The public health impact of injury during sport and active recreation

Injuries can be an adverse outcome of participation in sport and recreational activities. The aim of this study was to determine the public health impact of injury during sports and active recreation injury in a select population in Australia. A random household telephone survey was conducted quarterly over a 12-month period in a well-defined geographic region, the Latrobe Valley, Australia. Information was collected on participation in sport and active recreation and associated injuries over the previous 2 weeks for all household members aged over 4 years. Injury rates were calculated per 10,000 population and per 1000 sports participants. Data were collected on 1084 persons from 417 households. Overall, 648 people reported participating in at least one sport or active recreation and 34 (5.2%, 95% CI: 4.8, 5.6%) of these sustained an injury during this activity. Overall, 51.4% of injured cases had a significant impact: 26.5% sought treatment, 34.4% had their activities of daily living adversely affected and 36.0% had their performance/participation limited. Cricket (51 injuries/10,000 population), horse riding (29/10,000 population) and basketball (25/10,000 population) had the highest injury rates. After adjusting for participation, cricket (242 injuries/1000 participants), horse riding (122/1000 participants) and soccer (107/1000 participants) had the highest injury rates. Cricket and soccer were the sports most associated with ‘significant’ injuries. Injury prevention efforts should be aimed at team ball sports (especially cricket, soccer and netball) because of their comparatively high rate of both overall and ‘significant’ injury.     

Epidemiology of medically treated sport and active recreation injuries in the Latrobe Valley, Victoria, Australia

OBJECTIVE: To quantify and describe medically treated sport and active recreation injuries in a defined region of the Latrobe Valley from 7 November 1994 to 6 November 1995. METHOD: A geographic target area was defined, restricted to the six postcodes that fell wholly within the catchment area of the Latrobe Regional Hospital. Data describing medically treated sport and active recreation injuries to Latrobe Valley residents aged over 4 years (about 70,000) were selected by postcode from three sources: the Victorian Admitted Episodes Dataset (hospital admissions), the Victorian Injury Surveillance System (presentations to hospital emergency departments), and the Extended Latrobe Valley Injury Surveillance (ELVIS) project (presentations to general practitioners). RESULTS: At least 2300 cases of medically treated sport and active recreation injury were recorded. This corresponds to a hospital admission rate of 16/10,000 population, emergency department presentation rate of 169/10,000 population, and a general practitioner presentation rate of 187/10,000 population. There were more male patients than female, and younger age groups were also overrepresented, but these data may reflect the greater participation of these groups in sport and active recreation. Australian football was associated with the highest number of injuries (accounting for 24.0% and 22.0% of presentations to emergency departments and general practitioners respectively) followed by cycling (15.7% and 12.6%) and basketball (17.5% and 13.5%). CONCLUSIONS: This study shows that routine health sector data collections in defined populations can provide useful information on the size, distribution, and characteristics of the problem of sport and active recreation injuries at the community level. However, all current health sector systems for injury data collection and surveillance require attention to improve case capture and identification and data quality.     

Incidence of serious injury and death during sport and recreation activities in Victoria, Australia

Background: Participation in sport and recreation is widely encouraged for general good health and the prevention of some non-communicable diseases. However, injury is a significant barrier to participation, and safety concerns are a factor in the decision to participate. An understanding of the sport/recreation activities associated with serious injury is useful for informing physical activity choices and for setting priorities for the targeting of injury prevention efforts. Objectives: To describe the epidemiology of serious injuries sustained in sport/recreation activities by adults in Victoria, Australia. Methods: The Victorian State Trauma Registry and the National Coroner''s Information Service were used to identify and describe sport/recreation related serious injuries, including deaths, occurring during the period July 2001 to June 2003. Age adjusted rates of serious injury and death were calculated using participation figures for each sport and general population data. Results: There were 150 cases of serious injury and 48 deaths. The rates of serious injury and death were 1.8 and 0.6 per 100 000 participants per year respectively. Motor, power boat, and equestrian sports had the highest rates of serious injury. Most deaths were due to drowning. Conclusion: Although the risk of serious injury through sport/recreation participation is low, motor, power boat, and equestrian sports should be priorities for further research into injury prevention. Most sport/recreation related deaths are due to drowning, highlighting this area for prevention efforts.     

