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InjuryWise: A new programme, devised by chartered sports
physiotherapists, that aims to help school-age athletes perform better in
their sport and with less chance of injury. Be among the first schools to
experience how effective this programme could be for your pupils. Five
Open Lectures are being offered free of charge.

There is growing concern in schools and among parents that the number of
injuries sustained by young people playing sport is on the increase. Not all
injuries can be avoided but every young person can reduce the risk of
unnecessary injury if they take certain steps to prevent it. With this in mind,
experienced sports physiotherapists Chris Boynes and Clara Fermor-Dunman
have developed InjuryWise; an Injury Prevention Programme aimed at raising
awareness and taking positive action to reduce the risk of sporting injuries in
young people. It is based on their combined experience of more than 30 years
working with athletes from school age to professional. In particular it focuses
on key elements, such as the importance of effective warm up and cool down,
sports specific exercise, movement patterns, flexibility, hydration, nutrition,
strength and conditioning.

So why are young people getting more sports injuries?

For many years medical professionals have tried to determine links between
certain sports, types of injuries, injury rates and possible risks. Unfortunately,
among school age developing athletes, there are very few statistics available,
although a useful study in 2008 suggested that a more structured approach to
warm-up could help reduce injury. The study was carried out on 1,890 female
footballers aged between 13 and 17 by the FIFA Medical Centre of Excellence
at the Oslo Sports Trauma Research Centre in Norway. It showed that their
11+ programme, a 20 minute warm-up programme consisting of a
combination of slow and speed running, as well as exercises to improve
strength, balance, muscle control and core stability, reduced total injuries by a
third and severe injuries by almost a half. (a)

In 2010 the Centre for Public Health published Sports Injuries: A review of
evidence for prevention by Sara Wood and Professor Mark Bellis. While they
concluded that it is difficult to generalise due to the great variability across
sports, there was some positive evidence for the use of safer sporting
equipment and protective clothing such as helmets, ankle braces,
mouthguards and eye goggles and also a modification of rules within certain
sports to prohibit aggressive or dangerous play. They also highlighted the
benefits of taking part in training programmes to improve co-ordination,
strength and technique and the use of multi-component programmes. (b)

It is the common factors in these two studies of improving strength, co-
ordination, muscle control and balance which InjuryWise addresses.

Some people will be acquainted with the Long Term Athletic Development
(LTAD) model, which is a highly detailed framework for an optimal training,
competition and recovery schedule for each stage of athletic development. (c).
Also Movement Dynamics which provides coaching and athletic development
for both elite and developing athletes (d). These excellent models, however,
require considerable commitment over a long period of time and go into far
greater depth than the IPP.

Chris Boynes and Clara Fermor-Dunman have been working with schools since
1996 and have experienced first-hand how injuries sustained within the school
years are potentially becoming more frequent and more severe. In their
opinion, the use of strength and conditioning programmes, combined with
close attention to individual movement patterns and co-ordination is not
given the priority it deserves within the school years. They believe that if
potential muscle imbalances in young athletes are identified earlier in a
musculoskeletal screening, they can be shown how to move more efficiently
and can retrain their bodies to be more effective as they play sport.

These days musculoskeletal screening is integrated into all professional sports
for elite athletes, so why not for school age pupils?

Says Chris: Children have regular checkups for their teeth and eyes, so why
not for the way they move, how flexible they are, how efficient their hand-eye
co-ordination is, how much strength they have in their core muscle groups
and so on. This early action will not only reduce their risk of sports injury but
also improve their sports performance.

Kemp and Boynes (2000) identified that screening for muscle imbalances (was)
the current cutting edge of injury prevention. The rationale behind this is that
there are detectable and correctable abnormalities of muscle strength and
length that are fundamental to the development of almost all musculoskeletal
pain and dysfunction. Detection of these abnormalities and correction before
injury has occurred should be part of any injury prevention strategy. Assessment
of muscle strength and balance can be beneficial in this strategy. (e)


Recently Chris and Clara have started introducing their Injury Prevention
Programme to selected schools. It has generated great interest among
parents, pupils and sports teachers. Where it has been most effective is in the
schools where the pupils, teachers and parents all work together to ensure an
integrated approach to the programme. Testimonials from some of these
schools can be found at the end of this article.

InjuryWise are keen to take this out to more schools and are delighted to
announce they have been given sponsorship to run five Open Lectures for
free. If your school would be interested in taking up the IPP, please contact
either Clara on 07990 59568 / clara.physiotherapy@gmail.com OR Chris on
07973459343 / chris@chrisboynesphysio.com


The Injury Prevention Programme

The programme consists of 4 stages:

1. Open lecture for all those interested including pupils, parents, teachers
and coaches. The lecture aims to educate attendees on the
components of injury prevention and introduce the concept of the IPP.

