Eye injury in sport

Eye injury sustained during sport is increasing in incidence worldwide, reflecting the rise in popularity of sport as recreation. It can account for up to 25% of severe eye injuries. This paper considers the historical context and demography of sports injuries, and the physical mechanisms and results of various types of ocular trauma in relation to sport. It reviews the specific problems associated with the sports considered to be most important in the epidemiology of eye injuries today. Certain sports, such as boxing, have an intrinsic risk of injury so high that some consider the sport should be banned. The risk of injury in many sports can be mitigated by changes in rules, such as the prevention of high sticking in ice hockey. Other sports with high risk of trauma could be made far safer with the widespread introduction of eye protection, and this applies especially to squash and badminton. The various types of eye protection are discussed. There is an urgent need to increase awareness of the risk of eye injury, to teach safe techniques, and to encourage the use of appropriate ocular protective wear in those at high risk of injury, especially the one-eyed.     

Common injuries among Nigerian games players

The study investigated the common types and sites of injuries which were sustained by male soccer, basketball and field hockey players during a period of 8 weeks of intensive training and competition. In all, 170 soccer players, 127 basketball players and 212 hockey players drawn from various clubs in Nigeria formed the subjects of the study, a total of 509 patients.

Questionnaires on the prospective injury experience were handed over to the club members. A total of 630, 308 and 641 injuries were recorded in soccer, basketball and hockey respectively. In soccer the common injuries were sprains and strains (45.6%), bruises and cuts (27.0%) and concussion (15.2%). The lower limb had the highest number of injuries (49.1%).

In basketball common injuries were sprains and strains (41.5%), bruises and cuts (26.7%) and swelling and blisters (22.1%). The most common site of injury was the upper limb which sustained 45.8% of the injuries.

The common injuries in hockey were bruises and cuts (50.8%), swelling and blisters (21.5%) and sprains and strains (20.2%). The lower limb sustained the highest number of injuries (57.5%).

     

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.     

Injuries in Rugby and Association Football

The number, site, severity and rate of accidents and the medical attention received has been measured for association and rugby football in the four northern counties of England during the 1970-1971 season. 696 out of 1601 (43%) association and 117 out of 232 (50%) rugby football clubs replied to the questionnaires. If all the clubs had replied an estimated 14078 injuries would have occurred in association and 3888 in rugby football. For soccer, the accident rate was 36.5 per 10,000 man-hours of play and for rugger 30.5. In soccer 65% of all injuries were to the lower limbs, but only 36% in rugger, which had a higher proportion of injuries to other sites compared with soccer. Fractures and dislocations were twice as common in rugger as in soccer. Concussion was also more common. In rugby football, the players are injured less often than in association football, but more seriously, as is shown by the fact that hospital treatment was needed by 29.8% of the soccer injuries, but 52.8% of those in rugby football. Similarly, a rugger injury needed on average 12 days off play, whereas one in soccer needed only 6 days off play.

A bigger proportion of soccer injuries (73.8%) received rapid first aid than did rugger injuries (45.8%). Better first aid cover at matches and simple protective clothing for the legs of soccer players and shoulders of rugby players are suggested.

     

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

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

Racquet sports--patterns of injury presenting to a sports injury clinic.

In an 8-year retrospective study, 631 injuries due to the racquet sports of squash (59%), tennis (21%) and badminton (20%) were seen in a sports injury clinic, males predominating (58 to 66%). The proportion of squash injuries was higher than expected and probably relates to higher physical stress and risk of contact in this sport. Also they occurred mainly in persons over 25 years (59%) i.e. the reverse for sport in general. Acute traumatic injuries were seen especially in squash players, a majority affecting the knee, lumbar region, muscles and ankle. Tennis injuries differed most with lateral epicondylitis, patello-femoral pain and lumbar disc prolapse being relatively common. The badminton injury pattern overlapped the others. Lower limb injuries predominated in all three. Detailed assessment of 106 cases showed many to be new, infrequent, social players. Poor warm-up was a common factor in new and established players. The importance of these findings is discussed.     

Catastrophic injuries and fatalities in high school and college sports, fall 1982-spring 1988

Direct and indirect deaths and catastrophic injuries, defined as any injury incurred during participation in a high school/college sponsored sport in which there is permanent severe functional neurological disability (nonfatal) or transient but not permanent functional neurologic disability (serious), are presented for all sports during the period of fall 1982 to spring 1988. Football contributed the greatest numbers of catastrophic injuries but also had the largest number of participants. Ice hockey, gymnastics, and wrestling are the other sports where participants are at greatest risk of catastrophic injury or death. Mechanisms of injury in each sport and corrective actions are identified and discussed. While high school and college catastrophic injuries may never be totally eliminated, they can be dramatically reduced by reliable injury data collection and analysis.     

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.     

