Ground hardness and injury in community level Australian football

ObjectivesTo describe the risk and details of injuries associated with ground hardness in community level Australian football (AF).DesignProspective injury surveillance with periodic objective ground hardness measurement.Methods112 ground hardness assessments were undertaken using a Clegg hammer at nine locations across 20 grounds, over the 2007 and 2008 AF seasons. Details of 352 injuries sustained by community level players on those grounds were prospectively collected as part of a large randomised controlled trial. The ground location of the injury was matched to the nearest corresponding ground hardness Clegg hammer readings, in gravities (g), which were classified from unacceptably low (<30 g) to unacceptably high hardness (>120 g).ResultsClegg hammer readings ranged from 25 to 301 g. Clegg hammer hardness categories from low/normal to high/normal were associated with the majority of injuries, with only 3.7% (13 injuries) on unacceptably high hardness and 0.3% (1 injury) on the unacceptably low hardness locations. Relative to the preferred range of hardness, the risk of sustaining an injury on low/normal hardness locations was 1.31 (95%CI: 1.06–1.62) times higher and 1.82 (95%CI: 1.17–2.85) times higher on locations with unacceptably high hardness. The more severe injuries occurred with low/normal ground hardness.ConclusionsDespite the low number of injuries, the risk of sustaining an injury on low/normal and unacceptably hard grounds was significantly greater than on the preferred range of hardness. Notably, the severity of the injuries sustained on unacceptably hard grounds was lower than for other categories of hardness.     

Match injuries in Sri Lankan junior cricket: A prospective,longitudinal study

ObjectivesUnderstanding the nature of injuries in cricket is key to mitigate injury risks and prioritise preventive measures. This study aimed to identify the incidence and nature of match injuries among Sri Lankan junior cricketers.DesignLongitudinal follow-up study with prospective in-season data collection.MethodsA national survey of schoolboy, division-1 cricket teams in under-15 and under-17 age groups. Using a paper-based questionnaire, distributed to school-teams at the start of the 2016 cricket season, respondents recorded any injuries, including the site, type and mechanism. Match injury incidence rates (match-IIR) (injuries/100 match-player-days) were calculated overall, by position and for match time loss (MTL) and non-MTL injuries.ResultsFrom 59 school-teams, 573 players responded, with 404 players reporting 744 injuries in 648 matches. The match-IIR was 28.0 injuries/100 match-player-days (95% CI = 26.0–30.2). The highest match-IIR was reported among fielders (46.0% of all injuries sustained; match-IIR = 12.9) compared with batters (25.4%; match-IIR = 7.1) and bowlers (20.3%; match-IIR = 5.7). Abrasions and bruises to the knee or elbow were the most common injuries among fielders, with the majority being non-MTL injuries.ConclusionsAlmost half (46.0%) of all injuries were to fielders, and more research into their severity and mechanisms is needed to identify the need for, and design of, preventive measures. Batters sustained a relatively large number of facial-organ injuries from being struck by the ball, presenting a need to evaluate the use and appropriateness of helmets by Sri Lankan junior cricketers. Similar to other junior cricket studies, the most common injuries among bowlers were strains and sprains, mainly affecting the lower limbs and lower back.     

The incidence,prevalence, nature,severity and mechanisms of injury in elite female cricketers: A prospective cohort study

