Evaluation of adolescent sport specialization and injury mechanism by sex: A secondary analysis

ObjectivesThe purpose of this study was to compare the association of sport specialization with previous overuse and acute injuries between male and female adolescent athletes.DesignCross-sectional study.MethodsQuestionnaires were completed by adolescent athletes from various sports at sport club summer events in the state of Wisconsin. Adolescent athletes (12–18 years old) who were active in organized sports in the previous year were recruited. The questionnaire contained demographics, sport participation, sport specialization classification, and previous injury history. Sport specialization classification was determined using common methods in sport specialization research. Previous injury was restricted to athletic injuries that occurred in the past year.ResultsTwo-thousand and eleven participants (age = 13.7 ± 1.6 years, females = 989) completed the questionnaire. Highly specialized athletes were more likely to report both acute and overuse injuries compared to low specialization athletes. However, this relationship differed by sex, with only moderate and highly specialized females being more likely (Moderate: OR [95%CI] = 1.74 [1.18–2.58], p = 0.005; High: OR [95%CI] = 1.69 [1.14–2.53], p = 0.010) to report an overuse injury compared to low specialization females. Highly specialized female athletes were more likely to report an acute injury (High: OR [95%CI] = 1.46 [1.06–2.02], p = 0.022) compared to low specialization females. Highly specialized male athletes were not associated with overuse or acute injuries.ConclusionsHighly specialized athletes were more likely to report acute and overuse injuries. However, when this analysis was separated by sex, only highly specialized females were more likely to report a previous overuse or acute injury.     

Proprioceptive abilities improve in expert skiers and snowboarders from early-season to mid-season

ObjectivesTo determine whether the proprioceptive ability of advanced and expert snowsport participants increased with time on-snow, and whether gender, age, snowsport discipline and/or previous ankle injury were factors in proprioceptive ability at the start of the winter snow season (T1, n = 80) compared to mid- season (T2, n = 39).DesignObservational studyMethodParticipants completed a questionnaire at T1, and proprioception was measured at T1 and T2 by the Active Movement Extent Discrimination Apparatus (AMEDA), which tests lower limb proprioception.ResultsAt T1 there was no significant difference between the proprioception scores of the two cohorts of advanced and expert snowsport participants, between females and males, younger and older age groups, nor between alpine skiers and snowboarders. At T2, after a minimum of 5 weeks on-snow, the whole group had improved their proprioception by 0.04 (p < .0001) as measured by the AMEDA. Groups undertaking different snowsport disciplines achieved different gains across the season, with minimal change of 0.02 in skiers (p = .056), while snowboarders and mixed ski/snowboard participants gained 0.05 (p = .034) and 0.06 (p = .005) (η² 0.63 and 0.47 respectively). Males, females, instructors and elite youth participants all improved their proprioception by mid-season (η² 0.29−0.46).ConclusionsAmongst an established group of snowsports participants, lower limb proprioception is a consistent skill that is equally well developed in all cohorts. Several weeks of regular snowsport exposure improves this proprioceptive acuity amongst snowboarders, and those who mix snowboarding with skiing. Exposure to a prolonged period of snowsport improves proprioception, with benefits to neuromuscular control mechanisms.     

Verletzungen beim BMX Freestyle

BackgroundBMX Freestyle developed in the 1970s as an independent fun sport. Today Contests in 4 main disciplines are organized and can be distinguished bei different injury pattern.Materials and MethodsIn an online survey the starters of the BMX-Masters® 2011 were asked about their training habits and injuries within a 1 year period.ResultsAll questioned athletes (n = 28) suffered injuries or chronic overuse disorders. Most frequently occured skin injuries and contusions (100%), followed by distorsions (32%). Severe Injuries like fractures (14%) an dislocations (7%) were relatively rare.ConclusionBMX freestyle is a high risk sport with a high number of minor injuries. Severe injuries occur less frequently.Level of evidenceV; case series     

A decade of head,neck and facial cricket injury hospitalisations in Victoria,Australia: From 2007/08 to 2016/17

