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

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

Epidemiology and traumatology of injuries in elite soccer: a prospective study in Finland

A prospective study of male soccer injuries among 12 teams playing at the highest competition level was carried out in Finland in 1993. Overall, two out of three players were injured during the whole season. The injury incidence per 1000 playing hours among injured players and all players during games was higher than during practice, 14.2 vs. 11.3 and 2.3 vs. 1.8, respectively. The lower extremity was involved in 76% of the injuries. Thigh injuries were most frequent (22%), whereas overuse injuries were scarce (6%). Eighteen per cent of the injured players needed surgery and in most cases (58%) the reason for surgery was a knee injury. Sixteen per cent of all injured players were absent from soccer for more than 1 month after the injury. The mean absence time was 17 days for all and 84 days for operatively treated players.     

The incidence and differential diagnosis of acute groin injuries in male soccer players

This prospective cohort study evaluated the incidence of acute groin injuries and estimated the distribution of differential diagnoses in male soccer players. Two senior male soccer divisions (21 teams, 326 players) were followed for 1 year. Patients with groin injuries were examined clinically as well as by herniography, sonography and by plain x-ray of the pelvic bones. Groin injuries accounted for 8% of all injuries. The incidence of groin injury was 0.8/1000 h of exposure. Thirteen (52%) of the 25 patients were clinically considered to have a muscle/tendon injury. However, when using sonography, muscle/tendon injury was only verified in 1 patient. Clinical suspicion of hernia or incipient hernia was evident in 4 (16%) of the patients, while 14 (56%) had a pathological finding at herniography. Clinical and paraclinical (i.e. diagnostic methods using imaging and other advanced techniques) diagnoses do not correspond very well in acute groin injury.     

Epidemiology of ankle and foot overuse injuries in sports: A systematic review

Studies regarding ankle and foot overuse injuries are quite diverse in research methodology, data reporting, and outcomes. The aims of this systematic review were to analyze the methodology of published studies regarding ankle and foot overuse injuries in different sports disciplines and to summarize epidemiological data of ankle and foot overuse injuries. Four electronic databases, PubMed (MEDLINE), EMBASE, CINAHL, and SPORTDiscus^® were systematically searched up to June 2011. A total of 89 articles on 23 sports disciplines were included in this review. Soccer, running, and gymnastics were the most frequently studied sports. Achilles tendinopathy, plantar fasciitis, and stress fracture were the most frequently studied injuries. Study design and reporting methods were heterogeneous. Most studies suffered from a weak methodology and poor reporting. The most common weaknesses were lack of a clear case definition, describing assessment procedures and reporting sample characteristics. Due to methodological heterogeneity of studies, inter‐sports and intra‐sports comparisons and meta‐analysis were not possible. Methodology of most studies on incidence and prevalence of ankle and foot overuse injuries is insufficient. Based on the results, we recommend authors to clearly define cases, describe assessment procedures and report sample characteristics adequately.     

Differences in injury risk and characteristics of injuries between novice and experienced runners over a 4-year period

Objectives: Running is increasingly popular, but also carries a high injury risk, especially in novice runners. This study investigates differences in incidence and characteristics of running-related injuries (RRIs) between novice and experienced runners in the open population, in order to adapt to more specific needs for future prevention programs.

Methods: Data were obtained from Injuries and Physical Activity in the Netherlands (IPAN), a Dutch questionnaire on injuries, physical activity, and sports. A representative sample of runners (n = 4621) from IPAN, including 1405 novice runners, was used to assess injury incidence rates, anatomical site, onset and need for medical attention of RRIs. Participants who started running during the past 12 months were defined as ‘novice’ runners. ‘Experienced’ runners are participants who had been running for more than 1 year.

Results: Of the 4621 runners, 41,8% were female. The average age was 34.2 years. From 2010 to 2013, a total of 416 injuries were reported. The incidence of RRIs was significantly higher in novice runners compared with experienced runners: 8.78 (8.59–8.96) vs. 4.24 (4.11–4.37) per 1000 h running. In both novice and experienced runners, most RRIs were located at the knee (30.5%) and lower leg (17.8%), with the Achilles’ tendon less frequently injured in novice runners (2.3% vs. 8.4%, p = 0.031). Novice runners sustained more medical attention injuries (36.8%) than experienced runners (29.2%) (p > 0.132).

