A recent research report was published in JOSPT, or the Journal of Orthopedic & Sports Physical Therapy, that looked at the effect of a neuromuscular training program on knee/ankle injury risk in the youth basketball player. Being the nerds we are here at Made 2 Move, we obviously dove into the research! While the research focused specifically on youth basketball players, this type of warmup can be applied to anyone from the recreational runner to the group fitness guru.
Here is a list of the exercises from the university that conducted the research and a video of the exercises demonstrated for quick reference, but let’s dig a little deeper!
What is SHRed?
SHRed sounds fancy, but it is really just an acronym for Surveillance in High School and community sport to Reduce injuries in basketball (Emery et. al 2022) ie. they took a group of youth basketball players and tracked their injury rates after including this neuromuscular warmup into their routine. The intervention consisted of a 10 minute neuromuscular warmup, which some refer to as a dynamic warmup. A systematic review notes, “Dynamic, or “neuromuscular” warmup activities can be defined as neuromuscular training programs that incorporate general (e.g., fundamental movements) and specific (e.g., sport-specific movements) strength and conditioning activities such as resistance, dynamic stability, balance, core strength, plyometric, and agility exercises” (Davis et. al 2021).
The goal of a neuromuscular warmup is to essentially “wake up the system.” You are trying to increase your body temperature, get blood flow to tissues, and give your joints and body a better sense awareness and mind-muscle connection. Your brain’s communication to your muscles, tendons, and ligaments is a two-way highway that runs 24/7, with your brain sending messages to these structures and these structures sending messages back in response. These signals move even quicker when you’re in “sport mode.” There’s a whole bunch sciencey stuff happening at a microscopic level, but stated very simply: neuromuscular warmups help make this communication highway more efficient.
Our bodies are amazing! Even though it may not be recognized as such, we do neuromuscular training and warmups in our PT sessions at Made 2 Move and you are likely doing them in your workout classes as well. A neuromuscular warmup consists of four components, which are not novel. Warmups for any sport should hit these 4 components. The 4 components of this studied warmup include:
Aerobic
Agility
Strength
Balance
What did the research show about the SHRed protocol?
In this study, researchers followed youth basketball players across two seasons. 502 athletes were followed in season one and 307 players were followed in season two. No specific protocol was utilized the first season, with coaches just being instructed to implement their normal warmup. In the second season, coaches were trained on the SHRed protocol and instructed to implement it for 10 minutes before practice at least 3 days per week. Injury rates in both seasons one and two were recorded.
What did researchers find? The study reports, “this quasi-experimental study examining the effectiveness of a neuromuscular training warm-up program in reducing all-complaint knee and ankle injuries in male and female youth basketball players showed a 36% reduction in all-complaint knee and ankle injury rates” (Emery et. al 2022).
A 36% reduction in knee and ankle injuries?! This is a pretty substantial and meaningful impact for a warmup that takes just 10 quick minutes. This was just one study, and like always, more research is needed in evaluating the best warmups for our athletes. Regardless, a 36% risk reduction in lower extremity injuries is significant enough to encourage its implementation in our youth athletes!
Will the SHRed warmup help my achilles or patellar tendinopathy?
A couple of common injuries we see in athletes is achilles and patellar tendinopathy. The research showed less effect on a neuromuscular training program in its prevention of tendonapthies. This is likely due to tendinopathies being more of a load management issue, rather than a lack of physical preparedness or warmup. You can do all the warmups you want, but if the work you’re doing exceeds the capacity that your body holds at that point in time, your tendons risk becoming irritated.
Overall volume increases during the season with it being game time! Managing your volume (maybe having a light practice 1-2 days in season), strength training, and recovering with proper sleep and nutrition are all ways to help minimize these in-season tendonpathies. No warmup can balance out underrecovery, as adding in a warmup would likely just add more stress to the system in this scenario. Moral of the story: get a solid warmup in, but also make sure you dial in your protein, sleep, and rest days!
The Take Home:
Okay enough preaching about the importance of recovery. The above study demonstrates that a neuromuscular focused warmup can be an effective tool in the toolbox of a coach, athlete, or PT. The warmup is simple, effective, and “kills two birds with one stone” by getting an athlete prepared for the game or practice in the short term, while simultaneously reducing the risk for injury in the long term.
Interested in working with a performance PT that is passionate about your long term health? Reach out to frontdesk@made2movept.com today to set up an initial evaluation with one of our physical therapists or athletic trainers!