Injury risk is different in team and individual youth sport

ObjectivesThis study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries.DesignProspective cohort follow-up.MethodsPupils from a public sports school (12–19 years) were recruited over two separate school years (2008–2009: 42 weeks, n = 199 athletes; 2009–2010: 40 weeks, n = 89 athletes). Training and competition volume and intensity were recorded via a personal sports diary. Sports injuries (time-loss definition) were registered by medical staff members using a standardized questionnaire.ResultsInjury incidence was significantly higher in team compared with individual sports (6.16 versus 2.88 injuries/1000 h, respectively), as a result of a higher incidence of both traumatic (RR = 2.17; CI95% = 1.75–2.70; p < 0.001), and overuse injuries (RR = 2.06; CI95% = 1.46–2.91; p < 0.001). A Cox proportional hazards regression revealed that team sports participation had a hazard ratio of 2.00 (CI95% = 1.49–2.68; p < 0.001) compared to individual sports, with additionally previous injury being a risk and age a protective factor. The number of competitions per 100 days was significantly higher in team sports, whereas the number of intense training sessions per 100 days was significantly lower. In team sports, the number of competitions per 100 days was positively associated with injuries (HR = 1.072; CI95% [1.033; 1.113]; p < 0.001), while in individual sports the number of competitions per 100 days had a protective effect (HR = 0.940; CI95% [0.893; 0.989]; p = 0.017).ConclusionsTeam sports participation entailed a higher injury risk, whatever the injury category. Further research should elucidate the role of characteristics related to sport participation in injury causation.     

Incidence,prevalence and consequences of illness in academy rugby league players

ObjectivesTo assess the incidence, prevalence and consequences of illness in one professional academy rugby league club during an in-season period.DesignObservational prospective cohort study.MethodSeventeen male rugby league players (age 17.7 ± 0.7 years, stature 178.8 ± 5.1 cm, body mass 87.2 ± 9.6 kg) completed a weekly self-report illness questionnaire using an amended version of the Oslo Sports Trauma Research Centre (OSTRC) questionnaire on health problems.ResultsA total of 24 new illnesses were reported over the 25-week study period. 65% of players experienced at least one illness during the study. The incidence of illness in this cohort was 14.3 per 1000-player days, with the respiratory system being most commonly affected (n = 15; 62.5%). The average weekly illness prevalence was 10.3%. Time-loss illness incidence was 1.4 per 1000-player days. Loss of body mass and sleep disruptions were the most commonly reported consequences of illness episodes. Mean body mass loss during a period of illness was 2.2 ± 0.6 kg.ConclusionsAcademy rugby league players are most commonly affected by respiratory illness with a total of nineteen training and competition days lost to illness. Associated consequences of illness, such as loss of body mass and sleep disruptions may present a challenge and negatively impact a rugby league player’s development. Appropriate medical provisions should be provided for Academy rugby league players to support them during periods of illness to limit the impact of these consequences.     

A prospective study of health problems at the 2018 17/U and 19/U Australian National Netball Championships with comparison of surveillance methodology

ObjectiveTo investigate the incidence, site, nature and cause of injuries sustained during and four weeks following the 2018 Australian National Netball Championships (ANNC’s) using medical attention and self-report surveillance tools.DesignProspective cohort study.MethodInjuries were recorded prospectively using medical attention and self-report data collection methods. One hundred and ninety-two athletes competed at the 2018 ANNC’s with 96 athletes in each age group (17/U & 19/U).ResultsThere were 103 medical attention injuries sustained by 80 athletes resulting in an incidence rate of 89.4 per 1000 player hours. The most frequently recorded medical attention injury diagnoses across both age groups were lateral ankle ligament sprain (n = 14, 13.6%), foot blisters (n = 11, 10.7%), and lumbar pain (n = 10, 9.7%). Ankle sprains (n = 4), anterior cruciate ligament (ACL) ruptures (n = 3) and concussion (n = 3) recorded as the highest sports incapacity injuries. The self-report data collection revealed that 46 (27.2%) athletes arrived at the tournament with an existing self-reported injury/illness and 57 (39.3%) athletes had a self-reported injury/illness at the conclusion of the ANNC (RR 1.44 95%CI 1.05–1.99, p = 0.030).ConclusionThere are no recent studies reporting injury rates specifically in pre-elite netball players. This study found an incidence rate of 89.4 per 1000 player hours. Ankle sprains are the highest medical attention and sports-incapacity injury in pre-elite netball athletes. Foot blisters and low back pain also feature in the highest medical attention injuries and ACL rupture and concussion were high sports incapacity injuries at the ANNC’s. Finally, combining both the medical attention and self-report injury/illness data collection methods identified more injuries/illnesses than the use of one method alone.     