ObjectivesIncidence, prevalence, nature, severity and mechanisms of injury in elite female cricketers over two seasons from March 2014 to March 2016, inclusive.DesignProspective cohort study.MethodsInjury data collected via Cricket Australia’s Athlete Management System on all elite female players over two seasons were analysed. Profiles of the nature, anatomical location and mechanism of injuries were presented according to dominant player position. Injury incidence rates were calculated based on match playing hours.ResultsThere were 600 medical-attention injuries; with 77.7% players reporting ≥1 injury. There were 79.5% acute injuries compared to gradual onset injuries. Of the all medical-attention injuries, 20.2% led to time-loss; 34.7% were match-time-loss injuries. Match injury incidence was 424.7 injuries/10,000 h for all injuries and 79.3 injuries/10,000 h for time-loss injuries. Of all the injuries, 31.8% were muscle injuries and 16.0% joint sprains. Wrist and hand (19.8%), lumbar spine (16.5%) and knee (14.9%) injuries were the most common time-loss injuries. Six players sustained lumber spine bone stress injury that resulted in the most days missed due to injury (average 110.5 days/injury).ConclusionsThere is a need to focus on specific injuries in female cricket, including thigh, wrist/hand and knee injuries because of their frequency, and lumbar spine injuries because of their severity.     

The epidemiology of injury for an elite junior Australian Football cohort

ObjectivesTo implement an injury recording protocol in a junior elite Australian Football competition and determine the injury profile of this population.DesignLongitudinal cohort study.MethodsPlayers from an elite Under 18 Australian Football competition were tracked throughout one football season in terms of participation or non-participation in the football competition. Injury reporting forms were collected for all players who were not available for selection as a result of injury.ResultsThe cohort consisted of 532 players who provided consent for inclusion in the study (100% of players in the competition). There were 256 injuries sustained during the season. Results were standardised to a 40 man team to allow comparison with results from the Australian Football League. The injury incidence was 17.1 new injuries per club (95% CI 14.1–19.4), and prevalence 63.3 missed matches per club (95% CI 59.1–67.1). The category “Ankle joint injuries” was the most commonly reported (n = 34) and “Collision with another player” was the main injury mechanism (n = 75).ConclusionsThe most commonly injured region in junior elite Australian Football was the ankle and collision with another player was the most common injury mechanism. As with previous reports on junior Australian Football, injury incidence was low in comparison to the senior elite competition. Defining the injury profile guides injury prevention strategies. Analysis of injury in junior elite football may provide a unique opportunity to affect both junior and senior injury rates.     

Injury profiles in elite women’s T20 cricket

ObjectivesTo Describe the injury incidence and prevalence during two years of a professional women’s T20 cricket tournament.DesignProspective cohort study.MethodsInjuries were recorded prospectively for 68 matches during a professional women’s T20 tournament in 2016 and 2017. There were six teams of 15 players. Participants were female, aged between 16–38 years (mean 23.4 ± 4.8). Time-loss and non time-loss incidence and prevalence were calculated for match days, region, skill group, mode and activity at time of injury.ResultsThe greatest incidence occurred in the shoulder (1.8 injuries per 100 match days), lower back (1.7 injuries per 100 match days) and knee (1.7 injuries per 100 match days). The highest time-loss prevalence occurred in hand (1.7%), head/face (0.8%) and thigh (0.6%). All head injuries were concussion. Catching related injuries caused the most time-loss (2.5% prevalence) and throwing related shoulder injury had the highest incidence (2.3 injuries per 100 match days). Gradual onset injuries had the highest overall incidence (7.9 injuries per 100 match days).ConclusionsIn elite female T20 cricket, time-loss injuries, particularly impact/traumatic injuries are most likely to occur during fielding, suggesting pitch side support and trauma training is a priority. The high incidence of gradual onset injuries, particularly throwing related shoulder pain, indicates that managing workload and ensuring physical preparedness is vital.     

Training habits and injuries of masters' level football players: A preliminary report

ObjectiveTo profile training habits and injuries in football players participating in a national Masters tournament.MethodsA cross-sectional retrospective study design was used to survey male football players attending the 2008 New Zealand Masters Games. Information regarding player demographics, football injuries, football related training, and risk factors for injury were collected.Results199 Players were recruited, with a median age of 44 yrs (range 35–73) and a median football playing history of 15 yrs (range 0–66). Irrespective of age, 112 (84%) players included a warm-up and 104 (78%) included a stretching regime in their regular training programme. In the 12 months prior to the tournament, 128 football related injuries were reported by 93 players (64 injuries/100 players or 46 injured players/100 players). The most frequently injured region was the lower limb; specifically the lower leg (n = 23), ankle (n = 18), hamstring (n = 17), knee (n = 15), and Achilles tendon (n = 15).ConclusionThis study provides a preliminary insight into the training habits and injury profiles of Masters football players. Despite all players including some form of injury prevention strategy in their training, a significant number of players experienced an injury in the 12 months prior to the tournament.     

