Proprioception training to reduce lower body injury

The most common area’s of injury occurrence in team-sport athletes are the ankle, knee and low back. These injuries can be quite debilitating, often requiring time away from training, practicing and competing. Coaches must be proactive in limiting injury risk in their athletes by devising evidence based programs that improve strength, stability and mobility of these joints and their surrounding musculature.

In the sport of basketball, the ankle joint is particularly vulnerable to injury. This is due to the high amounts of acceleration, deceleration, change of direction and jumping/landing associated with basketball play. Additionally, high-top sneakers may or may not be a contributing factor. Of the various strategies that exist for reducing ankle injury risk in athletes, proprioception training appears to be one of the most effective methods. Ankle injury recurrence has been shown to be reduced between 30-50% based on previous research.

Propriocetors provide feedback to the brain regarding joint position/angle, muscle length and muscle tension. This feedback is processed by the central nervous system to derive information regarding the position of the limb in time and space. Proprioceptors help us maintain balance, coordination and support athletic performance.

A new study published ahead of print in the Journal of Strength and Conditioning Research investigated the effectiveness of proprioception training on reducing the incidence of ankle, knee and low back injury in a professional basketball team. Over a 6 year period, 55 basketball players from the same organization were put through a progressive proprioception training program. The 6 year period was separated into 3 phases:

Year 1-2: Traditional proprioceptive training (i.e., basic instability training)

Year 3-4: Electronic proprioceptive equipment was introduced

Year 5-6: Intensity and volume of proprioception training was increased

All injuries during the 6-year observation time were recorded for analysis.

Statistical analysis revealed an 81% reduction in ankle sprain in years 5-6 compared to years 1-2. Low back pain responded similarly showing an impressive 77.8% decline. Knee sprains were reduced b 64.5% though this figure was not statistically significant. Lastly, proprioceptive control improved by 72.2%. The authors concluded that improvements in proprioceptive control (in single leg stance) may effectively reduce lower body injury incidence.

In practice, coaches may wish to include unilateral balance training into training sessions. For example, single leg balance with eye’s open progressing to eye’s closed would be a good introductory proprioception drill. Eventually adding in instability devices may be useful, such as bosu balls, wobble boards or Airex pads. These drills can easily be implemented during warm-up routines or even between main working sets.

Reference:

Riva, D., et al. (2015) Proprioceptive training and injury prevention in a professional men’s basketball team: a six-year prospective study. Journal of Strength and Conditioning Research, Ahead of print.