Sports related maxillofacial injuries: the first maxillofacial trauma database in Switzerland

Background: With the increase in the amount of medical data handled by emergency units, advances in computerisation have become necessary. New computer technology should have a major influence on accident analysis and prevention and the quality of research in the future.

Objectives: To investigate the occurrence of sports related maxillofacial injuries using a newly installed relational database. To establish the first sports trauma database in Switzerland.

Methods: The Qualicare databank was used to prospectively review 57 248 case histories of patients treated in the Department of Emergency Medicine between January 2000 and December 2002. Pre-defined key words were used to collect data on sports related maxillofacial injuries.

Results: A total of 750 patients with maxillofacial injuries were identified. Ninety (12%) were sports related maxillofacial fractures. Most (27%) were sustained during skiing and snowboarding, 22% during team sports such as soccer or ice hockey, and 21% were from cycling accidents. Sixty eight per cent of the cyclists, 50% of the ice hockey players and soccer players, and 48% of the skiers and snowboarders had isolated fractures of the midface. Fractures of the mandible were noted predominantly in contact sports.

Conclusions: Computerisation of trauma and emergency units and the introduction of customised software can significantly reduce the workload of researchers and doctors. The effective use of new computer technology should have a considerable influence on research and the quality of future prospective and retrospective studies.

     

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

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

From which level of competition in clubs are adolescents at greater risk of injury compared with outside-of-clubs athletes? A school-based study

Objectives: Sport practice is a key factor in a person’s physical and mental health but, for adolescent athletes, some injuries lead to health problems in the long term. The literature provides multiple factors for understanding injury but does not give information about injury risk related to each level of play in a large sample of multisport athletes. This study investigates this relationship in 14- to 19-year-old adolescents.

Methods: The survey on adolescents and health was conducted in classrooms of France, from February to March 2015. Only sports players were included in the analyses (n = 986). The levels of play were divided into five categories: outside of a club/no competition, club player/no competition, club player/local level, club player/state level and club player/national and higher level. A three-step binary logistic regression analysis with age, sex, type of sport, weekly hours of exposure, and level of play was used.

Results: During the past year, 48.1% of the adolescents were injured. Age and sex were not risk factors. The injury risk associated with the increases in level of play is higher than those related to the hours of exposure per week or the type of sport. In clubs, adolescents who do not compete or play at a local level showed no evidence of greater injury risk whereas state-level and national- and higher-level athletes were at greater risk than outside-of-club players (OR = 2.18, 95%CI = 1.13–3.94 and OR = 3.89, 95%CI = 2.07–7.31, respectively).

Conclusion: Adolescents who play sports in clubs are clearly more exposed to injury than those who play outside of a club, mainly from state level. Age and sex are not related to injury. Future epidemiological studies should control adolescents’ level of play. Special attention should be accorded to the injury risk of athletes playing at these levels of competition.     

Peripheral nervous system injuries in sport and recreation: a systematic review

Many sports are associated with a variety of peripheral nervous system (PNS) injuries specific to that sport. A systematic review of sport-specific PNS injuries has not been attempted previously, and will assist in the understanding of morbidities and mortality associated with particular sporting activities, either professional or amateur. A systematic review of the literature using PubMed (1965-2003) was performed examining all known sports and a range of possible PNS injuries attributable to that sport. Numerous sporting activities (53) were found to have associated PNS injuries. The sports most commonly reported with injuries were football, hockey, soccer, baseball and winter activities. There are a number of sporting activities with injuries unique to the individual sport. This review should be of assistance for the neurologist, neurosurgeon, orthopaedic surgeon, physiatrist, sports medicine doctor, athletic trainer and general physician in contact with athletes possessing neurological injuries.     

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

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

Poor peak dorsiflexor torque associated with incidence of ankle injury in elite field female hockey players

This study set out to determine the incidence of ankle injuries amongst provincial female field hockey players in KwaZulu-Natal (KZN), South Africa, during the 2004 field hockey season and relate this to their injury and playing profile, proprioceptive ability and peak isokinetic torque of the ankle plantar and dorsiflexor muscles. Players participating in the senior, U21 and U19/high school provincial A teams (n = 47) detailed their hockey playing and training history and injuries sustained during the 2004 season. A subsample of injured and matched, uninjured controls (n = 18) underwent anthropometric, proprioceptive and isokinetic testing. Incidence of injury in the 2004 season was 0.98 per player or 6.32 injuries per 1000 player/h⁻¹, with 25.5% of players (n = 12) reporting injuries to the ankle joint. All ankle injuries occurred on artificial turf and 75% occurred during a match. Forwards and links that had been playing for six to seven years presented with the highest incidence of ankle injuries. Injured players were able to maintain balance on a proprioceptive board for 10.31 ± 8.2 s versus 23.9 ± 15.3 s in matched, uninjured controls (p = 0.078). Both mean (27.4 ± 5.5 Nm versus 32.7 ± 4.7 Nm) and median (27.0, 23.0–31.5 versus 31.8, 30.0–35.1 Nm) peak isokinetic torque of the dorsiflexors of injured legs was significantly lower than in uninjured, contralateral legs of the injured players (p = 0.01 and 0.03, respectively). Poor peak dorsiflexion torque in the injured leg was identified as a factor associated with ankle injury in this sample of injured, elite field hockey players.     

