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.     

Acute hamstring strain injury in track‐and‐field athletes: A 3‐year observational study at the Penn Relay Carnival

This study aimed to observe the incidence rates of hamstring strain injuries (HSIs) across different competition levels and ages during the Penn Relays Carnival. Over a 3‐year period, all injuries treated by the medical staff were recorded. The type of injury, anatomic location, event in which the injury occurred, competition level, and demographic data were documented. Absolute and relative HSI (per 1000 participants) were determined, and odds ratios (ORs) were calculated between sexes, competition levels, and events. Throughout the study period 48 473 athletes registered to participate in the Penn Relays Carnival, with 118 HSIs treated by the medical team. High school girls displayed lesser risk of HSI than high school boys (OR = 0.55, P = 0.021), and masters athletes were more likely than high school‐ (OR = 4.26, P < 0.001) and college‐level (OR = 3.55, P = 0.001) athletes to suffer HSI. The 4 × 400‐m relay displayed a greater likelihood of HSI compared with the 4 × 100‐m relay (OR = 1.77, P = 0.008). High school boys and masters‐level athletes are most likely to suffer HSI, and there is higher risk in 400‐m events compared with 100‐m events.     

A 1‐year prospective analysis of injuries in amateur and elite fistball

The purpose of this study was to examine the incidence and mechanisms of acute injuries in the sport of fistball. No scientific studies on injury characteristics have yet been conducted in this traditional sport game. The study was conducted prospectively over the course of 12 months. During a total of 40.308 h of sport‐specific exposure, 240 players reported 492 injuries, representing an overall injury rate of 12.2 injuries/1000 h of exposure. Most injuries were classified as bagatelle injuries (67.8%). The majority of the injuries were located in the knee (23.5%) followed by the elbow (11.9%) and the hip (11.5%). Ankle injuries resulted in the longest impairment from sports participation. The most common types of injury were abrasions (38.2%), contusions (21.1%), distortions (7.5%) and muscle strains (6.9%). Wrong or insufficient equipment (15.0%) was the most commonly mentioned causes of injury. The data indicate that the injury risk in fistball is rather high; however, the sport should not be considered a high‐risk sport because most of the injuries are slight and do not prevent the players from training or competition. Injury prevention strategies should include the development of fistball‐specific protective equipment with focus on the knee and elbow joint.     

Exercise program for prevention of groin pain in football players: a cluster‐randomized trial

Groin injuries cause major problems in sports and particularly in football. Exercise is effective in treating adductor‐related groin pain, but no trials have been published regarding the specific prevention of groin pain or prevention specifically targeting overuse injuries in sport using exercise programs. We performed a cluster‐randomized trial including 55 football clubs representing 1211 players. The clubs were randomized to an exercise program aimed at preventing groin injuries (n=27) or to a control group training as usual (n=28). The intervention program consisted of six exercises including strengthening (concentric and eccentric), coordination, and core stability exercises for the muscles related to the pelvis. Physiotherapists assigned to each club registered all groin injuries. Twenty‐two clubs in each group completed the study, represented by 977 players. There was no significant effect of the intervention (HR=0.69, 95% CI 0.40–1.19). The risk of a groin injury was reduced by 31%, but this reduction was not significant. A univariate analysis showed that having had a previous groin injury almost doubles the risk of developing a new groin injury and playing at a higher level almost triples the risk of developing a groin injury.     

Injury risk factors in junior tennis players: a prospective 2‐year study

The aim was to investigate injury risk factors in junior tennis players. Fifty‐five players, 35 boys and 20 girls, answered a questionnaire about training habits, time of exposure, previous injuries and equipment factors. A battery of clinical tests and functional performance tests were also carried out. All tennis‐related injuries that occurred during a 2‐year period were identified and recorded. An injury was defined as an injury if it was impossible to participate in regular tennis training or playing matches during at least one occasion, a time loss injury. Potential injury risk factors were tested in a forward stepwise logistic regression model for injury. Thirty‐nine players sustained totally 100 new and recurrent injuries. Injuries to the lower extremity were the most common ones (51%) followed by the upper extremity (24%) and the trunk (24%). Injured players performed more singles per week (P<0.0001) and played more tennis hours per year (P=0.016) than the uninjured players. Playing tennis more than 6 h/week was found to be a risk factor for back pain. A previous injury regardless of location was identified as an injury risk factor, and a previous injury to the back was a risk factor for back pain.     

