Sport, age, and sex specific incidence of sports injuries in Western Australia

OBJECTIVE: To describe the trends in recreational sports injury in Perth, Western Australia. DESIGN: A prospective cohort study of sports injuries during the 1997 winter season (May to September). SETTING: Sample of Australian football, field hockey, basketball, and netball players from the Perth metropolitan area, Western Australia. METHODS: A cohort of sports participants was followed over the five month winter sports season. Before the season, participants completed a baseline questionnaire and during the season were interviewed every four weeks by telephone. RESULTS: Overall, 92% of participants (n = 1391) who completed a baseline questionnaire completed at least one follow up telephone interview. About half (51%) of the cohort sustained one or more injuries during the winter season accounting for a total of 1034 injuries. Most injuries were of moderate (58%, n = 598) or minor (40%, n = 412) severity, with only 3% (n = 24) requiring emergency department treatment or a hospital stay. The injury incidence rate was greatest for football (20.3/1000 hours of participation), similar for field hockey and basketball (15.2/1000 hours and 15.1/1000 hours respectively), and lowest for netball (12.1/1000 hours). The incidence of injury was greatest in the first four weeks of the season, and participants aged between 26 and 30 years had about a 55% greater risk of injury than those aged less than 18 years. CONCLUSIONS: This is one of the first studies to show that recreational sports are safe. Although the likelihood of injury was greatest in the first month of the season, few injuries required admission to hospital or emergency department treatment. A greater emphasis on prevention in the early part of the season should help to reduce the elevated incidence of injury found at this time.     

Counting organised sport injury cases: Evidence of incomplete capture from routine hospital collections

Organised sports are a popular form of physical activity, but unfortunately, participation can result in injury. Despite this, there have been surprisingly few studies that have reported the population rate of sports injury. Data from the 2005 New South Wales (NSW, Australia) Population Health Survey were analysed to describe self-reported injury experiences during participation in organised sports activities and the source of treatment for such injuries during a 12-month period in a population representative sample of adults aged 16+ years. At interview, 2414 respondents stated that they had participated in organised sport in the previous 12 months and just under one-third (30.9%) reported that they had been injured during this participation. Half of all injuries required formal treatment from a health or medical practitioner. Physiotherapists most commonly provided treatment for sports injury (26.6% of cases) followed by general practitioners (15.6%). Only 2.8% of all injured sports participants were admitted to hospital for their injury and a further 6.1% received treatment in an emergency department. This corresponds to at most only 8.9% of all treated sports injuries receiving treatment in a hospital setting. Population-based estimates of the rate and burden of sports injuries that rely solely on routine hospital data collections are likely to grossly underestimate the size of the problem, as very few cases are treated in a hospital setting.     

A prospective study of rock climbing injuries.

OBJECTIVES: To study the rate, causes, and nature of rock climbing injuries presenting to an accident and emergency (A&E) department. METHODS: Patients presenting with rock climbing injuries to an urban A&E department were studied prospectively for one year. RESULTS: 19 rock climbers presented during the year, at a rate of one per 2774 A&E attendances. Fourteen climbers were injured on outdoor cliffs and five on the local indoor climbing wall, where the safety mats were noted to be in poor condition. Eighteen climbers had been injured during falls, 17 hitting the ground. Twelve of these climbers sustained fractures, four of which were missed on initial attendance. The remaining climber sustained the characteristic A2 pulley finger injury, which was treated conservatively with a good result. CONCLUSIONS: The risks of rock climbing in Britain would be reduced if lead climbers arranged protection at earlier stages of climbs. Sports centres with climbing walls should regularly inspect and repair their safety equipment. It is important for staff in A&E departments to appreciate the large forces involved in any climbing fall, in order that significant injuries are not missed. Those treating injured climbers should also be aware of the specific injuries to which elite climbers are predisposed.     