Epidemiology of injuries in Australian junior rugby league players

ObjectivesConduct a large-scale epidemiological study of injury characteristics (location, type, mechanism, severity, burden) and incidence in community junior rugby league.DesignProspective cohort epidemiology study.MethodsInjury surveillance was conducted in three district leagues (Penrith, Canberra, Melbourne) in under 6 (U6) to under 18 years (U18) age groups across the 2016 season. Club sports trainers recorded all match/training medical-attention injuries using a commercial electronic application which recorded injury circumstances and characteristics.ResultsA total of 13,169 players from 897 teams participated and 408 (89% male) players sustained 485 injuries, 94% of which were match related. The overall injury incidence was 5.9 injuries/1000 player hours and highest in U13–U18 female players (22.2 injuries/1000 player hours). The mean injury severity of 16 ± 31 days missed training/match-play caused an overall injury burden of 94.2 days missed/1000 player hours). Tackles accounted for 84% of injuries. Joint and contusion injuries were the most prevalent injury type and the head (35% total injuries, primarily bruising and bleeding) was the most injured body site.ConclusionsThis is the first study to report injuries across a large cohort of all-age Australian community junior rugby league players over one season. Injury prevalence was lower than previously reported in junior rugby league suggesting the sport has not become more dangerous for junior players. These findings provide an evidence-base to inform or revise policy, training and injury prevention programs and athlete development pathways in relation to game-wide safety and develop best-practice protocols in injury management for rugby league athlete support personnel.     

Is the pink ball still under review? Cricket umpires’ perceptions of the pink ball for day/night matches

ObjectivesThe visibility of the pink ball used in day/night Test cricket has been under scrutiny, with recent research suggesting cricketers find the pink ball less visible at dusk under floodlights. With increasing interest in this match format, this study sought to investigate elite umpires’ opinions pertaining to the visibility of the pink cricket ball during day/night matches.DesignPurposeful sampling of a cross-section of elite umpires with experience adjudicating matches played using a pink cricket ball.MethodsTwenty-seven international/first-class umpires completed a questionnaire consisting of Likert scale and free text responses covering perceptions of the pink cricket ball, with a particular emphasis on visibility.ResultsThe pink ball when viewed at night under floodlights was rated as being significantly more visible than the red ball during natural lighting (ps < 0.050). Umpires who actively participated in training reported a significantly higher rating of the visibility of the pink ball (mean −3.14) at night under floodlights compared to those who didn’t (mean p = 0.010). No significant difference was reported in visibility in natural light or dusk under floodlights. Free text responses (n = 10) revealed the following themes: use of eyewear (coverage 0.30), and adjustment to positioning (coverage 0.20) to improve visibility of the pink ball.ConclusionsUmpires report the visibility of the pink ball is equal to the red in natural light and at dusk but is significantly better at night. Preference for the pink ball is likely due to the predominantly perceptual nature of visual tasks performed by umpires.     