Prevalence of injuries among young adults in sport centers: relation to the type and pattern of activity

The rate of injuries resulting from physical exercise in sport centers as well as related factors has not yet been described. The aims of this study were to describe the prevalence of self‐reported activity‐specific injuries, to identify the relations between injury profile and different types and patterns of physical activity and to assess whether gender is a modifying variable in that connection. Four hundred and fifty‐seven men and women aged 20–35 years participated in this cross‐sectional study. A questionnaire was used to evaluate the types and patterns of physical activity performed in the 12 months preceding the study and sports injuries sustained during that time. One hundred and ninety of the 457 subjects reported an injury as a result of exercising (41.6%). A relationship was found between weight training and injuries of the upper extremity (UE) for men and between spinning classes and knee injuries for women. Among those who participated in weight‐training exercises, more frequent and longer duration exercise was associated with UE injury, and among those who participated in spinning classes more frequent exercise was associated with knee injury. Future injury prevention programs in sport centers should pay special attention to men who participate in weight training and to women who participate in spinning classes.     

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.     

Nonelite exercise‐related injuries: Participant reported frequency,management and perceptions of their consequences

This mixed methods study explored the frequency of sport/exercise‐related injuries in nonelite sport, participant‐reported management and perceptions of potential injury consequences. Focus group participants, who trained two to four times a week and had previously sustained musculoskeletal sports‐related injuries, reported seeking medical advice secondary to advice from teammates or online research. General practitioners were viewed as gatekeepers to specialist secondary care and less able to effectively treat sport‐related injuries. Participants displayed limited awareness of potential future implications of injury, and considered physical and psychological benefits of exercise more valuable than potential injury‐associated risks. In the survey of physically active people, over half reported sustaining an exercise‐related injury (562/1002, 56%). Previously injured respondents were less likely to consider consulting a health professional for injury‐related advice than those with no injury history (45% vs 64%; P < 0.001) and more likely to continue exercising despite injury (51% vs 37%; P < 0.001). Concerns about injuries largely related to short‐term issues; only 32% were concerned about possible long‐term joint problems including osteoarthritis. Exercise‐related injury was common in nonelite exercise participants. There was some dissatisfaction with care pathways for sports‐related injuries and a lack of awareness about appropriate injury management and potential consequences of injury, particularly in the long‐term.     

Factors influencing sport participation among athletes with spinal cord injury

OBJECTIVE: This exploratory study examined the relationships between pre- and post-injury sport participation among active individuals with spinal cord injury (SCI) in the United Kingdom. In particular, factors that influence individuals with SCI into sport were identified. METHODS: A total of 143 British individuals with SCI currently participating in wheelchair basketball, wheelchair rugby, wheelchair tennis, and wheelchair athletics were recruited. A total of 112 subjects were active prelesion, and 31 subjects were inactive preinjury. A Disability Sport Participation questionnaire developed by the authors was used for data collection. The questionnaire was distributed through the British Wheelchair Sport Associations. Personal, impairment, health and fitness, socialization, and participation data of athletes with SCI were collected. Groups of active preinjury and inactive preinjury were compared. RESULTS: For athletes who had been active pre-SCI, the in-hospital rehabilitation program and specialized sport club for people with disabilities were more important contexts for introducing the sport after injury to individuals. Friends and peers with disabilities were much more influential as initial and continuing socialization agents than rehabilitation therapists. The main reasons for athletes with SCI who participated in sports after injury were for fitness, fun, health, and competition, although many athletes noted that social aspects and rehabilitation also influenced their sport participation. CONCLUSION: This study identified social contexts, social agents, difficulties, sources of information, and reasons for sport participation of athletes with SCI. The results may offer some directions for the improvement of rehabilitation programs for people with SCI and also help the development of appropriate strategies to encourage people with SCI to participate in sports and leisure activities.     

Prevalence,incidence and course of lower extremity injuries in runners during a 12‐month follow‐up period

To describe the incidence, 12‐month prevalence, and course of lower extremity injuries that occurred during and after the Amgen Singelloop Breda in 2009. The design was based on a prospective cohort study with a population‐based setting. In total, 3605 registered runners received a web‐based baseline questionnaire of which 713 participants completed and returned it. Information about previous injuries, training programs, and demographic data were gathered at baseline. Site and intensity of running injuries and occurrence of new injuries were obtained from five post‐race questionnaires. The main outcome measurement was lower extremity injury. The incidence of running injuries during the Amgen Singelloop Breda itself was 7.8%; most of these injuries occurred in the calf muscle, thigh, and knee joint. Three‐month incidence of injuries during follow‐up varied between 13.5% and 16.3%. During the 12‐month follow‐up period, 277 new running injuries were reported. Runners who ran more than 10 km are more susceptible to injury in comparison with runners who ran short distances (10 km or less). In total, 69.1% of running injuries resolves within 10 days. Running injuries are very common among recreational runners. Injuries mostly occur in the knee, thigh, and calf muscle.     