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.     

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

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

Incidence and risk factors of injuries and their impact on academic success: A prospective study in PETE students

Injuries can have a major impact on the physical performance and academic career of physical education teacher education (PETE) students. To investigate the injury problem, risk factors, and the impact of injuries on academic success, 252 PETE students were followed during their first semester. Risk factor analysis was conducted by means of logistic regression analysis with a differentiation for upper body, lower body, acute, overuse, and severe injuries. An incidence of 1.26 injuries/student/semester was found. Most injuries involved the lower body (61%), were new injuries (76%), occurred acutely (66%), and were sustained during curricular gymnastics (25%) or extracurricular soccer (28%). Significant risk factors for lower body acute injuries were age (OR=2.14; P=.01), previous injury (OR=2.23; P=.01), and an injury at the start of the year (OR=2.56; P=.02). For lower body overuse injuries, gender (OR=2.85; P=.02) and the interval shuttle run test score (OR=2.44; P=.04) were significant risk factors. Previous injury (OR=2.59; P=.04) and injury at the start of the year (upper body: OR=4.57; P=.02; lower body: OR=3.75; P<.01) were risk factors for severe injuries. Injury‐related time loss was positively related to total academic success (r=.20; P=.02) and success in theoretical courses (r=.24; P=<.01). No association was found between time loss and academic success for sport courses.     

Incidence and severity of reported acute sports injuries in 35 sports using insurance registry data

Acute injuries in sport are still a problem where limited knowledge of incidence and severity in different sports at national level exists. In Sweden, 80% of the sports federations have their mandatory injury insurance for all athletes in the same insurance company and injury data are systematically kept in a national database. The aim of the study was to identify high‐risk sports with respect to incidence of acute and severe injuries in 35 sports reported to the database. The number and incidences of injuries as well as injuries leading to permanent medical impairment (PMI) were calculated during 2008–2011. Each year approximately 12 000 injuries and 1 162 660 licensed athletes were eligible for analysis. Eighty‐five percent of the injuries were reported in football, ice hockey, floorball, and handball. The highest injury incidence as well as PMI was in motorcycle, handball, skating, and ice hockey. Females had higher risk of a PMI compared with males in automobile sport, handball, floorball, and football. High‐risk sports with numerous injuries and high incidence of PMI injuries were motorcycle, handball, ice hockey, football, floorball, and automobile sports. Thus, these sports ought to be the target of preventive actions at national level.     

The prevalence and severity of health problems in youth elite sports: A 6‐month prospective cohort study of 320 athletes

Little is known regarding the overall health of youth elite athletes. Our aim was to describe the prevalence and severity of health problems in a cohort of youth elite athletes representing a variety of endurance, team, and technical sports. Elite sport athletes (N = 260, 16.2 years) from different Sport Academy High Schools in Norway, and a group of their teammates (N = 60, 16.4 years) attending regular high schools, were included in the study. The Oslo Sports Trauma Research Centre (OSTRC ) questionnaire on health problems was used to self‐report injuries and illnesses for 26 weeks. At any given time, an average of 43% [95% CI : 37%‐49%] of the elite sport athletes had some form of health problem and 25% [20%‐31%] had substantial health problems. The prevalence of health problems was similar between the elite team sport athletes and their teammates, except for substantial injuries (22% [16%‐30%] vs 10% [5%‐20%]). Endurance sport athletes reported more illnesses (23% [15%‐35%]) than technical and team sport athletes (10% [5%‐20%] and 8% [4%‐14%]). In contrast, technical and team sport athletes reported more injuries (36% [95% CI : 25‐48] and 37% [95% CI 29‐45]) compared to endurance sport athletes (15% [8%‐25%]). The total impact of health problems was roughly split in thirds between overuse injuries (37%), acute injuries (34%), and illnesses (30%). This is the first prospective study to present self‐reported injury and illness data in a large heterogeneous group of youth elite athletes, documenting a substantial impact of both injuries and illnesses on the health of this population.     