The prognostic value of the hamstring outcome score to predict the risk of hamstring injuries

ObjectivesHamstring injuries are common among soccer players. The hamstring outcome score (HaOS) might be useful to identify amateur players at risk of hamstring injury. Therefore the aims of this study were: To determine the association between the HaOS and prior and new hamstring injuries in amateur soccer players, and to determine the prognostic value of the HaOS for identifying players with or without previous hamstring injuries at risk of future injury.DesignCohort study.MethodsHaOS scores and information about previous injuries were collected at baseline and new injuries were prospectively registered during a cluster-randomized controlled trial involving 400 amateur soccer players. Analysis of variance and t-tests were used to determine the association between the HaOS and previous and new hamstring injury, respectively. Logistic regression analysis indicated the prognostic value of the HaOS for predicting new hamstring injuries.ResultsAnalysis of data of 356 players indicated that lower HaOS scores were associated with more previous hamstring injuries (F = 17.4; p = 0.000) and that players with lower HaOS scores sustained more new hamstring injuries (T = 3.59, df = 67.23, p = 0.001). With a conventional HaOS score cut-off of 80%, logistic regression models yielded a probability of hamstring injuries of 11%, 18%, and 28% for players with 0,1, or 2 hamstring injuries in the previous season, respectively.ConclusionsThe HaOS is associated with previous and future hamstring injury and might be a useful tool to provide players with insight into their risk of sustaining a new hamstring injury risk when used in combination with previous injuries.     

Negative association between injuries and team success in professional cricket: A 9-year prospective cohort analysis

ObjectivesTo examine the relationship between injuries and team success in professional cricket.DesignProspective cohort analysis.MethodsA prospective cohort of all match time-loss injuries and County Championship point tallies for nine seasons (from 2010 to 2018 inclusive) for all 18 First-Class County Cricket (FCCC) cricket teams in England and Wales. Two injury measures of match time-loss injury incidence and burden were assessed for within-team (linear mixed model on season-to-season changes) and between-team (correlation on differences averaged over all seasons) effects. County Championship league points tally was used as the measure of team success.ResultsA moderate negative correlation was found between injury burden and team performance (r = ?0.36; 90% CI ?0.66 to 0.05; likely negative, P = 0.15). A reduction in match injury incidence of 2 match time-loss injuries per 1000 days of play (90% CI 1.4–2.9, P = 0.10) within a team, or a reduction in match injury burden of 75 days per 1000 days of play (90% CI 50–109, P = 0.053) in any given season was associated with the smallest worthwhile change in County Championship points (+13 points) for Division 1, but not for Division 2.ConclusionModerate reductions in injury burden are associated with potentially worthwhile effects on performance for a domestic cricket team in the County Championship Division 1.     

The incidence,prevalence, severity,mechanism and body region of injury in elite junior Australian football players: A prospective cohort study over one season

Objectives

To describe the incidence, prevalence, severity, mechanism and body region of injuries in elite junior Australian football (AF) players over one competitive season in order to help inform injury prevention interventions.

Life after the game – Injury profile of past elite Australian Football players

ObjectivesTo investigate the long-term health and well-being of past elite Australian Football League (AFL) players, with particular emphasis on the effect of playing injuries on current lifestyle.DesignCross sectional survey.MethodsA health and well-being survey, completed by past AFL players (n = 592) with mean (±SD) age of 55.1 y (±15.8) and playing career of 7.7 y (±4.1) sought information on demographics, education and employment, subjective well-being, lifestyle behaviours, physical health, disease prevalence, community and social structures, and playing history.ResultsA majority of past players experienced serious injuries (76%) and concussion (73%) throughout their career, both increasing significantly with the number of games played. Of those who received injuries, 60% require on-going treatment, yet only 6% receive treatment costs covered by their club or the AFL Players’ Association. A large proportion (64%) of respondents are affected in daily life from previous AFL injuries.ConclusionsAFL careers are compounded by high injury rates, including loss of consciousness with a high incidence of multiple concussions amongst those players reporting a serious injury. Greater number of injuries received will further the likelihood of requiring on-going treatment and being affected later in life. Additional research and planning may be important in assisting other improvements in the quality of life of past AFL players.     

