Sport and active recreation injuries in Australia: evidence from emergency department presentations

OBJECTIVE: Despite the rise in specialist clinical services for the management of sports and active recreation injury, many patients attend hospital emergency departments for treatment. The purpose of this study was to describe sports injury cases presented to selected hospital emergency departments around Australia for the period 1989-1993. METHODS: Routinely collected emergency department injury presentation data from the Australian National Injury Surveillance Unit were examined. Data on 98,040 sports and active recreation emergency department presentations were analysed. Sports and active recreation activities were ranked according to frequency of presentation. Relative proportions of injury type and body region injured were determined. Data are presented separately for children (<15 years of age) and adults (>15 years of age). RESULTS: Among the 10 activities that most commonly led to a sports or active recreation injury presentation for all ages were cycling, Australian football, basketball, soccer, cricket, netball, and rugby. For children, injuries were also commonly associated with roller skating/blading, skateboarding, and trampolining. Hockey, martial arts, and dancing injuries were frequent in adults. Most sporting injuries occurred during organised competition or practice whereas the active recreation injuries occurred in a variety of settings. Fractures, strains, and sprains, particularly to the lower and upper extremities, were common types of injury. CONCLUSION: The rich, but nevertheless limited, information available about sports and active recreation injuries from data collected in emergency departments indicates that these activities are a common context for injury at the community level in Australia.


     

A 7-year study on risks and costs of knee injuries in male and female youth participants in 12 sports

Knee injuries are common and account in various sports for 15-50% of all sports injuries. The cost of knee injuries is therefore a large part of the cost for medical care of sports injuries. Furthermore, the risk of acquiring a knee injury during sports is considered higher for females than for males. The nationwide organization "Youth and Sports" represents the major source of organized sports and recreation for Swiss youth and engages annually around 370000 participants in the age group of 14 to 20 years. The purpose of this study was to combine data on knee injuries from two sources, the first being data on the exposure to risk found in the activity registration in "Youth and Sports" and the second injuries with their associated costs resulting from the activities and filed at the Swiss Military Insurance. This allowed calculation of knee injury incidences, to compare risks between males and females and to estimate the costs of medical treatment. The study comprises 3864 knee injuries from 12 sports during 7 years. Females were significantly more at risk in six sports: alpinism, downhill skiing, gymnastics, volleyball, basketball and team handball. The incidences of knee injuries and of cruciate ligament injuries in particular, together with the costs per hour of participation, all displayed the same sports as the top five for both females and males: ice hockey, team handball, soccer, downhill skiing and basketball. Female alpinism and gymnastics had also high rankings. Knee injuries comprised 10% of all injuries in males and 13% in females, but their proportional contribution to the costs per hour of participation was 27% and 33%, respectively. From this study it can be concluded that females were significantly more at risk for knee injuries than males in six sports and that knee injuries accounted for a high proportion of the costs of medical treatment.     

Martial arts injuries. The results of a five year national survey

A 5 year national survey of martial arts was done using the National Electronic Injury Surveillance System (NEISS). Seventy-four percent of the injuries involved the extremities and 95% were mild to moderate in nature. Even though most of the injury types were contusions/abrasions (36%). lacerations (14%), and sprains/strains (28%), 15% were dislocations and fractures. Five percent of all injuries were severe, and there were 18 hospitalizations. There were no deaths. Weapon-related injuries were rare and never serious. Overall, the risk of serious injury in the sport was found to be low, especially when compared to other contact sports.     

Changing injury pattern of acute anterior cruciate ligament tears treated at Tampere University Hospital in the 1980s

During the years 1980–1989, 450 patients with an acute anterior cruciate ligament (ACL) rupture were treated at the University Hospital of Tampere, Finland. ACL ruptures were diagnosed by arthroscopy or open surgery. The data were analyzed in terms of patient age, sex, injury etiology, injury type and sports activity to determine the trends in the 1980s. The number of ACL tears seen in the Hospital increased by 247% over this period. Sixty-three percent of the patients were male (mean age 33 years) and 37% female (mean age 39 years), and there were no changes in the sex and age distribution in 1980s. The most common injury type was the isolated ACL rupture (51%), followed by a combination injury of the ACL and medial collateral ligament (38%). Isolated ACL ruptures in the 1980s increased 6.5 times. Sports accounted for 54% of all injuries with out any sign of change in their relative proportion in 1980s. The most common sports causing the rupture were soccer (29%), downhill skiing (20%), cross-country skiing (12%) and volleyball (12%). From 1980 to 1989, there was a decrease (2 times) in ACL injuries sustained in crosscountry skiing and a substantial (30 times) increase in ACL injuries sustained in downhill skiing.     

