Injuries in team sport tournaments during the 2004 Olympic Games

Injury data of major international field hockey tournaments

BACKGROUND

Detailed injury data are not available for international tournaments in field hockey. We investigated the epidemiology of field hockey injuries during major International Hockey Federation (Fédération Internationale de Hockey, FIH) tournaments in 2013.

MATERIALS AND METHODS

FIH injury reports were used for data collection. All major FIH tournaments for women (n=5) and men (n=11) in 2013 were included. The main focus of this study was to assess the pattern, time, site on the pitch, body site and mechanism of each of the injuries. We calculated the average number of injuries per match and the number of injuries per 1000 player match hours.

RESULTS

The average number of injuries was 0.7 (95% CI 0.5 to 1.0) per match in women's tournaments and 1.2 (95% CI 0.8 to 1.7) per match in men's tournaments. The number of injuries per 1000 player match hours ranged from 23.4 to 44.2 (average 29.1; 95% CI 18.6 to 39.7) in women and 20.8 to 90.9 (average 48.3; 95% CI 30.9 to 65.8) in men. Most injuries occurred in the circle (n=25, 50%, in women, n=95, 51%, in men). The rate of injuries increased after the first quarter. Injuries to the head and face (n=20, 40%) were most common in women. The head/face (n=51, 27%) and the thigh/knee (n=52, 28%) were equally affected in men. The ball caused the most injuries, followed by the stick, collisions and tripping/falling. There were no deaths or injuries that required hospital treatment in the entire cohort.

SUMMARY

Field hockey has a low incidence of acute injuries during competition.

Injury risk is low among world-class volleyball players: 4-year data from the FIVB Injury Surveillance System

Background

Little is known about the rate and pattern of injuries in international volleyball competition.

Objective

To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation (FIVB) Injury Surveillance System (ISS) (junior and senior, male and female).

Methods

The FIVB ISS is based on prospective registration of injuries by team medical staff during all major FIVB tournaments (World Championships, World Cup, World Grand Prix, World League, Olympic Games). This paper is based on 4-year data (September 2010 to November 2014) obtained through the FIVB ISS during 32 major FIVB events (23 senior and 9 junior).

Results

The incidence of time-loss injuries during match play was 3.8/1000 player hours (95% CI 3.0 to 4.5); this was greater for senior players than for junior players (relative risk: 2.04, 1.29 to 3.21), while there was no difference between males and females (1.04, 0.70 to 1.55). Across all age and sex groups, the ankle was the most commonly injured body part (25.9%), followed by the knee (15.2%), fingers/thumb (10.7%) and lower back (8.9%). Injury incidence was greater for centre players and lower for liberos than for other player functions; injury patterns also differed between player functions.

Conclusions

Volleyball is a very safe sport, even at the highest levels of play. Preventive measures should focus on acute ankle and finger sprains, and overuse injuries in the knee, lower back and shoulder.

Effects of muscle injury severity on localized bioimpedance measurements

Muscle injuries in the lower limb are common among professional football players. Classification is made according to severity and is diagnosed with radiological assessment as: grade I (minor strain or minor injury), grade II (partial rupture, moderate injury) and grade III (complete rupture, severe injury). Tetrapolar localized bioimpedance analysis (BIA) at 50 kHz made with a phase-sensitive analyzer was used to assess damage to the integrity of muscle structures and the fluid accumulation 24 h after injury in 21 injuries in the quadriceps, hamstring and calf, and was diagnosed with magnetic resonance imaging (MRI). The aim of this study was to identify the pattern of change in BIA variables as indicators of fluid [resistance (R)] and cell structure integrity [reactance (Xc) and phase angle (PA)] according to the severity of the MRI-defined injury. The % difference compared to the non-injured contralateral muscle also measured 24-h after injury of R, Xc and PA were respectively: grade I (n = 11; -10.4, -17.5 and -9.0%), grade II (n = 8; -18.4, -32.9 and -16.6%) and grade III (n = 2; -14.1, -52.9 and -43.1%), showing a greater significant decrease in Xc (p < 0.001). The greatest relative changes were in grade III injuries. However, decreases in R, that indicate fluid distribution, were not proportional to the severity of the injury. Disruption of the muscle structure, demonstrated by the localized determination of Xc, increased with the severity of muscle injury. The most significant changes 24 h after injury was the sizeable decrease in Xc that indicates a pattern of disrupted soft tissue structure, proportional to the severity of the injury.

Competing with injuries: injuries prior to and during the 15th FINA World Championships 2013 (aquatics)

BACKGROUND

Injury and illness surveillance is the foundation for the development of prevention strategies.

OBJECTIVE

To examine injuries among the aquatic disciplines in the 4 weeks prior to and during the 2013 FINA World Championships.

METHODS

The study was comprised of two components: (1) a retrospective athlete survey recording injuries in the 4 weeks prior to the Championships and (2) a prospective recording of injuries and illnesses by the medical teams of the participating countries and the local host medical team.

