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.     

Survey of sport participation and sport injury in Calgary and area high schools.

OBJECTIVE: To examine (1) sport participation and (2) sport injury in adolescents. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective survey design. In total, 2873 adolescents were recruited from a random sample of classes from 24 Calgary and area high schools. Each subject completed an in-class questionnaire in March 2004. MAIN OUTCOME MEASUREMENTS: Overall and sport-specific participation rates (number of sport participants/number of students completing survey). Overall and sport-specific injury rates (number of injuries/number of participants). RESULTS: In the previous 1 year, 94% of students participated in sport. The top 5 sports by participation for males were basketball, hockey, football, snowboarding, and soccer, and for females, basketball, dance, volleyball, snowboarding, and soccer. The injury rate including only injuries requiring medical attention was 40.2 injuries/100 adolescents/y (95% CI, 38.4-42.1), presenting to a hospital emergency department was 8.1 injuries/100 adolescents/y (95% CI, 7.1-9.2), resulting in time loss from sport was 49.9 injuries/100 adolescents/y (95% CI, 48-51.8), and resulting in loss of consciousness was 9.3 injuries/100 adolescents/y (95% CI, 8.3-10.5). The greatest proportion of injuries occurred in basketball, hockey, soccer, and snowboarding. The top 5 body parts injured were the ankle, knee, head, back, and wrist. The top 5 injury types were sprain, contusion, concussion, fracture, and muscle strain. A previous injury was associated with 49% of the injuries and direct contact with 45% of injuries. CONCLUSIONS: Rates of participation in sport and sport injury are high in adolescents. Future research should focus on prevention strategies in sports with high participation and injury rates to maximize population health impact.     

Risk factors for dive injury: a survey study

Scuba diving is a world sport, but it is not medically regulated. Study objectives sought to identify risk behaviors, preexisting medical conditions, compliance to dive guidelines, and injury patterns of recreational scuba divers. An Internet-based survey examined risk behaviors and diver safety practices. Responses from 682 of 770 (88.6%) divers revealed that 80.6% were certified; 51.7% of certified divers reported diving injuries versus 75.0% for noncertified divers (RR = 1.31; 95% CI: 1.16-1.48; P < 0.001); suspected decompression symptoms were witnessed by 52.6% of divers; 32.7% of certified divers reported medical problems including hypertension, asthma, diabetes, and epilepsy. No significant differences were observed in injuries among the certified divers based on dive frequency (P = 1.000), medical conditions (P = 0.750), smoking (P = 0.545), alcohol (P = 0.649), or illicit substances use (P = 0.230). Among certified divers, there was a positive association with fewer diving injuries but not with diving frequency, preexisting medical condition(s), smoking, alcohol, or illicit substance use.     

Sociodemographic predictors of sport injury in adolescents

OBJECTIVE: To examine sociodemographic risk factors for sport injury in adolescents. METHODS: This is a cross-sectional survey design in which a random sample of high school students (ages 14-19) completed an in-class survey (N = 2721). Students were asked questions regarding sociodemographic factors, sport participation, and sport injury in the past year. RESULTS: The incidence proportion of self-reported and medically treated sports injury, adjusting for the clustering effect of school, was 67.5 (95% CI; 64.2-71.1) and 43.2 (95% CI; 40.4-46.3) per 100 adolescents per year, respectively. Students from small towns had a lower risk of injury than those in the larger urban center (ORadjusted = 0.76, 95% CI 0.63-0.92). Non-Caucasian students had a lower risk of injury than did Caucasian students (ORadjusted = 0.63 (95% CI 0.5-0.79) for all sport injury and 0.57 (95% CI 0.47 - 0.7) for medically treated sport injury. Students with BMI in the 50th-90th percentiles had the greatest risk of sport injury. The risk of injury increased with weekly hours of participation. CONCLUSIONS: Location of residence, weekly exposure (participation hours), ethnicity, and BMI were simultaneous predictors of sport injuries in adolescents.     

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.     

