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.     

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.     

Prevalence of anterior cruciate ligament reconstructions in professional soccer players

Abstract In the literature there are many studies on soccer injuries, but data regarding the epidemiology of anterior cruciate ligament (ACL) ruptures of professional players are scarce. The aim of this retrospective study was to investigate the prevalence and the incidence of ACL surgical reconstructions of top-level professional soccer players. A questionnaire was administered by the sports physicians of the 18 teams competing in the 2002–2003 Italian Serie A Championship to players who reported in their career one or more ACL reconstructions. The prevalence of ACL reconstructions was 10.4%; the incidence was 1.08 every 1000 competitive playing exposures or 0.72 every 1000 h of game. Players who reported an ACL reconstruction when younger (20.3±2.1 years) had a higher risk of ACL injury to the other side. Contact injuries were more frequent during official games, while during training or nonofficial games non-contact injuries were more frequent. These data should be considered by team physicians and coaches to prevent ACL injuries and re-injuries in professional soccer.     

Sports injuries in school-aged children. An epidemiologic study

In November 1982, epidemiologic data were collected in a unique, large scale, population-based survey on sports injuries in school-aged children living in Holland. A total of 7,468 pupils, aged 8 to 17, completed questionnaires covering a retrospective period of 6 weeks. Seven hundred ninety-one sports injuries were registered, amounting to an incidence of 10.6 sports injuries per 100 participants. In 31% of the cases, medical consultation was needed. Injuries incurred during the study period caused 36% of the children to miss one or more physical education classes and caused 6% to miss school for at least 1 day. Contusions and sprains were the most common lesions (77%). Three of four injuries involved the lower extremity, in particular the ankle. Sixty-two percent of all the injuries occurred in organized sports, 21% in physical education classes, and 17% in unsupervised sports activities. The highest injury rates were found in basketball and field hockey. In this study population, 15 and 16-year-old boys who had a high sports activity index and played team sports, particularly contact team sports, formed a high risk group.     

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.     

Is overweight a risk factor for sports injuries in children,adolescents, and young adults?

Physical activity and sports participation are promoted to counteract the increased prevalence of overweight and obesity in children and young adults. Both high body mass index and physical activity level have been associated with an increased risk of sports injuries. The objective is to determine the relationship between sports injuries and overweight in sports participants (4–24 years), taking physical activity into account. Data were obtained from the 2006–2011 “Injuries and Physical Activity in the Netherlands” survey. Analyses were based on a representative sample of 3846 sports participants (4–24 years). Univariate and multiple logistic regression analyses were applied to investigate the association between sports injury and weight status. Of all the sports participants, 14.7% were overweight. Compared with normal‐weight sports participants, the odds of sustaining a sports injury was 0.73 [confidence interval (CI): 0.53–1.00, P = 0.050] for overweight sports participants; the odds for underweight sports participants was 0.80 (CI: 0.56–1.15, P = 0.226). There is some evidence that overweight sports participants (4–24 years) do not have an increased injury risk compared with normal‐weight sports participants, even when the level of physical activity is taken into account. Additional research is recommended regarding overweight people who start to participate in a physically active lifestyle.     

Comparing the incidence of anterior cruciate ligament injury in collegiate lacrosse, soccer, and basketball players: implications for anterior cruciate ligament mechanism and prevention

BACKGROUND: Female college basketball and soccer athletes have higher rates of anterior cruciate ligament injury than do their male counterparts. Rates of anterior cruciate ligament injuries for women and men in collegiate lacrosse have not been examined. Understanding anterior cruciate ligament injury patterns in lacrosse, a full-contact sport for men and noncontact sport for women, could further injury prevention efforts. HYPOTHESES: Female anterior cruciate ligament injury rates will decrease over time owing to longer participation in sports. Lacrosse anterior cruciate ligament injury rates will be lower than rates in basketball and soccer possibly owing to beneficial biomechanics of carrying a lacrosse stick. STUDY DESIGN: Cohort study (Prevalence); Level of evidence, 2. METHODS: Data from the National Collegiate Athletic Association Injury Surveillance System were analyzed to compare men's and women's anterior cruciate ligament injuries in basketball, lacrosse, and soccer over 15 years. RESULTS: Anterior cruciate ligament injury rates in women's basketball and soccer were 0.28 and 0.32 injuries per 1000 athlete exposures, respectively, and did not decline over the study period. In men's basketball, injury rate fluctuated between 0.03 and 0.13 athlete exposures. Rates of anterior cruciate ligament injury did not significantly change in men's soccer over the study period. The rate of anterior cruciate ligament injury in men's lacrosse (0.17 athlete exposures, P < .05) was significantly higher than in men's basketball (0.08 athlete exposures) and soccer (0.12 athlete exposures). Injury rate in women's lacrosse (0.18 athlete exposures, P < .05) was significantly lower than in women's basketball and soccer. CONCLUSION: There was no discernable change in rate of anterior cruciate ligament injury in men or women during the study period. Men's lacrosse is a high-risk sport for anterior cruciate ligament injury. Unlike basketball and soccer, the rates of anterior cruciate ligament injury are essentially the same in men's and women's lacrosse. The level of allowed contact in pivoting sports may be a factor in determining sport-specific anterior cruciate ligament risk.     

