Recording injuries among World Cup skiers and snowboarders: a methodological study

No long‐term injury surveillance programs exist for competitive skiing or snowboarding. The objective of this study was, therefore, to compare different methods to record injuries among World Cup athletes in alpine, freestyle, and cross‐country skiing, snowboarding, ski jumping and Nordic combined. Information regarding injuries sustained during the 2006–2007 winter season was recorded through three separate and independent systems: prospective injury reports by technical delegates (TD) from the International Ski Federation, prospective medical team registration by selected teams, and retrospective athlete interviews at the end of the season. A total of 100 unique injuries to 602 World Cup athletes were identified from any of the three recording methods. Of these, 91% were registered through the athlete interviews, 47% by the medical team registration and 27% by the TD reports. Only 20 injuries (20%) were captured by all three methods. A total of 64 time‐loss injuries were registered. The interviews captured 60 (94%), the medical team registration 39 (61%), and the TD reports 23 (36%) time‐loss injuries, while 18 (28%) were registered by all three systems. Retrospective interviews with athletes/coaches regarding injuries during the last 6 months gave the most complete picture of injuries to World Cup skiers and snowboarders.     

Injuries in powder skiing

A Norwegian multicentre study of the winter 1985-1986, when 328 injured skiers were compared with a control population of 316 uninjured skiers, revealed a significantly lower injury risk for skiers on ungroomed than for skiers on groomed slopes. Thirty-seven skiers were injured on ungroomed slopes, and skiers aged 15–29 years were at risk. The population of uninjured powder skiers was significantly younger than the uninjured skiers on groomed slopes. Beginners were significantly overrepresented among the injured powder skiers, but the skiing ability for uninjured powder skiers was significantly higher than for uninjured skiers on groomed slopes. In conclusion, a lower injury risk was recorded for powder skiers than for skiers on groomed slopes, probably due to a higher skiing ability of the powder skiers.     

A comparison of recreational skiing- and snowboarding-related injuries at a Colorado ski resort, 2012/13-2016/17

ABSTRACT

The purpose of this study was to compare injury patterns between recreational skiers and snowboarders. Injured skiers (n = 3,961) and snowboarders (n = 2,428) presented to a mountainside medical clinic, 2012/13-2016/17. Variables investigated for analysis included demographics/characteristics, injury event information, and injury information. Skiers were older than snowboarders (34.3 ± 19.3 vs. 23.2 ± 10.5 years, p < 0.001); a greater proportion of skiers were female (46.3% vs. 27.8%, p < 0.001). Most skiers (84.4%) and snowboarders (84.5%) were helmeted at the time of injury (p = 0.93). Snowboarders were most frequently beginners (38.9%), skiers were intermediates (37.8%). Falls to snow (skiers = 72.3%, snowboarders = 84.8%) and collisions with natural objects (skiers = 9.7%, snowboarders = 7.4%) were common injury mechanisms. Common skiing injuries were knee sprains (20.5%) and head trauma (8.9%); common snowboarding injuries were wrist fractures (25.7%), shoulder separations (9.1%), and head trauma (9.0%). Given that injury patterns significantly differ between sports, it is important for clinicians, ski patrollers, and resorts to develop and deliver sport-specific injury prevention interventions to most effectively decrease injury burden.     

Injuries among elite snowboarders (FIS Snowboard World Cup)

Background

Although snowboarding is already established as an Olympic sport, it is still a developing sport, with new disciplines, more demanding snow installations, and spectacular tricks. A recent study on subjects at Norwegian national elite level showed that injury risk is high and that injuries among competitive snowboarders differ from those seen in recreational snowboarders, with fewer wrist injuries and more knee and back injuries.

Objective

To describe the incidence and type of injuries among female and male snowboarders at international elite level.

Method

At the last race of the Fédération Internationale de Ski Snowboard World Cup, acute injuries resulting in missed participation and overuse injuries influencing performance, were recorded during a retrospective interview (91% response rate). The registration period was from April 2002 (end of season) until March 2003. Exposure was recorded as the number of runs in all disciplines, and the incidence was calculated as number of injuries per 1000 runs.

