Athletic Training and Sports Health Care

Original Research Supplemental Data

Coach and Player Views Toward Injury Prevention Exercise Programs in Camogie: A Cross-sectional Survey

Siobhán O'Connor, MSc, PhD, CAT; Enda Whyte, MSc, PhD, CAT; Sean O'Hanlon, BSc; Lauren Fortington, PhD

Abstract

Purpose:

To identify the awareness and use of injury prevention exercise programs (IPEPs) by camogie coaches and players, compare coach and player attitudes to IPEPs, and explore the willingness and perceived ability of coaches to implement an IPEP within their teams, as reported by coaches and players.

Methods:

Adult camogie coaches (n = 98) and players (n = 187) completed an anonymous online survey. Three main outcome scales are presented: attitudes toward IPEPs, willingness to conduct an IPEP, and perceived ability to implement an IPEP. Frequencies and descriptive statistics were conducted with Mann-Whitney U tests used to examine differences between groups (coach vs player, men vs women, and elite vs community).

Results:

Overall, 34% of coaches and 11.8% of players were using an IPEP. Coaches (92.2%) and players (82.9%) would like further education on IPEPs. Coaches and players were willing to support an IPEP, but few coaches reported having sufficient knowledge (30%), experience (22.6%), or skills (43.1%) to do so. Female coaches had a lower perceived ability to implement an IPEP than male coaches (P = .004).

Conclusions:

The uptake of IPEPs in camogie to date has been relatively unsuccessful. Coaches and players demonstrate positive attitudes and willingness to use IPEPs. To achieve a real-world reduction in injuries in this sport, a camogie IPEP should be supported with an implementation plan to improve its adoption and use.

[Athletic Training & Sports Health Care. 20XX;XX(X):XX–XX.]

Abstract

Purpose:

To identify the awareness and use of injury prevention exercise programs (IPEPs) by camogie coaches and players, compare coach and player attitudes to IPEPs, and explore the willingness and perceived ability of coaches to implement an IPEP within their teams, as reported by coaches and players.

Methods:

Adult camogie coaches (n = 98) and players (n = 187) completed an anonymous online survey. Three main outcome scales are presented: attitudes toward IPEPs, willingness to conduct an IPEP, and perceived ability to implement an IPEP. Frequencies and descriptive statistics were conducted with Mann-Whitney U tests used to examine differences between groups (coach vs player, men vs women, and elite vs community).

Results:

Overall, 34% of coaches and 11.8% of players were using an IPEP. Coaches (92.2%) and players (82.9%) would like further education on IPEPs. Coaches and players were willing to support an IPEP, but few coaches reported having sufficient knowledge (30%), experience (22.6%), or skills (43.1%) to do so. Female coaches had a lower perceived ability to implement an IPEP than male coaches (P = .004).

Conclusions:

The uptake of IPEPs in camogie to date has been relatively unsuccessful. Coaches and players demonstrate positive attitudes and willingness to use IPEPs. To achieve a real-world reduction in injuries in this sport, a camogie IPEP should be supported with an implementation plan to improve its adoption and use.

[Athletic Training & Sports Health Care. 20XX;XX(X):XX–XX.]

Camogie is one of the most popular team sports played by adolescent and adult females in Ireland and is governed by the Camogie Association.1,2 It is one of Ireland's Gaelic games and is the female equivalent to the sport of hurling, varying only by minor rule differences.3 Camogie has a mix of actions similar to field hockey and lacrosse2 and is a multi-directional, high-speed contact field sport.1 Players hit a small leather ball (sliotar) with a stick called a hurley.4 Mandatory equipment consists of a helmet with a faceguard.5 Injuries are common in camogie, with 88% of adult camogie players sustaining an injury in the previous season, 60% reporting more than one injury, and 33% attending a hospital due to the injury.2 Most reported injuries are to the lower limb (primarily the knee, ankle, and hamstring).2 These injuries in particular have been the target injuries of many injury prevention exercise programs (IPEPs).6,7

The governing bodies for Gaelic games, including the Camogie Association, have several strategies to counter the high number of injuries experienced by its participants. Alongside rules on wearing protective equipment and injury management principles, resources have also been put toward the development of exercise-based warm-up activities specific for Gaelic sports.8 Similar to other IPEPs designed for soccer, Australian football, lacrosse, and rugby union, the Gaelic Athletic Association's (GAA) “GAA 15” and “Activate GAA” programs consist of several exercises designed to target the muscles and movements required to participate safely in the sport. These similar programs were designed based on the FIFA 11+ program and are recommended to be conducted during the warm-up for all training sessions and games.8,9 Both programs involve exercises that target lower limb running, cutting, landing mechanics, and strength, balance, agility, and power. Information on these programs and resources such as videos and handouts for use by coaches are available on the GAA and Camogie Association websites. The GAA15+ has been reported to reduce injuries in male adolescent hurlers10 and collegiate Gaelic games players.11

However, as with other sports and settings,12,13 up-take of and adherence to IPEPs outside of dedicated research studies are anecdotally considered to be low. Although GAA-specific programs have been designed and offered, like many programs, they have potentially had inadequate focus and resourcing on how they can best be promoted, taught, shared, integrated, and maintained. Previous research in male Gaelic football coaches reported that, although 96% of coaches believed that an IPP would reduce injuries for their players, only 2 of 26 coaches reported using a specific IPP.14 IPEP effectiveness is unlikely to reach its full potential and injuries will continue to be a problem unless program implementation to maximize adoption and compliance is considered and completed.15,16

The adoption and implementation of IPEPs in camogie has yet to be established. Establishing the current success or lack of success of the GAA IPEPs in camogie and identifying areas where further development on program implementation may have the most impact is important. Thus, this study aimed to: (1) identify the awareness and use of IPEPs by camogie coaches and players; (2) compare player and coach attitudes to IPEPs; and (3) explore the willingness and perceived ability of coaches to implement an IPEP within their teams, as reported by coaches and players.

Methods

This study was designed as an anonymous cross-sectional survey of adult camogie coaches' and players' views toward IPEPs. Ethical approval was granted by the Dublin City University's Human Research Ethics Committee.

