Can We Predict Injuries? A Closer Look at Movement, Biomechanics, and Injury Risk
Introduction
Predicting injury or reinjury is a tantalizing prospect for clinicians, coaches, and athletes alike. If we could reliably anticipate injuries, preventative strategies would revolutionize sports and rehabilitation. However, the research suggests that our ability to predict injuries is far from reliable. Additionally, commonly labeled "abnormal biomechanics" may not be inherently problematic but rather reflect individual differences in morphology and motor control. In this article, we’ll explore why predicting injury is so challenging and dispel myths about "bad movement" being synonymous with danger.
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The Limits of Predicting Injury
Injury prediction models often rely on biomechanical, strength, and flexibility assessments, yet research shows that these metrics are poor at identifying individuals who will sustain injuries:
1. Multifactorial Nature of Injury: Injuries are influenced by a complex interplay of factors, including training load, fatigue, psychological stress, and previous injury history. No single measure can account for this complexity.
2. Low Predictive Value of Biomechanics: Studies attempting to link specific movement patterns (e.g., knee valgus during a jump or squat) with injury risk often find inconsistent or weak associations. Even common screening tools like the Functional Movement Screen (FMS) have limited predictive utility.
While identifying risk factors may inform interventions, the notion that we can predict who will get injured remains unsupported by current evidence.
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"Abnormal Biomechanics" and Individual Differences
One reason injury prediction falls short is the oversimplified labeling of certain movement patterns as "bad" or "dangerous." In reality, biomechanics vary widely among individuals due to differences in anatomy, such as:
Hip Joint Morphology: Variations in femoral neck angles, acetabular depth, and torsion can influence how individuals move during tasks like squatting or running.
Femur and Tibia Alignment: Structural differences may lead to movement patterns like knee valgus that are entirely normal for certain individuals.
These morphological factors challenge the notion of a "one-size-fits-all" approach to movement analysis.
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Movement in Context: Control Over "Poor Mechanics"
Professional athletes often display movement patterns traditionally labeled as "poor mechanics" yet perform at elite levels without injury. This underscores the idea that no movement is inherently dangerous. Instead, the ability to control movement is key:
1. Strength and Motor Control: An athlete who can control excessive knee valgus during dynamic tasks may be less prone to injury than one who cannot, regardless of the visual appearance of their movement.
2. Movement Variability: Allowing for natural variation in movement may enhance adaptability and resilience, reducing injury risk over time.
Encouraging athletes and patients to optimize control and build capacity, rather than adhere rigidly to "ideal" movement patterns, aligns with modern injury prevention strategies.
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The Takeaway: From "Bad Movement" to Functional Resilience
The belief that specific movement patterns inherently predict injury is outdated. Instead, clinicians and coaches should focus on building strength, resilience, and control within an individual’s unique movement framework.
As research evolves, the key to reducing injury risk lies not in identifying “bad biomechanics” but in fostering adaptable and robust movement patterns.
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References (AMA Format)
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3. Gabbett TJ. The training-injury prevention paradox: Should athletes be training smarter and harder? Br J Sports Med. 2016;50(5):273-280. doi:10.1136/bjsports-2015-095788
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