Bringing complexity to sports injury prevention research: from simplification to explanation

Sports injury prevention research takes being formulaic to the extreme. Countless papers begin by reminding that sports injuries remain a significant public health burden,1 and we are reassured that the proven efficacy of numerous interventions shows that sports injuries can be prevented.2 Despite this optimistic picture, and amidst the proliferation of consensus statements and guidelines, the effectiveness of sports injury prevention interventions remains disappointingly inconsistent. We trace these discrepancies to two approaches that have guided past work—simple and complicated—and then move to propose a potentially useful way forward, that of complexity. The ‘simple’ perspective advocates that injury incidence can be reduced via a recipe-type approach. Simplicity casts sports injuries as straightforward occurrences for which an optimal intervention is sought, where interventions either ‘work’ or ‘do not work’. The Sequence of Prevention model,3 for example, consists of four steps: (1) establish the extent of the problem, (2) establish the aetiology and extent of the injury, (3) introduce preventative measures and …