Participants and Setting

Adult camogie coaches and registered adult camogie players aged 18 years or older who took part in camogie the previous season were eligible to complete the survey. Camogie players could be elite (represent their county and club team) or non-elite (represent their club team only). Participants were excluded if they were younger than 18 years or did not coach or play camogie the previous season. Participants were requested to read a plain language statement and provide informed consent before proceeding to the survey questions.

Survey Procedures

The survey was delivered online using SurveyMonkey (SVMK Inc) and was open for responses from July 13 to August 15, 2018. An invitation to participate was sent by email from the Camogie Association to all 572 camogie club secretaries in Ireland, and the survey was promoted through social media and word of mouth. In total, a 56% completion rate was noted; 482 people opened the survey and 297 surveys with at least 80% of the survey completed were received. Twelve surveys were removed because participants reported that they were younger than 18 years, leaving a total sample of 285 participants.

Survey Instrument

The survey (Tables AB, available in the online version of this article) was adapted from a survey developed for Ladies Gaelic Football coaches and players that had been validated using a three-round Delphi review process with a panel of five international injury prevention experts.17 The original survey was developed based on the Theory of Planned Behavior.18,19 One screening question was included at the beginning of the survey to ensure that coaches or players had participated in camogie last season. Subsequently, the survey consisted of four parts with 16 questions for players and 22 questions for coaches, with a greater number of demographic questions included for coaches than players. IPEPs were defined in the questionnaire for the participations as “specifically designed programs that aim to provide strength and movement control to players in order to prevent injury occurrence.”

Coach QuestionnaireCoach QuestionnaireCoach QuestionnaireCoach QuestionnaireCoach QuestionnaireCoach Questionnaire

Table A:

Coach Questionnaire

Player QuestionnairePlayer QuestionnairePlayer QuestionnairePlayer QuestionnairePlayer Questionnaire

Table B:

Player Questionnaire

Survey Part A. Coaches and players were asked to report their age, years spent coaching/playing camogie, and their main team (the team they spend most of their time with, or more than 50% of their time playing/coaching). Coaches were additionally asked to report their sex, previous coaching qualifications, and the estimated number of injuries sustained by their team last season (defined as injuries that resulted in a player being unable to participate in training or games for a minimum of 24 hours).

Survey Part B. Coaches' and players' awareness of IPEPs, both GAA-specific and those from other sports, were examined. Respondents who were aware of an IPEP were asked to name it. Coaches and players were also asked whether they were currently using an IPEP. If so, they were further asked to report what encouraged them to choose this IPEP, who delivers the IPEP, how often it is completed, how long is allocated to complete the IPEP, and the broad contents of the IPEP. Coaches were also requested to report where they sourced their IPEP from.

Survey Part C. Three themes, each containing several statements, were presented for which respondents indicated their agreement using a Likert scale response consisting of 5 levels from strongly agree to strongly disagree. There were 8 statements on attitudes toward IPEPs, 8 statements on willingness to use an IPEP, and 11 statements on current perceived ability to deliver an IPEP. Response options were presented in reverse for some items to reduce automated responses.

Survey Part D. An open-ended question identifying anything further that respondents believed would reduce previously identified barriers to the use of IPEPs in camogie was also included. Their interest in further education on IPEPs was examined and participants were asked to rank (from very likely to very unlikely) whether they would participate in seven differing formats of future injury prevention education and training (Table 1).

Likeliness to Take Part in Different Education Formats for Injury Prevention, % (n)

Table 1:

Likeliness to Take Part in Different Education Formats for Injury Prevention, % (n)

Data Management and Analysis

Data were downloaded from SurveyMonkey in Microsoft Excel (Microsoft Corporation) format and were then imported to SPSS Statistics for Windows (version 23.0; IBM Corporation). Data were cleaned and checked for missing or erroneous responses. Frequencies and descriptive statistics were generated from responses by coaches and players on awareness and current use of IPEPs, attitudes to IPEPs, willingness and perceived ability to conduct IPEPs, and views on coach education around injury prevention. The open-ended question was coded into any prevailing themes. A total attitudes scale was created by assigning a score from 1 to 5 for each response to the 8 statements examined, with a score of 1 assigned to strongly disagree and 5 to strongly agree. Negative statements were reversed (as indicated in the results tables) so that a higher score was provided for each statement representing a more positive attitude toward IPEPs. All responses were then summed to create an attitudes scale with a maximum score of 50. This process was repeated to create a willingness scale (maximum score of 40) and perceived ability scale (maximum score of 55). The more positive the attitudes toward IPEP, willingness to use an IPEP, or perceived ability in using an IPEP, the greater the total score for each scale. Normality tests were conducted and the data were not normal. Therefore, Mann-Whitney U tests were conducted to examine whether attitudes, willingness to complete IPEPs, and perceived ability to conduct IPEPs differed between (1) coaches and players, (2) elite or non-elite coaches and players, (3) male and female coaches, and (4) underage and adult team coaches. Statistical significance was set a priori at 0.05. Effect sizes were classified as small (0.1), medium (0.3), and large (0.5).20

Results

A total of 285 participants (98 coaches and 187 players) were included. Table 2 displays the demographic information of coaches. Many coaches had completed a previous coaching qualification (92.7%). Players reported a mean of 15.6 ± 7.1 years playing camogie, mostly with non-elite teams (78.5%).

Demographic Information for Coaches

Table 2:

Demographic Information for Coaches

Awareness and Use of IPEPs by Camogie Coaches and Players

Thirty-two percent of coaches (n = 31) were aware of and could name an IPEP (either one specific for Gaelic games or more generally). Of the 32%, two-thirds (66.7%, n = 16) specified the GAA 15+ and one-third (33.3%, n = 8) named the Activate GAA warm-up. Thirty-four percent of coaches (n = 33) are currently using an IPEP with their teams. The main factors that encouraged coaches to use an IPEP were the following: it doubles as a warm-up (64.1%, n = 25), research shows it is beneficial (48.7%, n = 19), it improves team performance (41.0%, n = 16), and having observed elite teams using an IPEP (38.5%, n = 15). Coaches were largely responsible for delivering the IPEP (77.8%, n = 28), followed by the strength and conditioning coach (16.7%, n = 6). Of those coaches using an IPEP, the main actions included were: muscular activation (86.1%, n = 31), jumping and landing (80.6%, n = 29), change of direction (80.6%, n = 29), running (80.6%, n = 29), dynamic balance (75.0%, n = 27), and neuromuscular control (41.7%, n = 15).

