A prospective cohort study of anterior cruciate ligament injuries in elite Norwegian team handball

The purpose of this study was to examine gender differences in the incidence of anterior cruciate ligament (ACL) injuries in a population of highlevel team handball players. We also wanted to examine injury mechanisms and possible risk factors for ACL injuries, including menstrual status. The study was done prospectively during the 1993-94, 1994-95, and 1995–96 seasons. We found 28 ACL injuries, 23 among women (incidence: 0.31 ± 0.06 injuries per 1000 player hours) and 5 among men (0.06 ± 0.03 inj./1000 h; P < 0.001 vs women; risk ratio: 5.0). Of the 28 injuries, 24 occurred during competiton (0.91 ± 0.19 inj./1000 h; women: 1.60 ± 0.35 inj./1000 h; men: 0.23 ± 0.13 inj./1000 h; P ±0.001 vs. women; risk ratio: 7.0) and 4 during training (0.03 ± 0.02 inj./1000 h; P ±0.001 vs. competition; risk ratio: 29.9). Nearly all the injuries ( n = 25) occurred in noncontact situations when the players performed high-speed plant-and-cut movements which they were well accustomed to. A reliable menstrual history could be obtained in 17 of the 23 cases among females. Five of the injuries occurred in the menstrual phase, 2 in the follicular phase, 1 in the early luteal phase and 9 in the late luteal phase (chi-square_{3 d.f.}= 13.2; P ±0.01). The results suggest that there may be an increased risk of ACL injury during the week prior to or after the start of the menstrual period.     

A prospective study of kitesurfing injuries

BACKGROUND: To date, the pattern and rate of kitesurfing injuries are largely unclear. HYPOTHESIS: The pattern and rate of kitesurfing injuries are comparable to that of contact sports such as football and soccer. STUDY DESIGN: Prospective study. METHODS: The study was conducted over a 6-month period of 1 season and included 235 kitesurfers. RESULTS: The number of self-reported injuries was 124, for an overall self-reported injury rate of 7 per 1000 hours of practice. One fatal accident (polytrauma) and 11 severe injuries occurred during the study period (2 knee ligament injuries and 9 fractures at various sites). The most commonly injured sites were the foot and ankle (28%), skull (14%), chest (13%), and knee (13%). Fifty-six percent of the injuries were attributed to the inability to detach the kite from the harness in a situation involving loss of control over the kite. There was a tendency for athletes using a quick-release system to sustain fewer injuries than athletes without such a release system. CONCLUSION: Kitesurfing can be considered a high-risk sport. CLINICAL RELEVANCE: The use of a quick-release system that enables the surfers to detach the kite in case of an accident might aid in the prevention of injuries.     

Prognosis and prognostic factors of running-related injuries in novice runners: A prospective cohort study

Objectives

To investigate the prognosis and possible prognostic factors of running-related injuries (RRIs) in novice runners.

Musculoskeletal injuries in the Norwegian National Ballet: a prospective cohort study

The purpose of the present study was to determine the incidence of musculoskeletal injuries among professional ballet dancers in the Norwegian National Ballet. A 19 weeks prospective study with registration and clinical assessment of dancers with injuries was conducted. Medical staff working for the National Ballet registered incidence of injuries. In addition the dancers filled out a questionnaire about previous injuries, their work situation, and factors they believed increased the risk of injuries. Of the 41 dancers (80% response rate), 31 dancers experienced one injury or more. The majority of injuries involved foot and ankle. Twenty-two per cent of the injuries were acute injuries. Seventy-five per cent of the injuries were soft tissue injuries. Most injuries were of mild to moderate severity. Sixteen per cent of the injuries resulted in absence from work. Factors, the dancers believed were associated with risk of injuries were related to training, organizational factors and environmental factors. Seventy-eight per cent of the dancers experienced "negative" stress at work. Sixty-four per cent experienced that they had little influence on their work conditions. This study showed, however, no significant association between these psychological factors and musculoskeletal injuries. It is concluded that there is a high incidence of musculoskeletal injuries in the Norwegian National Ballet.     

