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 youth bandy: an epidemiological study of a league season

PURPOSE: Bandy, with a century-long tradition in northern Europe, is a winter team-sport similar to ice hockey. To investigate the occurrence of injuries during competitive youth bandy games, injury incidence, injury types, and age-related risks were analyzed for one youth league season. METHODS: The National Athletic Injury/Illness Reporting System (NAIRS) definition of sports injury was used for the injury registration. All 416 games during the 1999-2000 season in the Swedish southeastern youth bandy league were included in the study. Primary data was collected by a questionnaire and completed by the team coaches after each game. At the end of the season, physician interviews with each team coach were performed to assure that no injuries had been missed as well as to ascertain whether there was any remaining disability. RESULTS: In total, 2.0 injuries (95% confidence interval 1.2-2.9 injuries) per 1000 player game hours were recorded. Sixty-eight percent of the injuries caused the injured player to be absent from bandy play for more than a week. Collision was the most common cause of injury (36%), and contusion was the most common injury type (41%). The injury incidence in the leagues for older players (Youth 14 -Youth 16) was slightly higher than in the leagues for the younger players (Youth 12 -Youth 13), while participation by under-aged players in games organized for older players led to an almost four-fold increase of injury risk. For severe injuries, the mean rehabilitation time away from bandy practice or competition was 27 d (range 8-56 d). CONCLUSION: The overall injury incidence during youth bandy games is low, but the injuries that occur cause extensive absences from the only four months long bandy season. From a public health perspective, bandy can be recommended for consideration when physical exercise is to be promoted among school-age children in countries with a winter climate.     

Injury rates and profiles in female ice hockey players

BACKGROUND: Little data exist on injury rates and profiles in female ice hockey players. OBJECTIVE: To examine the incidence of injury in female ice hockey players and compare injury rates with those of male players. STUDY DESIGN: Prospective cohort study. METHODS: Six male and six female teams from the Canada West Universities Athletic Association were followed prospectively for one varsity season. Preseason medical history forms were completed by each player. Injury report forms and attendance records for each team session were submitted by team therapists. RESULTS: Male players reported 161 injuries, whereas female players reported 66 injuries. However, the overall injury rates for male (9.19 injuries per 1000 athlete-exposures) and female (7.77 injuries per 1000 athlete-exposures) players did not differ significantly. Ninety-six percent of injuries in female players and 79% in male players were related to contact mechanisms, even though intentional body checking is not allowed in female ice hockey. Women were more likely than men to be injured by contacting the boards or their opponent. Men sustained more severe injuries than women and missed about twice as many sessions (exposures) because of injury. Concussions were the most common injury in female players, followed by ankle sprains, adductor muscle strains, and sacroiliac dysfunction. CONCLUSION: Although the injury rate in female ice hockey players was expected to be lower than that in male players because of the lack of intentional body checking, the injury rates were found to be similar.     

Dental injuries in ice hockey games and training

PURPOSE: The purpose of this study was to determine the incidence, cause, and nature of maxillofacial and dental injuries in ice hockey games and training and also evaluate the use and the effect of dental or facial guards. METHODS: Maxillofacial and dental ice hockey injuries in Finland were studied during years 1991 and 1992. Material was gathered from the insurance company that had practically all the ice hockey licenses in those years. The material consisted of 479 injured ice hockey players who suffered from 650 separate injuries. The most common dental injury was a noncomplicated crown fracture, which accounted for 43.5% of all maxillofacial or dental injuries. Of these noncomplicated crown fractures, almost 70% occurred in the games. RESULTS: The most common cause of accidents was a blow from the ice hockey stick. The stick as a cause of injury was approximately 3 times as common in the games than in training. Only 10% of injured players wore some kind of protective guard. CONCLUSION: A mandatory use of mouthguards and face masks or tightened rules for protection to decrease the high number of maxillofacial and dental injuries in the ice hockey games should be considered.     

Concussion among Swedish elite ice hockey players.

OBJECTIVE: To evaluate the frequency of concussion in Swedish ice hockey and to establish a uniform grading and treatment model for concussions of different severity. METHODS: Frequency of concussion was investigated in two studies, one retrospective and one prospective. In the retrospective study, all Swedish elite ice hockey players (n = 265) were asked to answer a questionnaire on the number and treatment of previous concussions. Only concussions diagnosed by a doctor were recorded. The questionnaire was completed by 227 players (86%). In the prospective study, all injuries including concussions occurring during game and practice in the Swedish Elite League (n = 12 teams) were recorded during four years. The causes of injury, referees judgements, diagnosis, treatment, and time absent from ice hockey were registered on special cards. RESULTS: In the retrospective study, 51 out of 227 players (22%) in the Swedish Elite League reported at least one concussion. In the prospective study, 52 concussions were reported. The incidence of a concussion is at least one concussion every year/team or a yearly risk of about 5% for a player to sustain a concussion. Most concussions occurred during league play (81%). Body contact (checking or boarding) was the most common cause of concussions. The players were absent from full training and play on a mean of 6 d. CONCLUSIONS: As this injury is potentially dangerous it must be treated seriously according to a simple treatment model presented. In cases of repeated concussions during the same season, a longer period of time away from play is suggested. In players who have sustained several concussions over the years a thorough medical examination including EEG, CT/MRI, and neuropsychological tests should be performed. If any of these is pathological the player should be advised to give up ice hockey.     