Coaches stated they used the IPEP during every training session and match (47.2%, n = 17), during every training session (30.6%, n = 11), during one training session a week (8.3%, n = 3), during every match (5.6%, n = 2), player self-administration outside of training and matches (2.8%, n = 1), or as an one-off session (2.8%, n = 1). Most coaches allocated 6 to 10 minutes for IPEP completion (41.7%, n = 15), followed by 11 to 15 minutes (27.8%, n = 10). Coaches sourced their IPEPs from a strength and conditioning coach (50.0%, n = 18), current research (41.7%, n = 15), a course/presentation (25.0%, n = 9), designed it themselves (25.0%, n = 9), saw it online or on social media (22.2%, n = 8), or it was provided by a medical or allied health care professional (11.1%, n = 4).

For players, 13.9% reported they were aware of a specific IPEP, and 11.8% (n = 22) of players indicated that they currently use an IPEP at their club. Players reported that a strength and conditioning coach (47.8%, n = 11) or their regular coach (26.1%, n = 6) led the IPEP during training sessions and/or warm-ups. For the players who reported using an IPEP, 52.2% (n = 12) used it at every training session and match and 26.1% (n = 6) used it as a self-administered session. Players who used an IPEP commonly reported completing muscular activation (87.0%, n = 20), jumping and landing (82.6%, n = 19), and dynamic balance (72.7%, n = 16) as part of their IPEP, whereas running (59.1%, n = 13), neuromuscular control (27.3%, n = 6), and change of direction (27.3%, n = 6) were less common.

Coach and Player Attitudes Toward IPEPs and Injury Prevention Education

Coaches and players agreed and/or strongly agreed that it was important for coaches (95.9%, 96.7%) and players (95.9%, 97.8%) to have current knowledge of IPEPs and that injury prevention is important during training sessions (96.9%, 95.2%, respectively) (Table 3). However, 64.6% of coaches and 67.2% of players disagreed and/or strongly disagreed that an IPEP takes up too much training time. No significant difference in attitude scores was noted between coaches and players (P > .05). However, elite coaches and players had significantly higher scores (median = 34, range = 23 to 39) than non-elite coaches and players (median = 32, range = 24 to 40, P = .01) with a small effect size (r = 0.17). No significant differences were noted between women and men who were coaching or between individuals who coached junior or adult teams.

Coach and Player Attitudes Toward Injury Prevention Exercise Programs

Table 3:

Coach and Player Attitudes Toward Injury Prevention Exercise Programs

Coaches and players primarily believed that education (90.3%, n = 28; 75.9%, n = 41), more funding (3.2%, n = 1; 20.4%, n = 11), and time (6.5%, n = 2; 3.7%, n = 2) would reduce the barriers to conducting injury prevention programs. Coaches (92.2%, n = 83) and players (82.9%, n = 107) would like further education on injury prevention programs. Table 1 displays players' likeliness to take part in future injury prevention education and training formats.

Coaches' Willingness and Perceived Ability to Implement an IPEP Within Their Teams

Coaches and players were willing to complete an IPEP if it was shown to significantly lower the chance of injury (97.8%, 97.8%) and improve player performance (95.7%, 97.1%), respectively (Table 4). Fewer than half of coaches reported that they had sufficient knowledge (30.8%), experience (22.6%), and skills (43.1%) to implement an IPEP (Table 5). Coaches (46.3%) also reported insufficient educational resources available to them to assist with implementing an IPEP.

Willingness of Coaches to Conduct an IPEP as Reported by Coaches and Players

Table 4:

Willingness of Coaches to Conduct an IPEP as Reported by Coaches and Players

Perceived Ability of Coaches to Conduct an IPEP as Reported by Coaches and Players

Table 5:

Perceived Ability of Coaches to Conduct an IPEP as Reported by Coaches and Players

Willingness and perceived ability to implement an IPEP did not differ between players and coaches, elite and non-elite players and coaches, and those who coached junior or adult teams (P > .05). However, whereas willingness did not differ between female and male coaches (P >.05), female coaches reported a lower perceived ability score (median = 33.5) than male coaches (median = 39.5, P = .004), with a medium effect size (0.31).

Discussion

It was previously thought that the uptake of IPEPs in camogie was low, which was similar to what has been reported in other sports such as association football, where the uptake is between 6% and 22% in youth professional male teams12 and 20% in youth community female coaches.13 Our study confirmed this for camogie with 1 in 3 coaches and approximately 1 in 10 players using an IPEP with their current team. This presents multiple questions regarding why some coaches use an IPEP when others do not. This study sought to understand these reasons to improve future iterations of similar programs.

More players (69.5%) than coaches (40.2%) agreed and/or strongly agreed that injuries were an issue with their team. Therefore, educating coaches on camogie injury incidence and the future negative consequences due to injury could demonstrate the importance of IPEPs and encourage IPEP use. As noted above, the use of IPEPs was generally low, with approximately one-third of coaches aware of a specific IPEP and currently using an IPEP. Fewer players indicated they knew of or used an IPEP in their clubs. Similarly low awareness of a specific IPEP (FIFA 11+) has been noted in professional soccer players (9%)22 and Nigerian youth soccer players (21%).23 Without widespread awareness of specific IPEPs, the chances of adoption by camogie teams are low. Thus, it is important that pervasive dissemination of IPEPs is prioritized with this population, particularly with those most likely to deliver these injury prevention strategies. We found that coaches primarily delivered the IPEPs (77%), highlighting the important role coach education can play in improving IPEP knowledge and uptake. Current camogie coach education courses do not contain information on injury prevention, and the Camogie Association should consider introducing injury prevention education into the course program.