Verletzungen und Überlastungsbeschwerden der deutschen paralympischen Athleten bei den Sommerspielen 2012 in London

BackgroundMusculoskeletal complaints are frequently recorded in paralympic athletes. Despite the increased training and competition load and more professional support of handicapped athletes, documentation of injury and illnesses during high-level competition is sparse. The aim of the study was the standardised recording and analysis of all athletes’ injuries of the German paralympic team during the London 2012 Paralympic Games.Material and MethodsDuring the In-competition-period all traumatic and overuse injuries of the 153 German athletes were recorded and documented in standardised case report forms. Documentation included effective date and severity of the injury, medical diagnosis, treatment modalities and consecutive restrictions in training and competition. Injury rates and localisations were analysed by sports discipline.ResultsDuring the in-competition-period, 140 athletes attended medical consultation for 201 different orthopaedic complaints (1,4/injured athlete). The men age of injured athletes did not differ from the uninjured athletes (∅ 33years). Higher injury rates were found in women's wheelchair basketball and rowing (1,6 injuries per competing athlete). Visual impaired athletes had no higher risk of injury.The most frequent diagnoses were myalgias (n = 105), tendinopathies (n = 14), unspecific back pain (n = 14), vertebral subluxations (n = 11), skin abrasions (n = 10), contusions (n = 6) and distorsions (n = 8). Injuries were mainly located at the upper extremities (37,6%) and spine (37,6%), whereas the lower extremities were only affected in 21,5%. 12,5% of the complaints were already existing before the arrival in London. Most athletes were able to continue their sporting activities (77%).ConclusionThe overall injury rate was higher in the German Paralympic team compared to the report of the International Paralympic Committee. This is probably due to the different definitions of injury (in this study: recording of all consultations regardless of severity) and the good availability of medical services for German athletes. The mean age of paralympic athletes is higher than for Olympic sports but within Paralympians, older athletes seem to have no higher risk for injury. Injury rates were higher in rowing and women's wheelchair basketball, whereas no higher prevalence of injuries was found in athletes with visual impairments. According to the presented results, sports-specific injury prevention programs may be developed and evaluated in the future.     

Monitoring of sport participation and injury risk in young athletes

ObjectivesCareful modulation of training characteristics in high-level sports optimizes performance and avoids inappropriate workloads and associated sports injury risk. The aims of this study were to compare sport participation characteristics in different youth sport categories and to investigate their relationship with injury.DesignProspective cohort follow-up.MethodsYoung (12–19 years) high-level athletes (n = 154) from a regional sport school were followed during 41 weeks regarding sport participation characteristics and traumatic and overuse sports injuries (time-loss definition). All data were self-recorded by the athletes in an electronic system “TIPPS” (Training and Injury Prevention Platform for Sports) and subject to a systematic data quality control. Volume and intensity (self-rated perceived exertion) of each sport session were used to compute weekly load, monotony and strain. Sport categories were defined as team, racket, and individual sports.ResultsAll sport participation characteristics were dependent on sport category (p < 0.05). Weekly intensity, load and strain were dependent on age (p < 0.05). Racket and individual sports were associated with lower injury risk (HR = 0.37 and 0.34, p = 0.001 and p < 0.001, respectively) compared to team sports. Average sport participation characteristics were not related to injury according to the survival analysis. However, intensity during the week prior to injury was significantly higher (p < 0.01) compared to that of the 4 preceding weeks.ConclusionsThis study investigated for the first time the relationship between sport participation pattern and injury risk in young athletes. The monitoring method was sensitive to variations according to pertinent variables and might help identify athletes with increased sports injury risk.     