Sports injuries in a large urban population: occurrence and epidemiological aspects

Most studies reporting on sports injuries have been investigations of specific types and locations in specific sports events and levels. This study aims at outlining the features of sports injuries in general regardless of type, severity, or treatment during 1 year among the adult population of the Greater Helsinki area (pop. 600,000). This study was carried out in cooperation with the Central Statistical Office, which in 1980 performed a nationwide survey aimed at outlining the incidence and features of accidents occurring in Finland. The actual data from this study concerning sports injuries in the Greater Helsinki area was broken down and further analyzed. During the actual time period under investigation, an estimated 40,380 acute sports injuries occurred in the area. Based on this estimate, the calculated occurrence of sports injuries was found to be 670 +/- 121/10,000 inhabitants. Sports injuries were found mainly among young people in their productive working years, though surprisingly low was the occurrence of injuries among women of 20-24 years of age. The majority of the injuries were of mild character, though 9% were classified as severe, and it was estimated on the basis of the data obtained from this study that some 4000 patients attended a casualty department in the area because of an injury sustained in sports, thus placing a considerable burden on these agencies. Distorsions formed with 65% the most common type of injury, and the application of an adhesive bandage was the commonest form of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)     

Epidemiology and Severity of Sports and Recreation Injuries Presenting to a Tertiary Adult Emergency Department

Objective: This study aims to evaluate all sports and recreation injuries that present to an emergency department, identify the activity and injury patterns associated with hospital admission, and determine injuries that could be better treated in alternative care settings.

Methods: This is a retrospective review of all sports injuries that presented to the emergency department of a high volume, urban, tertiary referral center from 1/1/2010 to 12/31/2011. These were identified by a sports term search algorithm applied to all emergency department records. The main outcome measured was hospital admission status after sports injury. Univariate and multivariate regression analysis was performed to identify risk factors for hospital admission in the sports injury population.

Results: 1,101 of the 191,259 encounters (0.6%) had 1,210 sports injuries. 84 were admitted (7.6%). Basketball injuries were most prevalent (31.6%). All-terrain vehicle (ATV) related injuries was most often admitted (46.4%). Logistic regression identified ATV riding (95% CI 6.15–23.37, p < 0.001) and age over 50 years-old (4.09–17.40, p < 0.001) as independent risk factors for admission while basketball (0.101–0.985, p = 0.047) and black race (0.17–0.77, p = 0.008) were independently protective. Isolated sprains/strains and soft tissue injuries (4/649, 0.6%) rarely required admission.

Conclusions: The 7.6% admission rate is higher than previously reported, likely because the study institution is a tertiary referral center. ATV riding is associated with higher severity injuries that are more likely to require hospital admission. Most sports injuries that present to an emergency department, specifically isolated soft tissue injuries of the extremities, may be more efficiently treated in a non-emergent setting.     

The Harstad injury prevention study: the epidemiology of sports injuries. An 8 year study.

OBJECTIVE--To describe the epidemiology of sports injuries occurring in a community during 8 years and to evaluate the outcome of an intervention implemented against injuries occurring in downhill skiing. METHODS--Hospital treated sports injuries occurring in Harstad, Norway (population 22 600) were recorded prospectively during an 8 year period. A prevention programme targeting downhill skiing injuries was evaluated. RESULTS--2234 sports injuries accounted for 17.2% of recorded unintentional injuries. Two out of three injuries occurred in team sports. Soccer accounted for 44.8% of all sports injuries. Downhill skiing injuries had higher mean score on the abbreviated injury scale than all other sports analysed combined (P < 0.01). Postintervention injury rates for downhill skiing were reduced by 15% when adjusting for exposure (P = 0.24). Further observations are needed for assessing the effectiveness of the downhill skiing safety programme. CONCLUSIONS--Strategies for future sports injury prevention include community involvement, particularly sports organisations. Local data analysis seems to justify some priorities, for example, promotion of helmet use in downhill skiing for young adolescents and prevention of lower limb fractures in male soccer players 15+ years old. Prospective hospital recording of injuries provides a tool for the design and outcome evaluation of sports injury intervention research.     

Analysis of sex‐specific injury patterns and risk factors in young high‐level athletes

This study analyzed sex‐specific injury patterns and risk factors in young athletes (n=256) from 12 sport disciplines practicing at the national or the international level in the Grand‐Duchy of Luxembourg. Injury occurrence as a result of sport practice was analyzed retrospectively over the year 2006 using a standardized self‐administered questionnaire. Overall incidence was not different between girls and boys (1.20 and 1.21 injuries/1000 athlete‐hours, respectively), but in the context of team sport competition girls tended to be at a greater risk (rate ratio 2.05, P=0.053). Girls had a higher proportion of injuries in the ankle/foot region compared with boys (34.8% vs 16.8%). No sex‐related differences were found regarding injury severity. Multivariate logistic regression (controlling for age and practice volume) revealed that girls' team sports were associated with a greater injury risk compared with individual sports [odds ratio (OR) of 4.76], while in boys this was observed for racket sports (OR=3.31). Furthermore, physical or emotional stress tended to be a specific risk factor in girls. There was a tendency for injury outside sports to be coupled to a higher injury risk in girls and boys. Consideration of sex‐specific injury patterns and risk factors could be of importance for effective injury prevention.     