RESULTS

One-third of the 1116 responding athletes reported an injury/physical complaint in the 4 weeks prior to the Championships. Significantly more women (36.7%) than men (28.6%) reported injuries. Divers reported the highest rate of injury/physical complaints (55.7%). At the start of the Championships, 70% of injured respondents (n=258) were still symptomatic; however, full participation was expected by 76%. During the Championships, 186 new injuries were reported (8.3/100 registered athletes) with the highest injury incidence rate in water polo (15.3/100 registered athletes). The most common injured body part was the shoulder (21%). A total of 199 illnesses were reported during the Championships (9.0/100 registered athletes) with the most common diagnosis of illness being gastrointestinal infection. Environmental exposure (allergy, otitis and jellyfish stings) was responsible for 27% of all illnesses in open water swimming.

CONCLUSIONS

Injuries pose a significant health risk for elite aquatic athletes. A prospective study would improve understanding of out-of-competition injuries. Future injury and illness surveillance at FINA World Championships is required to direct and measure the impact of prevention strategies.

Evidence of validity for the Japanese version of the foot and ankle ability measure

CONTEXT

The Foot and Ankle Ability Measure (FAAM) is a valid, reliable, and self-reported outcome instrument for the foot and ankle region.

OBJECTIVE

To provide evidence for translation, cross-cultural adaptation, validity, and reliability of the Japanese version of the FAAM (FAAM-J).

DESIGN

Cross-sectional study.

SETTING

Collegiate athletic training/sports medicine clinical setting.

PATIENTS OR OTHER PARTICIPANTS

Eighty-three collegiate athletes.

MAIN OUTCOME MEASURE(S)

All participants completed the Activities of Daily Living and Sports subscales of the FAAM-J and the Physical Functioning and Mental Health subscales of the Japanese version of the Short Form-36v2 (SF-36). Also, 19 participants (23%) whose conditions were expected to be stable completed another FAAM-J 2 to 6 days later for test-retest reliability. We analyzed the scores of those subscales for convergent and divergent validity, internal consistency, and test-retest reliability.

RESULTS

The Activities of Daily Living and Sports subscales of the FAAM-J had correlation coefficients of 0.86 and 0.75, respectively, with the Physical Functioning section of the SF-36 for convergent validity. For divergent validity, the correlation coefficients with Mental Health of the SF-36 were 0.29 and 0.27 for each subscale, respectively. Cronbach α for internal consistency was 0.99 for the Activities of Daily Living and 0.98 for the Sports subscale. A 95% confidence interval with a single measure was ±8.1 and ±14.0 points for each subscale. The test-retest reliability measures revealed intraclass correlation coefficient values of 0.87 for the Activities of Daily Living and 0.91 for the Sports subscales with minimal detectable changes of ±6.8 and ±13.7 for the respective subscales.

CONCLUSIONS

The FAAM was successfully translated for a Japanese version, and the FAAM-J was adapted cross-culturally. Thus, the FAAM-J can be used as a self-reported outcome measure for Japanese-speaking individuals; however, the scores must be interpreted with caution, especially when applied to different populations and other types of injury than those included in this study.

The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies

BACKGROUND

Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist.

OBJECTIVE

Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity.

METHODS

We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields.

RESULTS

One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with high-quality studies (0.54 vs 11.55 per 1,000 exposures). Ankle sprain prevalence period estimates were similar across sub-groups. Lateral ankle sprain was the most commonly observed type of ankle sprain.

CONCLUSIONS

Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains.

Traumatic upper limb injuries during the Men's Field Hockey Junior World Cup 2009

This study was a prospective epidemiological investigation of upper limb injuries during the Men's Field Hockey Junior World Cup 2009. Three hundred twenty-four players were observed in 58 matches of the tournament. Twenty-eight upper limb-related injuries were documented. The injury incidence was 0.48 per match and 19 per 1,000 match hours. Most injuries were due to contact with the ball, and the left hand was the most commonly injured part. Contusion was the most common type of injury. The odds ratio for hand and wrist injuries in players not wearing gloves was 4.01 (95% CI, 0.52-30.62), and the relative risk of hand and wrist injuries in players wearing gloves was 0.26 (95% CI, 0.03-1.92). Male youth hockey players are at a high risk of upper limb, especially hand and wrist, injuries during major international tournaments and that use of protective gloves can provide significant protection against hand and wrist injuries in the sport.

