Injuries during physical activity in school children

During the spring of 2001, 1975 children, from grades 3, 6 and 9 participated in a nationwide, multidisciplinary collaboration study. The students came from randomly selected classes throughout Sweden, representing different geographical and socio-economic areas. The aim of this study was to collect and evaluate self-reported injuries and associated factors during various physical activities as recalled retrospectively for 3 months by the students. Every sixth student (n=299 or 16%) reported 306 injuries. Twice as many girls than boys were injured during physical education class. Ninth-grade students reported relatively more injuries during organized sports than during physical education class and leisure activities. There were no age or gender differences in incidence rate during leisure activities. Most injuries were minor, as 70% were back in physical activity within a week. Half of the students (50%) reported that they previously had injured the same body part. Primary care of the injured student was, with the exception of a family member, most often carried out by the physical education teacher or coach, which accentuates the importance of continuous sports medicine first aid education for this group.     

Work-related acute injuries from mandatory fitness training in the Swedish Police Force

Acute injuries in the Swedish Police Force from on-duty fitness training were selected retrospectively from the Information System of Occupational Injuries (ISA) at the National Board of Occupational Safety and Health and, if having caused a sick-leave exceeding 2 weeks, to the Labour Market Insurance (AMF Insurance). The latter included injuries from 1995 only. During the seven-year period 1992 to 1998, 920 injuries (80 % in males) from fitness training involving police officers were reported to the ISA-register. The total incidence was 1.6 for policemen per 10 000 hours of exposure and 2.2 for policewomen, which is 1.4 times higher than in men. Around 50 % of the injuries occurred in team and contact sports, with a slightly higher percentage for males, 54 % versus 49 % in females. The percentage of injuries from self-defense training was twice as high as in women than in men, 29 % versus 15 %. In 1995, 42 of the 72 injuries in males and 6 of the 21 injuries in females caused more than 14 days of sick-leave and were announced to the Occupational No Fault Liability Insurance. The major part, 32 of 48 injuries, came from team or contact sports (mainly floorball and soccer). Six policemen incurred injuries that were classified with a degree of disability ranging from 2 to 5 %. The total cost for medical treatment and production loss for the 48 injuries was Euro 248 448 and 99 336, respectively. Team and contact sports accounted for 89 % of the costs and 77 % of the production loss through sick-leave.     

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.     

Sports injuries in physical education teacher education students

Sports injuries could be highly detrimental to the career of a physical education teacher education (PETE) student. To enable the development of future sports injury prevention programs, sports injuries in 128 first‐year academic bachelor PETE students were registered prospectively during one academic year. Common risk factors for sports injuries, taken from the literature, were also evaluated by means of logistic regression analysis. We found an incidence rate of 1.91 and an injury risk of 0.85, which is higher than generally found in a sports‐active population. Most injuries involved the lower extremities, were acute, newly occurring injuries, and took place in non‐contact situations. More than half of all injuries lead to an inactivity period of 1 week or more and over 80% of all injuries required medical attention. A major part of these injuries happened during the intracurricular sports classes. Few differences were seen between women and men. A history of injury was a significant risk factor (P = 0.018) for the occurrence of injuries, and performance of cooling‐down exercises was significantly related to a lower occurrence of ankle injuries (P = 0.031). These data can inform future programs for the prevention of sports injuries in PETE students.     

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.     

Medical treatment and costs of sports-related injuries in a total population

A prospective study of acute injuries from sports and physical exercise was carried out during 1 year in a total population of a municipality with 31,620 inhabitants. The medical treatment and the services required for the injuries have been calculated and related to the total consumption of medical care in the municipality. A total of 571 injuries (17% of all injuries) occurred in 28 different sports: 65% of the injured were males. Sports injuries accounted for 3% of all acute visits and there were altogether 1,083 outpatient visits, which yields a mean of 1.9 visits per injury. Related to the total consumption of outpatient visits to the five clinics in the municipality sports injuries also accounted for 3%. Forty-four patients were hospitalized; the proportion of inpatient care due to sports injuries was 0.7% and the mean length of stay in hospital 3.9 days. The total amount of sick leave compensated for sports injuries (3,477 days) was 1.2% of all days compensated in 1984. The overall mean cost per injury was US$ 335. Individual sports (motorcycling, downhill skiing and equine sport) were by far the most costly in the Falk?ping survey, the dearest of the team sports ranking only fifth (handball followed by soccer).     