Dietary intakes of professional Australian football league women’s (AFLW) athletes during a preseason training week

ObjectivesIn 2016 the Australian football league introduced the first women’s league, integrating part-time female athletes into the professional sporting environment. This study aims to assess the dietary intakes of professional Australian football league women’s (AFLW) athletes to highlight key focus areas for nutrition and additionally provide nutrition recommendations for dietitians working with these athletes.DesignCross-sectional study.MethodsDietary intake data was collected from 23 players from the same club competing in the Australian football league women’s, during a preseason week. Dietary intakes were assessed using three day estimated food records.ResultsMajority of athletes did not meet recommendations for carbohydrate (96%, n = 22), iron (87%, n = 20) and calcium (61%, n = 14). In comparison, majority of athletes met protein (74%, n = 17) and fat (78%, n = 18) recommendations. No significant difference was found in energy intake on main training, light training and recovery days (p > 0.05). Energy and carbohydrate intakes reported by AFLW athletes (1884 ± 457 kcal day⁻¹ and 2.7 ± 0.7 g kg⁻¹ day⁻¹) were consistent with values reported in previous studies that included professional female athletes.ConclusionsThis research highlights that further exploration of the factors that influence dietary intake is required to support athletes to meet energy and carbohydrate recommendations required for desired training and performance outcomes.     

Use and perception of breast protective equipment by female contact football players

ObjectivesFemale contact football players sustain contact breast injuries that can negatively affect their sporting performance. This study investigated what female contact football players wear on their breasts during training and competition, and their perceptions on the protection provided by these garments against contact breast injury.DesignA custom-designed survey about breast injuries and prevention strategies was distributed via an online link to coaches and team staff of contact football teams throughout Australia. The fit and features of breast support and/or protection that players wore during training and competition were also directly assessed.Methods207 female Australian Football League (AFL), Rugby League, Rugby Union (XVs) and Rugby 7 s players completed the survey. The breast support of 112 of these players was also assessed.ResultsOnly 17% (n = 35) of players reported using breast protective equipment, of which 66% (n = 23) perceived it provided protection against contact breast injuries. Reasons reported for not using protective equipment included not knowing it existed (n = 79, 53%), it was too uncomfortable/hot (n = 50, 24%) and that it did not fit or was restrictive (n = 33, 22%). Although most players (n = 97, 87%) reported to wear a sports bra, 52% (n = 58) wore an ill-fitted bra and only 31% (n = 63) perceived it provided any protection against contact breast injuries.ConclusionsBreast protective equipment is not commonly worn by female contact football players reportedly due to a lack of awareness of its existence, discomfort or poor fit. Although most female contact football players usually wore a sports bra, most players perceived these bras did not provide breast protection.     

Probiotic supplementation elicits favourable changes in muscle soreness and sleep quality in rugby players

Probiotic supplementation may offer team sport athletes a range of benefits beyond the immune and gastrointestinal systems.ObjectivesTo examine the effects of a probiotic formulation on perceptual markers of sleep quality and quantity, and muscle soreness, leg heaviness and motivation in elite rugby union athletes.MethodsA double-blind randomised controlled trial involving 19 elite male rugby athletes was conducted over 17 weeks encompassing both domestic and international competition. Psychometric variables and salivary biomarkers were assessed twice a week. Athletes were assigned either a daily probiotic (Ultrabiotic 60?) and Saccharomyces boulardii (during international competition) or a placebo. Associations between psychometric scores for perceptual and salivary biomarkers of sleep (melatonin) and inflammation C-reactive protein (CRP) were investigated.ResultsMuscle soreness was ～0.5 units lower (F(1, 343) = 42.646, p < 0.0001) and leg heaviness scores ～0.7 units lower (F(1, 334) = 28.990, p < 0.0001) in the probiotic group compared to the placebo group. Across both groups, as self-reported muscle soreness scores and salivary CRP concentrations increased, sleep quantity, quality and motivation scores decreased. Conversely as muscle soreness scores and CRP decreased, sleep quantity and quality, and motivation scores improved.ConclusionsA long-term programme of probiotic supplementation in international-level rugby union players may yield favourable effects on self-reported muscle soreness and sleep quality associated with muscle soreness during training and competitions.     