A greater understanding of athlete's willingness and motivation to implement an IPEP is important to ensure strategies capitalize on these facilitators and emphasize them during education. Camogie coaches and players in this study demonstrated high willingness to complete an IPEP if it could reduce injury risk and/or improve player performance. This result of strong willingness to complete an IPEP if it reduces injury risk has previously been reported in female adolescent athletes.24 However, improving their sporting performance did not affect their willingness to conduct an IPEP.24 Coaches and players also agreed that it was important to have current knowledge of IPEPs and that injury prevention is an important component in training sessions. This has been similarly noted by high school coaches25 and high acceptance of an IPEP has been highlighted as a key facilitator by both players and team staff in professional youth soccer.12 The overall idea of an IPEP was supported by most players and coaches, with positive responses to statements of “the activities included in IPEPs are relevant and beneficial to players” and “I believe that using an IPEP will reduce the number of injuries with my team.” Similarly, when these statements were reversed, respondents disagreed that “IPEPs take up too much training time away from necessary tasks” or that “IPEPs cost too much money.” This suggests that an IPEP, if designed and delivered appropriately for a community sport like camogie, has potential to be well received. This is important because attitudes to a behavior can have a strong affect on uptake and compliance.19,26 Elite coaches and players displayed better attitude scores toward injury prevention and IPEPs in particular, compared to coaches and players of non-elite teams. Thus, the Camogie Association should focus on educating those involved in camogie at the non-elite level on the importance of injury prevention in the sport.

Understanding and addressing potential barriers and challenges to the implementation of IPEP specific to the population and setting can improve their success, particularly in community-based sports,12,27,28 such as camogie. Approximately 3 of 5 camogie players reported that they believed poor training attendance would offset the benefits of implementing an IPEP. This issue unique to amateur community sports like camogie may affect the reach of the IPEP, because those not at training will not undertake the IPEP if delivered in that format. In community Australian football, the IPEP only reached 50% to 60% of targeted players due to missed training sessions.29 If some players are missing training sessions, the exercise intensity and progressions within the IPEP should be modified for them to ensure they are appropriate for their level.28

With regard to coaches, one of the identified barriers to IPEP uptake was perceived insufficient coach knowledge, experience, and skills to implement an IPEP. Female coaches also reported a lower perceived ability to implement an IPEP score than male coaches. Further, coaches reported they did not have sufficient educational resources to support them in conducting an IPEP. Previous studies have reported similar findings, with poor perceived capability to implement an IPEP in Australian junior netball coaches30 and a desire for stronger training for providing feedback when supervising IPEPs in soccer.13 Thus, identifying how to support coaches' perceived competence, particularly that of female coaches, is a critical component of any future injury prevention educational strategies. Camogie coaches overwhelmingly displayed a keen interest in further education on injury prevention. Currently, information on IPEP programs available on the GAA and Camogie Association websites include videos and handouts that can be used by coaches. Incorporating practical sessions that improve a coach's ability to communicate skills training and strategies to highlight that specialist coaches are not required for an IPEP to be effective should be explored in future research. Smartphone applications and instructional DVDs were the least preferred format for educational material requested by coaches, despite a growing interest in “m-Health” or disseminating information via mobile applications to help prevent unintentional31 or sports32 injuries. Thus, the Camogie Association should prioritize developing educational resources in the formats that coaches prefer to maximize engagement, such as by running injury prevention courses, or delivering the information via posted injury prevention packages and website platforms. However, previous research has shown that following education on an anterior cruciate ligament IPEP, despite increased intention to complete the anterior cruciate ligament IPEP, only 58% of coaches actually implemented it.33 Thus, the fidelity of a camogie IPEP education program should also be examined.

This study was the first of its kind to examine IPEP implementation in camogie coaches and players, and there were limitations to this study. Convenience sampling was used for data collection and respondents to this survey elected to complete it on a self-selected basis. Thus, response bias may have impacted the generalizability of the findings because those who may have previous experience or interest in injury prevention may have been more likely to complete the survey. A further limitation was that only survey responses that completed at least 80% of the complete survey were included in the analysis. The survey was also developed for use in Ladies Gaelic football and not specifically validated in the camogie population. However, Ladies Gaelic football is a similar Irish community sport with a sporting structure comparable to camogie. Due to constraints with the length of the survey, intention to conduct IPEPs with their teams was not analyzed in the study and should be included in future similar research. A deeper examination of players' and coaches' reasoning, using qualitative approaches, could identify the reasoning behind barriers and potential strategies to overcome these.

Implications for Clinical Practice

Education strategies to enhance the practical knowledge and skills of camogie coaches in conducting IPEPs, particularly female coaches, in formats they prefer is necessary. Incorporating IPEP education in the mandatory camogie coaching foundation course held by the Camogie Association would ensure all camogie coaches have IPEP education. Players have an important role in the success of an IPEP implementation strategy and enhancing the awareness from players of already developed IPEPs that can be readily used in camogie is essential. Thus, it is imperative that any developed IPEP and education strategy target both players and coaches to maximize adherence to the IPEP. Supporting an IPEP with an implementation plan can improve the adoption and use of IPEPs34 and is a critical next step for a community sport like camogie to achieve a real-world reduction in injuries.

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  30. White PE, Otago L, Saunders N, et al. Ensuring implementation success: how should coach injury prevention education be improved if we want coaches to deliver safety programmes during training sessions?Br J Sports Med. 2014;48(5):402–403. doi:10.1136/bjsports-2012-091987 [CrossRef]
  31. Omaki E, Rizzutti N, Shields W, et al. A systematic review of technology-based interventions for unintentional injury prevention education and behaviour change. Inj Prev. 2017;23(2):138–146. doi:10.1136/injuryprev-2015-041740 [CrossRef]
  32. Verhagen E, Bolling C. Protecting the health of the athlete: how online technology may aid our common goal to prevent injury and illness in sport. Br J Sports Med. 2015;49(18):1174–1178. doi:10.1136/bjsports-2014-094322 [CrossRef]
  33. Frank BS, Register-Mihalik J, Padua DA. High levels of coach intent to integrate a ACL injury prevention program into training does not translate to effective implementation. J Sci Med Sport. 2015;18(4):400–406. doi:10.1016/j.jsams.2014.06.008 [CrossRef]
  34. Donaldson A, Gabbe BJ, Lloyd DG, et al. Controlled ecological evaluation of an implemented exercise training programme to prevent lower limb injuries in sport: differences in implementation activity. Inj Prev. 2018;0:1–7.

