Sometimes sports injuries occur
due to contact with some hard object. This can result in torn tendon or
ligament or even a broken bone. For instance runner's knee is a painful
situation related with running and tennis elbow is associated with stress
injury to elbow.
Injuries are quite common and
frequent in professional sports and teams have a trained and specialized staff
for handling players' injuries.
The common symptoms of sports
injuries are localized swelling, redness, loss of function and heat generation.
The Public Health Model is a four
stage model and aims at promoting the research in sports medicine in a stepwise
manner and involves recognition of the problem and adoption of effective
problem solving interventions.
Stage 1- Assessing the magnitude
of the problem;
Stage 2- Recognizing the risk
Stage 3- Development of effective
Stage 4-Ensuring widespread use
Dale Hanson and colleagues
analyzed the role of research and active interventions in preventing sports
Oldenburg et al discovered that
63 percent of research publications were descriptive (Stage 1 and 2), 11
percent were method development and 16 percent of publications were
intervention-based (Stage 3) only 5 percent were related with policy
implementation and less than 1 percent was concerned with diffusion research
Though the researchers have
gathered significant knowledge from surveillance, identification of risk
factors and efficacy and effectiveness of the studies, yet this knowledge is to
be adopted for bringing about a change and improvement in the field of sports
The lacunas responsible for
preventing proper research and safety promotion are:
• The efficacy-to-effectiveness gap,
• The research-to-practice gap,
• The injury-prevention-to-safety-promotion gap.
These lacunas or gaps have
emerged from contrasting approaches among policy-makers, researchers,
This is a scientific problem.
"The transition from researching what works (i.e., efficacy and effectiveness
research) to how to make it work (i.e., implementation research) is a critical
step, but not straightforward."
The problem arises from the way
researchers approach the problem in a complicated way.
It is important to understand
that success is not entirely determined by the efficacy of intervention but is
also affected by multiple inter-related factors.
Green has mentioned, 'Where did
the field get the idea that evidence of an intervention's efficacy from
carefully controlled trials could be generalized as 'best practice' for widely
varied populations and situations?'
Sports injuries are a complex
problem and not a complicated problem. It requires a more scientific approach
and health researchers are now adopting innovative techniques in dealing with
them such as multilevel analysis, systems modeling, network analysis and
The research-to-practice gap-
This is an implementation
problem. "The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation
and Maintenance)13 has recently been proposed as a reporting template to
encourage sports researchers to document their research in a way that enables
practitioners, policy makers and communities to use them effectively."
About 27 articles from 11 leading
health journals dealing with community-based interventions were reviewed and
efficacy was observed in 100 percent and reach in 88 percent while
implementation was noticed in 59 percent and behavioral in 33 percent articles.
None of the articles reported institutional maintenance and the condition is no
different for sports medicine.
This is a political problem. The
widespread adoption of sports injury interventions is a social objective and is
affected by political interests. Politicians are Public Policy makers and are
in a position to make active and effective interventions for preventing sports
Closing the gap-
Mercy et al first proposed the
Public Health Model for injury prevention and stated that a bottom-line
approach is needed to bring practitioners, policy makers and the community to a
common platform in order to bring a sustainable solution to the problem.
Some researcher advocated a
top-down approach and expected to bring an effective intervention. It is
important to keep in mind the importance of community after all it is the
community that is ultimately affected.
"Sports researchers who ignore
the community's perspective are destined to fail in the final critical
dissemination and widespread adoption phase of the Public Health Model."
The effectiveness of
interventions can be established by three types of experts:
• Researchers (i.e., content experts),
• Clinicians, practitioners and policy makers (ie, process experts),
• Members of the target community,
sports bodies (ie, context experts).
All three are essential partners
in bringing about active and effective interventional alterations in sports
Good communication, excellent translation
and good research are needed to have good dialogue and multidirectional
conversation where other's opinion is respected and valued. We should have the
patience and humility to listen to practitioners, policy makers and sports
community, the relevance and magnitude of our research can be enhanced. The
research can become more practical and more applicable for the real world.
It can be concluded by saying
that sports injuries are very much preventable. It is important to understand
'how it can be prevented' rather than 'what can be done'. There should be
mutual communication and healthy dialogue between researchers, practitioners
and sports community. This combined cooperation will produce benefits for
public health as well as sports medicines.
Research alone is not sufficient to prevent
sports injury; Dale Hanson et al; Br J Sports Med doi:10.1136/bjsports-2012-091434