Sport and active recreation injuries in Australia: evidence from emergency department presentations

OBJECTIVE: Despite the rise in specialist clinical services for the management of sports and active recreation injury, many patients attend hospital emergency departments for treatment. The purpose of this study was to describe sports injury cases presented to selected hospital emergency departments around Australia for the period 1989-1993. METHODS: Routinely collected emergency department injury presentation data from the Australian National Injury Surveillance Unit were examined. Data on 98,040 sports and active recreation emergency department presentations were analysed. Sports and active recreation activities were ranked according to frequency of presentation. Relative proportions of injury type and body region injured were determined. Data are presented separately for children (<15 years of age) and adults (>15 years of age). RESULTS: Among the 10 activities that most commonly led to a sports or active recreation injury presentation for all ages were cycling, Australian football, basketball, soccer, cricket, netball, and rugby. For children, injuries were also commonly associated with roller skating/blading, skateboarding, and trampolining. Hockey, martial arts, and dancing injuries were frequent in adults. Most sporting injuries occurred during organised competition or practice whereas the active recreation injuries occurred in a variety of settings. Fractures, strains, and sprains, particularly to the lower and upper extremities, were common types of injury. CONCLUSION: The rich, but nevertheless limited, information available about sports and active recreation injuries from data collected in emergency departments indicates that these activities are a common context for injury at the community level in Australia.


     

Don't save the ball!

OBJECTIVES: To identify, over a period of 12 months, all attendances at an accident and emergency department by children over the age of 5 years with an injury to a wrist, hand, or finger, and to examine those sustained as a result of a blow from a ball. METHODS: The case notes of all children aged 6-13 years attending the Accident and Emergency Department of the Royal Aberdeen Children's Hospital in the year 2001 as a result of a wrist, hand, or finger injury sustained from a blow by a ball were reviewed, and the cause, type, and severity of the injury noted. RESULTS: A total of 187 children were identified; 69% were boys and football was the main sport involved. Most (93%) were radiographed, and 40% were positive; most fractures were sustained outwith school. Hand dominance was not significant. CONCLUSIONS: These injuries are common and may be preventable with modification of rules, equipment, and coaching. A register of youth sporting injuries may show if there are any detrimental long term effects.     

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.     

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.     

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.

     

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.     

The risk of abdominal injury to women during sport

Although trauma to pregnant women is a potential risk during sport, as there is no published information about the magnitude of this risk, it is presumed to be low. Whilst there is an emerging literature about the risk of adverse outcomes following severe and catastrophic trauma to pregnant women, this literature almost exclusively focuses on road trauma victims or the result of assault. This paper describes the risk of abdominal injuries to women participants across a range of sports in Australia. An extensive search of the available literature could not identify any studies that had discussed this issue specifically in pregnant women. Studies, which have reported injuries in athletes, have generally found abdominal/chest injuries to account for fewer than 2% of all injuries, even in contact sports. Most of these published studies do not differentiate between the chest and abdomen and provide no specfic details on the exact nature or mechanisms of the injuries. Given the limitations of the published studies, an examination of data from two Australian general injury databases (one describing hospital admissions, the other hospital emergency department presentations), three Australian sports-injury treatment databases (sports medicine clinic attendances and medical coverage services) and one cohort study was undertaken to describe sports-related abdominal injuries. These analyses confirm that the risk of abdominal injury during sport is very low. In conclusion, currently there is not an adequate evidence-base for quantifying the risk of abdominal injuries during sport in women, let alone pregnant women or for justifying a ban of sport on this basis. Recommendations for future epidemiological sports injury studies and the potential for linkages with perinatal morbidity and mortality databases are given.     

Risk factors for acute and overuse sport injuries in Swedish children 11 to 15 years old: What about resistance training with weights?

