A focused warm-up program may stave off female athletes’ injuries


Lower extremity injuries can derail a young athlete, but a study finds that a 20-minute neuromuscular warm-up might go a long way in preventing that damage.

The study, released Monday in the Archives of Pediatrics & Adolescent Medicine, looked at the effect of a comprehensive warm-up on lower-body injuries among high school female soccer and basketball athletes compared with a regular warm-up routine.

Taking part in the study were 90 coaches and 1,492 female athletes; the athletes were from urban, primarily low-income areas with mixed ethnicity. They were randomly assigned to the neuromuscular training or their usual warm-up program, which served as the control group.


Coaches in the neuromuscular training group received a two-hour training session for the 20-minute pre-practice warm-up that included agility, balance, plyometric and strengthening exercises and appears similar to established programs such as the Prevent Injury and Enhance Performance program developed by the the Santa Monica Sports Medicine Research Foundation. A shorter version of the program was given for pre-game warm-ups.

These types of programs are designed to prevent lower-body injuries such as anterior cruciate ligament tears of the knee, which are common among female athletes involved in sports that require pivoting, jumping and stop-and-start movements. Athletes are not only taught conditioning exercises, but also how to use proper form when jumping and landing.

Coaches who went through the training used the program on average before 80% of practices, and the cost for training 15 to 20 coaches was estimated at $80 per coach.

The results? Athletes who did the neuromuscular warm-up had 50 lower extremity injuries compared with 96 in the control group. Two athletes in the neuromuscular warm-up group and 13 in the control group sustained two injuries to their lower extremities. Athletes who had non-contact injuries that resulted in surgery were in the control group.

Researchers encountered some hurdles in the study. The 90 coaches who took part were among 258 who were invited to participate; the most common reasons for not joining were a lack of time or having no interest in collecting data. Coaches who were older, overweight and less fit were more likely to do fewer exercises, suggesting, the authors wrote, “that they may have omitted exercises that they could not demonstrate themselves.” Most of the coaches in the control group didn’t provide any set warm-up for their athletes before practice.

“If effective interventions are not widely adopted and sustained,” said an accompanying editorial, “there will be little impact on the injury epidemic.”