Likeliness to Take Part in Different Education Formats for Injury Prevention, % (n)

Injury Prevention FormatCoachPlayer


Very LikelyLikelyNeither Likely Nor UnlikelyUnlikelyVery UnlikelyVery LikelyLikelyNeither Likely Nor UnlikelyUnlikelyVery Unlikely
Injury prevention training courses62.5 (55)33.0 (29)4.5 (4)0.0 (0)0.0 (0)36.4 (50)53.5 (68)3.1 (4)3.9 (5)0.0 (0)
Attend an injury prevention talk and/or seminar63.6 (56)33.0 (29)2.3 (2)1.1 (1)0.0 (0)29.9 (38)55.1 (70)11.0 (14)3.9 (5)0.0 (0)
Online injury prevention resources67.0 (59)27.3 (24)3.4 (3)1.1 (1)1.1 (1)42.5 (54)39.4 (50)10.2 (13)7.9 (10)0.0 (0)
Phone application for injury prevention programs35.3 (31)30.7 (27)17.0 (15)10.2 (9)6.8 (6)25.2 (32)33.9 (43)16.5 (21)20.5 (26)3.9 (5)
Sign-up to receive an injury prevention package62.5 (55)33.0 (29)1.1 (1)2.3 (2)1.1 (1)37.8 (48)48.0 (61)5.5 (7)7.1 (9)1.6 (2)
Instructional DVDs53.4 (47)34.1 (30)2.3 (2)8.0 (7)2.3 (2)22.0 (28)33.1 (42)15.0 (19)22.8 (29)7.1 (9)
Instructional posters and information sheets59.1 (52)28.4 (25)6.8 (6)4.5 (4)1.1 (1)26.0 (33)52.8 (67)7.9 (10)13.4 (17)0.0 (0)

Demographic Information for Coaches

ParameterValue
Gender (%, n)
  Male39.8 (39)
  Female59.2 (58)
  Prefer not to say1.0 (1)
Years coaching (mean ± SD)11.1 ± 8.3
Level coaching (%, n)
  Elite13.3 (13)
  Non-elite86.7 (85)
Coaching adult or junior (%, n)
  Adult35.7 (35)
  Junior64.3 (63)
Camogie coaching course completed (%, n)61.2 (60)
  Foundation61.2 (60)
  Level 148.2 (41)
  Level 213.8 (11)
No. of injured players in the previous season (%, n)a
  014.3 (14)
  1 to 567.3 (66)
  6 to 1011.2 (11)
  11 to 155.1 (5)
  N/A1.0 (1)

Coach and Player Attitudes Toward Injury Prevention Exercise Programs

StatementCoachPlayer


Strongly AgreeAgreeNeither Agree Nor DisagreeDisagreeStrongly DisagreeStrongly AgreeAgreeNeither Agree Nor DisagreeDisagreeStrongly Disagree
Negative statements relating to IPEP and injury prevention attitudes, % (n)
  Injuries are an issue with my team7.2 (7)33.0 (32)18.6 (18)28.9 (28)12.4 (12)19.0 (35)50.5 (93)19.6 (36)9.2 (17)1.6 (3)
  IPEPs cost too much money2.2 (2)11.2 (10)34.8 (31)28.1 (25)23.6 (21)5.7 (9)15.7 (25)41.5 (66)27.7 (44)9.4 (15)
  IPEPs take up too much training time away from necessary tasks1.1 (1)7.5 (7)26.9 (25)40.9 (38)23.7 (22)2.3 (4)6.2 (11)24.3 (43)53.1 (94)14.1 (25)
Positive statements relating to IPEP and injury prevention attitudes, % (n)
  Important for coaches to have current knowledge of IPEPs56.7 (55)39.2 (38)4.1 (4)0.0 (0)0.0 (0)61.4 (113)35.3 (65)3.3 (6)0.0 (0)0.0 (0)
  Important for players to have current knowledge of IPEPs61.9 (60)34.0 (33)3.1 (3)1.0 (1)0.0 (0)63.0 (116)34.8 (64)1.1 (2)1.1 (2)0.0 (0)
  Injury prevention is important during training sessions64.6 (62)32.3 (31)2.1 (2)1.0 (1)0.0 (0)58.2 (107)37.0 (68)3.3 (6)1.6 (3)0.0 (0)
  Activities included in IPEPs are relevant and beneficial to players42.2 (38)34.4 (31)23.3 (21)0.0 (0)0.0 (0)43.5 (74)47.1 (80)8.8 (15)0.6 (1)0.0 (0)
  I believe that using an IPEPs will reduce the number of injuries for my team42.6 (40)42.6 (40)13.8 (13)1.1 (1)0.0.(0)35.4 (64)55.8 (101)8.8 (16)0.0 (0)0.0 (0)