Efeitos do treinamento proprioceptivo na estabilidade do tornozelo em atletas de voleibol

INTRODUÇÃO: Nos esportes onde há contato entre os atletas, como no voleibol, a entorse por mecanismo de inversão é a lesão mais frequente e o tornozelo é a articulação mais acometida quando comparada com as outras, acarretando déficits importantes como a instabilidade articular. Programas de treinamento proprioceptivo têm sido amplamente utilizados para minimizar essas questões.OBJETIVO: Avaliar o efeito de um treinamento proprioceptivo na estabilidade articular do tornozelo por meio do teste Star Excusion Balance Test (SEBT) em atletas de voleibol.MÉTODOS: Foram avaliadas 11 atletas de voleibol de um clube poliesportivo da cidade de Porto Alegre, RS, Brasil, por meio de um teste de avaliação para estabilidade articular do tornozelo, SEBT. As atletas passaram por um programa de treinamento proprioceptivo composto por seis exercícios que trabalharam propriocepção em diferentes graus de exigência durante quatro semanas e este teste foi aplicado no pré e pós-intervenção pelo programa de treinamento proprioceptivo das atletas.RESULTADOS: As variáveis quantitativas foram descritas por média e desvio padrão, e o estudo da normalidade das variáveis foi descrito pelo teste de Shapiro-Wilk. As variáveis categóricas foram descritas por frequências absolutas e relativas. Para a comparação de médias de ambos os tornozelos pré e pós-intervenção foi utilizado o teste T pareado. O nível de significância adotado foi de 5% (p≤0,05) e as análises foram realizadas no programa SPSS (Statistical Package for the Social Sciences) versão 18. Os resultados no teste SEBT das atletas pré e pós-intervenção proprioceptivo mostrou diferença significativa em seis direções para o tornozelo direito e cinco para o tornozelo esquerdo.CONCLUSÃO: Um programa de treinamento proprioceptivo parece ser eficaz para o incremento da estabilidade articular que é fundamental para atletas de voleibol expostas ao risco de entorses de tornozelo que geram instabilidades crônicas.

Ground reaction forces and throwing performance in elite and novice players in two types of handball shot

The purpose of this study was to examine the differences in the ground reaction force (GRF) patterns between elite and novice players during two types of handball shots, as well as the relationships between throwing performance and the GRF variables. Ball velocity and throwing accuracy were measured during jump shots and 3-step shots performed by 15 elite and 15 novice players. The GRF pattern was recorded for the vertical and the anterior-posterior GRF components (Kistler forceplate type-9281, 750Hz). One-way ANOVA was used for the group differences and the Pearson coefficient for the correlation between throwing performance and GRF variables (SPSS 21.0, p ≤ 0.05). The elite players performed better in both types of shot. Both groups developed consistent and similar GRF patterns, except for the novices’ inconsistent Fz pattern in the 3-step shot. The GRF variables differed significantly between groups in the 3-step shot (p ≤ 0.05). Significant correlations were found only for ball velocity and predominantly for the novice players during the 3-step shot (p ≤ 0.05). The results possibly highlight a shortage in the novice ability to effectively reduce their forward momentum so as to provide a stable base of support for the momentum transfer up the kinetic chain, a situation that may predispose athletes to injury.

Residual mechanical effectiveness of external ankle tape before and after competitive professional soccer performance

OBJECTIVE

To evaluate the presupposed preventive residual mechanical effectiveness of the widespread use of adhesive elastic ankle tape after a nonlaboratory, realistic soccer-specific outfield intervention reflecting a soccer halftime.

DESIGN

A prospective nonrandomized test-retest design was used.

SETTING

Laboratory.

PARTICIPANTS

Seventeen professional male outfield players (mean age, 25.5) without any signs of chronic ankle instability.

INTERVENTION

Participants were investigated before and after a 45-minute soccer-specific field intervention.

MAIN OUTCOME MEASURES

The passive inversion range of motion (ROM) of the ankle was tested unloaded on a self-developed inversion device with and without a standardized ankle tape before and after the intervention. Additionally, electromyography signal was taken to assure the inactivity of the protective evertor muscles, and reliability tests for the inversion device (test-retest and trial to trial) were conducted in 12 healthy controls.

RESULTS

Tape restricted the maximum passive inversion ROM of the uninjured ankle significantly to 50.3%. The protection declined nearly completely after 45 minutes of outfield soccer performance to a negligible nonsignificant ROM restriction of 9.7%. Pearson correlation coefficient for the reliability was 0.931 (P ≤ 0.001) for the test-retest and 0.983 (P ≤ 0.001) for the trial-to-trial test.

CONCLUSIONS

The initial significant protection of external ankle-tape support declines almost completely without relevant remaining residual mechanical effect after 45 minutes, reflecting a soccer halftime. The so far presupposed residual mechanical effectiveness of tape to prevent injury is increasingly irrelevant during soccer performance and consequently antidromic to the increasing injury risk toward the end of a soccer halftime.

Injuries among Spanish male amateur soccer players: a retrospective population study

BACKGROUND

Soccer is the most popular sport worldwide, with about 265 million players, both professionals and amateurs. Most research investigating soccer injuries has focused on professional players because they have greater exposure time, but most soccer players are at the recreational level.

PURPOSE

To undertake a retrospective epidemiological study of the injuries sustained in Spanish amateur soccer during the 2010-2011 season.

STUDY DESIGN

Descriptive epidemiological study.

METHODS

Any injuries incurred by the 134,570 recreational soccer players (aged 18-55 years) registered with the Spanish Football Federation were reported to the federation's medical staff. A standardized medical questionnaire, based on the Fédération International de Football Association (FIFA) Medical and Research Centre (F-MARC) consensus for collection procedures in studies of soccer injuries, was used to classify the injury according to type, severity, location, and treatment.