2. Musculoskeletal screening - group sessions are carried out with the
young athletes to assess flexibility, power generation, muscle
imbalances, balance and in particular movement patterns. This is led by
a minimum of 2 physiotherapists, who assess foundation skills such as
running, throwing, squatting and hopping to highlight any problematic
areas.



3. Feedback/Action plan following the musculoskeletal screening each
attendee is provided with an individual report highlighting key areas
requiring development and the exercises they need to help them
achieve this. In addition feedback on the screenings can be provided in
the form of a seminar to PE staff, along with suggestions for
appropriate techniques and exercises that can be incorporated into PE
activities.

4. Review to monitor progress following the exercise prescription a
review would be carried out between 3 and 6 months after the
musculoskeletal screening. This will enable the athlete to see what
improvements have been achieved as well as suggestions for
progression of exercises for future improvements.


Testimonials
"Clara gave an inspired presentation to the staff, the pupils and their parents. It
was perfectly pitched, subtly tailored to suit their differing needs and was
positively received by all who were present. The Q & A and interactive sessions
dovetailed well with Claras clear and powerful message and allowed time for
the participants to consider a variety of strategies which will undoubtedly help
them in the future. The professional way in which potential problems were
highlighted was excellent and her attention to detail and personalised exercise
& rehabilitation programmes really made a difference. As a fellow athlete, Clara
fully understands the physical demands of school sport and provided great
advice which the pupils could clearly relate to. The quality of specialist expertise
from Clara is simply outstanding by far the best I have ever experienced. Her
approach is pragmatic, clear and entertaining, and she succeeded in making a
positive and tangible difference. Highly recommended!"
John Cooper - Deputy Head, Eltham College


I thought the lecture was excellent and I liked the fact that it was done using
clear and straightforward language and in bite-sized chunks which helped to
keep the attention of the boys. At the end of the day, it is the boys who benefit
from this sort of advice and information and its great for them to hear it first-
hand. The practical demos were also a good tool for keeping the younger
members of the audience interested.
Hilary Bunger, Parent

It was during our contact at the 1st XV rugby fixtures that Chris, a parent and
supporter of the school, first introduced me to the Injury Prevention Programme.
His IPP lecture at the school for parents, pupils and staff was very informative
and helpful, especially his explanation of functional movement testing and the
impact it can have if used successfully. Chris professionalism is second to none
and I have no reservations in recommending Chris and his team. We hope to
work more closely with them in the future.
Richard Sims - Head of Sports Academy/Head of Rugby, Norwich School


I was very pleased to attend and found the lecture very informative and helpful.
It seemed to me you had spent a significant amount of time preparing the
presentation materials yet you delivered a significant volume of information in
a way that the younger members of the audience could easily absorb.
Barry McCarthy, Parent



Biographies:
Chris Boynes MCSP, BEd (Hons) PE, first carried out musculoskeletal screening
on professional athletes in the early 1990s. At the Laban Centre in South
London (1991-92) he introduced injury seminars for the student dancers and
their teachers so that they could work together analysing individual
movement patterns to reduce the risk of injury. Likewise, as Club Physio to
London Irish RFC, movement data analysis of the squad from 1997-98, led to
improved injury collection and subsequent injury reduction. Chris has carried
out musculoskeletal screening on a range of elite athletes over the years,
including youth squads in badminton, rugby, gymnastics and athletics and
with GB Olympic weightlifter Zoe Smith. Working in close liaison with her
lifting coaches, Chris was able to monitor and affect her movement patterns
and subsequently her injury rates. More information available at
www.chrisboynesphysio.com

Clara Fermor-Dunman MCSP, BSc (Hons) qualified from Brunel University with
a first class honours degree in 2004. Since then she has worked in a number of
clinical environments within both the NHS and private sector. Clara first
started working with developing athletes in 2005 and has helped both
amateur and elite athletes in a variety of disciplines including rugby, netball,
cricket, table-tennis and hockey. Over the years she has worked closely with a
number of schools to help improve awareness of injury prevention and
movement analysis with the ultimate goal of empowering younger athletes to
improve not only their performance but reduce their risk of injury.






(a) Br J Sports Med 2013;47:8480-487 Published Online First 13March 2013doi:10.1136/bjsports-2012-091887
(b)Sports Injuries A review of evidence for prevention from the UK focal point for violence and injury prevention
Wood.S; Bellis,MA 2010
(c)Long Term Athletic Development LTAD canadiansportforlife.ca/learn-about-canadian-sport-life/ltad-stages
(d)Movement Dynamics Kelvin Giles www.movementdynamics.com
(e) KEMP, S. (2000) Why detecting muscle imbalance is an essential part of an injury prevention strategy. Peak
Performance, 128, p. 4-6