Results

The 258 athletes interviewed reported 3193 competition days (n = 46 879 runs) in all disciplines. In total, 135 acute injuries were recorded; 62 (46%) during competition in the official disciplines. Of the 135 acute injuries, the most common injury locations were knee (n = 24; 18%), shoulder (n = 18; 13%), back (n = 17; 13%), and wrist (n = 11; 8%). The overall incidence during competition was 1.3 (95% confidence interval 1.0 to 1.7) injuries per 1000 runs; 2.3 (0.9 to 3.8) for big air (n = 10), 1.9 (1.1 to 2.8) for halfpipe (n = 21), 2.1 (1.2 to 3.0) for snowboard cross (n = 20), 0.6 (0.2 to 1.0) for parallel giant slalom (n = 8), and 0.3 (0.0 to 0.7) for parallel slalom (n = 3). The severity of injuries was graded based on time loss (27% lost >21 days) and score on the Abbreviated Injury Scale (AIS) (38% AIS 1, 61% AIS 2 and 1% AIS 3). There were 122 overuse injuries, 38 (31%) of these to the knee.

Conclusion

The injury risk for big air, snowboard cross, and halfpipe disciplines is high, while that for the snowboard slalom disciplines is lower. The injury pattern is different from recreational athletes, with a greater share of knee injuries and fewer wrist injuries. Compared with national level, the injury risk appears to be lower at World Cup level.     

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.     

Current performance testing trends in junior and elite Austrian alpine ski,snowboard and ski cross racers

Alpine winter sports are very popular in Austria, and Austrians have had much international success in alpine ski racing, snowboarding and ski cross. These sports demand high physical fitness levels in all age groups. Sport-specific tests are crucial to effectively monitor training programs and individual fitness. The following article provides an overview of physical testing with a special emphasis on sport-specific tests used in young and elite athletes, such as bench press and pull tests, loaded power test, snowboard and ski cross start test and gliding test.     

Injuries among male and female elite football players

All 12 female football clubs (228 players) and 11 of 14 male clubs (239 players) in the Swedish premier league were followed prospectively during the 2005 season. Individual exposure (playing time), injuries (time loss), and injury severity (days lost due to injury) were recorded by the team medical staffs. Injury incidence was higher for male players during both training (4.7 vs 3.8 injuries/1000 h, P=0.018) and match play (28.1 vs 16.1, P<0.001). However, no difference was found in the incidence of severe injury (absence >4 weeks) (0.7/1000 h in both groups). The thigh, especially the hamstrings, was the overall most commonly injured region in both sexes, while the hip/groin was more commonly injured in male players and the knee in female players. Knee ligament injuries accounted for 31% and 37% of the total time lost from football for male and female players, respectively. In conclusion, male elite players had a higher injury incidence than their female counterparts although no difference was observed in the incidence of moderate to severe injury. We recommend that preventive measures should be focused on hamstring and knee ligament injury in order to reduce the overall injury burden.     

Injury surveillance in male professional football; is medical staff reporting complete and accurate?

Since the 2000 season, an injury surveillance system has been established to monitor injury risk and injury patterns in the Norwegian professional football league. The aim of this study was to assess the accuracy of routine injury registration performed by medical staff in professional football. The team medical staff completed injury registration forms on a monthly basis throughout the 2007 season (January–October). Players were interviewed at the end of the season (October/November) about all injuries that occurred from July through September. Thirteen of fourteen teams, 296 of 310 A‐squad players were interviewed. An injury was recorded when a player was unable to take fully part in football training or match the day after injury. A total of 174 injuries were registered, 123 acute injuries and 51 overuse injuries. Of these, 141 were reported by medical staff and 122 by players. Eighty‐nine injuries (51%) were registered using both methods, 52 (30%) by medical staff only and 33 (19%) by player interviews only. Prospective injury surveillance by team medical staff in Norwegian male professional football underestimates the incidence of time‐loss injuries by at least one‐fifth.     

Mechanical parameters as predictors of performance in alpine World Cup slalom racing

The aims of the present study were to develop a method for classifying slalom skiing performance and to examine differences in mechanical parameters. Eighteen elite skiers were recorded with three‐dimensional kinematical measurements and thereafter divided into a higher (HP) and lower performance group, using the ratio between the difference in mechanical energy divided by the mass of the skier and section entrance velocity (Δe_mech/v_in). Moreover, the skiers' velocity (v), acceleration (a), center of mass turn radii (R_CM) and skis' turn radii (R_AMS), ground reaction forces (GRF) and differential specific mechanical energy [diff(e_mech)] were calculated. v and diff(e_mech) were different between the performance groups (P<0.001 and <0.05), while no inter‐group differences in R_CM, R_AMS, a and GRF were observed. A relationship between R_AMS and diff(e_mech) was demonstrated (r=0.58; P<0.001). The highest GRFs were related to the lowest diff(e_mech) and a was related to GRF (r=?0.60; P<0.001). The Δe_mech/v_in predicted the performance over short course sections. The HP skiers skied with a higher v and a similar range of diff(e_mech). We suggest that shortest R_AMS and the highest GRFs should be reduced in elite slalom in order to increase performance.     

