Sports injuries during the Summer Olympic Games 2008

Sport injuries in elite paralympic swimmers with visual impairment

CONTEXT

Visually impaired athletes sustain overuse injuries in the lower limbs, but the pattern of injuries may vary according to the sport. The characteristics of sports injuries in visually impaired swimmers are unknown.

OBJECTIVE

To determine the characteristics and epidemiologic measures (prevalence, clinical incidence, and incidence rate) of sports injuries in visually impaired elite national swimmers and to assess differences among visual classes and between sexes.

DESIGN

Descriptive epidemiology study.

SETTING

International Paralympic competitions held between 2004 and 2008.

PATIENTS OR OTHER PARTICIPANTS

Twenty-eight elite, visually impaired swimmers (19 males, 9 females) from the Brazilian Paralympic Team participated in this study. Twelve were visual class S11 (blind swimmers), 12 were S12 (low-vision swimmers), and 4 were S13 (low-vision swimmers).

INTERVENTION(S)

A standardized report form was used to collect data during 5 competitions. This was endorsed by 2 Brazilian sports governing bodies.

MAIN OUTCOME MEASURES

The characteristics, prevalence, clinical incidence, and incidence rate of injuries were calculated.

RESULTS

Eighteen athletes reported 41 sports injuries, with a prevalence of 64%, clinical incidence of 1.5 injuries per athlete, and an incidence rate of 0.3 injuries per athlete per competition. Overuse injuries (80%) were more frequent than traumatic injuries (20%). The clinical incidence and prevalence varied according to sex and visual class, but no statistical differences were observed (P > .05). The highest proportion of injuries was in the trunk (46.34%), followed by the upper limbs (34.15%). The shoulders (29.27%) were most affected, followed by the thoracic (21.95%) and lumbar spine (17.07%). Spasm (36.59%) was the most frequent diagnosis, followed by tendinopathy (26.83%).

CONCLUSIONS

Visually impaired swimmers had a relatively high proportion of overuse injuries, predominantly associated with muscle spasm in the spine and tendinopathy in the shoulders. No differences were apparent in injury prevalence and clinical incidence among visual classes or between sexes.

[Evidence for treatment of acute syndesmosis injuries in sports]

Injuries of the distal syndesmosis often accompany acute ankle sprains especially in professional team sports. While small partial syndesmosis lesions can often be missed as a consequence of impressive symptoms due to ventrolateral capsuloligamentous injuries, higher grade injuries of the syndesmosis can mostly be diagnosed without any problem. Furthermore, there is a consensus concerning the necessity of operative treatment in significantly unstable situations as well concerning conservative treatment of incomplete partial lesions. Consequently, the greatest challenge regarding diagnostic tools, quantification and optimal therapy arises in the most common form of sport-associated, complete or partial lesions of the distal syndesmosis. This review article summarizes sports-associated injuries of the distal tibiofibular syndesmosis considering the current literature and placing the emphasis on the anatomy, pathobiomechanics, diagnostics and therapy of syndesmosis lesions from an evidence-based viewpoint.

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.

Epidemiology of overuse and acute injuries among competitive collegiate athletes

CONTEXT

Although overuse injuries are gaining attention, epidemiologic studies on overuse injuries in male and female collegiate athletes are lacking.

OBJECTIVE

To report the epidemiology of overuse injuries sustained by collegiate athletes and to compare the rates of overuse and acute injuries.

DESIGN

Descriptive epidemiology study.

SETTING

A National Collegiate Athletic Association Division I university.

PATIENTS OR OTHER PARTICIPANTS

A total of 1317 reported injuries sustained by 573 male and female athletes in 16 collegiate sports teams during the 2005-2008 seasons.

MAIN OUTCOME MEASURE(S)

The injury and athlete-exposure (AE) data were obtained from the Sports Injury Monitoring System. An injury was coded as either overuse or acute based on the nature of injury. Injury rate was calculated as the total number of overuse (or acute) injuries during the study period divided by the total number of AEs during the same period.

RESULTS

A total of 386 (29.3%) overuse injuries and 931 (70.7%) acute injuries were reported. The overall injury rate was 63.1 per 10 000 AEs. The rate ratio (RR) of acute versus overuse injuries was 2.34 (95% confidence interval [CI] = 2.05, 2.67). Football had the highest RR (RR = 8.35, 95% CI = 5.38, 12.97), and women's rowing had the lowest (RR = 0.75, 95% CI = 0.51, 1.10). Men had a higher acute injury rate than women (49.8 versus 38.6 per 10 000 AEs). Female athletes had a higher rate of overuse injury than male athletes (24.6 versus 13.2 per 10,000 AEs). More than half of the overuse injuries (50.8%) resulted in no time loss from sport.