Conclusions: In total, over 30% of all (novice and experienced) runners, suffered from RRI within 1 year. Novice runners reported more injuries per 1000 h of running in comparison to experienced runners. A tendency toward receiving medical attention more frequently was found in novice runners compared to experienced runners. In view of this higher injury incidence of RRIs and healthcare consumption in novice runners, more studies are needed to develop effective injury prevention programs for novice runners.     

Exposure and injury risk in Swedish elite football: a comparison between seasons 1982 and 2001

The long-term development of injury risk in Swedish male elite football was studied. Two prospective cohort studies from seasons 1982 and 2001 were compared with respect to exposure to football, injury incidence and injury severity. The mean number of training sessions during the season had increased by 68% between 1982 and 2001 (142 vs. 238, P<0.001), whereas teams played more matches in 1982 (49 vs. 41, P=0.02). The total exposure to football had increased by 27%. Three out of four players incurred an injury in both seasons. In 2001, players suffered more training injuries due to an increased training exposure. Accounting for risk exposure, there was no difference in injury incidence or severity between the two seasons. The incidence was 8.3 injuries/1000 h of total exposure (4.6 in training and 20.6 in matches) in 1982, compared to 7.8/1000 h-1 (5.2 in training and 25.9 in matches) in 2001. Major injuries accounted for 9% of all injuries, corresponding to an incidence of 0.8/1000 h of football, in both seasons. A trend from semi-professionalism to full professionalism in Swedish elite football was seen during the last two decades. The injury risk did not change over the same period.     

Sports injuries in school-aged children: A Studyd of traumatologic and socioeconomic outcome

In this Danish study we attempted to identify the socioeconomic consequences of sports injuries in childre. A total of 1320 children, 650 boys and 670 girls, aged 6–17, completed questionnaires covering the period from the injury to recovery. The incidence rate was 74 per 1000 per year. The hospitalization rate was 4.1%. Due to the injury 37.2% of the children were absent from school for an average of 1.2 days (range 0–60 days), resulting in 1598 days' absence from school. Most of the children were injured during training (34.7%) or competition (22.6%). The other injuries occurred durin recreational sporting activities (32.0%) or at school (10.7%). Fifty-four percent were absent from work, on average for 2.2 days. Two hundred and nineteen children were absent from an after-school job, for an average of 8.6 days. The total loss was 1896 working days. training or games, on average 6.0 times (range 0–99), with a total loss of 7897 training sesions. Fiften percent of the percent of the parents wre absent from work, on average for 2.2 days. Two hundred aqn nineten children wer absent from an afterschool job, for an average of 8.6 days. The total low was 1896 working day. The study shows that the socioenconomic consequences of sports injuries in children are a complex consisting of different parts and that the ijuries had a substantial impact on the functional and social status of the children and their families.     

Injuries in Swedish elite football--a prospective study on injury definitions, risk for injury and injury pattern during 2001

The purpose of this study was to study the risk for injury and injury pattern in Swedish male elite football and to compare two different injury definitions. A prospective cohort study was conducted during 2001 on all 14 teams (310 players) in the Swedish top division. Injuries and individual exposure were recorded. Injury was defined as time-lost injury (715 injuries) and for comparison as tissue injury (765 injuries). No significant difference in the risk for injury between tissue injuries and time-lost injuries was found during matches (27.2 vs. 25.9 injuries per 1000 match hours, P=0.66) or training sessions (5.7 vs. 5.2 injuries per 1000 training hours, P=0.65). The risk for injury during training was significantly higher during the pre-season compared with the competitive season (P=0.01). Thigh strain was the single most common injury (14%). Knee sprain was the most common major injury (absence >4 weeks). Overuse injuries and re-injuries were frequent and constituted 37% and 22% of all injuries. Re-injuries caused significantly longer absence than their corresponding initial injuries (P=0.02). The risk for re-injury (P=0.02) and overuse injury (P<0.01) was significantly higher during the pre-season compared with the competitive season.     