Spinal injuries in professional rugby union: a prospective cohort study.

OBJECTIVES: To determine the incidence, severity, nature, and causes of cervical, thoracic, and lumbar spine injuries sustained during competition and training in professional rugby union. DESIGN: A 2 season prospective cohort design. SETTING: Twelve English Premiership rugby union clubs. PARTICIPANTS: Five hundred and forty-six male rugby union players of whom 296 were involved in both seasons. MAIN OUTCOME MEASURES: Location, diagnosis, severity (number of days unavailable for training and matches), and cause of injury: incidence of match and training injuries (injuries/1000 player-hours). RISK FACTORS: Player age, body mass, stature, playing position, use of headgear, and activity and period of season. RESULTS: The incidences of spinal injuries were 10.90 (9.43 to 12.60) per 1000 player match-hours and 0.37 (0.29 to 0.47) per 1000 player training-hours. No player sustained a catastrophic spinal injury, but 3 players sustained career-ending injuries. Overall, players were more likely to sustain a cervical injury during matches and a lumbar injury during training. Forwards were significantly more likely to sustain a spinal injury than backs during both matches (P < 0.01) and training (P = 0.02). During matches, injuries to the cervical (average: 13 days; P < 0.01) and lumbar (13 days; P < 0.01) spine were more severe than injuries to the thoracic (5 days) spine; during training, injuries to the lumbar spine (26 days) were more severe than injuries to the cervical (13 days; P = 0.10) or thoracic (12 days; P = 0.06) spine. A total of 4037 days were lost to competition and training through spinal injuries with lumbar disc injuries sustained during training accounting for 926 days (23%) and cervical nerve root injuries sustained during matches for 621 days (15%). During matches, more injuries were caused by tackles (37%), and during training more injuries were caused by weight-training (33%). CONCLUSIONS: The results showed that rugby union players were exposed to a high risk of noncatastrophic spinal injury during tackling, scrummaging, and weight-training activities; injury prevention strategies, therefore, should be focused on these activities.     

A three-year epidemiological prospective cohort study of rugby league match injuries from the European Super League

Objectives

Conduct a comprehensive epidemiological study of match injury characteristics (incidence, severity, causes, diagnostics, and temporal trends) in professional rugby league.

Injury risk factors in female European football. A prospective study of 123 players during one season

The purpose of this study was to register prospectively the injuries in female soccer and to study their correlation to potential risk factors. A total of 123 senior players from eight teams of different levels were followed during one season. Isokinetic knee muscle strength at 60 and 180 degrees/s, one-leg-hop, vertical jump, square-hop, and continuous multistage fitness test (MFT) were tested at the end of the pre-season. In addition, Body Mass Index (BMI) and general joint laxity were measured. During the season, April-October, all injuries resulting in absence from one practice/game or more were registered. Forty-seven of the 123 players sustained altogether 65 injuries. The total injury rate was 14.3 per 1000 game hours and 3.7 per 1000 practice hours. The knee (26%) was the most commonly injured region followed by the foot (12%), ankle (11%), thigh (11%) and back (11%). The risk of sustaining moderate and major injuries increased in the later part of the game or practice. Significant risk factors for injuries were an increased general joint laxity (odds ratio (OR)=5.3, P<0.001), a high performance in the functional test square-hop (OR=4.3, P=0.002), and an age over 25 years (OR=3.7, P=0.01). The injury rate was not different compared to male soccer, but knee injuries were more common, which is in accordance with previous studies. None of the risk factors identified in this study is easily applicable for future intervention studies in the attempts to reduce the injury rate in female soccer.     