Shoulder injury in professional cricketers

ObjectiveTo describe the impact of shoulder injuries on professional cricketers during the 2005 England and Wales first class cricket season.DesignProfessional cricketers in England were asked to complete two questionnaires relating to shoulder injuries. Players who returned both questionnaires were included in this study.Main outcome measurementsThe impact of any shoulder pain whilst playing cricket, impaired cricketing performance and shoulder injury related problems during training and activities of daily living.ResultsOne hundred and fifty eight of a total of 378 players (42%) returned both questionnaires. Twenty-three per cent of the participants described shoulder injury during the 2005 season. Injury prevalence (the percentage of players not available for selection in a match due to shoulder injury) was 1.7%. Sixty-four per cent of shoulder injured players often or always had associated problems when fielding, and 58% of shoulder injured players fielded in a specific position to avoid shoulder injury related problems. Eighteen per cent of all study participants felt pain on throwing at some stage during the survey period.ConclusionsProfessional cricketers generally play on with shoulder injuries without missing matches, though their performance, especially during fielding, is often compromised. Research into the diagnoses, aetiology, appropriate treatment and prevention of shoulder injuries in cricket is required.     

The financial and performance cost of injuries to teams in Australian professional soccer

ObjectivesTo determine the relationship between injury incidence, player-salary cost and team performance in the professional Australian soccer league.DesignProspective observational cohort study.MethodsInjury incidence, player-salary cost and team performance data were collected from the 10-club A-League competition (n = 27 matches/season) over 6 seasons from 2012/13. Player-salary cost of injury was calculated from the salary cap, injury-induced missed matches and player exposure, and trends were reported from Poisson regressions. Team performance was determined from ranking, points, goals (scored, conceded and difference) and match outcome (win, loss or draw) per season and analysed via a mixed-effects Poisson models to estimate association with injury.ResultsNine-hundred-and-sixteen injuries resulted in 3148 missed matches. Injury incidence remained stable apart from a decrease in 2015/16 (p = 0.01). Missed matches were significantly higher in season 2013/14 (55.1 [50.7–59.9]; p < 0.01) and 2014/15 (71.4 [66.4–76.8]; p < 0.001) compared to 2012/13, without differences between other seasons. Player-salary cost ranged between AUD$187,990–AUD$332,680/team, peaking in 2014/15 (p < 0.01). Multi-collinearity was detected for team performance variables except for matches lost. Teams who finished the season with greater positive goal differences were associated with 1% less injuries (p = 0.003). Similarly, more missed matches were associated with 1% less league points and losses (p < 0.001).ConclusionsPlayer-salary costs remained stable, concomitant with stable injury rates and missed matches. Despite injury being associated with goals difference, points and match losses; the magnitude of these relationships are small and team performance is more complex than injury occurrence alone. Injury prevention remains necessary for reducing injury-induced player-salary costs; however, additional services are required to improve team performance.     

Synthetic grass cricket pitches and ball bounce characteristics

The use of synthetic grass cricket pitches is becoming more common at club and sub-elite levels which constitute the majority of cricket participants but there is sparse data on ball bounce characteristics on these surfaces.ObjectivesTo compare the speed, angle and consistency of ball bounce on two types of synthetic cricket surfaces, the Traditional and the All-Seasons, and compare these ball bounce characteristics with published data for natural turf pitches.DesignGroup-based comparison.MethodsHigh speed motion analysis was used to capture data from balls projected onto the cricket pitches from a bowling machine at three speeds: slow (47 km h^?1), medium (72 km h^?1) and fast (104 km h^?1). Both ends of the cricket pitches were assessed and two types of balls were used: 2-piece and 4-piece leather cricket balls. Digitisation was used to determine the ball speed and angle pre and post bounce and then to calculate the ratios of ball speed and angle. Consistency was determined by the coefficient of variation.ResultsThe All-Seasons synthetic surface generated a lower speed ratio and a higher angle ratio than the Traditional synthetic surface. The speed ratio for the Traditional surface fell within the range reported for natural turf, whilst the value for the All-Seasons surface was outside the range. Both synthetic surfaces produced angle ratios greater than those for natural turf surfaces.ConclusionsDifferences were detected between the different synthetic cricket surfaces and also when compared to natural turf. This variability may have implications for skill development as well as safety.     