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.     

High ankle injury rate in adolescent basketball: A 3‐year prospective follow‐up study

This prospective study investigated the incidence and pattern of acute time‐loss injuries in young female and male basketball players. Eight basketball teams (n=201; mean age 14.85±1.5) participated in the follow‐up study (2011‐2014). The coaches recorded player participation in practices and games on a team diary. A study physician contacted the teams once a week to check new injuries and interviewed the injured players. In total, 158 injuries occurred. The overall rate of injury (per 1000 hours) was 2.64 (95% CI 2.23‐3.05). Injury rate was 34.47 (95% CI 26.59‐42.34) in basketball games and 1.51 (95% CI 1.19‐1.82) in team practices. Incidence rate ratio (IRR) between game and practice was 22.87 (95% CI 16.71‐31.29). Seventy‐eight percent of the injuries affected the lower limbs. The ankle (48%) and knee (15%) were the most commonly injured body sites. The majority of injuries involved joint or ligaments (67%). Twenty‐three percent of the injuries were severe causing more than 28 days absence from sports. Number of recurrent injuries was high (28% of all injuries), and most of them were ankle sprains (35 of 44, 79%). No significant differences were found in injury rates between females and males during games (IRR 0.88, 0.55, to 1.40) and practices (IRR 1.06, 0.69, to 1.62). In conclusion, ankle and knee ligament injuries were the most common injuries in this study. Moreover, the rate of recurrent ankle sprains was alarming.     

Floorball‐related eye injuries: The impact of protective eyewear

Several previous studies have shown that floorball belongs to a high‐risk group of sports in terms of eye injuries. Protective eyewear is available, but the extent of its use and impact on eye injuries are unknown. The purpose of this study was to investigate the current incidence of eye injuries caused by floorball and to compare it with the present use of protective eyewear. Medical records were used to identify all eye injuries suffered while playing floorball in Jönköping County from 2008 to 2011 (N = 167). All these patients were sent a questionnaire that included inquiries about the use of protective eyewear. The study shows that floorball caused more eye injuries than all other sports combined (56%). Prolonged decreased visual acuity was very unusual (0.5%), but moderate eye injuries with some risk of future problems were seen in 62% of the sample. More than one fifth of the injured patients reported some kind of vision‐related problem 2–7 years after the original injury. Only one player had been using protective eyewear at the time of injury. Our results underline the importance of protective eyewear to prevent floorball‐related injuries.     

Risk factors for football injuries in young players aged 7 to 12 years

Football (soccer) is very popular among children. Little is known about risk factors for football injuries in children. The aim was to analyze potential injury risk factors in 7‐ to 12‐year‐old players. We collected prospective data in Switzerland and the Czech Republic over two seasons. Coaches reported exposure of players (in hours), absence, and injury data via an Internet‐based registration system. We analyzed time‐to‐injury data with extended Cox models accounting for correlations on team‐ and intra‐person levels. We analyzed injury risk in relation to age, sex, playing position, preferred foot, and regarding age‐independent body height, body mass, and BMI . Further, we analyzed injury risk in relation to playing surface. In total, 6038 player seasons with 395 295 hours of football exposure were recorded and 417 injuries occurred. Injury risk increased by 46% (Hazard Ratio 1.46 [1.35; 1.58]; P  < .001) per year of life. Left‐footed players had a higher injury risk (Hazard Ratio 1.53 [1.07; 2.19]; P  = .02) for training injuries compared to right‐footed players. Injury risk was increased in age‐adjusted taller players (higher percentile rank). Higher match‐training ratios were associated with a lower risk of match injuries. Injury risk was increased on artificial turf (Rate Ratio 1.39 [1.12; 1.73]; P  < .001) and lower during indoor sessions (Rate Ratio 0.68 [0.52; 0.88]; P  < .001) compared to natural grass. Age is known as a risk factor in older players and was confirmed to be a risk factor in children's football. Playing surface and leg dominance have also been discussed previously as risk factors. Differences in injury risks in relation to sex should be investigated in the future.     