The epidemiology of injuries in powerlifting at the London 2012 Paralympic Games: An analysis of 1411 athlete‐days

Sport injury epidemiology has received increased recognition as a field of sport medicine research that can improve the health and safety of athletes. Injuries among Paralympic powerlifters have not previously been systematically studied. The purpose of this prospective cohort study was to characterize injuries among Paralympic powerlifters. Athletes competing in the sport of powerlifting were followed over the 7‐day competition period of the 2012 London Paralympic Games. The main outcome measurements were injury incidence rate (IR; number of injuries per 1000 athlete‐days) and injury incidence proportion (IP; injuries per 100 athletes). A total of 38 injuries among 163 powerlifters were documented. The overall IR was 33.3 injuries/1000 athlete‐days (95% CI 24.0–42.6) and the overall IP was 23.3 injuries per 100 athletes (95% CI 16.8–29.8). The majority of injuries were chronic overuse injuries (61%). The most commonly injured anatomical region was the shoulder/clavicle (32% of all injuries), followed by the chest (13%) and elbow (13%). The information obtained in this study opens the door for future study into the mechanisms and details of injuries into powerlifters with physical impairments.     

Longitudinal influence of musculo‐skeletal injuries and extra physical education on physical fitness in schoolchildren

The aims of this study were to investigate if (A) injuries and (B) increased physical education (PE) influenced the development of physical fitness in schoolchildren. Simultaneously, to investigate if a possible PE effect was modified by sport participation outside school hours. This was a longitudinal controlled school‐based study. Six schools with 270 min of PE (extra PE) and four schools with 90 min of PE were followed up for 2.5 years. In total, 1054 children were included for analysis (normal PE = 443, extra PE = 611). Development in fitness was analyzed using composite z‐scores from six fitness tests measured four times. Information of injury and sport was derived from weekly automated mobile phone text messages surveying the presence of musculo‐skeletal pain and organized sport participation. Injury and extra PE both influenced the development of physical fitness. Injury decreased development of physical fitness with ?1.01 composite z‐score units (95% CI: ?1.57; ?0.45). Extra PE increased physical fitness development with 0.80 (95% CI: 0.49; 1.10) composite z‐score units. The influence of injury was not dependent on extra PE. No modifying effect was found by mean weekly sport participation outside school hours. In conclusion, extra PE had a positive effect, whereas injuries had a negative effect on physical fitness development in schoolchildren.     

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.


     

International Physical Activity Questionnaire: Validity against fitness

PURPOSE: This study was conducted to criterion-validate the short format of International Physical Activity Questionnaire (IPAQ) against health-related fitness. METHODS: Participants included 951 men, aged 21-43 yr. VO2max by ergometer was used to measure cardiorespiratory fitness. Muscular fitness tests included the number of sit-ups, push-ups, and squats performed during 60 s. Physical activity was assessed from IPAQ by categories for health (health-enhancing physical activity (HEPA)) and by calculating total and vigorous MET-hours per week. The participants were classified in five groups of almost equal size by the IPAQ outcomes. Moreover, the frequency of vigorous activity was assessed by one precoded question (single-item question on leisure-time vigorous physical activity (SIVAQ)). RESULTS: The mean fitness improved from the first through the fourth IPAQ group. VO2max in the most active IPAQ group, however, was lower than in the fourth group (P < 0.05), both with HEPA categories and vigorous METs as the outcome. In contrast, the weekly frequency of vigorous physical activity showed a positive association with fitness through all six categories. The 65 sedentary (according to SIVAQ) and unfit individuals who belonged to the highest 20% (by IPAQ total METs) were older (30.6 +/- 5.1 vs 28.9 +/- 3.8, P = 0.02), more obese (waist 93 +/- 12 vs 89 +/- 10 cm), more often current smokers (59.4 vs 42.0%; P = 0.03), and less educated (<12 yr of education 70.8 vs 52.0%; P = 0.02), compared with the others in the highest IPAQ group. CONCLUSIONS: Almost 10% of young men had poor fitness and apparently low physical activity, but they reported very high physical activity by IPAQ. An evident need therefore exists to develop IPAQ further to solve the apparent overreporting by a considerable proportion of sedentary individuals.     