To determine the 1‐year self‐reported incidence of overuse and traumatic sport injuries and risk factors for injuries in children participating in a summer sports camp representing seven different sports. 4363 children, 11 to 15 years old participating in a summer camp in seven different sports answered a questionnaire. Injury in this cross‐sectional study was defined as a sport‐related trauma or overload leading to pain and dysfunction preventing the person from participation in training or competition for at least 1 week. A number of risk factors for injury were investigated such as sex, age, number of hours spent on training in general, and on resistance training with weights. Nearly half [49%, 95% confidence interval (CI) 48–51%] of the participants had been injured as a result of participation in a sport during the preceding year, significantly more boys than girls (53%, 95% CI 50–55% vs 46%, 95% CI 43–48%; P < 0.001). Three factors contributed to increased incidence of sport injuries: age, sex, and resistance training with weights. Time spent on resistance training with weights was significantly associated with sport injuries in a logistic regression analysis. In children age 11 to 15 years, the risk of having a sport‐related injury increased with age and occurred more often in boys than in girls. Weight training was the only modifiable risk factor that contributed to a significant increase in the incidence of sport injuries.     

Sports-related injuries in children. A study of their characteristics, frequency, and severity, with comparison to other types of accidental injuries

In 1981 to 1982, within a 1 year period, details were recorded of children aged 0 to 15 years and 3 months, who were treated for accidental injury in a French health care district; 789 sports-related accidents were registered, representing 11% of all accidents. Sports areas were the leading sites of accident among children over age 12. Out-of-school sports accidents were more frequent among boys, but boys and girls had similar injury rates in school physical education. Compared to home, school, and road accidents, sports accidents had the highest rate of upper limb injury. The fracture rate was 22% and the hospitalization rate 11%. In most cases children were injured without any participation of other players or sports equipment. Sports-related injuries were usually benign, but several hospital admissions for the same accident were required in 20% of the admitted children (significantly higher than in home, school, and road accidents), and the time elapsed between the accident and the end of the last stay in hospital was significantly greater than in other kinds of accidents. This might be explained by a higher rate of epiphyseal fractures (10%) and internal fixation (17%). Musculoskeletal sequelae were observed in 12% of inpatient children.     

Skateboarding injuries of today

Background—Skateboarding injuries have increased with the rise in popularity of the sport, and the injury pattern can be expected to have changed with the development of both skateboard tricks and the materials used for skateboard construction. Objective—To describe the injury pattern of today. Methods—The pattern of injuries, circumstances, and severity were investigated in a study of all 139 people injured in skateboarding accidents during the period 1995–1998 inclusive and admitted to the University Hospital of Umeå. This is the only hospital in the area, serving a population of 135 000. Results—Three of the 139 injured were pedestrians hit by a skateboard rider; the rest were riders. The age range was 7–47 years (mean 16). The severity of the injuries was minor (AIS 1) to moderate (AIS 2); fractures were classified as moderate. The annual number of injuries increased during the study period. Fractures were found in 29% of the casualties, and four children had concussion. The most common fractures were of the ankle and wrist. Older patients had less severe injuries, mainly sprains and soft tissue injuries. Most children were injured while skateboarding on ramps and at arenas; only 12 (9%) were injured while skateboarding on roads. Some 37% of the injuries occurred because of a loss of balance, and 26% because of a failed trick attempt. Falls caused by surface irregularities resulted in the highest proportion of the moderate injuries. Conclusions—Skateboarding should be restricted to supervised skateboard parks, and skateboarders should be required to wear protective gear. These measures would reduce the number of skateboarders injured in motor vehicle collisions, reduce the personal injuries among skateboarders, and reduce the number of pedestrians injured in collisions with skateboarders. Key Words: skateboard; injury; prevention     

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.     

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

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

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 in Saudi Arabia.

Saudi Arabia has now a wealth of sporting facilities of which the youth of the country is making full use. A prospective study of sports related injuries was conducted during the twelve months of 1983. We present an analysis of 846 such injuries seen at the King Fahd University Hospital, Al Khobar. These injuries formed 8.36% of those who attended after an accident for emergency treatment, of which 63% were under 20 years. The majority was sustained during soccer games. The most frequent site of injury was the knee. We believe that specialised Sports Injury Clinics, initially based at the University Hospitals should be established here, to give guidance and education concerning avoidance of injuries, and for the treatment and follow-up of those injured and enable them to return to sports early.     