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

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

The role of hyperbaric oxygen therapy in sports medicine

During the past decade, we have seen a growing number of individuals participating in sport and recreational activities. All indications show an increase in sport participation at every age level. However, the number of sport and recreational injuries as a result of this increase has also risen. Unfortunately, a primary cost related to injury recovery is the time lost from participating in and resuming normal functional activity. This has compelled health care professionals to seek more efficient and effective therapeutic interventions in treating such injuries. Hyperbaric oxygen (HBO) therapy may serve to provide a means of therapy to facilitate a speedier resumption to pre-injury activity levels as well as improve the short and long term prognosis of the injury. Although a growing interest in sports medicine is becoming evident in the literature, the use of HBO as an intervention in this field has received a great deal of cynicism. To date, numerous professional athletic teams, including hockey (NHL), football (NFL), basketball (NBA) and soccer (MLS), utilise and rely on the use of HBO as adjuvant therapy for numerous sports-related injuries acquired from playing competitive sports. However, to date, very little has been published on the application benefits of hyperbaric therapy and sports injuries. The majority of clinical studies examining the efficacy of HBO in treating soft tissue injuries have been limited in their sample size and study design. Further research needs to be conducted suggesting and validating the significant effects of this treatment modality and further grounding its importance in sports medicine.     

A preliminary investigation into the long-term injury consequences reported by retired baseball players

Seventy-five retired baseball players participated in a survey (37.8% response rate) in order to establish the long-term consequences of injuries sustained during their playing careers. Respondents had a mean age of 55.8 (+/-11.4) years with a mean age of 41.3 (+/-11.4) years at retirement from play. The mean overall rate of injury suffered per player/playing career was 5.6 (+/-7.1). 54.7% of respondents experienced a major injury (i.e. injury resulting in 5 or more consecutive weeks absence from training and play) with a mean major injury per player/playing career of 1.5 (+/-2.2). The rate for significant injuries (i.e. injury resulting in more than 1 week but less than 5 weeks absence from training and play) was 4.1 (+/-6.5) per player/playing career. Catchers had significantly less injuries than all other positions (p=0.027). 18.7% of all respondents reported suffering from arthritis, 24% from restricted joint mobility and 4% from chronically stiff fingers; all of these conditions were associated with their participation in baseball based on medical examination by their GP or medical specialist. 29.3% of respondents indicated that they had incurred additional medical costs and 12% reported significant loss of income associated with their injuries. Some injuries were severe enough that they resulted in extended stays in hospital producing costs carried by the health care system.     

New Zealand's Injury Prevention Research Unit: reducing sport and recreational injury.

The Injury Prevention Research Unit was established in 1990 to reduce the incidence, severity and consequences of injury. Research into sport and recreational injury is one of five major areas of research being undertaken. National data sources have been used to estimate the overall size of the problem and to describe the nature and circumstances of injury associated with a variety of sport and recreational activities. Analytical studies are now being undertaken to identify significant risk and protective factors. Research activity is being directed toward the development, implementation and evaluation of preventive measures.     

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.     

Impact of school sports injury

BACKGROUND: Most injuries in school occur during sport. OBJECTIVES: To explore the impact of sports injury in supervised school sport. METHOD: A prospective study of sports injury in children of secondary school age presenting to the accident and emergency department. Each patient was identified on registration, matched with medical records after discharge, and contacted later by telephone to complete a structured interview. Patients were only included if their injury was sustained during supervised school sport. RESULTS: During the study period, 194 patients aged 11-18 attended the accident and emergency department with an injury, 51% of which occurred during school sport. Injuries occurred most commonly in rugby (43%), followed by physical education and games together (17.5%). Most injuries were x rayed (72%). Just over 12% of pupils lost no time from sport, most (71%) were back to sport within three weeks, and 2.7% were injured for more than eight weeks. Almost a third of parents needed to take time off from work to deal with the injured child. CONCLUSION: School sports injuries are important. They account for just over half of all injuries in secondary school children. They cause significant disruption to school and sport and have important implications for the wider family.     

Stress fractures in runners

As the running community as well as the primary care medical community become more sophisticated in their knowledge of and treatment of repetitive stress injuries, only the more difficult problems will arrive at the orthopedist's office. As a result, injuries such as stress fracture will constitute a larger percentage of running and other repetitive stress injuries. The universal occurrence of stress fracture and its possible at-risk nature for serious injury if undertreated underscores the need to observe good treatment principles. With these principles in mind, the physician can usually treat stress fracture without major interruption of the recreational or competitive athlete's sport style.     

