The Importance of Injury Prevention in Sport From The Feet Up

Sport is woven into our Australian culture, but it also comes with a cost. Here are the facts:

Just over 62 100 sports‑injury hospitalisations were recorded in Australia in 2023 to 24, with males accounting for about 70 % of all cases [1]. Rates peak in adolescence; males aged 15 -19 years experienced around 890 hospitalisations per 100 000 population, compared with about 300 per 100 000 for females [2].

Children are particularly vulnerable. An Australian study found that about 13 000 children are hospitalised every year for a sports injury, costing the health system about $40 million AUD per year [3]. Over the decade 2002 to 2012, 130,167 sports injury related hospitalisations of Australian children cost an estimated $396 million AUD , with a mean cost of $3 058 AUD per injured child [4]. Globally, the picture is similar; in the United States, emergency departments treated 4.4 million sports‑related injuries in 2024 [5].

Injury Costs More Than Money

The burden of injury extends beyond hospital bills. Sports injury rates in Australian children have remained stubbornly high for more than a decade [6]. The largest causes are team ball sports (43 % of hospitalisations) and wheeled sports like cycling (22 %) [7]. Boys make up about three‑quarters of hospitalised children, often injured in team sports or motorbike riding, while girls have higher injury rates in horse‑riding and gymnastics [7]. These injuries lead to time away from sport and school; U.S. data suggest that approximately 20 million school days are lost each year due to sports injuries among youth [24]. Such absences disrupt skill development, team cohesion and academic progress.

The emotional toll is significant too. Injuries are linked with stress, anxiety and even depression among athletes and their families [25]. At the elite level, the financial impact is stark; for example, a study of German football found that additional injury days or unavailable players per matchday were associated with lower league rankings and reduced broadcasting revenue [8]. A similar analysis in professional cricket reported average annual injury costs of £167 447 per team [9].

Injury prevention is therefore an investment in performance, wellbeing and community health.

Why Generic Prevention Programmes Fail

Traditional injury‑prevention strategies often focus on group‑based stretching and strengthening. Yet a 2024 study of youth athletes found that 55 % experienced an acute injury in the previous six months, and injuries were linked to poorer physical and mental health [10]. The authors argued that biopsychosocial, personalised strategies are needed [11]. A 2025 BMJ viewpoint reinforces this, advocating a shift from binary “injured/not injured” screening to continuous monitoring and individualised interventions [12].

One‑size‑fits‑all programmes ignore differences in anatomy, biomechanics, sport demands and development. They may even reinforce dysfunctional patterns when athletes skip neuromuscular retraining and jump straight into resistance training [13].

Dynamic Neuromuscular Stabilisation: Returning to First Principles

Dynamic neuromuscular stabilisation (DNS) offers a more holistic solution. DNS reactivates the developmental movement patterns we learned as infants - rolling, crawling and squatting, whilst emphasising coordinated activation of deep core muscles, intra‑abdominal pressure and diaphragmatic breathing [14].

Rather than isolating muscles, it teaches the nervous system to organise movement efficiently. Evidence shows DNS can improve posture, enhance performance and reduce pain [15]. In a 2025 randomised controlled trial, adults with intellectual disabilities who undertook an eight‑week DNS programme showed significantly greater improvements in balance and coordination than controls, and these gains persisted two months after training [16]. A meta‑analysis of neuromuscular training programmes, many incorporating DNS principles, reported a 27 % reduction in lower‑extremity injuries; the best results came from 20 to 30 minute sessions conducted one to two times per week over at least six months [17].

Feet‑Up Integration: The Australian Way

Australia’s sporting culture often involves running barefoot on the beach or kicking a footy in the park. DNS starts from the feet up, recognising that the foot is part of a system involving the diaphragm, pelvic floor and fascia. From The Feet Up Sports and Podiatry Clinic and its online education arm  - The Stabilisation Academy notes that foot and ankle rehabilitation must involve a full‑body strategy [18]. If athletes jump straight into heavy strength work without re‑establishing neuromuscular control and patterning, they risk reinforcing dysfunction [13]. Integrated foot control is also supported by research on integrative neuromuscular training, which shows that dynamic postural control, lower‑limb stability and proprioception improve with such programmes [19] - all vital for preventing common injuries (specifically lower limb such as hamstring, calf anf in sprain and reducing the impact of collision injuries common in Australian sports like AFL, Netball  and rugby.

Key elements of a feet‑up programme

1. Reconnect developmental movements: use positions like rolling, crawling and squatting to retrain the nervous system [14].

2. Optimise breathing: harness the diaphragm, pelvic floor and deep abdominal muscles to generate intra‑abdominal pressure, stabilising the spine [20].

3. Enhance foot proprioception: Improve foot mobility and sensory feedback to influence alignment and joint centration throughout the body [18].

4. Progress gradually: Once control is regained, add load and complexity without sacrificing movement quality [13].

Make Prevention a National Priority

The Australian Institute of Health and Welfare reports that sports‑injury hospitalisation rates have risen by about 0.8 % per year since 2017–18, stabilising only recently [22]. Meanwhile, the number of children being hospitalised each year remains stubbornly high [6]. Researchers warn that these trends suggest existing safety initiatives are inadequate [23]. To reverse them, Australia needs a national injury‑prevention strategy that incorporates dynamic neuromuscular stabilisation into mainstream coaching and physical education. Early adoption in schools and community clubs could prevent the first injury, which is a major predictor of dropout from sport [21].

Investing in neuromuscular training may seem like an extra cost in a system already spending billions on sport and healthcare. Yet the average annual cost of injuries in professional cricket and the AU$40 million per year spent on hospitalised children [9][3] pales in comparison with the long‑term benefits of a healthier, more active population. By focusing on dynamic, personalised, feet‑up training, Australia can lead the world in sustainable injury prevention and ensure that athletes of all ages enjoy sport safely.

About Me and My Business

I run a sports therapy business in Perth that specialises in integrating injury prevention into every treatment and training plan. Rather than treating injuries as isolated incidents, we view them as signals that the body’s movement patterns have become inefficient. My approach centres on dynamic neuromuscular stabilisation and a “feet‑up” philosophy - teaching athletes to reconnect with their innate movement patterns, optimise breathing and core control, and build resilience from the ground up. This holistic method isn’t just for elite athletes; it’s essential for weekend warriors, schoolchildren and anyone who wants to move well throughout life.

In my practice, injury prevention isn’t an add‑on or a quick band‑aid fix- it’s the foundation of long‑term health and performance. I work closely with clients to tailor programmes that address their unique biomechanics, sport demands and lifestyle factors.

I also educate other health professionals on integrating injury-prevention principles into their practice, promoting a culture shift within the industry. By investing time in neuromuscular retraining and personalised conditioning, we help clients avoid recurring injuries, improve performance and enjoy their chosen sports for years to come. I believe this proactive, evidence‑based approach should be a major part of every healthcare and fitness professional’s business.

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