Injuries during physical activity in school children

During the spring of 2001, 1975 children, from grades 3, 6 and 9 participated in a nationwide, multidisciplinary collaboration study. The students came from randomly selected classes throughout Sweden, representing different geographical and socio-economic areas. The aim of this study was to collect and evaluate self-reported injuries and associated factors during various physical activities as recalled retrospectively for 3 months by the students. Every sixth student (n=299 or 16%) reported 306 injuries. Twice as many girls than boys were injured during physical education class. Ninth-grade students reported relatively more injuries during organized sports than during physical education class and leisure activities. There were no age or gender differences in incidence rate during leisure activities. Most injuries were minor, as 70% were back in physical activity within a week. Half of the students (50%) reported that they previously had injured the same body part. Primary care of the injured student was, with the exception of a family member, most often carried out by the physical education teacher or coach, which accentuates the importance of continuous sports medicine first aid education for this group.     

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.


     

Cost of a roller skating rink to the local accident and emergency department.

A 14 month retrospective study was undertaken to determine the cost implications of the opening of a roller skating rink to the local hospital accident and emergency department (A and E). A total of 398 patients attended following injury at the roller skating rink, of whom 384 were included in the study. The estimated cost of their injuries was determined by the hospital accounts department. The average cost per patient attending the A and E department following roller skating injury was about 100 pounds. The total cost to the A and E department of all injuries sustained at the rink over this period was 38,412 pounds. The cost implications of opening a roller skating rink for the A and E department are considerable. If proposals for self-budgeting are applied, A and E departments will have to seek additional funding if such leisure facilities are opened in their vicinity.     

Knee injuries in leisure-time physical activities: a prospective one-year follow-up of a Finnish population cohort

This prospective one-year follow-up study compared the risks of knee injuries in various commuting and lifestyle activities as well as in recreational and competitive sports in a 15 to 74-year-old Finnish population cohort. A cohort of 3657 persons was randomly selected from the nationwide population register of Finland. Ninety-two percent of them accepted to participate (n = 3363). The subjects were interviewed by telephone three times during the one-year follow-up. The recorded data included all physical activities that lasted 15 minutes or more, and all injuries that were sustained during these activities. Fifteen percent (n = 321) of all reported injuries affected the knee. The individual risk of knee injury per 1000 exposure hours was low in commuting activities (cycling, walking), 0.06 (95 % CI 0.04 to 0.09) and in lifestyle activities (gardening, hunting, fishing, home repair etc.), 0.04 (0.03 - 0.06). In recreational and competitive sports, the knee injury risk was almost ten times higher, 0.44 (0.39 - 0.50). For commuting activities (p = 0.046) and for recreational and competitive sports (p < 0.001), there was a decreasing injury rate with age. In lifestyle activities (p = 0.038), in turn, there was an increasing trend of injuries with aging. In commuting activities (hazard ratio, HR 5.99, 95 % CI 1.40 to 25.6), the risk of knee injury was significantly higher in women than in men. In conclusion, the knee injury risk per exposure hours is almost ten times lower in commuting and lifestyle activities compared to recreational and competitive sports. The knee injury risk is especially high in the age group of 15 to 25 years, especially in various team sports and ball games. At population level, however, widely practiced low-to-moderate intensity activities with relatively low injury risk per exposure hours produce a large absolute number of knee injuries.     