Injuries treated at a sports injury clinic compared with a neighbouring accident and emergency department.

Previous reports relating to sports injuries treated at hospital Accident and Emergency departments (A&E) or Sports Injury Clinics (SIC) indicate differences between the groups. This study compared directly the sports injuries treated during overlapping time periods at an A&E department (n = 2490) and a SIC (n = 340) set within the same geographical area. The two populations were found to differ significantly in age, sport, injury and injury site. Hospital patients tended to be younger, with an acute injury to the upper body or head which occurred during participation in sports where contact is likely. SIC patients tended to be older, with chronic or overuse injuries to the back or lower limb. It was found that there are significant differences between the sports injuries treated at the sports injury clinic and the hospital casualty department. It is concluded that demand is clearly shown for both types of treatment site when both are available in the same geographical area.     

A profile of Australian football injuries presenting to sports medicine clinics

Most of the published data describing Australian football injuries is from hospital emergency departments and elite injury surveillance studies. There is a lack of good information about injuries to players at the lower levels of participation and those not severe enough to warrant hospital treatment. This study describes the profile of Australian football injuries that present to sports medicine clinics for treatment. New sports injury cases, presenting to five metropolitan Melbourne sports medicine clinics during a 12 month period in 1996-1997, were recorded through the Sports Medicine Injury Surveillance project. Both the patient and treating health professional provided personal and injury details. Australian football accounted for 29% of the 6479 recorded injury cases. The majority of injured players were male (99%) and from adult, community leagues (78%); the mean age was 23 years. Competition accounted for 78% of injuries and 72% of injured players presented for treatment to a sports physician/medical practitioner. Body contact accounted for half of all injuries and the most common injuries were medial ligament sprains of the knee (7%), lateral ligament sprains of the ankle (6%) and anterior cruciate ligament injuries (4%). In conclusion, sports medicine clinics treat a wide variety of football injuries and appear to be a good source of data about injuries to non-elite participants.     

A prospective study of kitesurfing injuries

BACKGROUND: To date, the pattern and rate of kitesurfing injuries are largely unclear. HYPOTHESIS: The pattern and rate of kitesurfing injuries are comparable to that of contact sports such as football and soccer. STUDY DESIGN: Prospective study. METHODS: The study was conducted over a 6-month period of 1 season and included 235 kitesurfers. RESULTS: The number of self-reported injuries was 124, for an overall self-reported injury rate of 7 per 1000 hours of practice. One fatal accident (polytrauma) and 11 severe injuries occurred during the study period (2 knee ligament injuries and 9 fractures at various sites). The most commonly injured sites were the foot and ankle (28%), skull (14%), chest (13%), and knee (13%). Fifty-six percent of the injuries were attributed to the inability to detach the kite from the harness in a situation involving loss of control over the kite. There was a tendency for athletes using a quick-release system to sustain fewer injuries than athletes without such a release system. CONCLUSION: Kitesurfing can be considered a high-risk sport. CLINICAL RELEVANCE: The use of a quick-release system that enables the surfers to detach the kite in case of an accident might aid in the prevention of injuries.     

Acute sports injuries in Oslo: a one-year study

All sport injuries treated at the Emergency Department, Ullevål Hospital in Oslo (OKL) were registered for one year. They accounted for 6.3% of the total number of patients treated at OKL in that period. 4673 patients were seen; 3292 males and 1381 females. The women were younger than the men, 55% were below 20 years of age; 41% of the males (p less than 0.05). Most of the men (64%) were injured in connection with competitive sports, but 52% of the women sustained their injury pursuing recreational sports. Football and skiing accounted for 49% of the total number of injuries. In males football caused most injuries--35%. In females handball accounted for most injuries--18%. Nearly 3/4 of the injuries affected the extremities; the most common injury being the ankle sprain (16%). Almost 1/4 of the patients had a fracture, and 218 patients (4.7%) were admitted to hospital, the rest being treated as outpatients. In all, the sports injuries required 7658 consultations.