CONCLUSIONS

Additional studies are needed to examine why female athletes are at greater risk for overuse injuries and identify the best practices for prevention and rehabilitation of overuse injuries.

Rowing: sport-specific concerns for the team physician

Rowing injuries occur mostly from overuse and are seen primarily in the back, rib, knee, and forearm. Many of these have a specific cause owing to the mechanics of the rowing stroke, which are discussed, as are sport-specific treatment strategies. Also discussed are specific injuries sustained on the rowing machine, emergency issues, and special population concerns.

Imaging of muscle injury in the elite athlete

Injuries to muscle in the elite athlete are common and may be responsible for prolonged periods of loss of competitive activity. The implications for the athlete and his/her coach and team may be catastrophic if the injury occurs at a critical time in the athlete's diary. Imaging now plays a crucial role in diagnosis, prognostication and management of athletes with muscle injuries. This article discusses the methods available to clinicians and radiologists that are used to assess skeletal muscle injury. The spectrum of muscle injuries sustained in the elite athlete population is both discussed and illustrated.

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.

Knee and ankle osteoarthritis in former elite soccer players: a systematic review of the recent literature

OBJECTIVES

To investigate the prevalence of knee and/or ankle osteoarthritis in former elite soccer player.

DESIGN

Systematic review.

METHODS

Medline, Embase and SPORTDiscus (2000 to January 2012) were used. To be included, studies were required to be a primary study, written in English, Dutch, French or German, former elite soccer players had to be the study population, and presenting knee or ankle OA had to be the outcome measure.

RESULTS

The search strategy resulted in four studies. Two studies, evaluated as having a high methodological quality, found a prevalence rate of knee OA between 60 and 80%. Both studies used radiographic examination as their measurement instrument to diagnose OA; the presence of ankle OA was not determined. The other two studies, evaluated as having a moderate methodological quality, found a prevalence rate of knee OA between 40 and 46% and a prevalence rate of ankle OA between 12 and 17%. These studies used a questionnaire as their measurement instrument wherein players were asked if they had ever been diagnosed with OA by a medical specialist.

CONCLUSIONS

The prevalence of knee and ankle OA in former elite soccer players can be considered high compared to the general population and to other occupations. To identify players at risk for OA, a health surveillance program should be implemented in elite soccer as a preventive measure. Further research should be conducted to determine if the risk of developing OA varies among different subgroups of elite soccer players and what the consequences of this high OA prevalence are.

Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance

Objective

To determine the incidence and characteristics of newly incurred injuries and illnesses during international Athletics Championships, by improving the medical surveillance coverage, in order to determine future prevention strategies.

Design

Prospective recording of newly occurred injuries and illnesses.

Setting

13th International Association of Athletics Federations World Championships in Athletics 2011 in Daegu, Korea.

Participants

National team and Local Organising Committee physicians; and 1851 registered athletes.

Main outcome measures

Incidence and characteristics of newly incurred injuries and illnesses.

Results

82% of athletes were covered by medical teams participating with a response rate of 94%. A total of 249 injuries were reported, representing an incidence of 134.5 injuries per 1000 registered athletes, and 119 (48%) resulted in time loss from sport. A total of 185 injuries affected the lower limb (74%). Hamstring strain was the main diagnosis and 67% resulted in absence from sport. Overuse (n=148; 59%) was the predominant cause. A total of 126 illnesses were reported, signifying an incidence of 68.1 per 1000 registered athletes. Upper respiratory tract infection was the most common reported diagnosis (18%), followed by exercise-induced dehydration (12%), and gastroenteritis/diarrhoea (10%). The highest incidences of injuries were found in combined events and middle and long-distance events, and of illness in race walking events.

Conclusion

During elite Athletics World Championships, 135 injuries, 60 time-loss injuries and 68 illnesses per 1000 registered athletes were reported. Higher risks of injuries were found in combined events and long-distance runs. Preventive interventions should focus on overuse injuries and hamstring strains, decreasing the risk of transmission of infectious diseases, appropriate event scheduling and heat acclimatisation.

The attenuation of strike acceleration with the use of safety equipment in tae kwon do

Purpose

The objectives of this study include: (1) Determination of the attenuation of strike acceleration that Tae Kwon Do sparring safety pads provide from kicks from Olympic style TKD fighters, (2) The sex and weight differentiation in acceleration achieved within the thorax model with the roundhouse kicks.