Obstructive sleep apnea in professional rugby league athletes: An exploratory study

ObjectivesTo explore the prevalence of obstructive sleep apnea (OSA) within a professional rugby league team and determine associations of OSA with ethnicity, positional group, and physical characteristics.DesignObservational prospective cohort study.MethodsTwenty-two professional rugby league athletes underwent one night of home-based polysomnography with apnea-hypopnea index (AHI), rapid eye movement (REM)_AHI, non-REM_AHI and supine_AHI determined to indicate OSA. Linear models were used to assess if playing position (back or forward) or ethnicity (European-Australian or Polynesian) influenced AHI, REM_AHI, non-REM_AHI and supine_AHI. Models were also built to determine differences according to body composition.ResultsSeven athletes were classified with mild OSA (6 forwards and 1 back, 3 European-Australians, and 4 Polynesians) and three with moderate OSA (2 forwards and 1 back, 3 Polynesians). When considering ethnicity, differences were observed between Polynesians and European-Australians for REM_AHI (ES = 0.90, p = 0.02). Increased body mass index (BMI) was associated with a moderate increase in AHI (r = 0.38, p = 0.04) and non-REM_AHI (r = 0.36, p = 0.05), while higher skinfold thickness moderately related to a higher AHI (r = 0.40, p = 0.05) non-REM_AHI (r = 0.47, p = 0.02), and supine_AHI (r = 0.41, p = 0.04).ConclusionsThis exploratory study found 10 cases of OSA. Polynesian athletes and athletes classified as forwards constituted the majority of reported cases, suggesting their susceptibility to OSA. Furthermore, the data suggests that athletes with greater BMI and skinfold thickness may be predisposed to OSA.     

Training habits and injuries of masters' level football players: A preliminary report

ObjectiveTo profile training habits and injuries in football players participating in a national Masters tournament.MethodsA cross-sectional retrospective study design was used to survey male football players attending the 2008 New Zealand Masters Games. Information regarding player demographics, football injuries, football related training, and risk factors for injury were collected.Results199 Players were recruited, with a median age of 44 yrs (range 35–73) and a median football playing history of 15 yrs (range 0–66). Irrespective of age, 112 (84%) players included a warm-up and 104 (78%) included a stretching regime in their regular training programme. In the 12 months prior to the tournament, 128 football related injuries were reported by 93 players (64 injuries/100 players or 46 injured players/100 players). The most frequently injured region was the lower limb; specifically the lower leg (n = 23), ankle (n = 18), hamstring (n = 17), knee (n = 15), and Achilles tendon (n = 15).ConclusionThis study provides a preliminary insight into the training habits and injury profiles of Masters football players. Despite all players including some form of injury prevention strategy in their training, a significant number of players experienced an injury in the 12 months prior to the tournament.     

Household illness is the strongest predictor of upper respiratory tract symptom risk in elite rugby union players

