Prevention of Knee and Ankle Injuries in Youth Team Handball - A Randomized Control Trial

Abstract

1070 Several studies have documented a high incidence of injuries to the knee and ankle among youth players in team handball. One prevention study from Danish team handball indicates that it may be possible to reduce the incidence of these injuries, but the study power was too low. PURPOSE: To investigate the effect of a warm-up program designed to reduce the incidence of knee and ankle injuries among young players in Norwegian team handball. METHODS: Female and male players from 120 clubs at age 16–17 years in Norway were randomized to an intervention group (80 teams, 958 players) and to a control group (76 teams, 879 players), and followed for one regular season (eight months). A warm-up program with exercises to improve running and landing technique, neuromuscular control, balance, flexibility and strength was introduced by instructors from the Norwegian Handball Federation to the intervention group at the start of the season. The program included sports specific exercises with the ball, and the use of a balance mat and board. The coaches were instructed to use the program 15–20 min in 1–3 sessions per week during the season, and compliance was recorded to evaluate the team's follow-up of the program. Ten physical therapists did the injury registration in both groups, and they were blinded to group allocation. The coaches reported injuries, and practice and game exposure each month. RESULTS: During the season, there were 129 acute knee and ankle injuries, 81 injuries in the control group (0.93 ± 0.09 injuries per 1000 player hours; training: 0.3; match: 5.3) and 48 injuries in the intervention group (0.51 ± 0.11 injuries 1000 h-1; training: 0.2; match: 2.5). There were significantly fewer injured players in the intervention group (76 in control group, 8.7%; 46 in intervention group, 4.8%; relative risk vs. control group: 0.55 (0.35–0.82); p<0.005, Cox model, Walds test). CONCLUSION: The results shown that a specific handball-related warm-up program – including use of a balance mat and board – prevents knee and ankle injuries in youth team handball.