The Protective Effect of Neuromuscular Training on the Medial Tibial Stress Syndrome in Youth Female Track and Field Athletes: A Clinical Trial and Cohort Study

Abstract

Context: Few reports have analyzed the effects of neuromuscular (NM) training programs on the injury incidence among youth female track and field athletes.

Objective: To determine the effects of a NM training on reducing lower limb injury incidence and to establish its effects on countermovement jump (CMJ) performance, balance, 30-m sprint and joint position sense in youth female track and field athletes.

Design: Single-blind, randomized-controlled clinical trial.

Setting: Sports research laboratory.

Participants: Twenty-two female athletes were allocated into two groups: Conventional (CONV) training (n = 11; age = 15.3 ± 2.1 years) and NM training (n = 11; age = 15.0 ± 2.7 years).

Interventions: Interventions were performed during a pre-season of six weeks. The CONV training included anaerobic, strength and aerobic trainings. The NM training consisted of a multi-component program that integrated jumps, landings and running with strength, endurance, agility, balance and CORE training.

Main outcome measures: A follow-up of the cohorts was carried out through the evaluation of lower limb injuries (main outcome) during a regular season (weeks 7 to 18). Secondary outcomes were measured before and after the intervention: Y-Balance Test, active joint repositioning, ground reaction force and CMJ height.

Results: The injury incidence rate was 17.89 injuries per 1000 h athlete-exposure in CONV training, and 6.58 in NM training (RR = 0.38; 95% CI = 0.18 to 0.82; p = 0.044). Particularly, the medial tibial stress syndrome incidence rate was 5.96 injuries per 1000 h athlete-exposure in CONV training, and 0.82 in NM training (RR = 0.17; 95% CI = 0.02 to 1.12; p = 0.012). In addition, a significant training x time interaction was noted favoring improvements in 30-m sprint and CMJ height after NM.

Conclusions: NM training may improve youth female athlete’s physical fitness and reduce their injury relative risk of medial tibial stress syndrome injury.