ObjectivesTo identify periods of increased risk for upper respiratory tract symptom (URTS) episodes, and examine whether biomarkers and/or self-reported lifestyle and wellness data can predict URTS risk in elite rugby union players.DesignProspective, longitudinal and repeated-measures study.MethodsSalivary secretory immunoglobulin A (SIgA), salivary cortisol, URTS, internal training load and self-reported lifestyle and wellness data including household illness, stress, mood, fatigue, muscle soreness and sleep quality were repeatedly measured in elite Southern hemisphere rugby union players (n = 28) throughout a season. Univariate frailty model analysis, which included 495 observations, was used to determine predictors of URTS risk.ResultsSurprisingly, the highest incidence of URTS occurred after rest weeks, namely the Christmas break and bye weeks (i.e., no scheduled trainings or matches); whereas URTS risk was reduced during weeks involving international travel (Hazard ratio (HR): 0.43, p < 0.001)). Household illness was the strongest predictor of URTS risk; players were almost three-fold more at risk for an URTS episode when illness in the household was present (HR: 2.90, p = 0.002). A non-significant, but potentially important trend for an inverse association between SIgA concentration and URTS incidence was also observed (HR: 0.99, p = 0.070).ConclusionsRest weeks were identified as periods of increased risk for URTS; while international travel did not appear to increase players risk for URTS. Incidence of household illness and SIgA concentration independently predicted URTS risk, with household illness being the strongest predictor. These findings can assist practitioners monitoring and management of athletes to potentially reduce URTS risk.     

Training injury incidence in an amateur women’s rugby union team in New Zealand over two consecutive seasons

ObjectivesTo describe the training injury incidence in amateur women’s rugby union in New Zealand over two consecutive seasons.DesignA prospective cohort observational studyMethodsA total of 69 amateur women’s rugby 15s team playerswere observed. Training exposure and training injury incidence were calculated.ResultsThe 38 training injuries resulted in a total injury incidence of 11.4 (8.3–15.6) per 1,000 training-hours. There were 12 injuries that resulted in a time-loss injury incidence of 3.6 (95% CI: 2.0–6.3) per 1,000 training-hours. Forwards recorded more total (RR: 1.8 [95% CI: 0.9–3.5]; p = 0.0516) and time-loss (RR: 2.0 [95% CI: 0.6–6.6]; p = 0.2482) injuries than Backs. The tackle was the most common injury cause for total (3.0 [95% CI: 1.6–5.6] per 1,000 training-hours.) injuries, but collisions (1.5 [95% CI: 0.6–3.6] per 1,000 training-hours.) with the ground or another person were the most common cause for time-loss injuries.The training injuries occurred most often to the lower limb and during the latter part of training sessions. These injuries were mostly minor in nature resulting in minimal time-loss away from training.DiscussionThe time-loss injury incidence (3.6 per 1,000 training-hours.) for the amateur women’s rugby 15s team players was higher than that reported for National (1.2 per 1,000 training-hours.) and Rugby World Cup for women (0.2 to 3.0 per 1,000 training-hours.) competitions.ConclusionThe training injury incidence in amateur women’s rugby union in New Zealand was higher than that reported for national and international rugby union injury incidences.     

The epidemiology of injury for an elite junior Australian Football cohort

ObjectivesTo implement an injury recording protocol in a junior elite Australian Football competition and determine the injury profile of this population.DesignLongitudinal cohort study.MethodsPlayers from an elite Under 18 Australian Football competition were tracked throughout one football season in terms of participation or non-participation in the football competition. Injury reporting forms were collected for all players who were not available for selection as a result of injury.ResultsThe cohort consisted of 532 players who provided consent for inclusion in the study (100% of players in the competition). There were 256 injuries sustained during the season. Results were standardised to a 40 man team to allow comparison with results from the Australian Football League. The injury incidence was 17.1 new injuries per club (95% CI 14.1–19.4), and prevalence 63.3 missed matches per club (95% CI 59.1–67.1). The category “Ankle joint injuries” was the most commonly reported (n = 34) and “Collision with another player” was the main injury mechanism (n = 75).ConclusionsThe most commonly injured region in junior elite Australian Football was the ankle and collision with another player was the most common injury mechanism. As with previous reports on junior Australian Football, injury incidence was low in comparison to the senior elite competition. Defining the injury profile guides injury prevention strategies. Analysis of injury in junior elite football may provide a unique opportunity to affect both junior and senior injury rates.     