RESULTS

A total of 15,243 injuries were reported, with an average of 0.11 injuries per player and per year. From the total number of injuries, 67.2% were classified as injuries that resulted in time loss, while the remaining 32.7% were injuries that required medical attention. Most injuries led to a minimum of 1 competitive match being missed (87%), and only 2.5% were recurrent injuries. The rate of injuries per 1000 hours of play was double during games (1.15/1000 hours) compared with during training (0.49/1000 hours). From the total number of injuries reported, 7.7% corresponded to goalkeepers, 24.2% to forwards, 33.8% to defenders, and 34.3% to midfielders. The knee (29.9%) and ankle joints (12.4%) were the most common body locations injured, while ligament sprains and ruptures accounted for 32.1% of the total injuries attended. Older amateur players (age ≥30 years) had a greater number of injuries per year and per 1000 hours of play than their younger counterparts.

CONCLUSION

The risk of injury in amateur soccer is lower than that previously reported in professional players. The most common complaints in amateur players are knee ligament injuries. Further research is needed to investigate ways of reducing the incidence of injuries in amateur soccer.

Descriptive epidemiology of injuries in a Brazilian premier league soccer team

Soccer, which has a large number of participants, has a high injury incidence that causes both financial and time burdens. Therefore, knowledge about the epidemiology of soccer injuries could allow sports-medicine professionals, such as physicians and physiotherapists, to direct their work in specific preventive programs. Thus, our aim was to conduct an epidemiological survey of injuries sustained by professional soccer players from the same team who participated in the Brazilian championship premier league in 2009. To this end, we evaluated retrospectively player medical records from the team, which included name, date of birth, position, date of injury, mechanism of injury, and type of injury. In the period of study, 95 injuries were recorded: 42 (44.2%) were recorded during matches, and 53 (55.8%) during the training period. Injuries occurred more frequently in midfielders and strikers. All injuries happened in the lower limb, most of the injuries were muscular, and most occurred as the result of collisions with other athletes. In summary, this study demonstrates that there is a need for greater safety awareness in the training environment.

Swedish translation and validation of a web-based questionnaire for registration of overuse problems

The main aim of this study was to translate the Oslo Sport Trauma Research Center (OSTRC) Overuse Injury Questionnaire into Swedish. The validity and applicability of the questionnaire for studying overuse injuries among Swedish handball, volleyball, tennis, and orienteering top athletes were also examined. The back-translation method was used for translation. An expert committee further developed it for use in a study of injuries in handball, orienteering, tennis, and volleyball. A 10-week pretest was then conducted on 43 athletes, average age 21 (18-31) from these sports, during which time the athletes completed the modified OSTRC questionnaire on a weekly basis. In the 10th week, four additional questions were added in order to examine the questionnaire's content validity. No major disagreement was found in the translation. The athletes perceived the web-based questionnaire to be smooth and easy to complete, accurately capturing overuse injuries. However, suggestions were made to add questions relating to the hip for orienteerers and to the hand/fingers for handball players. The average prevalence of overuse injuries for all athletes, in any anatomical area was 22% (95% confidence interval 20-25). Construct validity appeared to be high, and we therefore suggest that the questionnaire may be used when studying overuse injuries in different sports.

Development and validation of the Sports Athlete Foot and Ankle Score: an instrument for sports-related ankle injuries

BACKGROUND

Many existing scoring systems assess ankle function, but there is no evidence that any of them has been validated in a group of patients with a higher demand on their ankle function. Problems include ceiling effects, not being able to detect change or they do not contain a sports-subscale. The aim of this study was to create a validated self-administered scoring system for ankle injuries in the higher performing athlete.

METHODS

First, 26 patients were interviewed to solicit opinions needed to create the final score, which is modified from the Foot and Ankle Outcome Score (FAOS). Second, SAFAS was validated in a group of 25 athletes with and 14 athletes without ankle injury. It is a self-administered region specific sports foot and ankle score that contains four subscales assessing the levels of symptoms, pain, daily living and sports.

RESULTS

The Spearman correlation coefficients between SAFAS and the Foot and Ankle Ability Measure (FAAM) ranged from 0.78 to 0.88. Content validity is established by key informant interviews, expert opinions and a high satisfaction rate of 75%. Cronbach's alpha indicated good internal consistency of each subscale ranging from 0.77 to 0.92.

CONCLUSION

SAFAS has shown good evidence for being a valid instrudent for assessing sports-related ankle injuries in high-performing athletes.

Injury surveillance in the World Football Tournaments 1998-2012

BACKGROUND

International sports bodies should protect the health of their athletes, and injury surveillance is an important pre-requisite for injury prevention. The Fédération International de Football Association (FIFA) has systematically surveyed all football injuries in their tournaments since 1998.

AIMS

Analysis of the incidence, characteristics and changes of football injury during international top-level tournaments 1998-2012.