Epidemiology of physical activity‐related injuries in Chinese university students

Knowledge gaps of the physical activity‐related injury (PARI) problem among general undergraduates exist. We conducted a study in four universities, where 1421 students graded 1‐3 were interviewed face‐to‐face during April and May after their completion of the baseline survey in March and April 2017, aiming to describe the incidence and characteristics of PARI. PARI experience and physical activity (PA) participation in the past 12 months were collected. Injury incidence density (IID) and risk, and injury characteristics were evaluated for the overall sample and by gender. Pearson chi‐square or Fisher's exact tests and independent‐sample t tests were used to test between‐group differences. We found that 486 PARIs were reported totally by 289 participants , with an overall IID of 0.57 per 1000 hours of exposure (males: 1.07, females: 0.45) and an injury risk of 0.34 injuries/student/y (males: 0.52; females: 0.28) . Higher IIDs were found in roller skating, football, and basketball. The majority of injuries occurred outdoors and involved the lower extremities, with sprain and strain being the primary injury types. Moreover, most injuries were new, acute, and happened in non‐contact situations. Of all injuries, 52.1% required medical attention and 64.6% resulted in inactivity of one or more days. Some significant differences were observed between males and females. Our study indicates that PARI is a public health concern among Chinese university students, which can provide direction for targeted prophylactic interventions to underpin the sex‐specific injury mechanism to reduce PARI.     

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.     

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.     

The association between physical fitness level and number and severity of injury and illness in youth elite athletes

Youth elite athletes often double their training and competition load after enrollment into specialized sport academy high school programs. The least fit athletes may be exposed to an excessive and too rapid increase in training load, with negative adaptations such as injury and illness as a consequence. In this study, our aim was to determine whether these least fit athletes were at greater risk of injury or illness during their first school year. Participants were 166 youth elite athletes (72% boys) from a variety of team, technical, and endurance sports newly enrolled into specialized sport academy high schools. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used to self‐report injuries and illnesses weekly for 26 weeks. Athletes completed the Ironman Jr physical fitness test battery at baseline, evaluating endurance, strength, agility, and speed properties. We ranked the athletes based on their combined test scores and identified the least fit quartile. The main outcome was the number and severity of health problems, comparing the least fit quartile of athletes to the rest of the cohort. Overall, the least fit quartile of athletes did not report more health problems (mean 3.7, 95% CI 3.0‐4.4) compared with the rest of the cohort (3.6, 3.2‐3.9). In conclusion, we demonstrated no association between low physical fitness level and number and severity of injury and illness in youth elite athletes after enrollment into a specialized sport academy high school program.     

Benefits of early development of eye–hand coordination: Evidence from the LOOK longitudinal study

We investigated longitudinal and cross‐sectional relationships between eye–hand coordination (EHC) and cardiorespiratory fitness (multistage run), physical activity (pedometers), percent body fat (%BF, dual energy x‐ray absorptiometry), body image, and organized sport participation (questionnaires) in 406 boys and 384 girls at 8 and 10 years of age. EHC was measured by a throw and wall‐rebound catch test involving 40 attempts of increasing difficulty. Median EHC improved during two years from 18 to 32 (boys) and 9 to 24 (girls), and gender differences and improvements were both significant (P < 0.001). Cross‐sectional analyses showed that boys and girls with better EHC were fitter (P < 0.001), and a longitudinal relationship showed that girls who improved their EHC over the two years became fitter (P < 0.001). There was also evidence that children with better EHC possessed a more positive body image (P = 0.05 for combined sex data), but there was no evidence of any relationships between EHC and %BF or PA (both P > 0.3). Finally, even at age 8 years, boys and girls participating in organized sport possessed better EHC than non‐participants. These data provide evidence for the premise that early acquisition of this single motor skill promotes the development of a child's fitness, body image, and participation in sport.     

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.