Sports medicine in New Zealand.

Sports medicine in New Zealand is characterized by a team approach. Experienced professionals work together to the benefit of athletes, be they elite performers or those in sport for purely recreational purposes. A no-fault accident compensation scheme is used to provide speedy access to treatment services for those injured in sport and also for advice on accident prevention. Recent initiatives include a task force on drugs in sport and the creation of regional sports foundations. Sports medical education is a prominent part of the New Zealand scene.     

Eye Injuries in Sports: Results of a Five-Year Study

In brief: From 1982 to 1986, Quebec ophthalmologists reported 869 sports-related eye injuries. Hyphema was the most common injury, with a frequency of 33%. Most injuries occurred in ice hockey, followed by racket sports (32% and 28%, respectively); most of the injured players were not wearing eye protection. The authors suggest that wearing eye protection should be mandatory in some sports and encouraged in many others.     

Sports insurance and national governing bodies.

A postal survey was conducted of the attitudes and advice of Welsh governing bodies of amateur sports and their Cardiff-based clubs towards personal sports insurance. Information on 36 of the 39 sports surveyed (92%) was sufficient for analysis. Twenty-two of these 36 sports (61%) organized insurance at a national level, one at club level (3%) and 13 (36%) provided no insurance advice. Only 12 sports (33%) insisted on mandatory insurance cover. Many sportsmen and women are left to search for an appropriate insurance cover themselves or remain uninsured. Owing the lack of advice in 36% of cases it was decided to survey Cardiff-based insurance brokers to establish what type of policy they would recommend. Only 41% of the brokers were able to offer a suitable policy. Club policies recommended by the Central Council for Physical Recreation provide individuals with the same sports cover (but at a lower premium) as is available from a personal accident policy. However, cover is somewhat inadequate and may provide a false sense of security. Sports with mandatory sports insurance are not necessarily those with the highest risk of disabling injury.     

Epidemiology and traumatology of injuries in track athletes

During one year 4398 injured athletes were treated at the casualty wards of Aarhus, Denmark; 156 were practicing track and field disciplines. In the same period 54 track athletes of a Danish sport club were followed in order to register any lesion incurred during sports activity. Thirty-one athletes (57%) had 35 injuries, giving an injury incidence of 1.8 per 1000 hours of practice. At follow-up after 1 year, 13% of all athletes still had complaints, and none of them had returned to former sports activity. Jumpers had overuse symptoms correlated to take-off, and sprains or fractures related to downstrokes. Runners had a higher risk of overuse injuries than jumpers, especially involving the Achilles tendon and the plantar aponeurosis. Young athletes had a higher injury incidence per time than older participants; and women had higher injury risk than men.     

Personal risk factors associated with injury among female recreational ice hockey players.

INTRODUCTION: Women's ice hockey is a rapidly growing sport, however little is known about the injuries sustained by this group of athletes. PURPOSE: The objective of this research was to identify risk factors associated with injury among female recreational ice hockey players. METHODS: This prospective study followed players from two women's ice hockey leagues in Edmonton, Canada during the 1997-98 hockey season. The occurrence of injuries was monitored during the season through standardized telephone follow-up. Risk factors were determined using multiple logistic regression. RESULTS: The initial study sample consisted of 314 players, however as the season progressed 19 (6%) were lost to follow-up. The results of the study are based on 295 (94%) participants. A total of 125 injuries were reported; the injury rate was 7.5 injuries/1,000 player-exposures. Risk factors found to be significantly related to the occurrence of injury were: injury in the past year (OR= 1.57), more than 5 years of hockey experience (OR=1.49), and high exposure level (OR=1.41). CONCLUSION: This research is the first to quantify personal risk factors associated with injury among female recreational ice hockey players. A sports injury in the previous 12 months appears to be highly associated with injury and further research is required to more fully understand this relationship. The importance of controlling for level of exposure when investigating risk factors for sports injury was demonstrated.     

Injuries in competitive swimming

Competitive swimming is commonly thought to be an injury-free sport. Traumatic and overuse injuries do occur, especially if one includes accidents occurring to both athletes and spectators, and accidents resulting from some of the newer diving and starting techniques. United States Swimming, Incorporated, the national governing body for competitive swimming, and provider of insurance coverage for most of the swimming clubs in the United States, keeps track of reported injuries to club members, and requires specific safety accreditation for member coaches. These data provide an informative view on injuries to competitive swimmers.