Willingness of Coaches to Conduct an IPEP as Reported by Coaches and Players

StatementsCoachPlayer


Strongly AgreeAgreeNeither Agree Nor DisagreeDisagreeStrongly DisagreeStrongly AgreeAgreeNeither Agree Nor DisagreeDisagreeStrongly Disagree
Negative statements relating to willingness to conduct an IPEP
  My team's training sessions are not long enough to devote time to injury prevention0.0 (0)4.3 (4)1.1 (1)56.4 (53)38.3 (36)1.5 (2)18.7 (25)14.9 (20)53.7 (72)11.2 (15)
  I/my coach am/is not willing to participate as I/they haven't received training in order to implement an IPEP12.9 (12)29.0 (27)15.1 (14)24.7 (23)18.3 (17)1.5 (2)32.1 (43)20.9 (28)35.1 (47)10.4 (14)
  It is the responsibility of a medical or allied health care professional or other exercise professionals to implement an IPEP1.1 (1)6.5 (6)8.6 (8)57.0 (53)26.9 (25)0.0 (0)11.5 (15)21.4 (28)54.2 (71)13.0 (17)
  I/my coach am/is not willing to change the current warm-up and training activities that I am currently using0.0 (0)4.3 (4)1.1 (1)56.4 (53)38.3 (36)1.5 (2)7.6 (10)14.4 (19)59.8 (79)16.7 (22)
  The players on my team would not be willing to complete the IPEP0.0 (0)2.2 (2)7.6 (7)62.0 (57)28.3 (26)1.5 (2)5.3 (7)11.4 (15)62.1 (82)19.7 (26)
  I/my coach does not have access to anyone with the appropriate skills or knowledge to assist them with implementing an IPEP12.9 (12)29.0 (27)15.1 (14)24.7 (23)18.3 (17)7.0 (9)35.7 (46)18.6 (24)31.0 (40)7.8 (10)
Positive statements relating to willingness to conduct an IPEP
  I would be willing to include an IPEP if it is shown to significantly lower the chance of injury occurrence59.1 (55)38.7 (36)2.2 (2)0.0 (0)0.0 (0)65.7 (88)32.1 (43)2.2 (3)0.0 (0)0.0 (0)
  I would implement an IPEP if it was proven to improve player performance57.4 (54)38.3 (36)3.2 (3)0.0 (0)1.1 (1)67.2 (90)29.9 (40)3.0 (4)0.0 (0)0.0 (0)

Perceived Ability of Coaches to Conduct an IPEP as Reported by Coaches and Players

StatementsCoachPlayer


Strongly AgreeAgreeNeither Agree Nor DisagreeDisagreeStrongly DisagreeStrongly AgreeAgreeNeither Agree Nor DisagreeDisagreeStrongly Disagree
Negative statements relating to perceived abilitya
  I/my coach does not have sufficient experience conducting IPEP15.1 (14)41.9 (39)20.4 (19)17.2 (16)5.4 (5)9.3 (12)50.4 (65)20.2 (26)15.5 (20)4.7 (6)
  I/my coach does not have access to appropriate training equipment to implement an IPEP7.5 (7)21.5 (20)25.8 (24)35.5 (33)9.7 (9)4.7 (6)35.7 (46)18.6 (24)32.6 (42)8.5 (11)
  I feel poor player attendance at training will offset the benefits of conducting an IPEP5.6 (5)18.0 (16)24.7 (22)42.7 (38)9.0 (8)17.3 (23)41.4 (55)12.8 (17)26.3 (35)2.3 (3)
Positive statements relating to perceived abilitya
  I/my coach has sufficient knowledge to implement an IPEP11.7 (11)19.1 (18)14.9 (14)38.3 (36)16.0 (15)6.9 (9)20.8 (27)19.2 (25)44.6 (58)8.5 (11)
  I/my coach has sufficient skills to implement an IPEP10.8 (10)32.3 (30)18.3 (17)28.0 (26)10.8 (10)7.7 (10)31.5 (41)22.3 (29)31.5 (41)6.9 (9)
  I/my coach has adequate knowledge to explain the benefits and reasons for participating in injury prevention8.6 (8)52.7 (49)9.7 (9)21.5 (20)7.5 (7)7.6 (10)34.4 (45)19.8 (26)31.3 (41)6.9 (9)
  I/my coach has sufficient use of facilities to implement an IPEP8.6 (8)41.9 (39)20.4 (19)21.5 (20)7.5 (7)6.1 (8)36.6 (48)15.3 (20)33.6 (44)8.4 (11)
  I/my coach has sufficient educational resources available to assist with implementing an IPEP9.7 (9)24.7 (23)19.4 (18)32.3 (30)14.0 (13)3.1 (4)25.6 (33)24.0 (31)41.1 (53)6.2 (8)
  I/my coach would have no problems getting players to participate in IPEP24.2 (22)58.2 (53)16.5 (15)1.1 (1)0.0 (0)20.9 (28)59.7 (80)8.2 (11)9.0 (12)2.2 (3)
  I/my coach would have no issues or concerns from players' parents/guardians about participation in IPEP23.3 (21)57.8 (52)16.7 (15)2.2 (2)0.0 (0)17.8 (23)69.8 (90)6.2 (8)5.4 (7)0.7 (1)
  I/my coach would have the support of the club/county administration to implement an IPEP16.9 (15)36.0 (32)34.8 (31)5.6 (5)6.7 (6)14.3 (19)51.1 (68)21.8 (29)10.5 (14)2.3 (3)

Coach Questionnaire

1. Did you coach camogie last season?

Yes

No (excluded)

Q2. What is your gender?

Female

Male

Other ________________________

Prefer not to say

Q3. What age are you? (whole numbers) _________ years Q4. How many years have you coached in camogie? (whole numbers) _________ years Q5. Have you completed any coaching qualifications? (tick all that apply)

Camogie Foundation Course

Camogie Level 1

Camogie Level 2

GAA Foundation Award

GAA Award 1 Coach Education

GAA Award 2 Coach Education

LGFA FUNdamentals Course

LGFA Level 1

FAI Kick Start 1

FAI Kick Start 2

IRFU- Mini Rugby

IRFU- Foundation Level

IRFU- Level 1

IRFU- Level 2

IRFU- Level 3

No

Other ____________

The following questions consider your role coaching your MAIN team (the team you spend the most time coaching, i.e. more than 50% of your coaching time)Q6. What level is the MAIN team you currently coach?

Interprovincial

Adult County

College/University

Adult Club

Underage County

Underage Club

Secondary School

Primary School

Other __________

Q7. Approximately how many players on your main team sustained an injury last season, which resulted in them being unable to participate in training or games for a minimum of 24 hours?