ObjectivesTo present an epidemiological profile of hospital-treated head, neck and facial cricket injuries from 2007/08 to 2016/17 in Victoria, Australia.DesignRetrospective analysis of emergency department and hospital admission data.MethodsAn analysis of Victorian hospital-treated head, neck and facial cricket injuries of all cricket participants over 5 years old between July 2007 and June 2017.ResultsOver the decade, 3907 head, neck, facial (HNF) cricket injuries were treated in Victorian hospitals. The number of HNF cricket injuries substantially increased in the 2014/15 season from 367 to 435 injuries and remained over 400 in the subsequent years. More injuries were reported for male compared to female participants, 3583 compared to 324 injuries. When adjusted for participation in competitive cricket, the injury incidence rate was 1.3 per 1000 participants for males and 0.4 per 1000 participants for females. The 10−14 year age group most frequently required hospital treatment. Open wounds were the most common type of injury (1166, 29.8%) and the main mechanism for HNF cricket injury for this decade was hit/struck/crush (3361, 86.0%).ConclusionsThis study provides a novel and current insight of the incidence and details of HNF injuries among cricket participants in Victoria over a decade. It is evident that males and younger participants, regardless of gender, have a higher risk of sustaining a HNF injury. This study provides a solid evidence base for stakeholders in developing strategies to minimise head, neck and facial injuries to make cricket a safe sport for all.     

Schneesportverletzungen im Schulsport. Möglichkeiten der Prävention

During a period of ten years (2000 - 2009) 1522 school sports injuries have been reported to the health insurance agency (Allgemeine Unfallversicherungsanstalt) from all secondary schools in Tyrol. The major disciplines were ski (48%, n = 734), ice skating (23%, n = 349) and snowboard injuries (21%, n = 315), followed by tobogganing (6%, n = 91), cross-country skiing (1%, n = 17) and other snow sports (1%, n = 16). Preventive measures such as a fitness and coordinative training prior to winter sport courses, appropriate breaks and proper protective gear (i.e. helmet and spine protector) may reduce the injury rate in snow sport.     

Monitoring of sport participation and injury risk in young athletes

ObjectivesCareful modulation of training characteristics in high-level sports optimizes performance and avoids inappropriate workloads and associated sports injury risk. The aims of this study were to compare sport participation characteristics in different youth sport categories and to investigate their relationship with injury.DesignProspective cohort follow-up.MethodsYoung (12–19 years) high-level athletes (n = 154) from a regional sport school were followed during 41 weeks regarding sport participation characteristics and traumatic and overuse sports injuries (time-loss definition). All data were self-recorded by the athletes in an electronic system “TIPPS” (Training and Injury Prevention Platform for Sports) and subject to a systematic data quality control. Volume and intensity (self-rated perceived exertion) of each sport session were used to compute weekly load, monotony and strain. Sport categories were defined as team, racket, and individual sports.ResultsAll sport participation characteristics were dependent on sport category (p < 0.05). Weekly intensity, load and strain were dependent on age (p < 0.05). Racket and individual sports were associated with lower injury risk (HR = 0.37 and 0.34, p = 0.001 and p < 0.001, respectively) compared to team sports. Average sport participation characteristics were not related to injury according to the survival analysis. However, intensity during the week prior to injury was significantly higher (p < 0.01) compared to that of the 4 preceding weeks.ConclusionsThis study investigated for the first time the relationship between sport participation pattern and injury risk in young athletes. The monitoring method was sensitive to variations according to pertinent variables and might help identify athletes with increased sports injury risk.     

Catastrophic spine injuries in sports

Catastrophic spine injuries in sports are rare but tragic events. The sports with the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing and snowboarding, rugby, cheerleading, and baseball. A common mechanism of injury for all at-risk sports is an axial compression force to the top of the head with the neck slightly flexed. We review common mechanisms of injury and prevention strategies for spine injuries in the at-risk sports.     