Quantifying the risk of sports injury: a systematic review of activity-specific rates for children under 16 years of age

Injuries caused by sports and other forms of physical activity in young children constitute a significant public health burden. It is important to quantify this risk to ensure that the benefits of sport participation are not outweighed by the potential harms. This review summarises the literature reporting exposure-based injury rates for various forms of physical activity in children aged 15 years and younger. Forty eight studies were found, of which 27 reported injury rates per hourly based exposure measured and 21 reported injury rates according to some other measure. Fourteen different sports and activities were covered, mostly team ball sports, with soccer being the most widely studied. Injury definition and the method of ascertaining and measuring injuries differed between studies, which created a large variation in reported injury rates that did not necessarily represent actual differences in injury risk between activities. The highest hourly based injury rates were reported for ice hockey, and the lowest were for soccer, although the range of injury rates for both of these activities was wide. Very few studies have investigated sports-related injuries in children younger than 8 years or in unorganised sports situations.     

Injuries in team sport tournaments during the 2004 Olympic Games

BACKGROUND: Several authors have analyzed the incidence of injuries in a given sport, but only a few have examined the exposure-related incidence of injuries in different types of sports using the same methodology. PURPOSE: Analysis of the incidence, circumstances, and characteristics of injuries in different team sports during the 2004 Olympic Games. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: During the 2004 Olympic Games, injuries in 14 team sport tournaments (men's and women's soccer, men's and women's handball, men's and women's basketball, men's and women's field hockey, baseball, softball, men's and women's water polo, and men's and women's volleyball) were analyzed. After each match, the physician of the participating teams or the official medical representative of the sport completed a standardized injury report form. The mean response rate was 93%. RESULTS: A total of 377 injuries were reported from 456 matches, an incidence of 0.8 injuries per match (95% confidence interval, 0.75-0.91) or 54 injuries per 1000 player matches (95% confidence interval, 49-60). Half of all injuries affected the lower extremity; 24% involved the head or neck. The most prevalent diagnoses were head contusion and ankle sprain. On average, 78% of injuries were caused by contact with another player. However, a significantly higher percentage of noncontact (57%) versus contact injuries (37%) was expected to prevent the player from participating in his or her sport. Significantly more injuries in male players (46%) versus female players (35%) were expected to result in absence from match or training. The incidence, diagnosis, and causes of injuries differed substantially between the team sports. CONCLUSION: The risk of injury in different team sports can be compared using standardized methodology. Even if the incidence and characteristics of injuries are not identical in all sports, prevention of injury and promotion of fair play are relevant topics for almost all team sports.     

Trends and determinants of organised sports participation in immigrant and Australian children: A nine-year follow-up

ObjectivesThis study aimed to examine trends and determinants of organised sports participation among children of immigrant parents from low-and-middle-income countries, high-income countries, and Australian children.DesignLongitudinal (nine-year follow-up).MethodsData were from the birth-cohort of Australian Children aged 6–15 years with follow-up between 2010 and 2018. Organised sports participation was measured using two items about regular participation in team and individual sports. Multilevel logit modelling was used to assess the determinants of organised sports participation across groups.ResultsBoth team sports participation and individual sports participation increased between 6 and 11 years and declined between 11 and 15 years across the three groups. Children of immigrant parents from low-and-middle-income countries (OR 0.65; 95 % CI 0.57–0.74) and high-income countries (OR 0.82; 95 % CI 0.76–0.89) had lower odds of team sports participation than Australian children. Children of immigrant parents from low-and-middle-income countries had lower odds of team sports participation (OR 0.79; 95 % CI 0.69–0.90) than children of immigrant parents from high-income countries. Female children, high screen time, high psychological difficulties, increased number of siblings and low socio-economic position were identified as determinants of lower team and individual sports participation.ConclusionsThe present study identified evidence of disparities in organised sports participation among children of immigrant parents and Australian children. Multilevel and multicomponent interventions to promote children’s organised sports participation should be prioritised, with a focus on children of the female sex, older children, children with lower socioeconomic status, and children with higher screen time and higher psychological difficulties.     

Incidence rate of injuries during sport activity and physical exercise in a rural Swedish municipality: incidence rates in 17 sports

A prospective study of acute injuries from sports and physical exercise was carried out during 1 year in a total population of a municipality with 31,620 inhabitants. Data on exposure were collected: the number of participants in each sport, the hours of participation, and number of weeks in the season per year. The number of injuries was used as numerator and the exposure data as denominator in a formula modified from Chambers for the calculation of population at risk in sports. A total of 571 injuries occurred in 28 different sports: 65% of the injured were males. The majority of the injuries were from soccer: 50% of the males and 27% of the females. Incidence rates in 17 sports are presented. The ranking order differs, when calculating not only the number, but also the exposure. Ice hockey and handball were then found to have the highest risk followed by soccer. Team and contact sports on the whole had the highest rates in both genders. As a group, intercompany players had the highest rate, especially in soccer. The lowest rates were found in individual sports such as downhill skiing, horseback riding, racket sports, and running. Gymnastics, except in school physical education, had no injuries at all. Sprains and strains were diagnosed in nearly half of the cases and the foot and ankle were the most frequent sites. Preventive measures are proposed.     