A prospective study of high school wrestling injuries

We performed a prospective study to evaluate injury patterns in a large population of high school wrestlers during one season. Preseason screening was performed on 458 male wrestlers from 14 different high schools. Certified athletic trainers submitted detailed weekly team and individual injury reports. There were 219 injuries in 418 wrestlers followed throughout the season for an overall injury incidence of 52 injuries per 100 wrestlers per season and an injury rate of 6.0 injuries per 1,000 exposures. The most commonly injured areas were the shoulder (24%) and knee (17%). Injured wrestlers were an average of 5 months older and had a 32% higher experience level than noninjured wrestlers. Wrestlers with ligamentous laxity suffered fewer shoulder injuries than the other wrestlers. The majority of injuries occurred in practice (63%), although the injury rate was higher in match competitions. Sixty-eight percent of practice injuries occurred during hard wrestling, 23% during drills, and 9% during conditioning. The most common wrestling situation resulting in injury was the takedown position (68%). Our results show that the older and more experienced wrestler may be at greater risk of injury. Hard wrestling during practice and the takedown position resulted in the highest occurrence of injury.     

The incidence,prevalence, severity,mechanism and body region of injury in elite junior Australian football players: A prospective cohort study over one season

Objectives

To describe the incidence, prevalence, severity, mechanism and body region of injuries in elite junior Australian football (AF) players over one competitive season in order to help inform injury prevention interventions.

Fielders and batters are injured too: A prospective cohort study of injuries in junior club cricket

Internationally, there is a lack of good quality, prospectively collected injury data reported for junior club cricketers. This study describes injury rates according to age level of play and playing positions in junior community-level club cricketers to identify priorities for prevention. A prospective cohort study was used to monitor injuries in 88 under 12 years (U12), 203 U14 and 120 U16 players from the Ballarat Junior Cricket Association, Australia over the 2007/2008 playing season. Injury rates were calculated per 1000 participations when batting, bowling or fielding in matches and training sessions. Injury rate ratios were used to compare rates across age levels of play and position of play. Overall, 47 injuries were reported. Injury rates increased with age level of play with only one U12 player injured. Match injury rates were 3.57 per 1000 U14 participations versus 4.80 per 1000 U16 participations. Training injury rates were 4.20 per 1000 U14 participations versus 5.11 per 1000 U16 participations. On a proportionate basis, injuries occurred equally to fielders, batters and bowlers. There was a trend towards more injuries occurring while batting and fielding in matches, and more injuries occurring while bowling and batting during training sessions. In conclusion, injury rates in junior cricket players are low, but increase with age level of play. Unlike adult forms of the game, injuries occur to fielders and batters at least as frequently as to bowlers, indicating that preventive strategies need to be developed for all junior players and not just bowlers, as has been the focus previously.     

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.     

Knee injuries in volleyball

The knee is the most frequent site of injury in volleyball players. More than 40% of high level players suffer overuse injuries during this activity; this particularly painful syndrome is caused by the amount of jumping typical in volleyball play, and in its training which aims at strengthening the quadriceps muscle. In volleyball players the extensor apparatus is subject to continuously high stress and the bone tendon junction, being the weakest point, is susceptible to lesion. The prevention and treatment of 'jumper's knee' requires a high degree of cooperation among trainers, doctors and athletes. Although volleyball is a sport without contact between players, traumatic acute injuries are more frequent and more serious than would be expected. It is therefore important to emphasise that volleyball must be considered among the high risk sports that expose the knee not only to twisting, but also to contact with other players. Generally, the lesions are caused by frequent jumps with loss of balance and a consequent 'one-footed' landing. There is no specific method of preventing knee instability. Accurate diagnoses, rest and rapid surgical treatment after the first injury are recommended in order to avoid chronic knee instability with subsequent meniscal lesions and post-traumatic osteoarthritis.     

A prospective study of injuries in licensed floorball players

Injuries occuring among 457 licensed floorball players in teh Swedish National League were analysed prospectively during the season from 1993 to 1994. Fifty-one (11%) players sustained 58 injuries. The majority (76%) of the injuries were due to trauma mostly during the game (55%). Twenty-three (52%) of the traumatic injuries were caused by an opponent or a stick. Ankle sprain (35%) was the most common diagnosis. Injury severity classified with regard to time of absence from sport participation were similarly distributed for minor (36%), moderate (29%) and major (35%) injuries. The total rate of injury was 2.5 per 1000 hours for female and 2.6 for male players. Although this rate is lower than for contact sports like soccer and ice-hockey, we feel that further investigation of floorball injuries and improvement of protection devices would be valuable.     