A systematic review on ankle injury and ankle sprain in sports

This article systematically reviews epidemiological studies on sports injury from 1977 to 2005 in which ankle injury was included. A total of 227 studies reporting injury pattern in 70 sports from 38 countries were included. A total of 201,600 patients were included, with 32,509 ankle injuries. Ankle injury information was available from 14,098 patients, with 11 847 ankle sprains. Results show that the ankle was the most common injured body site in 24 of 70 included sports, especially in aeroball, wall climbing, indoor volleyball, mountaineering, netball and field events in track and field. Ankle sprain was the major ankle injury in 33 of 43 sports, especially in Australian football, field hockey, handball, orienteering, scooter and squash. In sports injuries throughout the countries studied, the ankle was the second most common injured body site after the knee, and ankle sprain was the most common type of ankle injury. The incidence of ankle injury and ankle sprain was high in court games and team sports, such as rugby, soccer, volleyball, handball and basketball. This systematic review provides a summary of the epidemiology of ankle injury in sports.     

Pediatric martial arts injuries presenting to Emergency Departments, United States 1990-2003.

Although an estimated 6.5 million United States (US) children aged 6-17 practiced a martial art in 2004, there have been no nationally representative studies comparing pediatric injuries among the three most popular disciplines, karate, taekwondo, and judo. Describe pediatric martial arts injuries presenting to a representative sample of US Emergency Departments (EDs) from 1990 to 2003. We reviewed all martial arts injuries captured by the US Consumer Product Safety Commission's (CPSC), National Electronic Injury Surveillance System (NEISS). An estimated 128,400 children 相似文献   

Injuries among young soccer players

We registered all new injuries among 496 male youth soccer players, aged 12 to 18 years, during the course of one year. The incidence of injury was 3.7 injuries per 1000 hours of soccer per player. The incidence increased with age, and at the higher ages within the youth players, approached the incidence rate of senior players (age greater than or equal to 18 years). Seventy percent of the injuries were located in the lower extremities, particularly the knee (26%) and ankle (23%). Back pain occurred in 14% of players. Fractures, which accounted for 4% of injuries, were most often in the upper extremities. We conclude that youth soccer is a relatively low-risk sport with an injury pattern that differs slightly from that of senior players.     

Injuries in youth amateur soccer and rugby players--comparison of incidence and characteristics

OBJECTIVES: In reviewing the literature on sports injuries, few studies could be found in which exposure related incidences of injury in different types of sport were compared. These studies indicated that ice hockey, handball, basketball, soccer, and rugby are popular team sports with a relatively high risk of injury. The aim of the study was to compare the characteristics and incidence of injuries in male youth amateur soccer and rugby players. METHODS: This prospective cohort study comprised an initial baseline examination to ascertain the characteristics of the players and their level of performance, and a one season observation period during which a physician visited the team weekly and documented all occurring injuries. Twelve soccer and 10 rugby school teams with male amateur players aged 14-18 years were selected for the study. 145 soccer and 123 rugby players could be followed up over one season. RESULTS: Comparison of the incidence of soccer and rugby injuries indicated that rugby union football was associated with a significantly higher rate of injury than soccer. The differences were pronounced for contact injuries, injuries of the head, neck, shoulder, and upper extremity, as well as for concussion, fractures, dislocations, and strains. Rugby players incurred 1.5 times more overuse and training injuries in relation to exposure time, and 2.7 times more match injuries than soccer players. Three rugby players but no soccer players had to stop their participation in sport because of severe injury. CONCLUSION: The incidence of injury in New Zealand school teams playing soccer or rugby union is high, probably in part because of the low ratio of hours spent in training relative to hours spent playing matches. The development and implementation of preventive interventions to reduce the rate and severity of injury is recommended.     

