Can motor control training lower the risk of injury for professional football players?
OBJECTIVE
Among injuries reported by the Australian Football League (AFL), lower limb injuries have shown the highest incidence and prevalence rates. Deficits in the muscles of the lumbopelvic region, such as a smaller size of multifidus (MF) muscle, have been related to the occurrence of lower limb injuries in the preseason in AFL players. Motor control training programs have been effective in restoring the size and control of the MF muscle, but the relationship between motor control training and occurrence of injuries has not been extensively examined.


METHODS
This pre- and postintervention trial was delivered during the playing season as a panel design with three groups. The motor control program involved voluntary contractions of the MF, transversus abdominis, and pelvic floor muscles while receiving feedback from ultrasound imaging and progressed into a functional rehabilitation program. Assessments of muscle size and function were performed using magnetic resonance imaging and included the measurement of cross-sectional areas of MF, psoas, and quadratus lumborum muscles and the change in trunk cross-sectional area due to voluntarily contracting the transversus abdominis muscle. Injury data were obtained from club records. Informed consent was obtained from all study participants.


RESULTS
A smaller size of the MF muscle (odds ratio [OR] = 2.38) or quadratus lumborum muscle (OR = 2.17) was predictive of lower limb injury in the playing season. At the time point when one group of players had not received the intervention (n = 14), comparisons were made with the combined groups who had received the intervention (n = 32). The risk of sustaining a severe injury was lower for those players who received the motor control intervention (OR = 0.09).


CONCLUSIONS
Although there are many factors associated with injuries in AFL, motor control training may provide a useful addition to strategies aimed at reducing lower limb injuries.
1School of Physiotherapy, Australian Catholic University, Brisbane Campus, Queensland, AUSTRALIA; and 2Mater/Back Stability Clinic, Mater Health Services, South Brisbane, Queensland, AUSTRALIA.
Julie A
JA
Hides
Warren R
WR
Stanton
D000009:Abdominal Muscles / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000502:physiology*; D001265:Athletic Injuries / Q000453:epidemiology / Q000517:prevention & control; D001315:Australia / Q000453:epidemiology; D005081:Exercise Therapy; D025461:Feedback, Physiological; D006801:Humans; D035002:Lower Extremity / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D009119:Muscle Contraction; D064170:Paraspinal Muscles / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000502:physiology*; D017773:Pelvic Floor / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000502:physiology; D010806:Physical Education and Training; D012307:Risk Factors; D012916:Soccer / Q000293:injuries*; D014463:Ultrasonography