About some factors influencing safety mattress performances in head impact collisions: A pilot study

ObjectivesIn recreational snow sports activities, safety mattresses are placed on obstacles to prevent injuries from a collision with users. However, the performances of these devices in field conditions remain unclear. The objective of this study is to evaluate the effect of mattress thickness, impact speed, impacting mass and atmospheric conditions on head acceleration during an in-field impact on safety mattress.Design42 in-field experimental drop tests of a normative metallic head were conducted on safety mattress to assess the influence of impact speed (5.8 m/s or 7.3 m/s), impacting mass (6 kg or 11.6 kg), outside conditions (3 conditions) and mattress thickness (24 cm, 32 cm, 44 cm) on head acceleration at impact.MethodsLinear accelerations were measured and Head Injury Criteria 15 ms (HIC₁₅) was computed. A statistical analysis (ANOVA) was used to characterize the effects of the varying parameters on maximal acceleration and HIC₁₅.ResultsReduced impact speed, increased mattress thickness and change in the outside conditions significantly decreased the head acceleration and HIC₁₅ (p < 0.001). The effect of the impacting mass on head acceleration was not significant.ConclusionsThis study highlights the influence of impact speed, atmospheric condition and mattress construction on absorption capacities of safety mattresses. It is a first step toward a better understanding and evaluation of safety mattresses performances.     

Is sport enough? Contribution of sport to overall moderate- to vigorous-intensity physical activity among adolescents

ObjectivesThis study examined the contribution of sports participation to overall moderate-to-vigorous physical activity (MVPA) among adolescents, and explored potential moderators.DesignCross-sectional observational study using survey and accelerometry data drawn from the NEighbourhood Activity in Youth (NEArbY) study.MethodsAdolescents (n = 358) were recruited from secondary schools in Melbourne, Australia. Average min/day in MVPA was assessed using accelerometry. Participants self-reported sports participation (number of teams, type, frequency, and months of participation). Regression models determined the percent variance in MVPA explained by the sport variables, adjusted for wear time, age and sex, and accounting for clustering at the school level. Additional analyses tested if age, sex, body mass index (BMI), and socioeconomic status (SES) moderated relationships between sport variables and MVPA.ResultsParticipants (mean 15.3 years, 59% female) spent a mean (SD) of 68.6 (27.4) min/day in MVPA and 50% reported participating in any sport. Those who participated in sport did so 3.4 times/week on average and accumulated 7 min/day of MVPA more than those who did no sport. For each additional sport participated in, on average, there were approximately 5 additional min/day of MVPA. The number and frequency of sports participation explained 3.2% and 3.8% of the variance in MVPA respectively. Participation in field hockey and gymnastics explained 2.2% and 3.6% of the variance in MVPA, respectively. There were no moderating effects.ConclusionsSport appears to make a very small contribution to adolescents’ average daily physical activity. Effectiveness of approaches to increasing youth population levels of physical activity via sports participation needs to be tested.     

Survey of sport participation and sport injury in Calgary and area high schools.

OBJECTIVE: To examine (1) sport participation and (2) sport injury in adolescents. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective survey design. In total, 2873 adolescents were recruited from a random sample of classes from 24 Calgary and area high schools. Each subject completed an in-class questionnaire in March 2004. MAIN OUTCOME MEASUREMENTS: Overall and sport-specific participation rates (number of sport participants/number of students completing survey). Overall and sport-specific injury rates (number of injuries/number of participants). RESULTS: In the previous 1 year, 94% of students participated in sport. The top 5 sports by participation for males were basketball, hockey, football, snowboarding, and soccer, and for females, basketball, dance, volleyball, snowboarding, and soccer. The injury rate including only injuries requiring medical attention was 40.2 injuries/100 adolescents/y (95% CI, 38.4-42.1), presenting to a hospital emergency department was 8.1 injuries/100 adolescents/y (95% CI, 7.1-9.2), resulting in time loss from sport was 49.9 injuries/100 adolescents/y (95% CI, 48-51.8), and resulting in loss of consciousness was 9.3 injuries/100 adolescents/y (95% CI, 8.3-10.5). The greatest proportion of injuries occurred in basketball, hockey, soccer, and snowboarding. The top 5 body parts injured were the ankle, knee, head, back, and wrist. The top 5 injury types were sprain, contusion, concussion, fracture, and muscle strain. A previous injury was associated with 49% of the injuries and direct contact with 45% of injuries. CONCLUSIONS: Rates of participation in sport and sport injury are high in adolescents. Future research should focus on prevention strategies in sports with high participation and injury rates to maximize population health impact.     

