Background: Implementation of an injury prevention program is important to keep injury rates low throughout a season. There are many existing injury prevention programs, however, there is limited evidence in passive recovery protocols. In this Level 2 CASE study, the availability rate of a professional soccer club was calculated from 2014-2018. Availability rate is defined as the average percent of players available to compete due to injury status. Patient: This case series consisted of a professional soccer club with a roster of 33 male athletes ranging 17 to 33 years old. The professional soccer club competitive season runs from March to December, depending on playoff standings. During each of the documented seasons from 2014-2018, all injuries were recorded. The most prevalent soft tissue injuries were hamstring strains, ankle sprains, and MCL sprains. Intervention or Treatment: This professional soccer club implemented a post-practice Recovery Lab to prevent soft tissue injuries at the beginning of the 2015 season. Everyday after training, athletes were required to participate in the Recovery Lab that consisted of three types of passive treatments. The first component is intermittent compression boots, which provide sequential compression in different chambers starting distally in the foot and moving proximally towards the hip. The pressure was set to modulate a pumping sensation to increase venous return of the lower extremities. The theory of intermittent compression is to increase the body's reabsorption rate of elements that cause muscle fatigue and soreness. Athletes were placed in the compression boots for 30 minutes with their legs elevated. The second component is working with a certified message therapist. Utilizing Physmodo MAPS (Physmodo, Plano, TX), inefficiencies within the athlete's mobility, activation, posture, and symmetry were identified as the athlete performs three body weight squats. With the limitations identified, the massage therapist would perform a deep tissue massage on the target muscles. Depending on the results of MAPS and subjective complaints, each massage would last between 10-20 minutes. After the massage, the athletic training staff would address individual treatment therapies as needed. Lastly, all athletes would sit in a cold tub immersion from the waist down for 10 minutes. Therefore, combining all three elements, each post-practice Recovery Lab would take about an hour. Outcomes or other Comparisons: To get the availability rate for each game, the total number of players was subtracted from the number of unavailable players due to injury and then divided by the total number of players. This gave the percentage of availability each game. The availability rate for the season was then calculated by adding the availability rate of each game and divided by the total number of games played that season. To be counted as unavailable, the athlete had to be injured and not available to dress for the match. In 2014, prior to the implementation of the Recovery Lab, the availability rate was at its lowest at 84.1%. When the Recovery Lab was implemented in 2015, availability rates started to increase. The availability rate was 85.5% in 2015, 92.9% in 2016, 95.2% in 2017, and 91.1% in 2018. Conclusions: Not all injuries are preventable, but athletic trainers are continuously searching for methods to decrease injuries. This study shows that a passive recovery protocol as a means of injury prevention increased the availability rates of athletes in a professional soccer club. While time and resources may be limited to many athletic trainers, a variation of a passive recovery protocol can be easily implemented at all levels. Clinical Bottom Line: A post-practice passive recovery injury prevention protocol can be useful in decreasing the number on injuries that limit athletes from participating in sport.
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