METHODS

All newly incurred football injuries during the FIFA tournaments and the Olympic Games were reported by the team physicians on a standardised injury report form after each match. The average response rate was 92%.

RESULTS

A total of 3944 injuries were reported from 1546 matches, equivalent to 2.6 injuries per match. The majority of injuries (80%) was caused by contact with another player, compared with 47% of contact injuries by foul play. The most frequently injured body parts were the ankle (19%), lower leg (16%) and head/neck (15%). Contusions (55%) were the most common type of injury, followed by sprains (17%) and strains (10%). On average, 1.1 injuries per match were expected to result in absence from a match or training. The incidence of time-loss injuries was highest in the FIFA World Cups and lowest in the FIFA U17 Women's World Cups. The injury rates in the various types of FIFA World Cups had different trends over the past 14 years.

CONCLUSIONS

Changes in the incidence of injuries in top-level tournaments might be influenced by the playing style, refereeing, extent and intensity of match play. Strict application of the Laws of the Games is an important means of injury prevention.

A treatment-based classification approach to examination and intervention of lumbar disorders

CONTEXT

Low back injuries are a common occurrence in athletes and often result in missed competition and practice time. The examination of athletes with low back pain commonly involves diagnostic imaging, which rarely guides the clinician in selecting the appropriate interventions.

DATA ACQUISITION

All years of PubMed, CINAHL, PEDro, and SPORTDiscus were searched in December 2010. Keywords included treatment based classification and lumbar with the following terms: rehabilitation, treatment, athlete, low back pain, sports, and outcomes.

RESULTS

A treatment-based classification approach is preferred for the management of the athlete with low back pain. The treatment-based classification approach involves 3 steps. First is to screen the patient for potentially serious conditions that are not appropriate for conservative management. Second is staging the athlete (based on current disability ratings and ability to perform functional activities). Finally, treatment interventions are selected on the basis of the athlete's signs and symptoms.

CONCLUSION

The treatment-based classification scheme provides the clinician with a reliable algorithm for matching an athlete's symptom presentation to the optimal intervention, potentially reducing participation loss. Managing individuals with low back pain using a treatment-based classification approach significantly reduces disability and pain compared with current clinical practice guideline standards.

Injury profile of a professional soccer team in the premier league of iran

Purpose

Despite numerous studies which have been done regarding soccer injuries worldwide, there is lack of available data considering the epidemiology of injuries in the Iranian soccer premier league, although it is the most popular sport in the country. The main goal of this research was to determine the incidence of physical injuries in the studied population, considering other characteristics such as site, type and mechanism as well.

Methods

Twenty one adult male professional soccer players (age 24±3), members of a team (Tehran-Pas) participating in Iranian premier league, were followed during a 4-month period. The injury characteristics and exposure times were recorded by the team physician during all the matches and training sessions.

Results

The total exposure time was 2610 playing hours (2352 h of training versus 258 h of competition). Eighty six percent of the injuries were acute. Incidence of acute injuries was 16.5 (95% CI: 12-22) per 1000 hours of playing (11.5 per 1000 hrs of training and 62 per 1000 hrs of competition). The most common types of injuries were strains followed by contusions, each of which constituted 30% of acute injuries. More than 80% of injuries occurred in lower limbs, especially in thigh and groin regions. Nearly 60% of acute injuries occurred in dominant side of the body, and collision was the reason of about half of the acute injuries. Severity of more than 70% of the injuries was minor. On average each injury had led the player being off the field for about 10 days.

Conclusion

The incidence of injury in this research is in range of numbers obtained in important international tournaments but the rate of injuries during training sessions is higher than comparable studies.

The volume of goal shooting during training can predict shoulder soreness in elite female water polo players

OBJECTIVES

Examine the association between measures shoulder soreness and the goal shooting volume in high performance women's water polo.

DESIGN

Seven national level female water polo players were monitored across two training camps (squad selection and team game-based).

METHODS

Performance analysis coded all shots for each athlete during the training camps and the shoulder soreness information was gathered through an athlete self-rating survey. Residual maximal likelihood analysis was used to predict shoulder soreness.

RESULTS

It was shown that 74% (p=0.013) of shoulder soreness was explained by the volume of goal shooting during training (R(2) 0.743) with greater soreness associated with less rest time between shots (p=0.032). Greater levels of shoulder soreness were reported in the squad selection training camp compared to team game-based camp (p=0.002) with 29% of this shoulder soreness prediction based on individual athlete differences.

CONCLUSIONS

Shoulder soreness increased with a greater number of shots in conjunction with less rest. Monitoring athletes on an individual basis seemed the most appropriate method of identifying increased shoulder soreness.

Head and face injuries during the men's field hockey Junior World Cup 2009

BACKGROUND

Head and face injuries in field hockey are a concern. However, published data on injuries in field hockey are minimal, with apparently no reports on head and face injuries in elite youth hockey players during major international tournaments.

PURPOSE

To provide a descriptive account of head and face injuries in elite youth male field hockey players during the Men's Junior World Cup 2009.

STUDY DESIGN

Descriptive epidemiological study.