Athletes using ergogenic and medical sport supplements report more favourable attitudes to doping than non-users

ObjectivesOur study objectives were twofold: 1) examine whether users and non-users of different types of sport supplements vary in doping attitudes and sport supplement beliefs, and 2) determine whether the type of sport supplement is directly and indirectly (via sport supplement beliefs) related to doping attitudes.DesignCross-sectional survey.MethodsAthletes (N = 557; 77% male, mean ± standard deviation; age = 20.8 ± 4.5 years, training = 5.7 ± 4.2 h per week, competing = 11.1 ± 5.2 years) completed measures of sport supplement use, sport supplement beliefs, and doping attitudes. Sport supplements were classified into: ergogenic, medical, sport food and drinks, and superfoods.ResultsCompared to non-users, users of ergogenic (d = 0.31, p < 0.01) and medical (d = 0.42, p < 0.01) sport supplements reported more favourable attitudes towards doping. In addition, compared to non-users, users of ergogenic (d = 1.10, p < 0.01), medical (d = 0.80, p < 0.01) and sport food/drink (d = 0.58, p < 0.01) supplements reported stronger beliefs in the effectiveness of sport supplements to improve sport performance. Use of ergogenic, medical and sport food/drink supplements was indirectly related to doping attitudes via sport supplement beliefs.ConclusionsResearchers examining the relationship between sport supplement use and doping should differentiate between sport supplement types to improve measurement accuracy. Sport practitioners administering ergogenic and medical sport supplements to athletes may need to provide additional anti-doping education to counteract any favourable attitudes towards doping.     

Participation in pre-injury level sport one-year following sport-related concussion: A prospective,matched cohort study

ObjectivesTo estimate the times taken to receive clearance to return to sporting activity and to return to pre-injury level of sport competition following sport-related concussion, and to estimate the proportion of athletes who were participating at their pre-injury level of sport competition six months and one-year following sport-related concussion.DesignProspective cohort study.MethodsAmateur, adult athletes (16–38 years old) were diagnosed with sport-related concussion at a university-affiliated hospital emergency department. Participants were assessed within one-week, upon medical clearance to return to sporting activity, two weeks following return to sporting activity, six months, and 12 months following sport-related concussion. We assessed sex-, age-, and activity-matched non-injured, control participants at matched time-points. Participants were asked during each study assessment whether they were participating in any sport, in a different sport than before their sport-related concussion, in the same sport but at a lower level of competition than before their sport-related concussion, or in the same sport at the same level of competition than before their sport-related concussion.ResultsFifty concussed participants and 50 non-injured, control participants completed the study. The median times taken to receive clearance to return to sporting activity and to return to pre-injury level of sport competition following sport-related concussion were 13 days (95%CI = 12,16) and 31 days (95%CI = 28,32), respectively. One-year following sport-related concussion, 52% of participants reported that they were no longer participating in the same sport and at the same level of competition as they were before their sport-related concussion, compared with only 24% of participants in the non-injured, control group (p = 0.003).ConclusionsA greater percentage of athletes in the concussion group were not participating at their perceived pre-injury level of sport competition one-year following sport-related concussion compared with a non-injured control group. Factors that explain the lower proportion of amateur athletes participating at their pre-injury level of sport competition one-year after sport-related concussion are likely multifaceted and should be considered in future investigations.     