Prospective study of concentric and eccentric leg muscle torques, flexibility, physical conditioning, and variation of injury rates during one season of amateur ice hockey

Twenty-three male ice hockey players in a third division amateur ice hockey team were prospectively studied during the 1987-1988 season. O2 uptake, muscle flexibility, and isokinetic concentric and eccentric leg muscle strength were measured before and after the season. All injuries were recorded by one and the same physician attending all the games: 68 injuries occurred altogether but only six of these led to absence from training or matches. O2 uptake and muscle flexibility were unchanged during the season, but a significant drop of both concentric and eccentric quadriceps and hamstring torques occurred in spite of the fact that the team played two games and trained twice per week during the entire season. No correlation between the fall in muscle strength and the injury rate was found. Although many injuries occur in ice hockey, the majority are minor ones that do not lead to absence from playing.     

Ice hockey injuries: incidence, nature and causes.

In this prospective study, we have investigated incidence of injuries of different severity, types of injury, and mechanisms of injury during ice hockey games. All twelve Swedish elite hockey teams were observed during the season 1988-1989 when a total number of 664 games were played. There was a total number of 285 injuries, of which the majority were minor (61%) and only 9% were classified as major. Seventy-four per cent of the injuries occurred during games and 26% during practice. The overall incidence of injury was 53.0 per 1000 player-game hours. Eighty-five per cent of injuries were caused by trauma and 15% by over-use. Injuries were most often localized to the head/face (39%) or the lower limb (32%). Most injuries resulted from stick contact or player contact including checking. A reduction of minor and moderate injuries should be possible by stricter enforcement of the hockey rules, and more widespread use of visors.     

Injuries to the upper extremity in ice hockey: analysis of a series of 760 injuries

BACKGROUND: Injuries to the upper extremity are common in ice hockey. PURPOSE: To investigate the mechanisms, types, and severity of upper extremity ice hockey injuries in patients in different age categories. STUDY DESIGN: Retrospective cohort study. METHODS: We analyzed 760 consecutive upper extremity injuries in Finnish ice hockey players reported to an insurance company during 1996. RESULTS: The overall injury rate of upper extremity injuries was 14.8 per 1000 player-years; 70% occurred during games. Of the 861 injury types, 32% were contusions, 28% sprains or strains, and 27% fractures. Checking or other collisions with players caused 76% of the injuries to the shoulder (170 of 223), 55% of the injuries to the elbow (35 of 64), and 45% of the injuries to the distal extremity (213 of 473). Of the 561 injuries with known severity, 38% were major. The injury risk increased significantly with age, from players younger than 12 years to players 25 to 29 years of age. The injury profile among 15- to 19-year-old players was similar to that of adult players. CONCLUSIONS: Injuries to the upper extremity are relatively serious because of the high number of shoulder injuries and fractures. The frequency of injuries increased with age. A considerable proportion of upper extremity injuries was caused by body checking.     

Injuries in women's professional soccer

Objective: The injury data from the first two seasons of the Women's United Soccer Association (WUSA) were analysed to determine the injury incidence, anatomic location of injuries, and relation of player position.

Methods: Injury data on 202 players from eight teams during the first two seasons of the WUSA were prospectively collected and analysed.

Results: A total of 173 injuries occurred in 110 players with an overall injury incidence rate of 1.93 injuries per 1000 player hours. The incidence of injury during practice and games was 1.17 and 12.63 per 1000 player hours, respectively. Of the injuries 82% were acute and 16% were chronic. Most of the injuries (60%) were located in the lower extremities. Strains (30.7%), sprains (19.1%), contusions (16.2%), and fractures (11.6%) were the most common diagnoses and the knee (31.8%) and head (10.9%) were the most common sites of injury. Anterior cruciate ligament (ACL) injuries accounted for 4.6% of all injuries and the incidence of ACL tears was 0.09 per 1000 player hours (practice 0.04, game 0.90). Midfielders suffered the most injuries (p<0.007).

