Does warming up prevent injury in sport? The evidence from randomised controlled trials?

The practice of warming up prior to exercise is advocated in injury prevention programs, but this is based on limited clinical evidence. It is hypothesised that warming up will reduce the number of injuries sustained during physical activity. A systematic review was undertaken. Relevant studies were identified by searching Medline (1966-April 2005), SPORTDiscus (1966-April 2005) and PubMed (1966-April 2005). This review included randomised controlled trials that investigated the effects of warming up on injury risk. Studies were included only if the subjects were human, and only if they utilised other activities than simply stretching. Studies reported in languages other than English were not included. The quality of included studies was assessed independently by two assessors. Five studies, all of high quality (7-9 (mean=8) out of 11) reported sufficient data (quality score>7) on the effects of warming up on reducing injury risk in humans. Three of the studies found that performing a warm-up prior to performance significantly reduced the injury risk, and the other two studies found that warming up was not effective in significantly reducing the number of injuries. There is insufficient evidence to endorse or discontinue routine warm-up prior to physical activity to prevent injury among sports participants. However, the weight of evidence is in favour of a decreased risk of injury. Further well-conducted randomised controlled trials are needed to determine the role of warming up prior to exercise in relation to injury prevention.