Completion rates and injuries in alpine races during the 1994 Olympic Winter Games

The starting lists for the alpine disciplines during the 1994 Olympic Winter Games in Lillehammer totalled 555 racers, but only 354 of them (64%) completed the different races. The race completion rate was 43% in the slalom, 51% in the giant slalom, 75% in the super giant slalom and 91% in the downhill. In combined downhill/slalom the race completion rate was 60%, but 96% in the downhill and 68% in the slalom part of the combination, respectively. Only three injuries were recorded, all in females. Including the training competitions a total of 1541 runs through the different alpine courses was recorded during the games. This means an injury rate of 1.9 injuries per 1000 runs. For downhill the injury rate was only 1.1 per 1000 runs. If the injury rate is related to the number of skiers who did not finish the race because of falls or skiing errors, the rate was 21.1 injuries per 1000 falls (skiing errors) for all alpine races. In conclusion, the race completion rate was twice as high in downhill as in slalom, and the injury rate was low.     

Prevalence,age at onset,and risk factors of self‐reported asthma among Swedish adolescent elite cross‐country skiers

The objective of the study was to compare the prevalence of self‐reported physician‐diagnosed asthma and age at asthma onset between Swedish adolescent elite skiers and a reference group and to assess risk factors associated with asthma. Postal questionnaires were sent to 253 pupils at the Swedish National Elite Sport Schools for cross‐country skiing, biathlon, and ski‐orienteering (“skiers”) and a random sample of 500 adolescents aged 16‐20, matched for sport school municipalities (“reference”). The response rate was 96% among the skiers and 48% in the reference group. The proportion of participants with self‐reported physician‐diagnosed asthma was higher among skiers than in the reference group (27 vs 19%, P =.046). Female skiers reported a higher prevalence of physician‐diagnosed asthma compared to male skiers (34 vs 20%, P =.021). The median age at asthma onset was higher among skiers (12.0 vs 8.0 years; P <.001). Female sex, family history of asthma, nasal allergy, and being a skier were risk factors associated with self‐reported physician‐diagnosed asthma. Swedish adolescent elite cross‐country skiers have a higher asthma prevalence and later age at asthma onset compared to a reference population. Being an adolescent, elite skier is an independent risk factor associated with asthma.     

Injuries among judokas during competition

AIMS: To investigate the type and severity of injury sustained during judo competitions, and to investigate any possible correlation between injury rate and gender, grade, weight category and rapid weight loss. METHOD: Three hundred and ninety-two judokas (284 males, 108 females) competed in three consecutive competitions. A judoka was "injured" if they requested medical treatment or could not continue. Following injury, a questionnaire was completed. Uninjured judokas were asked to complete a questionnaire at one competition to assess risk factors of injury. Follow-up was conducted 6 weeks after each competition. RESULTS: Fifty-three out of 392 judokas (13.5%) (40 males, 13 females) sustained an injury. No difference was found between injury rates among males (41.3/1000 anthlete-exposures (A-E's)) and females (40.9/1000 A-E's), or between judokas of different weight groups or grades. Rapid weight loss of 5% or more of a judoka's body weight placed the athlete at a higher risk of injury (P=0.022). Most injuries affected the upper extremities. Injuries most often resulted from grip fighting, being thrown, or attempting to throw. CONCLUSIONS: Judokas are advised not to lose weight before a competition as this increases the risk of injury. Neither grade, nor gender, or weight category are associated with an increase in injury rate.     

Epidemiology of injuries in Portuguese senior male rugby union sevens: a cohort prospective study

Objectives: To assess the incidence, type and location of injuries sustained during the Portuguese rugby union sevens circuit. To investigate the influence of players’ training loads on injury risk.

Methods: A prospective cohort study recording time-loss injuries was conducted with all teams competing in the Portuguese national rugby sevens circuit (eight from the top-tier and seven from the second-tier). Main outcome measures included: incidence rate, anatomical location, type, injury incident and severity. Data were also collected regarding players’ training loads. Fisher’s exact test was used to estimate the relative risk of suffering an injury during the sevens season and training sevens during the fifteens season.