The epidemiology of medically attended sport and recreational injuries in Queensland

The Queensland Sport and Recreation Injury Survey (QSRIS) is a retrospective study describing the annual incidence of injuries in the state of Queensland, Australia, resulting from sport and recreational activity involvement. Data were collected by means of a computer-assisted-telephone-interview (CATI) survey of a representative sample of Queenslanders in the spring of 2000. The sample produced a total of 1337 respondents aged 18 to 94 years. The survey asked information regarding medically attended, non-fatal injuries resulting from sport and recreational activities in the past 12 months. Of the 1337 individuals surveyed, 191 of the respondents reported one or more injuries that required medical attention resulting in a total of 222 Injuries. This represents an overall rate of 1,666 medically attended injuries per 10,000 people. Among those reporting a sport or recreational injury, the most common types of injuries were a strained/pulled muscle (30.9%), sprained/torn ligament (24.1%), and fracture (12.6%). The most common bodily locations of injuries were the shoulders (13.0%) and knees (12.5%). Results detail the nature and type of injury, medical professional attending to the injury and the nature of the sport or recreational activity that led to the reported injury, highlighting the number of injuries associated with general fitness activities achieved through high participation rates and low injury rates. This remains an area of much needed attention given the promotional push towards raising the levels of physical activity at a population level.     

Objectively-measured physical activity in New Zealand workers.

To date, no objective measurements of New Zealanders' physical activity have been reported. The relative contribution of work time activity to total daily physical activity by gender and occupational category has also not been measured objectively in any population. The present study reports such data using pedometer steps counts to quantify both work and non-work physical activity in a sample of New Zealand adult workers in six different occupational categories over a three-day period. Females (9943+/-3855 steps) had slightly higher, but not significantly different (F=0.084(1,179)1, p=0.772) daily step counts than males (9766+/-3965 steps). Using the 10 000 steps a day criterion, 57% of the sample were considered at least low-active. Analysis of variance was used to identify between group (occupational) differences in workplace physical activity (F=11.189(5,175), p<0.001), non-work physical activity (F=2.596(5.175), p=0.027), and total physical activity (F=6.265(5,175), p<0.001). Tukey post hoc comparisons showed significant differences with retail and blue collar workers achieving higher activity levels in comparison to the other occupational categories in work and total physical activity. Odds ratios were calculated to find the odds of being in the top half of activity classification for work and non-work physical activity by tertile splits of work time, active transportation use, sport and exercise participation, television and computer viewing, and passive recreation. Active transportation and passive recreation were related to increased odds of higher work pedometer steps. For non-work pedometer values, television and computer use increased the likelihood of being in the lowest activity group, while sport and exercise participation were associated with increased activity levels.     

Anterior cruciate ligament injury after more than 20 years: I. Physical activity level and knee function

Little is known about physical activity level and knee function including jump capacity and fear of movement/reinjury more than 20 years after injury of the anterior cruciate ligament (ACL). Seventy persons with unilateral ACL injury participated (23 ± 2 years post‐injury): 33 treated with physiotherapy in combination with surgical reconstruction (ACL_R), and 37 treated with physiotherapy alone (ACL_PT). These were compared with 33 age‐ and gender‐matched controls. Assessment included knee‐specific and general physical activity level [Tegner activity scale, International Physical Activity Questionnaire (IPAQ)], knee function [Lysholm score, Knee injury and Osteoarthritis Outcome Score (KOOS)], jump capacity (one‐leg hop, vertical jump, side hops), and fear of movement/reinjury [Tampa Scale for Kinesiophobia (TSK)]. Outcomes were related to degree of osteoarthritis (OA). ACL‐injured had lower Lysholm, KOOS, and Tegner scores than controls (P < 0.001), while IPAQ score was similar. ACL‐injured demonstrated inferior jump capacity in injured compared with noninjured leg (6–25%, P < 0.001–P = 0.010 in the different jumps), while noninjured leg had equal jump capacity as controls. ACL groups scored 33 ± 7 and 32 ± 7 of 68 on TSK. Lower scores on Lysholm and KOOS symptom were seen for persons with moderate‐to‐high OA than for no‐or‐low OA, while there were no differences for physical activity and jump capacity. Regardless of treatment, there are still negative knee‐related effects of ACL injury more than 20 years later.     

International physical activity questionnaire: 12-country reliability and validity

BACKGROUND: Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. METHODS: Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. RESULTS: Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. CONCLUSIONS: The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.     

