Research Summary: The effect of sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial [Hoskins W. (2010)]

This article can be found at: http://www.biomedcentral.com/1471-2474/11/64

This study looked at whether the addition of a sports chiropractic manual therapy intervention protocol to the current best practice management could prevent and reduce weeks missed due to the occurrence of lower-limb injuries, including hamstring strains in semi-elite AFL players. Compared with other body contact football codes, AFL has the highest rates of non-contact soft tissue injuries with an incident rate of 35% per season at the elite national level.

Two Victorian Football League (VFL) clubs partook in the study during the 2005 season with a total of 59 participants. The players at each club were randomized into two groups, a control group (n=30) and an intervention group (n=29). Both groups received what is currently considered the best practice medical, paramedical and sports science management; including medication, manipulative physiotherapy, massage, strength & conditioning and rehabilitation by club staff. All treatment from club staff was independently administered without restriction to type or number of treatments. The intervention group also received a sports chiropractic approach administered by a single practitioner (including chiropractic/HVLA manipulation and soft-tissue therapies). Each athlete in the treatment group received varied treatment and scheduling as determined by the chiropractor.

The intervention group had a statistically significant reduction in risk or primary lower limb muscle strain injury (3.6% in the intervention group and 27.6% in control group). The intervention group missed 4 matches with a lower limb muscle strain and the control group missed 21 matches. Although there was no statistically significant reduction in knee or hamstring injuries, rates were overall lower in the intervention group. Treatment was predominantly directed at non-local factors and areas, supporting previous evidence that several non-local factors may contribute to lower-limb injury occurrence.

Some care does need to be taken in interpreting these results as 2 of the initial 4 teams withdrawing prior to the study starting means that the required subject numbers were no met. Due to hesitation by the clubs a non-blinded study design was utilised, which means that a placebo effect cannot be ruled out. Since the date of publishing the study has also been retracted from the journal due to issues with the original ethics approval of this study.

Overall there appears the be a trend in the reduction of lower limb injuries with the addition of preventative sports chiropractic intervention to the current best practice multidisciplinary medical, paramedical and sports science management. There also appeared to be a reduction in low-back injuries and complains in the intervention group.

Hoskins W., Pollard H. “The effect of sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial”. BMC Musculoskeletal Disorders. (2010); 11:64. accessed 17/06/15 from: http://www.biomedcentral.com/1471-2474/11/64