METHODS

A total of 324 players were observed during 58 matches in the tournament. The injury reporting system was based on that used in team sports during international tournaments. All the head and face injury documentation was done by direct on-location observation by a trained sports medicine physician followed by confirmation from the team doctors or physical therapists.

RESULTS

A total of 24 head and face injuries were documented. The overall injury frequency rate was 16 per 1000 match hours and 19 per 1000 player matches. There were 92% of injuries that were of contact type, with the head being the most common site and contusion being the most common type of injury. The incidence of injuries was higher during the second half and during the medal/ranking phase of the tournament.

CONCLUSION

The risk of head and face injuries is high in elite youth players with a potential of both short- and long-term player time loss in international tournaments. Rigorous enforcement of rules prohibiting body contact can significantly reduce the chances of head and face injuries in elite youth field hockey players. In addition, player education on the injury risks and safe practices at the developmental stages is desirable to prevent injuries and prolong sporting careers.

Why do woodpeckers resist head impact injury: a biomechanical investigation

Head injury is a leading cause of morbidity and death in both industrialized and developing countries. It is estimated that brain injuries account for 15% of the burden of fatalities and disabilities, and represent the leading cause of death in young adults. Brain injury may be caused by an impact or a sudden change in the linear and/or angular velocity of the head. However, the woodpecker does not experience any head injury at the high speed of 6–7 m/s with a deceleration of 1000 g when it drums a tree trunk. It is still not known how woodpeckers protect their brain from impact injury. In order to investigate this, two synchronous high-speed video systems were used to observe the pecking process, and the force sensor was used to measure the peck force. The mechanical properties and macro/micro morphological structure in woodpecker's head were investigated using a mechanical testing system and micro-CT scanning. Finite element (FE) models of the woodpecker's head were established to study the dynamic intracranial responses. The result showed that macro/micro morphology of cranial bone and beak can be recognized as a major contributor to non-impact-injuries. This biomechanical analysis makes it possible to visualize events during woodpecker pecking and may inspire new approaches to prevention and treatment of human head injury.

Injuries and illnesses of football players during the 2010 FIFA World Cup

Background

The incidence and characteristics of football injuries during matches in top-level international tournaments are well documented, but training injuries and illnesses during this period have rarely been studied.

Aim

To analyse the incidence and characteristics of injuries and illnesses incurred during the 2010 Fédération Internationale de Football Association (FIFA) World Cup.

Methods

The chief physicians of the 32 finalist teams reported daily all newly incurred injuries and illnesses of their players on a standardised medical report form.

Results

Out of 229 injuries reported, 82 match and 58 training injuries were expected to result in time loss, equivalent to an incidence of 40.1 match and 4.4 training injuries per 1000 h. Contact with another player was the most frequent cause of match (65%) and of training (40%) injuries. The most frequent diagnoses were thigh strain and ankle sprain. 99 illnesses of 89 (12%) players were reported. Illnesses were mainly infections of the respiratory or the digestive system. Most illnesses did not result in absence from training or match. The incidence of time-loss illnesses was 3.0 per 1000 player days.

Conclusion

The incidence of match injuries during the 2010 FIFA World Cup was significantly lower than in the three proceeding World Cups. This might be a result of more regard to injury prevention, less foul play and stricter refereeing. Tackling skills and fair play need to be improved to prevent contact injuries in training and matches. Prevention of illness should focus on reducing the risk of infections by considering the common modes of transmission and environmental conditions.

Attentional and visual demands for sprint performance in non-fatigued and fatigued conditions: reliability of a repeated sprint test

Background

Physical performance measures are widely used to assess physical function, providing information about physiological and biomechanical aspects of motor performance. However they do not provide insight into the attentional and visual demands for motor performance. A figure-of-eight sprint test was therefore developed to measure the attentional and visual demands for repeated-sprint performance. The aims of the study were: 1) to assess test-retest reliability of the figure-of-eight sprint test, and 2) to study the attentional and visual demands for sprint performance in a non-fatigued and fatigued condition.

Methods

Twenty-seven healthy athletes were included in the study. To determine test-retest reliability, a subgroup of 19 athletes performed the figure-of-eight sprint test twice. The figure-of-eight sprint test consisted of nine 30-second sprints. The sprint test consisted of three test parts: sprinting without any restriction, with an attention-demanding task, and with restricted vision. Increases in sprint times with the attention-demanding task or restricted vision are reflective of the attentional and visual demands for sprinting. Intraclass correlation coefficients (ICCs) and mean difference between test and retest with 95% confidence limits (CL) were used to assess test-retest reliability. Repeated-measures ANOVA were used for comparisons between the sprint times and fatigue measurements of the test parts in both a non-fatigued and fatigued condition.

Results

The figure-of-eight sprint test showed good test-retest reliability, with ICCs ranging from 0.75 to 0.94 (95% CL: 0.40-0.98). Zero lay within the 95% CL of the mean differences, indicating that no bias existed between sprint performance at test and retest. Sprint times during the test parts with attention-demanding task (P = 0.01) and restricted vision (P < 0.001) increased significantly compared to the base measurement. Furthermore the sprint times and fatigue measurements increased significantly in fatigued condition. There was a significant interaction effect between test part and level of fatigue (P = 0.03).

