Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial

BMJ. 2005 Feb 26;330(7489):449. doi: 10.1136/bmj.38330.632801.8F. Epub 2005 Feb 7.


Objective: To investigate the effect of a structured warm-up programme designed to reduce the incidence of knee and ankle injuries in young people participating in sports.

Design: Cluster randomised controlled trial with clubs as the unit of randomisation.

Setting: 120 team handball clubs from central and eastern Norway (61 clubs in the intervention group, 59 in the control group) followed for one league season (eight months).

Participants: 1837 players aged 15-17 years; 958 players (808 female and 150 male) in the intervention group; 879 players (778 female and 101 male) in the control group.

Intervention: A structured warm-up programme to improve running, cutting, and landing technique as well as neuromuscular control, balance, and strength.

Main outcome measure: The rate of acute injuries to the knee or ankle.

Results: During the season, 129 acute knee or ankle injuries occurred, 81 injuries in the control group (0.9 (SE 0.09) injuries per 1000 player hours; 0.3 (SE 0.17) in training v 5.3 (SE 0.06) during matches) and 48 injuries in the intervention group (0.5 (SE 0.11) injuries per 1000 player hours; 0.2 (SE 0.18) in training v 2.5 (SE 0.06) during matches). Fewer injured players were in the intervention group than in the control group (46 (4.8%) v (76 (8.6%); relative risk intervention group v control group 0.53, 95% confidence interval 0.35 to 0.81).

Conclusion: A structured programme of warm-up exercises can prevent knee and ankle injuries in young people playing sports. Preventive training should therefore be introduced as an integral part of youth sports programmes.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Ankle Injuries / prevention & control*
  • Athletic Injuries / prevention & control*
  • Cluster Analysis
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Knee Injuries / prevention & control*
  • Male
  • Treatment Outcome