Use and perception of breast protective equipment by female contact football players

ObjectivesFemale contact football players sustain contact breast injuries that can negatively affect their sporting performance. This study investigated what female contact football players wear on their breasts during training and competition, and their perceptions on the protection provided by these garments against contact breast injury.DesignA custom-designed survey about breast injuries and prevention strategies was distributed via an online link to coaches and team staff of contact football teams throughout Australia. The fit and features of breast support and/or protection that players wore during training and competition were also directly assessed.Methods207 female Australian Football League (AFL), Rugby League, Rugby Union (XVs) and Rugby 7 s players completed the survey. The breast support of 112 of these players was also assessed.ResultsOnly 17% (n = 35) of players reported using breast protective equipment, of which 66% (n = 23) perceived it provided protection against contact breast injuries. Reasons reported for not using protective equipment included not knowing it existed (n = 79, 53%), it was too uncomfortable/hot (n = 50, 24%) and that it did not fit or was restrictive (n = 33, 22%). Although most players (n = 97, 87%) reported to wear a sports bra, 52% (n = 58) wore an ill-fitted bra and only 31% (n = 63) perceived it provided any protection against contact breast injuries.ConclusionsBreast protective equipment is not commonly worn by female contact football players reportedly due to a lack of awareness of its existence, discomfort or poor fit. Although most female contact football players usually wore a sports bra, most players perceived these bras did not provide breast protection.     

Shoulder functional ratio in elite junior tennis players

ObjectiveTo evaluate shoulder rotation strength and compare the functional ratio between shoulders of elite junior tennis players.DesignThis cross-sectional study evaluated muscular rotation performance of 40 junior tennis players (26 male and 14 female) with an isokinetic dynamometer.Main outcome measuresStrength variables of external (ER) and internal rotators (IR) in concentric and eccentric modes were considered. For the peak torque functional ratio, the eccentric strength of the ER and the concentric strength of the IR were calculated.ResultsAll variables related to IR were significantly higher on the dominant compared to the non-dominant side in males and females (p < 0.05), but only boys exhibited this dominance effect in ER (p < 0.05 and p < 0.001). Regarding functional ratios, they were significantly lower for the dominant shoulder (p < 0.001) and below 1.00 for both groups, indicating that the eccentric strength of the ER was not greater than the concentric strength of the IR.ConclusionElite junior tennis players without shoulder injury have shoulder rotation muscle strength imbalances that alter the normal functional ratio between rotator cuff muscles. Although these differences do not seem to affect the athletic performance, detection and prevention with exercise programs at an early age are recommended.     

Evaluation of shoulder joint position sense in both asymptomatic and rehabilitated professional rugby players and matched controls

ObjectiveTo assess if joint position sense (JPS) in the shoulder differed between un-injured rugby players, matched control subjects and previously injured rehabilitated rugby players.DesignMixed design.SettingUniversity biomechanics laboratory.Participants15 asymptomatic professional rugby union players, 15 previously injured professional rugby union players, 15 asymptomatic matched non-rugby playing controls had their JPS assessed.Main outcome measuresJPS was assessed using two criterion angles in the 90° shoulder abduction position (45° and 80° external rotation).ResultsThe study found a significant difference between groups in error score (p = 0.02). The testing angle also had a significant effect on error score (p = 0.002), with greater error scores occurring in the mid range position.ConclusionThis study showed rugby players to have better JPS than controls, indicating JPS might not be related to injury risk. Poor JPS appears to be related to injury, players having sustained an injury have decreased JPS despite surgery and/or rehabilitation and returning to sport without incident.