Conclusions

High ICCs and the absence of systematic variation indicate good test-retest reliability of the figure-of-eight sprint test. The attentional and visual demands for sprint performance, in both a non-fatigued and fatigued condition, can be measured in healthy team-sport athletes with the figure-of-eight sprint test.

The Prevention of Sport Injury: An Analysis of 12 000 Published Manuscripts

OBJECTIVE

To identify the nature and extent of research in sport injury prevention with respect to 3 main categories: (1) training, (2) equipment, and (3) rules and regulations.

DATA SOURCES

We searched PubMed, CINAHL, Web of Science, Embase, and SPORTDiscus to retrieve all sports injury prevention publications. Articles were categorized according to the translating research into injury prevention practice model.

RESULTS

We retrieved 11 859 articles published since 1938. Fifty-six percent (n = 6641) of publications were nonresearch (review articles and editorials). Publications documenting incidence (n = 1354) and etiology (n = 2558) were the most common original research articles (33% of total). Articles reporting preventive measures (n = 708) and efficacy (n = 460) were less common (10% of the total), and those investigating implementation (n = 162) and effectiveness (n = 32) were rare (1% of total). Six hundred seventy-seven studies focused on equipment and devices to protect against injury, whereas 551 investigated various forms of physical training related to injury prevention. Surprisingly, publications studying changes in rules and regulations aimed at increasing safety and reducing injuries were rare (<1%; n = 63) with a peak of only 20 articles over the most recent 5-year period and an average of 10 articles over the preceding 5-year blocks of time.

CONCLUSIONS

Only 492 of 11 859 publications actually assessed the effectiveness of sports injury prevention interventions or their implementation. Research in the area of regulatory change is underrepresented and might represent one of the greatest opportunities to prevent injury.

Long-term neuromuscular training and ankle joint position sense

Preventive effect of proprioceptive training is proven by decreasing injury incidence, but its proprioceptive mechanism is not. Major hypothesis: the training has a positive long-term effect on ankle joint position sense in athletes of a high-risk sport (handball). Ten elite-level female handball-players represented the intervention group (training-group), 10 healthy athletes of other sports formed the control-group. Proprioceptive training was incorporated into the regular training regimen of the training-group. Ankle joint position sense function was measured with the "slope-box" test, first described by Robbins et al. Testing was performed one day before the intervention and 20 months later. Mean absolute estimate errors were processed for statistical analysis. Proprioceptive sensory function improved regarding all four directions with a high significance (p<0.0001; avg. mean estimate error improvement: 1.77 degrees). This was also highly significant (p< or =0.0002) in each single directions, with avg. mean estimate error improvement between 1.59 degrees (posterior) and 2.03 degrees (anterior). Mean absolute estimate errors at follow-up (2.24 degrees +/-0.88 degrees) were significantly lower than in uninjured controls (3.29 degrees +/-1.15 degrees) (p<0.0001). Long-term neuromuscular training has improved ankle joint position sense function in the investigated athletes. This joint position sense improvement can be one of the explanations for injury rate reduction effect of neuromuscular training.

The ultimate frisbee injury study: the 2007 Ultimate Players Association College Championships

OBJECTIVE

To quantify and characterize the injuries incurred by ultimate players during the 2007 Ultimate Players Association College Championships.

DESIGN

Cross-sectional study.

SETTING

The Ultimate Players Association College Championships in Columbus, Ohio, in May 2007.

PARTICIPANTS

Athletes who left the field of play due to injury time-outs (ITOs). There were 107 recorded ITOs.

INTERVENTIONS

During the 3 days of the 2007 College Championships, 86 games were observed by the research staff. Athletes calling an ITO were interviewed. Sex, activity at time of injury, type of injury, and associated contact, if any, were recorded.

MAIN OUTCOME MEASURES

Return to play, injury type, and injured body part.

RESULTS

One injury prevented return to play in each of the 2 sex divisions, equivalent to 1.66 per 1000 athlete-exposures in championships bracket games. The majority of ITOs were related to contact, 53% in the men's division and 68% in the women's division. The lower extremities were injured in 53% and 51% of cases in the men's and women's divisions, respectively. Laying out was one of the most common activities at time of ITO (29% and 22% in men's and women's divisions, respectively) and accounted for all of the men's closed head injuries and 2 of the 3 women's closed head injuries.

CONCLUSIONS

There was a low rate of play-ending injuries. There were no statistically significant associations. Physical contact and laying out were frequently linked with ITO.