None

1–5 players

6–10 players

11–15 players

16–20 players

21–25 players

25+ players

Not applicable

Exact Number ____________

Injury Prevention Programmes are specifically designed programmes that aim to provide strength and movement control to players in order to prevent injury occurrence.Q8. Are you currently aware of any specific injury prevention programmes for Gaelic games or injury prevention programmes in general?

No

If YES, what injury prevention programmes _________________________________

Q9. Are you currently using an injury prevention programme with your team?

Yes

No

Unsure

Other___________

If “No” is selected the participant will be redirected to Question 16Q10. If you have used an injury prevention programme, what encouraged you to do so? (select all that apply)

Advised to by medical and allied healthcare professionals

It doubles as a warm-up

Current research shows benefits

Players requested it

To improve team performance

Due to high levels of injuries seen in previous seasons

Other teams coaches in the club have found it beneficial

I observed elite/high performance teams participating in injury prevention programmes

Other __________________

Q11. In your team, who is responsible for delivering the injury prevention programme? (tick one answer)

Coach

Assistant Coach/Selector

Medical and Allied Healthcare Professionals

Player/Captain

Sports/Exercise Scientist

Strength & Conditioning Coach

Any of the above

All of the above

Other __________________

Q12. What elements are included in your injury prevention programme? (tick all that apply)

Running

Muscular activation (e.g. Glutes)

Neuromuscular strengthening

Change of direction

Jumping and landing

Dynamic balance

Other ___________

Q13. How often does your team participate in injury prevention programmes?

Once off/pre-season screening and testing

During every training session and match

During every training session

During every match

During one training session a week

Player self-administration outside of training/matches

Other ___________

Q14. How much time is allocated for the injury prevention programme?

None

1–5 minutes

6–10 minutes

11–15 minutes

16–20 minutes

20+ minutes

Q15. Where did you source your injury prevention programme? (tick all that apply)

From current research

Self-designed

Provided by a Medical and Healthcare Professional

Provided by a Strength & Conditioning coach

Saw it online/on social media, if so where online _______________

Other __________

Q16. Please respond to the following questions surrounding injury prevention programmes. Please select one answer that best fits your opinion

Strongly agreeAgreeNeutralDisagreeStrongly disagreeN/A
Injuries are an issue with my team
It is important for coaches to have current knowledge of injury prevention programmes
It is important for players to have current knowledge of injury prevention programmes
Injury prevention is important during training sessions
Injury prevention programmes cost too much money
The activities included in injury prevention programmes are relevant and beneficial to my players
I believe that using an injury prevention programme will reduce the number of injuries in my team
Injury preventions programmes take up too much precious training time away from necessary tasks

Q17. The statements below are related to your understanding of the current use and participation in injury prevention programmes. Please select one answer that best fits your opinion

Strongly agreeAgreeNeutralDisagreeStrongly disagreeN/A
Most camogie coaches are using injury prevention programmes with their teams
Injury prevention programmes are only for top level senior club or intercountry teams
Only adult teams are participating in injury prevention programmes
Injury prevention programmes should not be used with underage teams
Players are requesting to participate in injury prevention programmes
Only teams with access to sports/exercise scientists are participating in injury prevention programmes
Only teams with access to medical/healthcare professionals are participating in injury prevention programmes

Q18. The statements below are related to your willingness to use an injury prevention programme with your team. Please select one answer that best fits your opinion.

Strongly agreeAgreeNeutralDisagreeStrongly disagreeN/A
I would be willing to include an injury prevention programme if it is shown to significantly lower the chance of injury occurrence
I would implement an injury prevention programme if it was proven to improve player performance
My team's training sessions are not long enough to devote time to injury prevention
I am not willing to participate as I haven't received training in order to implement an injury prevention programme
It is the responsibility of medical/healthcare professionals or other exercise professionals to implement the injury prevention programme
I am not willing to change the current warm-up and training activities that I am currently using
My players would not be willing to complete the injury prevention programmes
I do not have access to anyone with the appropriate skills or knowledge to assist me with implementing an injury prevention programme

Q19. The following questions are related to your current ability to conduct an injury prevention program with your current team(s). Please select one answer that best fits your opinion.

Strongly agreeAgreeNeutralDisagreeStrongly disagreeN/A
I have sufficient knowledge to implement an injury prevention programme
I have sufficient skills to implement an injury prevention programme
I do not have sufficient experience conducting injury prevention programmes
I have adequate knowledge to explain the benefits and reasons for participating in injury prevention
I have sufficient use of facilities to implement an injury prevention programme
I do not have access to appropriate training equipment to implement an injury prevention programme
I have sufficient educational resources available to me to assist with implementing an injury prevention programme
I have no problems getting my players to participate in injury prevention programmes
I have no issues or concerns from players about participating in injury prevention programmes
I have no issues or concerns from players' parents/guardians about participation in injury prevention programmes
I feel poor player attendance at training will offset the benefits of conducting an injury prevention programme
I have the support of the club/county administration to implement an injury prevention programme

Q20. What would reduce any of the previously identified barriers to the use of injury prevention programmes in camogie? If you have not identified any barriers please skip to Q21._________________________________________________________________________________ Q21. Would you be interested in receiving further education and knowledge on injury prevention programmes?

Yes

No

Unsure

Other___________

Q22. The statements below are related to your opinions and preference of types of future injury prevention education and training. Please select one answer that best fits your opinion.On a scale from very likely to very unlikely, how likely would you be to participate in/use;

Very likelyLikelyNeither likely nor unlikelyUnlikelyVery unlikelyN/A
Injury prevention training courses
Attend an injury prevention talk/seminar
Online injury prevention resources
Phone application for injury prevention programmes
Sign-up to receive an injury prevention package
Instructional DVDs
Instructional posters and information sheets

Player Questionnaire

1. Did you play camogie last season?

Yes

No (excluded)

Q2. What age are you? (whole numbers)_________ years Q3. How many years have you played camogie? (whole numbers)_________ years The following questions consider playing with your MAIN team (the team you spend the most time playing with, i.e. more than 50% of your playing time).Q4. What level is the MAIN team you currently play with?