Epidemiology of medically treated sport and active recreation injuries in the Latrobe Valley, Victoria, Australia

OBJECTIVE: To quantify and describe medically treated sport and active recreation injuries in a defined region of the Latrobe Valley from 7 November 1994 to 6 November 1995. METHOD: A geographic target area was defined, restricted to the six postcodes that fell wholly within the catchment area of the Latrobe Regional Hospital. Data describing medically treated sport and active recreation injuries to Latrobe Valley residents aged over 4 years (about 70,000) were selected by postcode from three sources: the Victorian Admitted Episodes Dataset (hospital admissions), the Victorian Injury Surveillance System (presentations to hospital emergency departments), and the Extended Latrobe Valley Injury Surveillance (ELVIS) project (presentations to general practitioners). RESULTS: At least 2300 cases of medically treated sport and active recreation injury were recorded. This corresponds to a hospital admission rate of 16/10,000 population, emergency department presentation rate of 169/10,000 population, and a general practitioner presentation rate of 187/10,000 population. There were more male patients than female, and younger age groups were also overrepresented, but these data may reflect the greater participation of these groups in sport and active recreation. Australian football was associated with the highest number of injuries (accounting for 24.0% and 22.0% of presentations to emergency departments and general practitioners respectively) followed by cycling (15.7% and 12.6%) and basketball (17.5% and 13.5%). CONCLUSIONS: This study shows that routine health sector data collections in defined populations can provide useful information on the size, distribution, and characteristics of the problem of sport and active recreation injuries at the community level. However, all current health sector systems for injury data collection and surveillance require attention to improve case capture and identification and data quality.     

Pilot study of the epidemiology of sports injuries and exercise-related morbidity.

In the pilot phase of a national study of the incidence of exercise-related morbidity (ERM), funded by the Sports Council, a questionnaire about recent participation in 'active sports and other recreational activities involving vigorous physical exercise' and associated injuries or illnesses was sent to a sample of 6744 people aged 16 to 65 years in two areas. Interviews with 101 respondents were held to validate the questions. Return rates of 73 and 81% from the two areas were achieved and results from the interviews indicated that sports and injuries were being reported sufficiently accurately on the postal questionnaires to yield reliable information. Of the 4961 usable returns, a total of 1249 respondents (25%) reported taking part in some activity in the 4 weeks before completing the questionnaire, and 137 (3%) reported 158 injury incidents. Nearly half (76, 48%) of these incidents resulted in some restriction in activity, and 21 resulted in some restriction in activity, and 21 resulted in a visit to a hospital casualty department. It is estimated that nationally 1-1.5 million episodes of ERM result annually in attendance at a hospital casualty department, and 4-5 million episodes of ERM result in some, usually temporary, incapacity.     

Non-fatal sports and recreational violent injuries among children and teenagers, United States, 2001–2003

BACKGROUND: An estimated 2.7 million non-fatal unintentional sports and recreational injuries are treated in U.S. hospital emergency departments (EDs) annually. However, little is known about the number of sports and recreational injuries resulting from violent behavior. METHODS: Data for 2001-2003 on sports and recreational injuries were obtained from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP)-a national sample of 66 U.S. EDs. National estimates and rates of persons treated for violence-related sports and recreational injuries in EDs are compared to those treated for unintentional sports and recreational injuries. Types of injuries and injury circumstances are described. RESULTS: During the study period, an estimated 6,705 (8.3 per 100,000; 95% confidence intervals (CI), 6.3-10.3) children and teenagers with violence-related sports and recreational injuries were treated in U.S. EDs annually, compared to 2,698,634 children and teenagers with unintentional sports and recreational injuries. Thus, violent behavior accounted for 0.25% of sports and recreational injuries. The highest incidence rate (13.6 per 100,000) for violence-related sports and recreational injuries was for children aged 10-14 years. Most patients with violence-related sports and recreational injuries were treated and released from the ED. A majority of those with violence-related sports and recreational injuries were injured to the head/neck region (52.2%), of which 24.1% were treated for traumatic brain injuries. Most violent injuries resulted from being pushed or hit (65.6%); the most common sports and recreational activity varied by age: playground (65.2%) for children < or =9 years; bicycling (26.7%) for 10-14-year-olds; basketball (45.3%) for 15-19-year-olds. CONCLUSIONS: National ED surveillance systems can provide useful information pertaining to prevention programs designed to reduce sports and recreational injuries resulting from violent behavior and unintentional causes.     