Shoulder internal and external rotations torque steadiness in overhead athletes with and without impingement symptoms

ObjectivesThis study aimed to investigate torque steadiness of shoulder internal and external rotations in regularly training overhead athletes with and without impingement symptoms.DesignCross-sectional laboratory study.MethodsThree groups were evaluated: athletes with impingement symptoms (n = 21), asymptomatic athletes (n = 25) and non-athletes (n = 21). To assess torque steadiness, the participants performed 3 submaximal contractions (35% of peak torque) for 10 s each, with the arm at 90° of shoulder abduction and 90° of external rotation. The standard deviation, coefficient of variation, mean exerted torque and time to stability were measured from the steadiness trials.ResultsThe standard deviation of internal rotation was higher in asymptomatic athletes than in non-athletes (p < 0.01); however, there was no difference between the athletes with impingement symptoms and the other groups. The other variables presented no differences among the groups.ConclusionsHigher torque fluctuation of shoulder internal rotation in asymptomatic athletes may point to neuromuscular adaptations related to throwing training. However, the steadiness patterns of athletes with impingement symptoms did not differ from those of asymptomatic athletes or non-athletes.     

Changes in bone turnover markers during the close season in elite football (soccer) players

ObjectivesBone turnover marker changes in response to physical activity are well documented. There is, however, little information on the extent and severity of skeletal de-conditioning in athletes in response to rest periods. This study analyses changes in markers of bone resorption and bone formation during the close season within the squad of an English Football Association Championship club.DesignEvaluation was performed on the first team football squad just before the end of the 2007/2008 football season and again 8 weeks later before pre-season testing and training.MethodBone resorption was measured by serum concentration of C-terminal telopeptide (CTx) and bone formation by serum concentration of the N-terminal propeptide of type I procollagen (PINP). Twenty football players aged from 18 to 36 years (mean 23.6 years) were included in the study.ResultsThe mean change in CTx during the close season was +0.14 ng/ml (95% CI: 0.21 to 0.06, p = 0.001). The mean change in PINP was ?10.8 ng/ml (95% CI: ?3.9 to ?17.7, p = 0.004).ConclusionsIn professional football players, a close season rest of 8 weeks results in an increase in bone resorption and a decrease in bone formation markers. This imbalance between formation and resorption may have negative effects on bone mass and structure. Future research should focus on understanding the many factors that could contribute to the changes found in the study during the close season.     

Is the consumption of beverages and food associated to dental erosion? A cross-sectional study in Portuguese athletes

ObjectivesThis cross-sectional study aimed to investigate if the consumption of acidic food and beverages, including energy drinks is associated with dental erosion in athletes.MethodsA questionnaire was applied in 110 athletes (swimmers, bodybuilders, football players, boxers, volleyball players and runners) to collect training and sport practice data, medical history and oral hygiene habits. A semi-quantitative food frequency questionnaire was used for acidic beverages and food consumption. The Basic erosive wear examination index was used to evaluate the presence of dental erosion lesions. Participants were organized into 4 groups: swimmers who consumed or did not consume energy drinks, and athletes (except swimmers) who consumed or did not consume energy drinks.ResultsThe prevalence of dental erosion was 83.6%. Of the 110 participants, 49.1% had low risk of erosion, 6.4% had an average risk of erosion, and 0.9% presented high risk of erosion. According to the multivariate logistic analysis, red wine (OR = 1.6; P = 0.038), citrus fruit (OR = 1.3; P = 0.037), frequency of tooth brushing (OR = 2.3; P = 0.018), energy drinks consumption in swimmers (OR = 15.2; P < 0.001), and energy drinks consumption in athletes (OR = 6.3; P = 0.003) were significant risk factors of dental erosion, whereas spicy food was a protective factor (OR = 0.64; P = 0.024).ConclusionsThe consumption of energy drinks by swimmers more than doubles the chance of dental erosion (BEWE score of “at least low risk”) when compared with non-swimmer athletes consuming the same energy drinks. Athletes consuming energy drinks should be clinical and regularly supervised, especially for dental erosion.