Conclusion: We conclude that the injury incidence in the WUSA is lower than the 6.2 injuries per 1000 player hours found in the corresponding male professional league (Major League Soccer); however, knee injuries predominate even in these elite female athletes.

     

Community level australian football: a profile of injuries

Identification of injuries and their risk factors is required in order to develop risk controls within the context of sports injury prevention. The Australian Football Injury Prevention Project (AFIPP) was a randomised controlled trial (RCT) examining the effects of protective equipment on injury rates in Australian Rules Football. The aim of this paper is to describe the general injury profile of community level Australian Football players over one season, as recorded during this RCT. Players were recruited from the largest community football league in Victoria, Australia, during the 2001 playing season. A total of 301 players participated (64% response rate) and all injuries occurring during training and games were recorded. The overall injury incidence rate was 12.1/1000 player hours. Bruises/soft tissue injuries made up more than a quarter of all injuries (28%) and the leg (lower leg, ankle, thigh/hamstring and knee) was the most commonly injured body region. Most injuries occurred at the beginning of the season (April-May, 53% of injuries), during competition (77%) and through body contact (49.9%). Midfielders (OR = 3.39, 95% CI: 1.13, 10.14) and players aged at least 25 years (OR = 2.15, 95% CI: 1.06, 4.34) were significantly more likely to experience an injury than other playing positions and younger players. Although the injury rate in this study was lower than that in previous studies, the results are consistent with the finding that injuries tend to occur earlier in the season and more commonly during competition. Injury prevention efforts should be particularly targeted at midfielders and older players.     

Epidemiology of injuries in Australian junior rugby league players

ObjectivesConduct a large-scale epidemiological study of injury characteristics (location, type, mechanism, severity, burden) and incidence in community junior rugby league.DesignProspective cohort epidemiology study.MethodsInjury surveillance was conducted in three district leagues (Penrith, Canberra, Melbourne) in under 6 (U6) to under 18 years (U18) age groups across the 2016 season. Club sports trainers recorded all match/training medical-attention injuries using a commercial electronic application which recorded injury circumstances and characteristics.ResultsA total of 13,169 players from 897 teams participated and 408 (89% male) players sustained 485 injuries, 94% of which were match related. The overall injury incidence was 5.9 injuries/1000 player hours and highest in U13–U18 female players (22.2 injuries/1000 player hours). The mean injury severity of 16 ± 31 days missed training/match-play caused an overall injury burden of 94.2 days missed/1000 player hours). Tackles accounted for 84% of injuries. Joint and contusion injuries were the most prevalent injury type and the head (35% total injuries, primarily bruising and bleeding) was the most injured body site.ConclusionsThis is the first study to report injuries across a large cohort of all-age Australian community junior rugby league players over one season. Injury prevalence was lower than previously reported in junior rugby league suggesting the sport has not become more dangerous for junior players. These findings provide an evidence-base to inform or revise policy, training and injury prevention programs and athlete development pathways in relation to game-wide safety and develop best-practice protocols in injury management for rugby league athlete support personnel.     

Soccer injuries among elite female players

Injuries occurring in two female elite soccer teams were recorded during 1 year. Of 41 players, 33 (80%) sustained 78 injuries. The incidence of injury during games was 24/1000 hours, while the incidence during training was 7/1000 hours. The majority (88%) of injuries were localized to the lower extremities, with equal occurrence in the left and right legs. Forty-nine percent of the injuries occurred in the knee or ankle. Most of the injuries were minor (49%), while 36% were moderate and 15% were major. Of the major injuries (N = 12), 10 were due to trauma and 7 (58%) were knee ligament or meniscal tears. Overuse injuries constituted 28% of all injuries and occurred mainly during preseason training and at the beginning and end of the competitive season. Traumatic injuries (72%) occurred mainly during games with a predominance at the beginning of the competitive season. Almost 80% of the traumatic injuries occurred during physical contact with an opponent. Extrinsic factors such as weather, playing surface, temperature, or the position of the player within the team did not influence the injury rate. We conclude that female elite soccer players sustain a high incidence of injury. Few injuries were major, but 17% of the players sustained a major knee injury during the year.     

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.     

Epidemiology of badminton injuries

In the badminton season 1983/1984, a prospective injury registration was done in 375 randomly chosen elite and recreational badminton players, of whom 81% could be followed. We found 257 injuries: an incidence of 2.9 injuries/player/1000 badminton hours. Men were more frequently injured than women. The prevalence was 0.3 injury per player. It was highest in men, and there was no difference between elite and recreational badminton players; 92% of the injured were playing with their injury. The pathophysiology was overuse in 74% (169/229), strains in 12% (28/229), sprains in 11% (26/229), and fractures in 1.5% (3/229). Possibilities for reducing the number of injuries and their severity are increased injury information to players and trainers and the introduction of stretching all involved muscle groups.     