Danish translation and validation of the Oslo Sports Trauma Research Centre questionnaires on overuse injuries and health problems

The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC‐O) and the Oslo Sports Trauma Research Centre questionnaire on Health Problems (The OSTRC‐H) make it possible to monitor illness and injury at regular intervals capturing prevalence and incidence of acute injury, overuse injury, and illnesses. The aim of this study was to translate, culturally adapt, and establish the face validity of the OSTRC‐O and the OSTRC‐H into a Danish context (DK) through cognitive interviews and the assessment of test–retest reliability. The OSTRC‐O.DK was distributed to 57 heterogenous respondents; response rate was 89%. The OSTRC‐H was distributed to 58 heterogenous respondents; response rate was 86%. No major disagreements were observed between the original and translated versions of the questionnaires. The OSTRC‐O had high internal consistency (Cronbach's alpha 0.80–0.93). The primary reliability analyses including all participants, showed reliability ICC: 0.62 (95% CI: 0.42–0.77. The secondary reliability analyses that only included subjects who did not change injury region from the test to the retest showed an ICC of 0.86 (95% CI: 0.77–0.92).The questionnaires were found to be valid, reliable, and acceptable for use in a Danish population.     

Aerobic physical activity assessed with accelerometer,diary, questionnaire,and interview in a Finnish population sample

This study evaluates the agreement between different methods to assess moderate to vigorous physical activity (MVPA) in a large sample of Finnish adults. Methods were classified and examined pairwise (accelerometer vs diary; questionnaire vs interview). Proportion of participants meeting the aerobic health‐enhancing physical activity (HEPA) recommendation was compared pairwise between all four methods. The present study of 1916 adults aged 18‐75 years (mean age 50 years, 57% women) is a sub‐sample of population‐based Health 2011 Study conducted by the National Institute of Health and Welfare in Finland. Participants used accelerometer for 7 days and completed physical activity (PA) diary during the same period. PA questionnaire and interview were completed retrospectively to assess typical weekly PA over the past year. Agreement between the methods was analyzed with paired samples t ‐test and Bland‐Altman plot. Kappa‐test was used to compare the prevalence of meeting the HEPA recommendation. The accelerometer resulted in 13 minutes (P  <  0.001) higher weekly total amount of MVPA compared to diary. According to Bland‐Altman plot, the 95% limit of agreement was from +273 to −247 in weekly minutes. The comparison between questionnaire and interview showed non‐significant mean difference of 3 minutes (P  =  0.60) in weekly MVPA, but the Bland‐Altman plot showing the 95% limit of agreement from +432 to −427 in weekly minutes. Agreement of meeting HEPA recommendation was moderate between questionnaire and interview (κ  = 0.43) but poor (κ  = 0.20‐0.38) between other comparisons. The inter‐method differences were large especially at the individual level. Thus the assessment of PA is strongly method‐dependent and not interchangeable.     

Injury incidence, mechanism and diagnosis in top-level teamgym: a prospective study conducted over one season

The aim of this study was to evaluate injury incidence, mechanism and diagnosis in Swedish teamgym. Sixteen male and 26 female gymnasts with international experience were prospectively followed during one season of training and competition. Injuries leading to a modified participation or total absence from gymnastics during 1 week or more were registered. Twenty-seven of the 42 gymnasts sustained 42 injuries. The injury incidence was 2.2/1000 gymnastics hours. No gender differences were found. Sixty-two percent of the injuries were located to the lower extremity, 28.5% to the back and 9.5% to the upper extremity. The most common injury was ankle sprain and the most frequent mechanisms were joint compression and joint rotation. The majority of the injuries occurred in the landing phase of the gymnastics skills and 50% of the injuries were reported at the end of the training session. Eighteen injuries occurred while the gymnasts were in a negative state of mood such as stressed or afraid. Injury prevention programs should be developed with respect to these findings. Special emphasis must be placed on the landing phase of the gymnastics skills as this phase seems to be critical.     