Epiphyseal Fracture in Sports

In this evaluation of 203 acute epiphyseal fractures in the long bones of 183 patients aged 3 to 18, 79 fractures (39%) were related to the following ten sports activities: football, hockey, basketball, downhill skiing, baseball/softball, wrestling, soccer, gymnastics, tennis, and volleyball. An additional 21 fractures occurred in weight lifting, roller skating, ice skating, and skateboarding. Approximately 50% of the fractures in this urban population were sports- related. The symptoms of epiphyseal fractures are the same as symptoms of fractures or ligament injuries in general. Physicians should always consider the possibility of epiphyseal fracture in adolescent injuries.     

Outcome of sports injuries treated in a casualty department.

The present investigation analyses 2493 patients with a sports injury treated in a casualty department during a one-year period. Of the patients 73% were men, the age of the patients averaging 26 years and the mean follow-up time was 24 months. Soccer and indoor ball games caused 24% and 23% of the injuries respectively, these being followed by injuries in ice hockey in 14%. Track and field injuries scored low with 2% out of all injuries. Injuries to the lower extremity predominated. At follow-up, ligamentous injuries of the lower extremity were the major cause of discomfort. Further, in the group of patients with persistent discomfort 36% had suffered a fracture or a dislocation, 13% a contusion and 10% a wound. The mean period of sports incapacity after a sustained injury was 3 weeks. In track and field events the injury seldom disturbed training for more than one week, but in soccer, indoor ball games, skiing and skating the mean sports incapacity period varied between 6 and 3 weeks. Out of the total injured, 2% had to give up their sports activity completely. An injury of the lower extremity demanded on average 4 weeks' rest, an injury of the upper extremity and the trunk 2 weeks and injuries of the head and neck one week's rest. According to the present investigation sports injuries were in the majority of cases of a relatively benign nature and sick leave from work seldom exceeded 2 weeks.     

Incidence and body location of reported acute sport injuries in seven sports using a national insurance database

Sports with high numbers of athletes and acute injuries are an important target for preventive actions at a national level. Both for the health of the athlete and to reduce costs associated with injury. The aim of this study was to identify injuries where injury prevention should focus, in order to have major impact on decreasing acute injury rates at a national level. All athletes in the seven investigated sport federations (automobile sports, basketball, floorball, football (soccer), handball, ice hockey, and motor sports) were insured by the same insurance company. Using this insurance database, the incidence and proportion of acute injuries, and injuries leading to permanent medical impairment (PMI), at each body location, was calculated. Comparisons were made between sports, sex, and age. In total, there were 84 754 registered injuries during the study period (year 2006‐2013). Athletes in team sports, except in male ice hockey, had the highest risk to sustain an injury and PMI in the lower limb. Females had higher risk of injury and PMI in the lower limb compared to males, in all sports except in ice hockey. This study recommends that injury prevention at national level should particularly focus on lower limb injuries. In ice hockey and motor sports, head/neck and upper limb injuries also need attention.     

Injuries in Norwegian female elite soccer: a prospective one-season cohort study

Female soccer has become increasingly popular during the last two decades. According to the International Football Association (FIFA) there are approximately 40 million registered female soccer players in the world. Three studies in elite soccer have shown an injury incidence during games ranging from 12.6 to 23.3 injuries per 1,000 h. A very high incidence of ACL-injuries ranging from 0.31 to 2.2 per 1,000 game hours has also been shown. We followed the Norwegian female elite series during the 2001 season to estimate the incidence and characteristics of injuries. A total of 181 female soccer players on ten teams were followed during the 2001 elite season in Norway. We recorded baseline data, match and training exposure and injury data as type of injury, location and severity of injury. The mean age of the players was 23 years (range 17–34). A total of 189 injuries were recorded and 19 (10%) of these were overuse injuries; 89 (47%) occurred during games and 100 (53%) during training sessions. The incidence of acute injuries was 23.6 per 1,000 game hours and 3.1 per 1,000 training hours. The majority of the injuries occurred in the lower extremities (81%), but there were also a significant number of head injuries (6.3%). The most common injury type was ankle sprain (17.2%). Half of the injuries were minor, with training or game absence of less than 7 days. Midfielders sustained the most injuries (32.6%) with an incidence of 42.4 per 1,000 game hours. We recorded two ACL-injuries and two PCL-injuries during the season. They all occurred during games, and the incidence was therefore calculated to 0.6 per 1,000 game hours for both injury types. The incidences of injuries reported for female soccer varies considerably, with the highest numbers reported from Germany and the present study. These studies have also the highest incidence of minor injuries registered. The location of the injuries is quite similar compared to other reports, but the number of ankle sprains seems to be higher in our study, whereas the number of knee and thigh injuries is lower. There has been much attention to ACL injuries in team handball and hamstring injuries in soccer in Norway, and this could have influenced the team’s pre-season training, resulting in a reduction in the incidence of these injury types. The high number of ankle injuries has to be addressed to see whether this is a result of inadequate rehabilitation routines leading to re-injuries, or other factors. The high number of ACL-injuries in these reports is alarming and needs special attention in the future.     