Incidence of injury in junior and senior rugby league players

Rugby league is an international collision sport played at junior, amateur, semi-professional and professional levels. Due to the high numbers of physical collisions and tackles, musculoskeletal injuries are common. A large percentage of injuries result in long-term employment and study limitations, medical costs and loss of income. Review articles addressing the applied physiology of rugby league and common rugby league injuries have been published. However, both of these review articles have focused on the professional rugby league player. This review addresses the extent of the injury problem in rugby league in all levels of competition (i.e. junior, amateur, semi-professional and professional). The incidence of rugby league injuries typically increases as the playing level is increased. The majority of studies have shown that the head and neck is the most common site of match injuries in senior rugby league players, while knee injuries are the most common site of injury in junior rugby league players. Muscular injuries are the most common type of injury sustained by senior rugby league players, while junior rugby league players more commonly sustain fractures. Injuries are most commonly sustained in tackles, by the tackled player. Thigh and calf strains are the most common injuries sustained during rugby league training, while overexertion is the most common cause of training injuries. Player fatigue may influence the incidence of injury, with most sub-elite (amateur and semi-professional) rugby league injuries occurring in the second half of matches or the latter stages of training sessions. The majority of training injuries occur in the early stages of the season, while match injuries occur in the latter stages of the season, suggesting that changes in training and playing intensity may influence the incidence of injury in rugby league. Injury prevention studies are required to reduce the incidence, severity and cost of rugby league injuries. These injury prevention strategies could include coaching on defensive skills, correct tackling technique, correct falling technique and methods to minimise the absorption of impact forces in tackles. Game-specific attacking and defensive drills practised before and during fatigue may also encourage players to make appropriate decisions under fatigued conditions and apply learnt skills during the pressure of competitive matches. Further studies investigating risk factors for injury in junior and senior rugby league players, injuries sustained by specific playing positions and the influence of injuries on playing performance are warranted.     

An examination of the frequency and severity of injuries and incidents at three levels of professional football

OBJECTIVE: To assess the risk of injury to professional footballers during European international and English Premier and First Division league matches. METHODS: Videotaped recordings of 29, 49, and 93 matches from the 1996 European Championship, 1996/1997 English Premier season and 1994 to 1997 English First Division seasons respectively were analysed. During each match, several relevant variables, including the number of fouls, injuries, time of incident, player identity, and injury mechanism, were recorded. RESULTS: Significantly more free kicks were awarded during international matches than during league matches; however, there were no significant differences between the numbers of free kicks awarded over the three First Division seasons assessed. Between 1.7 and 3.0% of fouls resulted in a player requiring treatment for injury, but only 15-28% of all injuries resulted from foul play. In all "non-foul" situations, in which injury resulted, at least 60% still involved player to player contact. No significant differences in injury frequency were observed between playing positions or match halves. CONCLUSIONS: The results equate to a total of 808 players per season from the estimated 2600 players in the four English professional football leagues sustaining a match injury that caused them to miss at least one game. The large number of underlying "non-injury" incidents is identified as the reason for this level of injury rather than a higher ratio of "injury" to "non-injury" incidents in professional football compared with other occupations.


     

Sport, age, and sex specific incidence of sports injuries in Western Australia

OBJECTIVE: To describe the trends in recreational sports injury in Perth, Western Australia. DESIGN: A prospective cohort study of sports injuries during the 1997 winter season (May to September). SETTING: Sample of Australian football, field hockey, basketball, and netball players from the Perth metropolitan area, Western Australia. METHODS: A cohort of sports participants was followed over the five month winter sports season. Before the season, participants completed a baseline questionnaire and during the season were interviewed every four weeks by telephone. RESULTS: Overall, 92% of participants (n = 1391) who completed a baseline questionnaire completed at least one follow up telephone interview. About half (51%) of the cohort sustained one or more injuries during the winter season accounting for a total of 1034 injuries. Most injuries were of moderate (58%, n = 598) or minor (40%, n = 412) severity, with only 3% (n = 24) requiring emergency department treatment or a hospital stay. The injury incidence rate was greatest for football (20.3/1000 hours of participation), similar for field hockey and basketball (15.2/1000 hours and 15.1/1000 hours respectively), and lowest for netball (12.1/1000 hours). The incidence of injury was greatest in the first four weeks of the season, and participants aged between 26 and 30 years had about a 55% greater risk of injury than those aged less than 18 years. CONCLUSIONS: This is one of the first studies to show that recreational sports are safe. Although the likelihood of injury was greatest in the first month of the season, few injuries required admission to hospital or emergency department treatment. A greater emphasis on prevention in the early part of the season should help to reduce the elevated incidence of injury found at this time.