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.     

Work-related injuries from mandatory fitness training among Swedish firemen

A considerable amount of employees incur injuries in professions with mandatory on-duty fitness training. The training is necessary for maintaining a good health status, physical condition and strength in professions requiring such qualities. Injuries in Swedish firemen from on-duty fitness training between 1992 and 1998 were selected retrospectively from the Information System of Occupational Injuries (ISA) at the National Board of Occupational Safety and Health and, if having caused a sick-leave exceeding 2 weeks, to the Labour Market Insurance (AMF Insurance). The latter comprised injuries from 1995 only. During the seven-year period 1,468 injuries from fitness training occurred in male firemen. With an estimated 147 h per man and year the injury incidence was 2.6 per 10,000 h of exposure. The mean number of days of absence from work was 24.1 days (SD 39.8). In 1995, the mean cost per injury for medical treatment was close to 7,000 Euro and for production loss almost 4,500 Euro. By far the major part of the injuries, 75 %, occurred during team and contact sports (primarily floorball and soccer) and this sport category also accounted for 83% of the medical costs and 78% of the costs for production loss. It is suggested that a restriction of team and contact sports as mandatory on-duty fitness training for firemen should be tested and evaluated concerning the injury incidence.     

Epidemiology of injuries in the Australian Football League, seasons 1997-2000

OBJECTIVE: To describe the epidemiology of injuries in the Australian Football League (AFL) over four seasons. METHODS: An injury was defined as "any physical or medical condition that caused a player to miss a match in the regular season." The rationale for this definition was to eliminate a previously noted tendency of team recorders to interpret injury definitions subjectively. Administrative records of injury payments to players who did not play matches determined the occurrence of an injury. RESULTS: The seasonal incidence of new injuries was 39 per club (of 40 players) per season (of 22 matches). The match injury incidence for AFL games was 25.7 injuries per 1000 player hours. The injury prevalence (percentage of players missing through injury in an average week) was 16%. The recurrence rate of injuries was 17%. The most common and prevalent injury was hamstring strain (six injuries per club per season, resulting in 21 missed matches per club per season), followed in prevalence by anterior cruciate ligament and groin injuries. CONCLUSIONS: The injury definition of this study does not produce incidence rates that are complete for all minor injuries. However, the determination of an injury is made by a single entity in exactly the same manner for all teams, which overcomes a significant methodological flaw present in other multiteam injury surveillance systems.     

A 7-year study on risks and costs of knee injuries in male and female youth participants in 12 sports

Knee injuries are common and account in various sports for 15-50% of all sports injuries. The cost of knee injuries is therefore a large part of the cost for medical care of sports injuries. Furthermore, the risk of acquiring a knee injury during sports is considered higher for females than for males. The nationwide organization "Youth and Sports" represents the major source of organized sports and recreation for Swiss youth and engages annually around 370000 participants in the age group of 14 to 20 years. The purpose of this study was to combine data on knee injuries from two sources, the first being data on the exposure to risk found in the activity registration in "Youth and Sports" and the second injuries with their associated costs resulting from the activities and filed at the Swiss Military Insurance. This allowed calculation of knee injury incidences, to compare risks between males and females and to estimate the costs of medical treatment. The study comprises 3864 knee injuries from 12 sports during 7 years. Females were significantly more at risk in six sports: alpinism, downhill skiing, gymnastics, volleyball, basketball and team handball. The incidences of knee injuries and of cruciate ligament injuries in particular, together with the costs per hour of participation, all displayed the same sports as the top five for both females and males: ice hockey, team handball, soccer, downhill skiing and basketball. Female alpinism and gymnastics had also high rankings. Knee injuries comprised 10% of all injuries in males and 13% in females, but their proportional contribution to the costs per hour of participation was 27% and 33%, respectively. From this study it can be concluded that females were significantly more at risk for knee injuries than males in six sports and that knee injuries accounted for a high proportion of the costs of medical treatment.     