Field hockey injuries

Field hockey is a popular sport that is played throughout the world. Most of the literature on the sport has focused on describing injury patterns. This research reveals that most injuries are minor and that the most common injury is an ankle sprain. Studies also suggest that men have a higher rate of injury and that they experience severe injuries more often than women. These severe injuries include trauma to the head, face, and upper limb and usually are the result of contact with the stick or ball. Consequently, many authors suggest that all players wear face and hand protection. Current International Field Hockey Federation rules recommend minimal protective equipment (e.g., mouthguard, shin, and ankle guards), and surveys indicate that many players do not wear mouthguards regularly. Looking into the future, research should focus on developing and evaluating effective strategies for injury prevention.

Sports injuries during the Summer Olympic Games 2008

BACKGROUND

Standardized assessment of sports injuries provides important epidemiological information and also directions for injury prevention.

PURPOSE

To analyze the frequency, characteristics, and causes of injuries incurred during the Summer Olympic Games 2008.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

The chief physicians and/or chief medical officers of the national teams were asked to report daily all injuries newly incurred during the Olympic Games on a standardized injury report form. In addition, injuries were reported daily by the physicians at the medical stations at the different Olympic venues and at the polyclinic in the Olympic Village.

RESULTS

Physicians and/or therapists of 92 national teams covering 88% of the 10,977 registered athletes took part in the study. In total, 1055 injuries were reported, resulting in an incidence of 96.1 injuries per 1000 registered athletes. Half of the injuries (49.6%) were expected to prevent the athlete from participating in competition or training. The most prevalent diagnoses were ankle sprains and thigh strains. The majority (72.5%) of injuries were incurred in competition. One third of the injuries were caused by contact with another athlete, followed by overuse (22%) and noncontact incidences (20%). Injuries were reported from all sports, but their incidence and characteristics varied substantially. In relation to the number of registered athletes, the risk of incurring an injury was highest in soccer, taekwondo, hockey, handball, weightlifting, and boxing (all >or=15% of the athletes) and lowest for sailing, canoeing/kayaking, rowing, synchronized swimming, diving, fencing, and swimming.

CONCLUSION

The data indicate that the injury surveillance system covered almost all of the participating athletes, and the results highlight areas of high risk for sport injury such as the in-competition period, the ankle and thigh, and specific sports. The identification of these factors should stimulate future research and subsequent policy change to prevent injury in elite athletes.

Injuries among male and female elite football players

All 12 female football clubs (228 players) and 11 of 14 male clubs (239 players) in the Swedish premier league were followed prospectively during the 2005 season. Individual exposure (playing time), injuries (time loss), and injury severity (days lost due to injury) were recorded by the team medical staffs. Injury incidence was higher for male players during both training (4.7 vs 3.8 injuries/1000 h, P=0.018) and match play (28.1 vs 16.1, P<0.001). However, no difference was found in the incidence of severe injury (absence >4 weeks) (0.7/1000 h in both groups). The thigh, especially the hamstrings, was the overall most commonly injured region in both sexes, while the hip/groin was more commonly injured in male players and the knee in female players. Knee ligament injuries accounted for 31% and 37% of the total time lost from football for male and female players, respectively. In conclusion, male elite players had a higher injury incidence than their female counterparts although no difference was observed in the incidence of moderate to severe injury. We recommend that preventive measures should be focused on hamstring and knee ligament injury in order to reduce the overall injury burden.

Incidência de lesões nos jogadores de futebol masculino sub-21 durante os Jogos Regionais de Sertãozinho-SP de 2006

INTRODUÇÃO: O futebol, o esporte mais popular e praticado pelo mundo, é também uma das modalidades esportivas onde o atleta é submetido a diversos tipos e intensidades de esforços. Atualmente essa modalidade sofreu modificações, deixando de dar ênfase à técnica e passando a privilegiar os componentes físicos, aumentando assim a probabilidade da ocorrência de lesões. OBJETIVO: Realizar um levantamento epidemiológico das lesões no Futebol de Campo Sub-21 durante os 50°s Jogos Regionais de Sertãozinho de 2006. METODOLOGIA: Este é um trabalho do tipo epidemiológico descritivo e analítico, com desenho transversal. Realizou-se o acompanhamento de todas as partidas da modalidade, registrando as lesões ocorridas, seguido de um levantamento e caracterização das lesões. As mesmas foram classificadas de acordo com seu perfil e segmento anatômico, posteriormente divididas por posição dos atletas. RESULTADOS: Houve maior incidência das lesões nos membros inferiores, com 127 (74,7%); quanto ao perfil, as lesões musculares foram mais prevalentes, com 64 (37,6%) lesões. Os atletas do meio-campo foram os mais acometidos, com 72 (42,4%) lesões. Dentro da classe de goleiros e defensores a maior prevalência de contusões foi de sete (63,6%) e 11 (50%), respectivamente. Já os atacantes, laterais e meio-campistas apresentaram como predomínio as lesões musculares, sendo os primeiros com 11 (36,7%), seguidos de 12 (34,3%) dos laterais e 33 (45,8%) dos meio-campistas. CONCLUSÃO: Constatou-se que ocorreu maior índice de lesões em membros inferiores, sendo estas caracterizadas como as musculares de maior prevalência. Demonstrou-se ainda que as lesões apresentadas estão diretamente relacionadas com as características de cada posição.