Paediatric casualties during OP TELIC

AIM: To audit all paediatric attendances to a British Army Field Hospital during warfighting. POPULATION: All patients <16-years-old who presented to 34 Field Hospital Accident & Emergency (A&E) Department during warfighting phase of OPTELIC (27 Mar 03 to 01 May 03). METHOD: A retrospective analysis of A&E attendance register, A&E clinical records, and A&E trainees' logbooks from the department of 34 Field Hospital. RESULTS: Seventy eight children were treated, mean age 7.9 years. 65.4% were male and 34.6% female. Children accounted for 2.9% of all patients (total attendances 2720) and 32.9% of non-coalition patients (non-coalition attendances 237). 44 (56%) children had burns as the principal injury; 7 (9%) had shrapnel injuries, 5 (6%) had blunt trauma from a road traffic accident. Only one child had GSW. 17% of attendances were related to 'medical' complaints rather than trauma. 78% of children required transfer to a specialist facility. CONCLUSIONS: Recognition of the potential for paediatric casualties is required to facilitate appropriate planning, training and equipping of medical units deployed on future operations.     

Ankle injuries in the Netherlands: Trends over 10–25 years

Ankle injuries are a common health problem; data on ankle injury rates and time trends in the population at large are scarce. Our aim was to investigate the incidence of and time trends in population‐based and emergency department‐treated ankle injuries related to sports activities and other activities related to daily living. Data were obtained from one national survey on accidents and injuries (2000–2010) and one based on emergency department data (1986–2010). Linear regression was used to determine linear trends in ankle injuries per 1000 person‐years. The number of ankle injuries related to sports activities and other activities of daily living increased from 19.0 to 26.6 per 1000 person‐years (P = 0.002). The number of sports‐related ankle injuries treated in emergency departments decreased from 4.2 to 1.5 per 1000 person‐years (P < 0.001), and from 3.2 to 2.1 per 1000 person‐years (P < 0.001) for other activities of daily living. According to our data, the incidence rates of all ankle injuries are around 5.5 times higher than those registered at emergency departments. The high incidence rates of ankle injuries highlight the need for proper ankle injury treatment and prevention.     

The risk of abdominal injury to women during sport

Although trauma to pregnant women is a potential risk during sport, as there is no published information about the magnitude of this risk, it is presumed to be low. Whilst there is an emerging literature about the risk of adverse outcomes following severe and catastrophic trauma to pregnant women, this literature almost exclusively focuses on road trauma victims or the result of assault. This paper describes the risk of abdominal injuries to women participants across a range of sports in Australia. An extensive search of the available literature could not identify any studies that had discussed this issue specifically in pregnant women. Studies, which have reported injuries in athletes, have generally found abdominal/chest injuries to account for fewer than 2% of all injuries, even in contact sports. Most of these published studies do not differentiate between the chest and abdomen and provide no specfic details on the exact nature or mechanisms of the injuries. Given the limitations of the published studies, an examination of data from two Australian general injury databases (one describing hospital admissions, the other hospital emergency department presentations), three Australian sports-injury treatment databases (sports medicine clinic attendances and medical coverage services) and one cohort study was undertaken to describe sports-related abdominal injuries. These analyses confirm that the risk of abdominal injury during sport is very low. In conclusion, currently there is not an adequate evidence-base for quantifying the risk of abdominal injuries during sport in women, let alone pregnant women or for justifying a ban of sport on this basis. Recommendations for future epidemiological sports injury studies and the potential for linkages with perinatal morbidity and mortality databases are given.     

Volleyball injuries presenting in casualty: a prospective study.

During 1986, all sports injuries (n = 5222) were prospectively recorded at the two casualty departments in Arhus, Denmark. Volleyball injuries (n = 278) accounted for 5.3% of all sports injuries. An evaluation of the rehabilitation period and the consequences of the injuries was undertaken by questionnaire three years after the injury. The injury incidence was 1.9 injuries/1000 inhabitants/year. Hand, finger, and ankle sprains were the most frequent injuries. Female players had significantly more hand/finger injuries than male players, who incurred more ankle/foot injuries. Knee (6%) and ankle injuries (31%) were responsible for the longest duration of absence from sports participation. There were relatively few chronic injuries. The study suggests the need to enhance prophylactic measures with regard to blocking and overhand pass techniques, in order to reduce the number and extent of ankle and hand/finger injuries.     