Injury risk is different in team and individual youth sport

ObjectivesThis study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries.DesignProspective cohort follow-up.MethodsPupils from a public sports school (12–19 years) were recruited over two separate school years (2008–2009: 42 weeks, n = 199 athletes; 2009–2010: 40 weeks, n = 89 athletes). Training and competition volume and intensity were recorded via a personal sports diary. Sports injuries (time-loss definition) were registered by medical staff members using a standardized questionnaire.ResultsInjury incidence was significantly higher in team compared with individual sports (6.16 versus 2.88 injuries/1000 h, respectively), as a result of a higher incidence of both traumatic (RR = 2.17; CI95% = 1.75–2.70; p < 0.001), and overuse injuries (RR = 2.06; CI95% = 1.46–2.91; p < 0.001). A Cox proportional hazards regression revealed that team sports participation had a hazard ratio of 2.00 (CI95% = 1.49–2.68; p < 0.001) compared to individual sports, with additionally previous injury being a risk and age a protective factor. The number of competitions per 100 days was significantly higher in team sports, whereas the number of intense training sessions per 100 days was significantly lower. In team sports, the number of competitions per 100 days was positively associated with injuries (HR = 1.072; CI95% [1.033; 1.113]; p < 0.001), while in individual sports the number of competitions per 100 days had a protective effect (HR = 0.940; CI95% [0.893; 0.989]; p = 0.017).ConclusionsTeam sports participation entailed a higher injury risk, whatever the injury category. Further research should elucidate the role of characteristics related to sport participation in injury causation.     

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.     

Isokinetic resistance training combined with eccentric overload improves athletic performance and induces muscle hypertrophy in young ice hockey players

ObjectivesTo determine the combined effects of slow isokinetic resistance training and eccentric overload and compare it to traditional resistance training on strength, power, body composition and muscle hypertrophy in young ice hockey players.DesignExperimental, randomized trial.MethodsTwenty-two resistance-trained ice hockey players (18 ± 1 year) were assigned to either isokinetic resistance training and eccentric overload (ISO/ECC; n = 11) or traditional resistance training (TRAD; n = 11). Participants underwent supervised progressive resistance training for 8 weeks (2–3 sessions/week) involving lower body multiple-joint exercises (heavy squats and explosive jump squats). The ISO/ECC group performed their training using a computerized robotic engine system (1080 Quantum synchro, Sweden), whereas the TRAD group performed the same resistance exercises with isotonic loading. Before and after the intervention, participants were evaluated in 1RM back squat, loaded jump squats, sprint- and jump performance, body composition and muscle thickness using ultrasound measurement.ResultsSimilar moderate increases in 1RM back squat and power output in the jump squats were found in both the ISO/ECC and TRAD groups (11–17%, P < 0.01), whereas only the ISO/ECC group showed improvements in drop jump performance (9.8%, P = 0.01). Moreover, similar trivial changes in body composition were observed in both groups, while only the ISO/ECC training group increased muscle thickness in the vastus intermedius (P = 0.01) and rectus femoris muscles (P = 0.03).ConclusionsBoth modalities effectively increased maximal strength and power output, whereas isokinetic resistance training, combined with eccentric overload, improved drop jump performance and induced greater muscle hypertrophy than traditional training in young ice hockey players.     

The associations of early specialisation and sport volume with musculoskeletal injury in New Zealand children

ObjectiveTo investigate associations of early specialisation (highly specialised before age 13 years) and sport participation volume with injury history in New Zealand children.DesignCross-sectional survey study.MethodsChildren attending a national sports competition were invited to complete a questionnaire capturing specialisation level (high, moderate or low), participation volume and injury history. Multiple logistic regression was used to investigate associations between variables.ResultsNine hundred and fourteen children (538 female) completed the questionnaire. After adjusting for age, sex and hours of weekly sport participation, the odds of reporting an injury history were not significantly higher for early specialised children compared to children categorised as low specialisation (OR = 0.88; CI = 0.59–1.31; p = 0.53). Participating in more hours of sport per week than age in years (OR = 2.42; CI = 1.27–4.62; p = 0.02), playing one sport for more than 8 months of the year (OR = 1.60; CI = 1.07–2.36; p = 0.02), or exceeding a 2:1 weekly ratio of organised sport to recreational free-play hours (OR = 1.52; CI = 1.08–2.15; p = 0.02), increased the odds of reporting a ‘gradual onset injury’.ConclusionEarly specialisation in one sport did not increase the odds of reporting a history of injury. Exceeding currently recommended sport participation volumes was associated with increased odds of reporting a history of gradual onset injury.