Sex-related injury patterns among selected high school sports

This cohort observational study was undertaken to test the hypothesis that the incidence of injuries for girls participating in high school sports is greater than that for boys. From 1995 through 1997, players were included in our study if they were listed on the school's varsity team roster for boys' or girls' basketball, boys' or girls' soccer, boys' baseball, or girls' softball. Injuries and opportunities for injury were recorded daily. Certified athletic trainers reported injury and exposure data. Based on 39,032 player-seasons and 8988 reported injuries, the injury rates per 100 players for softball (16.7) and for girls' soccer (26.7) were higher than for baseball (13.2) and boys' soccer (23.4). The knee injury rates per 100 players for girls' basketball (4.5) and girls' soccer (5.2) were higher than for their male counterparts. Major injuries occurred more often in girls' basketball (12.4%) and soccer (12.1%) than in boys' basketball (9.9%) and soccer (10.4%). Baseball players (12.5%) had more major injuries than softball players (7.8%). There was a higher number of surgeries, particularly knee and anterior cruciate ligament surgeries, for female basketball and soccer players than for boys or girls in other sports.     

Requirements and risk profile of soccer-playing children. Orthopedic aspects]

Although the rate of injuries in soccer is high, this sport puts children only at moderate risk of getting injured. In younger children this risk is very low but the number and severity of injuries increases with puberty. The most common cause for injuries is a collision with another player, the most common injury is distortion of the talocrural joint. Playing soccer indoors is more dangerous than playing outdoors. The danger of accidents and injuries can be reduced by preventive measures, such as weight categories in children leagues.     

Trends in sports injuries, 1982-1988: an in-depth study on four types of sport.

In this study, we analyzed the records of both inpatients and outpatients which were treated for acute sports injuries in the Trauma Department of the University of Groningen (The Netherlands) during the years 1982 to 1988. We examined whether there was a trend in sports injuries in this time period. The study comprised four types of sports, i.e., soccer, volleyball, gymnastics, and martial arts. The absolutely highest rates of injuries across the seven years were found in soccer, followed by gymnastics, volleyball, and martial arts. Injuries sustained at participating in soccer, volleyball, and gymnastics involved for the major part the lower extremities, followed by injuries of the upper extremities, whereas the reverse pattern was observed for patients who participated in martial arts. For all four types of sport, the ankle and foot were the most frequently site of injury of the lower extremities. Sprains and strains were the major types of injury. Most injuries were seen at ages between 10 and 30 years. The ratio of male to female patients within age groups did not differ significantly across the seven years. We concluded that, except for martial arts, the increased participation in sports in the last decade was not accompanied with a change in the patterns of sports injuries by the patients' age, sex, and number and nature of the injury. This consistency in results can be used to guide the development of prevention programs aimed at a reduction of injuries in specific sports.     

Effective Injury Prevention in Soccer

Abstract

Sports participation is accompanied by risk of injury, and each specific sport has its own unique injury profile. One of the goals of a sports medicine professional is injury prevention, and the past decade has seen numerous reports on the outcomes of injury-prevention studies. Health care professionals have been particularly vigilant in attempting to reduce common injuries in soccer, beginning with work in the early 1980s to the rigorous randomized trials of today. The use of a structured, generalized warm-up program has been shown to be effective in preventing common soccer injuries, reducing overall injury rates by approximately 30%. Given the number of individuals who play soccer worldwide, any injury reductions will likely have an impact on public health. It is an important goal of the sports medicine community to inform physicians and other sports medicine professionals about the effectiveness of prevention programs to increase use and compliance.     

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.     

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.     

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.


     

Incidence rate of injuries during sport activity and physical exercise in a rural Swedish municipality: incidence rates in 17 sports

A prospective study of acute injuries from sports and physical exercise was carried out during 1 year in a total population of a municipality with 31,620 inhabitants. Data on exposure were collected: the number of participants in each sport, the hours of participation, and number of weeks in the season per year. The number of injuries was used as numerator and the exposure data as denominator in a formula modified from Chambers for the calculation of population at risk in sports. A total of 571 injuries occurred in 28 different sports: 65% of the injured were males. The majority of the injuries were from soccer: 50% of the males and 27% of the females. Incidence rates in 17 sports are presented. The ranking order differs, when calculating not only the number, but also the exposure. Ice hockey and handball were then found to have the highest risk followed by soccer. Team and contact sports on the whole had the highest rates in both genders. As a group, intercompany players had the highest rate, especially in soccer. The lowest rates were found in individual sports such as downhill skiing, horseback riding, racket sports, and running. Gymnastics, except in school physical education, had no injuries at all. Sprains and strains were diagnosed in nearly half of the cases and the foot and ankle were the most frequent sites. Preventive measures are proposed.     

Prevention of pediatric sports injuries

With over 30 million children participating in sports each year across the United States, a number of significant injuries are to be expected. Although mild injuries such as strains, sprains, and contusions predominate, catastrophic injuries do occur. Young athletes are at an increased risk for growth plate and apophyseal injuries, overuse injuries, and heat illness. Many of these sports injuries can be prevented. Prevention strategies include protective equipment, rule changes, preseason and season prevention interventions, safety measures, better coaching, education, and a societal awareness of injury and prevention. This article discusses current injury prevention for children participating in baseball, football, soccer, and ice hockey.