Mission creep: an analysis of accident and emergency room activity in a military facility in Bosnia-Herzegovina

OBJECTIVE: To evaluate accident and emergency (A&E) room activity at a Role 3 Multinational Integrated Medical Unit (R3 MIMU) facility in Bosnia-Herzegovina. METHODS: Retrospective analysis of all patients attending the A&E room from 1st October 1999-30th September 2002. RESULTS: 1864 casualties are included in the analysis. 52.1% of casualties were Bosnian, 43.8% were military. Mean age of casualties was 35.5 years (SD 18.3), range 1-88 years. Traumatic injury was the leading cause of presentation (58.1%). Following treatment 66.7% of all cases were discharged or returned to unit, with 19.8% admitted to a ward area. During the 3 year period there was a 5 fold increase in the number of Bosnian nationals treated, this included 80 children (<13 years). CONCLUSION: There has been a dramatic increase in Methods A&E use during the period evaluated, Setting of study particularly by the local population. The increasing number of locals treated, both adult and child, has the potential to undermine the R3 MIMU mission and increase dependency within the Bosnian population. A balance is needed to ensure the staff and functions of a hospital are maintained whilst preserving the capability to deal with an influx of military casualties.     

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.     

Sports related injuries in Scottish adolescents aged 11-15

OBJECTIVES: To measure the age and sex distribution of self reported sports and leisure injuries in a 12 month retrospective recall period among a representative national sample of Scottish adolescents, and to examine the characteristics (gender, age, handedness, and level of sports participation) of sports related injuries in relation to injuries sustained during other activities. DESIGN/SETTING: Self completion questionnaire survey administered in schools during April- June 1994. SUBJECTS: 4710 pupils aged 11, 13, and 15 years drawn from a representative sample of 270 classes with returns from 224 classes (83% completion rate). RESULTS: 42.1% of the sample reported a medically attended injury. These were significantly more frequent among boys but there were no significant age differences in overall frequency of injury. Sport related injuries accounted for 32.2% of all medically attended injuries. As with all injuries, frequency was greater in boys than girls at all ages, and there are differences in the pattern of lesions in sports and nonsports injuries. Lower limb injuries were more frequent than upper limb injury in sports (57.6 v 23.9%), whereas there were no differences in non-sports injuries (31.5 v 31.3%). Age and handedness differences in sports injury rates were also identified. High sports participation was significantly associated with a higher risk of injury in general and sports related injury in particular. CONCLUSION: Age, gender, handedness, and level of sports participation have been shown to be implicated in differential risk of sports related injury. Reducing sports injury among adolescents should be a priority, but research into the injury profiles of different sports is needed before detailed injury prevention strategies can be developed.     

Sports injuries in physical education teacher education students

Sports injuries could be highly detrimental to the career of a physical education teacher education (PETE) student. To enable the development of future sports injury prevention programs, sports injuries in 128 first‐year academic bachelor PETE students were registered prospectively during one academic year. Common risk factors for sports injuries, taken from the literature, were also evaluated by means of logistic regression analysis. We found an incidence rate of 1.91 and an injury risk of 0.85, which is higher than generally found in a sports‐active population. Most injuries involved the lower extremities, were acute, newly occurring injuries, and took place in non‐contact situations. More than half of all injuries lead to an inactivity period of 1 week or more and over 80% of all injuries required medical attention. A major part of these injuries happened during the intracurricular sports classes. Few differences were seen between women and men. A history of injury was a significant risk factor (P = 0.018) for the occurrence of injuries, and performance of cooling‐down exercises was significantly related to a lower occurrence of ankle injuries (P = 0.031). These data can inform future programs for the prevention of sports injuries in PETE students.     

Acute sports injuries in Oslo: a one-year study

All sport injuries treated at the Emergency Department, Ullevål Hospital in Oslo (OKL) were registered for one year. They accounted for 6.3% of the total number of patients treated at OKL in that period. 4673 patients were seen; 3292 males and 1381 females. The women were younger than the men, 55% were below 20 years of age; 41% of the males (p less than 0.05). Most of the men (64%) were injured in connection with competitive sports, but 52% of the women sustained their injury pursuing recreational sports. Football and skiing accounted for 49% of the total number of injuries. In males football caused most injuries--35%. In females handball accounted for most injuries--18%. Nearly 3/4 of the injuries affected the extremities; the most common injury being the ankle sprain (16%). Almost 1/4 of the patients had a fracture, and 218 patients (4.7%) were admitted to hospital, the rest being treated as outpatients. In all, the sports injuries required 7658 consultations.