgson, L., Gissane, C., Gabbett, T., & King, D. (2007) · Clinical Journal of Sports Medicine · doi:10.1097/jsm.0b013e3180547513 · Cited by 95
“Identification of these events and complex interactions assists in the identification of etiologic factors and the mechanism of injuries involved in injuries.(31)”
Background
Metadata
- Authors
- Bahr, R., & Krosshaug, T.
- Affiliations
- Oslo Sports Trauma Research Center (NO)
- Corresponding author
- Bahr, R
- ORCID
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2005-05-23
- Volume
- 39
- Issue
- 6
- Pages
- 324-329
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- PMC
- PMC1725226
- OpenAlex
- W2077950187
- Cited by
- 1,255
- References
- 0
- Citations by year
- 2026: 80 · 2025: 87 · 2024: 78 · 2023: 73 · 2022: 86 · 2021: 104 · 2020: 87 · 2019: 68 · 2018: 68 · 2017: 60 · 2016: 83 · 2015: 64 · 2014: 54 · 2013: 53 · 2012: 34
- FWCI
- 3.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
- Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Keywords
- injury mechanisms, sports injury prevention, anterior cruciate ligament injury, knee injury, ankle injuries, injury risk factors, injury prevention programs, joint biomechanics, osteoarthritis risk
- MeSH terms
- Anterior Cruciate Ligament Injuries, Athletic Injuries, Biomechanical Phenomena, Female, Humans, Knee Injuries, Male, Physical Education and Training, Risk Factors, Sports, Ankle Injuries
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