Sports-related eye injuries: floorball endangers the eyes of young players

The objectives of this study were to determine the distribution of different sports-related eye injuries and to identify injury types to enable recommendations to be made about the use of protective eyewear. The study population comprises all 565 eye trauma patients examined at the Ophthalmology Emergency Clinic of the Helsinki University Central Hospital over a 6-month period. Data were collected from patient histories and questionnaires. In addition, three severe floorball eye injury cases are presented. Of the 565 eye traumas, 94 (17%) were sports related. Of these, 42 (45%) were associated with floorball. Countrywide, in Finland, estimated over 300 (+95% CI 228-415) floorball eye injuries occur annually. The mean age of floorball patients was 22 years. The most common finding (55%) in sports injury patients was hyphema. Clinically severe eye injuries during this period accounted for one-fourth of all cases. During the study period, no eye injury was found in an organized junior ice hockey, where facial protection is mandatory. Floorball is estimated to belong to the highest risk group in sports, and thus, the use of protective eyewear is strongly recommended. We conclude that national floorball federations should make protective eyewear mandatory.     

Indoor physical education measured by heart rate monitor. A case study in Portugal

AIM: Reports indicated that children are spending too much time being physically inactive during physical education classes and many school physical education programs are not meeting the recommendation. The purpose of this study was to investigate the physical activity levels in Portuguese indoor physical education classes. METHODS: The physical activity levels of 28 Portuguese 7th grade children were assessed by heart rate monitor during their indoor physical education classes. RESULTS: The study showed that much physical education class time had been wasted, and less than 70% of physical education class time had actually been used in classes. On average, 14.4 minutes of 45-min physical education classes and 27.9 min of 90-min physical education classes had been spent in MVPA with children's heart rates above 139 bpm; 6.7 min of 45-min physical education classes and 15.7 min of 90-min physical education classes had been spent in VPA with children's heart rates above 159 bpm. Children engaged in more MVPA, VPA, and continuous bouts of physical activity in 90-min physical education classes than those of 45-min physical education classes. There were no significant differences in activity levels between genders in co-educational indoor physical education classes. CONCLUSIONS: This indoor PE class study supports the results that children are less active during school physical education classes. Both the quantity and the quality of school physical education needs to improve to encourage children to engage in a substantial amount of physical activity both inside and outside school.     

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.     

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.     

Outcome of sports injuries treated in a casualty department.

The present investigation analyses 2493 patients with a sports injury treated in a casualty department during a one-year period. Of the patients 73% were men, the age of the patients averaging 26 years and the mean follow-up time was 24 months. Soccer and indoor ball games caused 24% and 23% of the injuries respectively, these being followed by injuries in ice hockey in 14%. Track and field injuries scored low with 2% out of all injuries. Injuries to the lower extremity predominated. At follow-up, ligamentous injuries of the lower extremity were the major cause of discomfort. Further, in the group of patients with persistent discomfort 36% had suffered a fracture or a dislocation, 13% a contusion and 10% a wound. The mean period of sports incapacity after a sustained injury was 3 weeks. In track and field events the injury seldom disturbed training for more than one week, but in soccer, indoor ball games, skiing and skating the mean sports incapacity period varied between 6 and 3 weeks. Out of the total injured, 2% had to give up their sports activity completely. An injury of the lower extremity demanded on average 4 weeks' rest, an injury of the upper extremity and the trunk 2 weeks and injuries of the head and neck one week's rest. According to the present investigation sports injuries were in the majority of cases of a relatively benign nature and sick leave from work seldom exceeded 2 weeks.     

Sports related injuries in Scottish adolescents aged 11-15

OBJECTIVES: To measure the age and sex distribution of self reported sports and leisure injuries in a 12 month retrospective recall period among a representative national sample of Scottish adolescents, and to examine the characteristics (gender, age, handedness, and level of sports participation) of sports related injuries in relation to injuries sustained during other activities. DESIGN/SETTING: Self completion questionnaire survey administered in schools during April- June 1994. SUBJECTS: 4710 pupils aged 11, 13, and 15 years drawn from a representative sample of 270 classes with returns from 224 classes (83% completion rate). RESULTS: 42.1% of the sample reported a medically attended injury. These were significantly more frequent among boys but there were no significant age differences in overall frequency of injury. Sport related injuries accounted for 32.2% of all medically attended injuries. As with all injuries, frequency was greater in boys than girls at all ages, and there are differences in the pattern of lesions in sports and nonsports injuries. Lower limb injuries were more frequent than upper limb injury in sports (57.6 v 23.9%), whereas there were no differences in non-sports injuries (31.5 v 31.3%). Age and handedness differences in sports injury rates were also identified. High sports participation was significantly associated with a higher risk of injury in general and sports related injury in particular. CONCLUSION: Age, gender, handedness, and level of sports participation have been shown to be implicated in differential risk of sports related injury. Reducing sports injury among adolescents should be a priority, but research into the injury profiles of different sports is needed before detailed injury prevention strategies can be developed.