Reduce ACL Injuries, Save $275 per Athlete

New research from Columbia University Medical Center has found that that universal neuromuscular training for high school and college-age athletes—which focuses on the optimal way to bend, jump, land and pivot the knee—is an effective and inexpensive way to avoid anterior cruciate ligament (ACL) sprains and tears. The study, published in the Journal of Bone and Joint Surgery, found that on average, universal training reduced the incidence of ACL injury by 63%, while the screening program, on average, reduced the incidence rate by 40%.

Researchers evaluated three strategies for young athletes: no training or screening, universal neuromuscular training, and universal screening with neuromuscular training for identified high-risk athletes only. The research used a mathematical model for risk and screening based on published data on real student athletes, ages 14-22. Costs of training and screening programs were estimated based on existing literature. Anterior cruciate ligament surgical costs were estimated at between $5, 000 and $17, 000, with costs running as high as $38, 000.

Out of 10, 000 athletes, the model predicted 300 ACL injuries in the no-screening group, 110 in the universal training group, and 180 in the universal training/screening for “at risk” athletes group. Researchers estimated the cost of implementing a universal training program, including coach and player instruction, at approximately $1.25 per day, saving an average of $275 per player, per season in injury-related costs.

“Use of both preventative measures and screening tools sounds appealing, but often there are significant financial, administrative and social hurdles that have to be overcome before they can be implemented on a widespread level, ” said lead study author Eric F. Swart, M.D., an orthopedic resident at Columbia University Medical Center in New York, in the May 8, 2014 news release.

Dr. Swart told OTW, “While we were not surprised that neuromuscular training was cost effective compared to screening or no training, we were surprised by the magnitude of the effect. Training was so much cheaper and prevented so many more injuries that it’s hard to make an argument against it. This seems to represent a simple, easy prevention measure that can drastically reduce the risk of a common injury, with very little up-front cost. It makes a pretty compelling case for a program that we should think about implementing more broadly.”

“The big barriers to implementation are largely acceptance by coaches, players, and families. Luckily, these injuries are something that people are becoming more aware of, and they’re looking ways to reduce their risk. Hopefully, people will be open to the idea that something as simple as altering the team’s warm up routine can have a real impact on that risk.”