Arcuate sign of posterolateral knee injuries: anatomic,radiographic, and MR imaging data related to patterns of injury

Objective The arcuate sign is considered a pathognomonic sign for injuries of the posterolateral (PL) corner of the knee. The purpose of our study was to identify different patterns of injury to the fibular head that may associate with injuries to specific ligaments and tendons of the PL corner of the knee. The anatomic relations between the insertions of fibular collateral ligament (FCL), biceps femoris tendon (BFT), popliteofibular ligament (PFL), and arcuate ligament in normal cadaveric knees were also investigated.Design and patients Magnetic resonance imaging was performed in two cadaveric knees which subsequently were dissected. Radiopaque markers were placed upon the fibular insertions of the FCL, BFT, PFL, and arcuate ligament in the dissected knees, and knee radiographs were then obtained. Twelve patients with radiographic or MR imaging evidence of isolated injury to the PL corner of the knee were retrospectively reviewed, with regard to avulsion fractures and marrow edema in the fibular head and the integrity of the ligaments of the PL corner of the knee.Results and conclusions The PFL and arcuate ligament were seen to attach directly to the posterior and medial aspect of the styloid process of the fibular head. The FCL and BFT attached as a conjoined structure on the lateral aspect of the fibular head lateral, anterior and inferior to the attachment site of the PFL and arcuate ligament. Injury to the arcuate ligament or PFL was diagnosed in 8 patients who presented with a small avulsion fracture of the styloid process of the fibula (n=2), bone marrow edema in the medial aspect of the fibular head (n=3), or both (n=3). In 4 patients with injury to the conjoined tendon or FCL, a larger avulsion fragment and more diffuse proximal fibular edema were seen. Radiographic and MR imaging findings in injuries of the posterolateral corner of the knee may suggest injury to specific structures inserting in the fibular head.Presented at the 87th Annual Meeting of the Radiologic Society of North America, 2001.     

Head injuries in the female football player: incidence, mechanisms, risk factors and management

Although all injuries in sports are a concern for participants, head injuries are particularly troublesome because of the potential for long-term cognitive deficits. To prevent any specific injury, it is important to understand the basic frequency and incidence of injury and then the mechanism of injury. Once these are established, prevention programmes can be tested to see if the rate of injury changes. A primary problem with head injuries is recognising that the injury has occurred. Many athletes are not aware of the seriousness of concussive injury, thus this type of injury is probably under-reported. Once the diagnosis of a concussion is made, the next difficult decision is when to return a player to the game. These two management issues dominate the continuing development of understanding of concussive head injury. This paper explores the known gender differences between head injuries and highlights the areas that need to be considered in future research.     

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.     

Radiation necrosis of the brain: Time of onset and incidence related to total dose and fractionation of radiation

Summary Clinical deterioration during or after brain irradiation may be due to progression of neoplasm or radiation induced necrosis of the neoplasm and/or of normal brain tissues, or a combination of all. Eight patients with histologically documented radiation induced lesions of the brain are included in this study. The radiation therapy included the fractional schedule, group A, who received 280 to 300 rads daily, to a total dose of 4500 to 5000 rads and weekly exposure did not exceed 900 rads. Group B patients were exposed to 850 rads, daily dose on day 1, 3, 21 and 23 to a total dose of 3400 rads. The incidence of radiation induced lesions of brain was 3.4% in patients group A and 8.7% in group B patients (without) statistical significance). The median time of onset of these lesions after completion of radiation therapy was significantly shorter in group B patients (8.5 months) as opposed to group A patients (21 months).     

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.     

Perceived barriers to physical activity across Norwegian adult age groups, gender and stages of change

This study investigated differences in the type of and number of perceived barriers to engagement in physical activity experienced by adult women and men in the same geographical area, the relationship between the experienced barriers and stages of change in relation to exercise behavior, and identified barriers related to reported engagement in leisure-time physical activity. Data were obtained from a population study by the National Institute of Public Health in two counties during 2000-2001. The sample consisted of 2709 females and 2212 men in the age groups 75, 60, 45, 40 and 30 years. Questionnaires measured barriers to engagement in physical activity, engagement in physical activity and readiness for engaging in physical activity (stages of change). Multivariate analyses of variance demonstrated significant age and gender differences in the perceptions of barriers at the various stages of change. The logistic regressions [estimated odds ratios (OR)] demonstrated that low scores for affective/cognitive and practical barriers were significantly associated with higher OR for engagement in physical activity for women, and low-priority barriers and lower age were associated with higher OR for being physically active for men. The information from this study should be valuable for designing and tailoring both motivational strategies and interventions to fit targeted groups.