Clinical outcome of isolated subcortical trabecular fractures (bone bruise) detected on magnetic resonance imaging in knees

Isolated subcortical trabecular bone injury (bone bruise) has rarely been described. Our purpose is to report a series of patients who had a history of traumatic injury, knee effusion, normal radiographs, and initial equivocal physical examination for ligament and meniscal integrity, and who were found to have isolated injury of the trabecular bone on magnetic resonance imaging. We evaluated demographic data, physical examination findings, radiographs, magnetic resonance imaging, and clinical outcome for 23 patients. Follow-up data included time to return to preinjury activity level, International Knee Documentation Committee activity level rating before and after injury, and postinjury Lysholm scores. All magnetic resonance imaging scans were negative for associated grade III meniscal lesions and ligament injury. Time to return to preinjury activity level was under 7 months in 96% of the patients. Postinjury International Knee Documentation Committee rating was unchanged in 91% of patients. Postinjury Lysholm score was 90 or more in 91% of patients. We propose that the recognition of these injuries is important because magnetic resonance imaging can distinguish them from meniscal or ligament injury requiring surgical intervention (arthroscopy). If detected on magnetic resonance imaging as an isolated injury, surgical arthroscopy is unnecessary since these patients can be expected to recover well in the short term with restricted weightbearing and initial activity modification.     

Does a history of youth sport-related knee injury still impact accelerometer-measured levels of physical activity after 3–12 years?

ObjectivesTo examine accelerometer-measured physical activity (PA) in individuals with a knee injury history and controls and the association of moderate to vigorous PA (MVPA) with self-reported and performance measures of knee function.DesignHistorical cohort.ParticipantsParticipants with a 3–12 year history of youth sport-related knee injury and matched controls.Main outcome measuresMVPA (Actigraph GT3x-BT), Knee Injury and Osteoarthritis Outcome Score (KOOS), Triple Single-Leg Hop, Y-Balance and isometric knee strength was measured. Regression analyses examined differences in PA and the association between MVPA and knee function, adjusted for injury history, sex and time since injury.ResultsParticipants (42 injured, 43 controls) had a median age of 23.4 (range 16–29) years. The previously injured group spent less daily adjusted minutes in MVPA [-13.5 (95% CI -25.6, −1.4)] than controls, and females had 10.8 min (95% CI -20.2, −1.4) less MVPA than males. Higher MVPA was associated with better KOOS sport and recreation [β = 0.05, 95% CI (0.01, 0.09)] adjusted for injury history. No other associations were observed.ConclusionPreviously injured youth participated in less MVPA compared to controls 3–12 years later. Lower MVPA is associated with poorer self-reported sport and recreation knee function which may have long-term negative health consequences.     

Risk factors for acute and overuse sport injuries in Swedish children 11 to 15 years old: What about resistance training with weights?

To determine the 1‐year self‐reported incidence of overuse and traumatic sport injuries and risk factors for injuries in children participating in a summer sports camp representing seven different sports. 4363 children, 11 to 15 years old participating in a summer camp in seven different sports answered a questionnaire. Injury in this cross‐sectional study was defined as a sport‐related trauma or overload leading to pain and dysfunction preventing the person from participation in training or competition for at least 1 week. A number of risk factors for injury were investigated such as sex, age, number of hours spent on training in general, and on resistance training with weights. Nearly half [49%, 95% confidence interval (CI) 48–51%] of the participants had been injured as a result of participation in a sport during the preceding year, significantly more boys than girls (53%, 95% CI 50–55% vs 46%, 95% CI 43–48%; P < 0.001). Three factors contributed to increased incidence of sport injuries: age, sex, and resistance training with weights. Time spent on resistance training with weights was significantly associated with sport injuries in a logistic regression analysis. In children age 11 to 15 years, the risk of having a sport‐related injury increased with age and occurred more often in boys than in girls. Weight training was the only modifiable risk factor that contributed to a significant increase in the incidence of sport injuries.     

Back injuries in a cohort of schoolchildren aged 6–12: A 2.5‐year prospective study

The aims of this prospective school cohort study were to describe the epidemiology of diagnosed back pain in childhood, classified as either nontraumatic or traumatic back injury, and to estimate the association with physical activity in different settings. Over 2.5 years, 1240 children aged 6–12 years were surveyed weekly using mobile text messages to ask about the presence or absence of back pain. Pain was clinically diagnosed and injuries were classified using the International Classification of Diseases version 10. Physical activity data were obtained from text messages and accelerometers. Of the 315 back injuries diagnosed, 186 injuries were nontraumatic and 129 were traumatic. The incidence rate ratio was 1.5 for a nontraumatic back injury compared with a traumatic injury. The overall estimated back injury incidence rate was 0.20 per 1000 physical activity units (95% confidence interval 0.18–0.23). The back injury incidence rates were higher for sports when exposure per 1000 physical activity units was taken into consideration and especially children horse‐riding had a 40 times higher risk of sustaining a traumatic back injury compared to the risk during non‐organized leisure time physical activity. However, the reasonably low injury incidence rates support the recommendations of children continuously being physically active.