Results: A total of 27 injuries were recorded corresponding to an incidence rate of 133.9 injuries per 1000 player match-hours. The average severity was 22.22 days. Contact events preceded 81.5% of injuries. Most injuries occurred in the lower limb (66.7%) and were joint/ligament or muscle/tendon injuries (85.1%). The association between injuries and lower volume of training during the sevens season was identified for the second-tier (p = 0.021). For the same level, an inverse relation between training hours and injury severity was also found (p = 0.008). Top-tier players training sevens and fifteens simultaneously during the year presented a significant increase of injury risk (relative risk = 3.2; p = 0.011).

Conclusions: Injury incidence in our study is similar to that reported for international sevens, although severity is lower. An association between training loads and the occurrence of injuries was found for both tiers, although with differential results, thus reinforcing the need to customize players’ preparation. Further studies at non-elite competitions are needed to gather significant data to accurately formulate future injury prevention protocols or recommend modifications to game laws or competition formats, aiming at players’ welfare.     

No holds barred sport fighting: a 10 year review of mixed martial arts competition

Objective

To identify the most salient medical issues that may be associated with mixed martial arts competition by determining the types and proportions of match stoppages.

Methods

Publicly available video footage of 1284 men competing in 642 consecutive televised matches from November 1993 to November 2003 was reviewed to determine the reasons for which matches were stopped. Matches were sanctioned by either a United States or Japan based mixed martial arts organisation.

Results

Of the 642 matches, 182 (28.3±3.4%) were stopped because of head impact, 106 (16.5±2.9%) because of musculoskeletal stress, 91 (14.1±2.7%) because of neck choke, 83 (12.9±2.6%) because of miscellaneous trauma, 173 (27.0±3.4%) because of expiration of match time, and seven (1.0±0.8%) because of disqualification, where the values in parentheses are percentages±95% confidence interval.

Conclusions

Blunt force to the head resulted in the highest proportion of match stoppages. Further research is warranted to delineate the morbidity associated with participation in mixed martial arts.     

Risk for injury when playing in a national football team

The Swedish male senior national football team was followed prospectively between 1991 and 1997. During these 6 years, the team played 73 official matches and had three training camps. The senior author (J. E.) attended 57 of these matches and the three training camps and these matches and training camps, are included in the present study. Exposure to football was recorded individually for each player. The team physician examined all injuries. Total exposure was 7245 h (6235 training and 1010 match hours) and there were 71 injuries (40 training and 31 match injuries). Five (16%) of the match injuries were major, with more than 4 weeks of absence from football. The injury incidence during training was 6.5/1000 h and the injury risk during matchplay was 30.3/1000 h. A significantly higher injury incidence was found for matches lost compared to matches won or drawn (52.5 vs. 22.7/1000 h, P=0.026). No statistically significant difference for injury was found between competitive matches and friendly matches. No difference was found between home and away matches or matches on neutral ground. The risk for injury when playing in a national team compares with previously reported figures for professional football at a high level.     

Injury pattern in youth team handball: a comparison of two prospective registration methods

The purpose of this study was to examine the injury incidence and pattern of injuries in youth female and male team handball players using two different prospective registration methods; match reports (90 teams, 1080 players) and coach reports (34 teams, 428 players). A total of 118 injuries were recorded by the coach report, of which 93 (79%) were acute injuries (incidence training: 0.9+/-0.16 injuries/1000 player hours; matches: 9.9+/-1.26; rate ratio vs training: 10.8 [95% confidence interval (CI) 7.0-16.6]; P<0.0001) and 25 (21%) were overuse injuries. Knee (26%) and ankle (24%) injuries accounted for half of the acute injuries (training: 0.5+/-0.12 injuries/1000/h; matches: 4.4+/-0.84; rate ratio vs training: 8.0 (95% CI 4.5-14.5); P<0.0001). No gender difference was found in the injury rate (rate ratio female vs male: 1.3 (95% CI 0.8-2.1); P=0.40). Most of the injuries occurred in the attacking phase by back or wing players doing a plant-and-cut, landing or turning movement, and more than half in contact situations with the opponent. Similar results were observed for acute match injuries in the match report. These results indicate that the rate of injuries in youth team handball is as high as at the senior level, and prevention should focus on knee and ankle injuries. The coach report seems to be the best method to register injuries in youth team handball to provide a full spectrum of injuries according to their type, incidence and severity.