Unfälle bei großen Mannschaftsballsportarten

Soccer injuries result primarily from the competitive tackling character of this sports discipline. The predominant injuries are contusion trauma, followed by ankle sprains, knee distortions and heading injuries. Particularly serious injuries are caused by sliding tackles. Because of the smaller distances and space in indoor soccer, more goalkeepers are injured due to parrying than in outdoor soccer. Soccer disability cases are primarily injuries to the knee joint caused by various mechanisms, such as twisting of the knee with and without an external influence, falling injuries, unfortunate collisions and sliding tackles. In principle traumatic deaths may occur in any team ball game sport if there is unfortunate body contact between players. Fatal skull and brain trauma injuries in soccer can be differentiated into unfortunate heading actions, the head being directly hit by the ball and direct head-to-head contact with another player as well as collisions against goalposts and other pieces of equipment. Contusion accidents also dominate in handball. Here the so-called rapid counterattack may result in serious injuries due to the high forces involved. Handball disability cases mainly concern the knee joint and severe invalidity is primarily caused by external influences (i.e. the opponent). In volleyball and basketball ankle sprains are the dominating injury types (in volleyball often when stepping on an opponent’s foot), followed by playing the ball, where primarily the fingers are affected. In the USA eye injuries were frequently registered in basketball, due to finger or elbow contact with the opposing players. Severe injuries in rugby affect the head and neck in approximately one-third of the cases, in rare cases with spinal cord involvement. In American football serious injuries resulted especially from a direct attack on the opponent (tackling). After optimization of the football helmet design in the early 1970s, a clear reduction of skull and brain injuries was observed, but unfortunately a massive increase in neck injuries was also registered, because the helmeted head was now used as a weapon in tackling. After changes to the rules in 1978 these injury mechanisms have now declined again.     

Martial arts sports medicine: Current issues and competition event coverage

More sports medicine professionals are becoming actively involved in the care of the martial arts athlete. Although there are many different forms of martial arts practiced worldwide, certain styles have shown a potential for increased participation in competitive-type events. Further research is needed to better understand the prevalence and profiles of injuries sustained in martial arts full-contact competitive events. Breaking down the martial art techniques into basic concepts of striking, grappling, and submission maneuvers, including choking and joint locking, may facilitate better understanding and management of injuries. This article outlines this approach and reviews the commonly encountered injuries and problems during martial arts full-contact competitions.     

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.     

Gymnastic injuries.

In the past 15 to 20 years gymnastics has become very popular. The increased participation exposes a greater number of athletes to potential injury. The risk of gymnastic injuries seems to be proportional to the level of the athletes; the higher the level of gymnastics, the more hours are spent in practice, with a greater exposure time. With the increased risk in gymnastics, the incidence of acute injuries will also increase, and as the skill level increases, the load during the workout will also increase, providing more opportunity for chronic injuries. As in many sports, the ankle is the most injured body part. Some injuries, however, seem to be specific to gymnastics. In gymnastics the upper extremities are used as weightbearing limbs, so high impact loads are distributed through the elbow and wrist joint. Back problems appear to result not only from single episodes of macrotrauma, but also from repeated microtrauma caused by specific impact loads during vaults and hyperextension. Early detection is the key to treating elbow, wrist and back pain in the gymnast. Reinjury following an acute injury may be reduced by allowing for complete rehabilitation before returning to full practice. Some studies indicate that maturation rate could play a potential role in injury predisposition. The combination of periods of rapid growth and intense training could provide for conditions where the gymnast is more injury prone.     

Injuries in martial arts: a comparison of five styles

Objective: To compare five martial arts with respect to injury outcomes.