Interprovincial

Adult County

College/University

Adult Club

Underage County

Underage Club

Secondary School

Primary School

Other __________

Injury Prevention Programmes are specifically designed programmes that aim to provide strength and movement control to players in order to prevent injury occurrence.Q5. Are you currently aware of any specific injury prevention programmes for Gaelic games or injury prevention programmes in general?

No

If YES, what injury prevention programmes _________________________________

Q6. Does your main team currently take part in an injury prevention programme?

Yes

No

Unsure

Other___________

If “No” is selected the participant will be redirected to Question 11Q7. In your team, who is responsible for delivering the injury prevention programme? (tick one answer)

Coach

Assistant Coach/Selector

Medical and Allied Healthcare Professionals

Player/Captain

Sports/Exercise Scientist

Strength & Conditioning Coach

Any of the above

All of the above

Other __________________

Q8. What elements are included in your injury prevention programme? (tick all that apply)

Running

Muscular Activation (e.g. Glutes)

Neuromuscular Strengthening

Change of Direction

Jumping and Landing

Dynamic Balance

Other ___________

Q9. How often does your team participate in injury prevention programmes?

Once off/pre-season screening and testing

During every training session and match

During every training session

During every match

During one training session a week

Player self-administration outside of training/matches

Other ___________

Q10. How much time is allocated for the injury prevention programme

None

1–5 minutes

6–10 minutes

11–15 minutes

16–20 minutes

20+ minutes

Q11. Please respond to the following questions surrounding injury prevention programmes. Please select one answer that best fits your opinion

Strongly agreeAgreeNeutralDisagreeStrongly disagreeN/A
Injuries are an issue with my team
It is important for coaches to have current knowledge of injury prevention programmes
It is important for players to have current knowledge of injury prevention programmes
Injury prevention is important during training sessions
Injury prevention programmes cost too much money
The activities included in injury prevention programmes are relevant and beneficial to players
I believe that using an injury prevention programme will reduce the number of injuries in my team
Injury preventions programmes take up too much precious training time away from necessary tasks

Q12. The statements below are related to your understanding of the current use and participation in injury prevention programmes. Please select one answer that best fits your opinion.

Strongly agreeAgreeNeutralDisagreeStrongly disagreeN/A
Most camogie coaches are using injury prevention programmes with their teams
Injury prevention programmes are only for top level senior club or intercountry teams
Only adult teams are participating in injury prevention programmes
Injury prevention programmes should not be used with underage teams
Players are requesting to participate in injury prevention programmes
Only teams with access to sports/exercise scientists are participating in injury prevention programmes
Only teams with access to medical/healthcare professionals are participating in injury prevention programmes

Q13. The statements below are related to your willingness to take part in injury prevention programmes. Please select one answer that best fits your opinion.

Strongly agreeAgreeNeutralDisagreeStrongly disagreeN/A
I would be willing to take part in an injury prevention programme if it is shown to significantly lower the chance of injury occurrence
I would take part in an injury prevention programme if it was proven to improve player performance
My team's training sessions are not long enough to devote time to injury prevention
My coach would not be willing to participate as they haven't received training to implement an injury prevention programme
It is the responsibility of medical/healthcare professionals or other exercise professionals to implement the injury prevention programme
My coach is not willing to change their current warm-up and training activities
My fellow players would not be willing to complete the injury prevention programmes
My coach does not have access to anyone with the appropriate skills or knowledge to assist them with implementing an injury prevention programme

Q14. The following questions are related to your coach's current ability to conduct an injury prevention program with your current team(s). Please select one answer that best fits your opinion.

Strongly agreeAgreeNeutralDisagreeStrongly disagreeN/A
My coach has sufficient knowledge to implement an injury prevention programme
My coach has sufficient skills to implement an injury prevention programme
My coach does not have sufficient experience conducting injury prevention programmes
My coach has adequate knowledge to explain the benefits and reasons for participating in injury prevention
My coach has sufficient use of facilities to implement an injury prevention programme
My coach does not have access to appropriate training equipment to implement an injury prevention programme
My coach has sufficient educational resources available to them to assist with implementing an injury prevention programme
My coach would have no problems getting my fellow players to participate in injury prevention programmes
My coach would have no issues or concerns from my fellow players about participating in injury prevention programmes
My coach would have no issues or concerns from my fellow players' parents/guardians about participation in injury prevention programmes
I feel poor player attendance at training will offset the benefits of conducting an injury prevention programme
My coach would have the support of the club/county administration to implement an injury prevention programme

Q15. What would reduce any of the previously identified barriers to the use of injury prevention programmes in camogie? If you have not identified any barriers, please skip to Q16._________________________________________________________________________________ Q16. Would you be interested in receiving further education and knowledge on injury prevention programmes?

Yes

No

Unsure

Other___________

Q17. The statements below are related to your opinions and preference of types of future injury prevention education and training. Please select one answer that best fits your opinion.On a scale from very likely to very unlikely, how likely would you be to participate in/use;

Very likelyLikelyNeither likely nor unlikelyUnlikelyVery unlikelyN/A
Injury prevention training courses
Attend an injury prevention talk/seminar
Online injury prevention resources
Phone application for injury prevention programmes
Sign-up to receive an injury prevention package
Instructional DVDs
Instructional posters and information sheets

Authors

From the Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland (SO'Connor, EW, SO'Hanlon); and Exercise Medicine Research Institute, School of Medical and Health Science, Edith Cowan University, Joondalup, Australia (LF).

The authors have no financial or proprietary interest in the materials presented herein.

The authors thank the players and coaches for taking the time to complete the questionnaire, and the Camogie Association, in particular Paul O'Donovan, for help in distributing the questionnaire.

Correspondence: Siobhán O' Connor, MSc, PhD, CAT, A144B, School of Health and Human Performance, Dublin City University, Dublin 9, Ireland. Email: siobhan.oconnor@dcu.ie

Received: August 06, 2019
Accepted: December 16, 2019
Posted Online: August 26, 2020

10.3928/19425864-20200426-01

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