Hand injuries in volleyball.

We studied the long-term sequelae of hand injuries as a result of playing volleyball. In a retrospective study, 226 patients with injuries of the hand who were seen over a 5-year period at our Trauma Department, were investigated. Females accounted for 66% of all injuries. The mean age was 26 years, with a peak in the age group of 15 to 29 years. Sprains and strains were observed most frequently (39%), followed by fractures (25%) and contusions (16%). The fingers were involved in 44% of the cases. Most injuries of the hand occurred in recreational players. Recreational players had more left-sided injuries, whereas competition players had more right-sided injuries (P less than 0.005), suggesting that lack of skill is an important determinant. Left-handedness was associated with an increased risk of hand injury in recreational players. One third of the volleyball players did not go to work or school for a median of 4 weeks as a result of the injury. In a survey after a mean period of 5 years, a high percentage of patients had complaints: 28% cited stiff and crooked fingers with limitations and tenderness in the movements as main inconveniences. We consider this incidence disturbingly high, regarding the seemingly innocent nature of these injuries.     

UEFA Champions League study: a prospective study of injuries in professional football during the 2001-2002 season

Background: No previous study on adult football involving several different countries has investigated the incidence and pattern of injuries at the highest club competitive level. Objective: To investigate the risk exposure, risk of injury, and injury pattern of footballers involved in UEFA Champions League and international matches during a full football season. Method: Eleven top clubs (266 players) in five European countries were followed prospectively throughout the season of 2001–2002. Time-lost injuries and individual exposure times were recorded during all club and national team training sessions and matches. Results: A total of 658 injuries were recorded. The mean (SD) injury incidence was 9.4 (3.2) injuries per 1000 hours (30.5 (11.0) injuries per 1000 match hours and 5.8 (2.1) injuries per 1000 training hours). The risk of match injury was significantly higher in the English and Dutch teams than in the teams from France, Italy, and Spain (41.8 (3.3) v 24.0 (7.9) injuries per 1000 hours; p = 0.008). Major injuries (absence >4 weeks) constituted 15% of all injuries, and the risk of major injury was also significantly higher among the English and Dutch teams (p = 0.04). National team players had a higher match exposure, with a tendency towards a lower training injury incidence than the rest of the players (p = 0.051). Thigh strain was the most common injury (16%), with posterior strains being significantly more common than anterior ones (67 v 36; p<0.0001). Conclusions: The risk of injury in European professional football is high. The most common injury is the thigh strain typically involving the hamstrings. The results suggest that regional differences may influence injury epidemiology and traumatology, but the factors involved are unclear. National team players have a higher match exposure, but no higher risk of injury than other top level players.     

Injuries in adolescent female players in European football: a prospective study over one outdoor soccer season

In this prospective study, injuries in 153 adolescent female soccer players were recorded during one outdoor season (April-October). The overall injury incidence rate was 6.8 per 1000 h soccer (games and practice) and the incidence rate of traumatic injury 9.1 and 1.5 per 1000 player-hours in games and practice, respectively. Sixty-three players (41%) sustained 79 injuries. Sixty-six percent of the injuries were traumatic and 34% were overuse injuries. Most of the traumatic injuries occurred during games. Eighty-nine percent of the injuries were located in the lower extremities and 42% occurred in the knee or ankle. The most frequent type of injury was ankle sprain (22.8%). Forty-one percent of the traumatic injuries and 56% of the ankle sprains were re-injuries. Most of the injuries were of moderate severity (52%), while 34% were minor and 14% were major. Most of the major injuries were traumatic such as knee ligament injuries and ankle sprains.