Sports injuries: population based representative data on incidence, diagnosis, sequelae, and high risk groups

Objective

To generate national representative data on the incidence, diagnosis, severity, and nature of medically treated sports injuries and to identify high risk groups.

Methods

The first national health survey for the Federal Republic of Germany, conducted in the format of a standardised, written, cross sectional survey in the period October 1997 to March 1999, gathered data on the incidence of accident and injury and information on social demographics, injury related disability/time off work, and injury location/setting. The net sample comprised 7124 people aged 18–79.

Results

3.1% of adult Germans said they sustained a sports injury during the previous year, corresponding to an annual injury rate of 5.6% among those engaging in regular recreational physical activity and ranking sports injuries as the second most common type of accident. About 62% of all sports injuries result in time taken off work. The period of occupational disability is 14 days or less in around two thirds of these cases. The occupational disability rate after occupational and traffic accidents is much higher by comparison. Dislocations, distortions, and/or torn ligaments make up 60% of all sports injuries, followed by fractures (18%), contusions, surface wounds, or open wounds (12%). Three out of four sports injury casualties are male. The incidence declines noticeably in higher age groups.

Conclusions

Future injury prevention measures should focus on the high risk group of young male recreational athletes. The data indicate that the fear of damage to health and injury, believed to be significant internal psychological barriers to participation in sports, is largely unwarranted for the female population and/or older age groups. Sporting injuries are a marginal phenomenon among the female population and mobile seniors actively engaged in sports.     

Injuries in Eleven Selected Sports

All the clubs for 10 sports in the four northern counties were surveyed for injuries for a whole playing season and a 50% sample of the badminton clubs were surveyed in the same way. After the two types of football, hockey comes third in the injury league with women getting injured mostly in the legs, but men in the upper part of the body. Protective padding for hockey players' legs is suggested. Finger injuries and occasional concussion are characteristics of cricket and sprains and strains of badminton. The severity rate in fencing was low with an occasional superficial cut. Cycling was safe, but when an accident did happen it usually produced multiple abrasions as can be readily understood by anyone who has fallen off a bicycle. Boxing and judo did not produce many injuries, but when they did, they were severe, and needed a relatively long time (on average 3 weeks) off sport. But, paradoxically the medical attention which they attracted was better than that attracted by the minor injuries of the other sports. Rowing and swimming were both very safe sports, notwithstanding the potentially hazardous nature of water. The injuries in sub-aquatic activities seemed to depend upon the club rather than upon the sport itself, which suggests that rather more careful supervision may sometimes be necessary.

The range of injury produced by sport is so wide—from a bruise to a brain injury—that it is difficult to avoid the conclusion that the hospital accident room is the right place to receive the injured player in the first instance. From here he can, if necessary, be routed to another department for more specialized treatment.

Introducing more first aid training into sport, at, perhaps, the level of club officials, players themselves, and in addition, regular supporters will be the most useful steps which can be taken in the management of sports injuries.

     

The injury experience of the competitive athlete with a disability: prevention implications.

The purpose of this project was to describe the injury experiences of athletes with disabilities. A cross-disability instrument was developed to measure variables of interest. A retrospective survey was administered to 426 athletes who participated at the 1989 national competition of the National Wheelchair Athletic Association (NWAA), United States Association for Blind Athletes (USABA), and the United States Cerebral Palsy Athletic Association (USCPAA). The definition of injury was any trauma to the participant that occurred during any practice, training, or competition session that caused the athlete to stop, limit, or modify participation for 1 d or more. Thirty-two percent (N = 137) of the total respondents reported at least one time-loss injury. By organization, 26% of the total injuries were from the NWAA and 37% were from the USABA and USCPAA, respectively. The shoulder and arm/elbow accounted for 57% of the total NWAA injuries. Fifty-three percent of the injuries to the USABA athlete were to the lower extremity. Injuries to the USCPAA athlete were distributed among four body locations, knee (21%), shoulder (16%), forearm/wrist (16%), and leg/ankle (15%). The athlete with a disability demonstrated approximately the same percentage of injury as the athlete without a disability in similar sport activities. Biomechanical considerations of locomotion and specific sport skills should be analyzed by experts to reduce the percentage of injuries.