Methods: A one year retrospective cohort was studied using an injury survey. Data on 263 martial arts participants (Shotokan karate, n = 114; aikido, n = 47; tae kwon do, n = 49; kung fu, n = 39; tai chi, n = 14) were analysed. Predictor variables included age, sex, training frequency (3 h/week v >3 h/week), experience (<3 years v 3 years), and martial art style. Outcome measures were injuries requiring time off from training, major injuries (7 days off), multiple injuries (3), body region, and type of injury. Logistic regression was used to determine odds ratios (OR) and confidence intervals (CI). Fisher's exact test was used for comparisons between styles, with a Bonferroni correction for multiple comparisons.

Results: The rate of injuries, expressed as percentage of participants sustaining an injury that required time off training a year, varied according to style: 59% tae kwon do, 51% aikido, 38% kung fu, 30% karate, and 14% tai chi. There was a threefold increased risk of injury and multiple injury in tae kwon do than karate (p<0.001). Subjects 18 years of age were at greater risk of injury than younger ones (p<0.05; OR 3.95; CI 1.48 to 9.52). Martial artists with at least three years experience were twice as likely to sustain injury than less experienced students (p<0.005; OR 2.46; CI 1.51 to 4.02). Training >3 h/week was also a significant predictor of injury (p<0.05; OR 1.85; CI 1.13 to 3.05). Compared with karate, the risks of head/neck injury, upper extremity injury, and soft tissue injury were all higher in aikido (p<0.005), and the risks of head/neck, groin, and upper and lower extremity injuries were higher in tae kwon do (p<0.001). No sex differences were found for any of the outcomes studied.

Conclusions: There is a higher rate of injury in tae kwon do than Shotokan karate. Different martial arts have significantly different types and distribution of injuries. Martial arts appear to be safe for young athletes, particularly those at beginner or intermediate levels.

     

Type of sport is related to injury profile: A study on cross country skiers,swimmers, long‐distance runners and soccer players. A retrospective 12‐month study

This 12‐month retrospective questionnaire compared the occurrence of sports injuries in 149 cross country skiers, 154 swimmers, 143 long‐distance runners and 128 soccer players aged 15–35 years. Soccer had significantly more injuries (5.1 injuries/1000 exposure hour) than other sports (2.1–2.8, P<0.001). More runners than soccer players reported overuse injuries (59% vs 42%, P=0.005), locating typically in the foot in runners, soccer players and skiers. Swimmers reported overuse injuries in the shoulder more commonly than skiers (40% vs 1%, P<0.001), who also intensively load shoulders. Acute injuries in skiers (80%) and in swimmers (58%), and overuse injuries in skiers (61%), occurred during exercise other than own event. In soccer and running the absence time from sport because of injuries was significantly longer than in skiing and swimming. No severe permanent disabilities occurred due to injury but seven women quit sports because of injury. In conclusion, type of loading is strictly associated with the anatomical location of an overuse injury as shown by the difference in shoulder injury incidence between swimmers and cross country skiers. In some sports, a significant proportion of acute injuries occur in other than the main event.     

Soccer injuries and their mechanisms: a prospective study

In order to study the incidence and mechanisms of injury in soccer and to recommend prophylactic measures, 180 players in a senior male soccer division were followed prospectively for 1 yr. Attendance records for games and practice sessions were kept, and all injuries were examined and treated by the same orthopaedic surgeon. One hundred twenty-four players incurred 256 injuries, mostly sprains and strains of the lower extremities. Of these, 62% were considered minor with ankle sprains being the most common (17%), while 11% were considered major with knee ligament sprains being the most frequent (32%). Overuse injuries were most frequent in the preseason training period. Traumatic leg injuries involved players with inadequate or no shin guards. Of the traumatic knee injuries, 11 of 18 (61%) occurred during a collision; non-contact knee injuries were frequently seen in those players with a history of knee injury and existing instability. Study of injury sequence disclosed that a minor injury was often followed within two months by a major one. In addition, with severe injuries incurred during fouls, the individual causing the penalty was injured. This prospective study suggested that those with knee instability and those allowed to resume play with poorly rehabilitated or clinically unhealed injuries are more apt to sustain further injury. Some injuries can be avoided by using better equipment and by observance of the rules.