Methods

This prospective, observational study utilized 15 Olympic style fighters from an “elite” team kicking a water core heavy bag thorax model with roundhouse kicks. The model was fitted with a tri-axial accelerometer (GCDC, model X250-2) to measure g acceleration from strikes to the bag. The bag was kicked in three, 10 kick phases by all subjects: kicks without padding; kicks with hogu on heavy bag, and kicks with hogu and instep guards on feet. The g acceleration readings were recorded in all phases.

Results

Kolmogorov-Smirnov failed for all variables. There were 8 female subjects: median age 14 years, median weight 53.4 kg and 7 male subjects: median age 17 years, median weight 70.45 kg. The ANOVA on ranks of the acceleration from kicks against the bag achieved significance, P=0.001. Spearman rank order correlation between the weights of players and acceleration of strike against the hogu without and with insteps pads was significant, P=0.035/r=0.54 and P=0.018/r=0.59, respectively.

Conclusion

Heavier and male subjects tend to produce more force in strikes. Protective chest guard reduces acceleration to the thorax model, but the utility of instep guards is questionable.

Instrumentos de avaliação para limitações funcionais associadas à instabilidade crônica de tornozelo: uma revisão sistemática da literatura

A instabilidade de tornozelo é definida como a sua tendência para sofrer falseios e entorses de repetição após a ocorrência de entorse lateral. Como a presença de instabilidade é definida por meio das queixas relatadas pelo indivíduo, apresenta caráter subjetivo, sendo importante identificar o melhor instrumento de avaliação para a determinação de sua presença e/ou gravidade. O objetivo deste estudo foi revisar, de forma sistemática, instrumentos de avaliação concebidos para pacientes com instabilidade crônica de tornozelo. Foram realizadas pesquisas bibliográficas nas bases de dados PubMed, Embase, BVS, LILACS e SciELO para identificar os instrumentos elegíveis. No total, seis estudos foram incluídos e apresentaram cinco instrumentos diferentes - Foot and Ankle Disability Index (FADI), Ankle Joint Functional Assessment Tool (AJFAT), Foot and Ankle Ability Measure (FAAM), Ankle Joint Functional Assessment Tool (AII) e Cumberland Ankle Instability Tool (CAIT). Foram encontrados instrumentos com qualidade que detectam limitações funcionais em indivíduos com instabilidade crônica de tornozelo, não sendo instrumentos válidos para diagnóstico de instabilidade. O CAIT mostrou-se a ferramenta mais completa, mas não foi validada em uma população específica de indivíduos com condição de instabilidade do tornozelo. Observa-se a necessidade de mais estudos clinimétricamente válidos a fim de atestar a sua validade para se obter uma ferramenta eficaz e completa da instabilidade funcional do tornozelo.

An overview of strength training injuries: acute and chronic

This article introduces the history of strength training, explains the many different styles of strength training, and discusses common injuries specific to each style. Strength training is broken down into five disciplines: basic strength or resistance training, bodybuilding, power lifting, style-dependant strength sports (e.g., strongman competitions, Highland games, field events such as shot put, discus, hammer throw, and javelin), and Olympic-style weightlifting. Each style has its own principal injuries, both acute and chronic, related to the individual technique. Acute injuries should be further categorized as emergent or nonemergent. Specific age-related populations (i.e., the very young and the aging athlete) carry additional considerations.

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.

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.

Wrestling injuries during the 2008 Beijing Olympic Games

BACKGROUND

Better understanding of the incidence, mechanisms, and characteristics of potential injuries in wrestling helps to implement preventive measures to better care for these athletes. Several studies have investigated the incidence and type of injuries in amateur and intercollegiate wrestling; however, there is a lack of studies that review the incidence and nature of injuries in elite wrestlers during Olympic Games or World Championships.

PURPOSE

The purpose of this study was to assess the injury profile of elite senior wrestlers in Greco-Roman, freestyle, and female wrestling during the 2008 Beijing Olympic Games.

STUDY DESIGN

Descriptive epidemiologic study.

METHODS

Study participants consisted of 343 wrestlers participating in the 2008 Beijing Olympic Games. Standard checkoff forms were used to collect the injury data, including injury type, severity, location, timing, and mechanism.

RESULTS

A total of 343 athletes sustained 32 injuries during 406 matches, which is equivalent to an overall incidence of 9.30 injuries per 100 athletes and 7.88 injuries per 100 matches. Among the 3 styles, freestyle had the highest injury rate (10.1%) and female wrestling the lowest (7.5%). In sum, 84.4% of all injuries were categorized as mild. Although the overall injury rate in male athletes was slightly higher than that among female athletes (9.7% versus 7.5%), this difference was not statistically significant (odds ratio = 1.21, 95% confidence interval = 0.46-3.68; P = .40).

CONCLUSION

The rate and severity of wrestling injuries during the 2008 Beijing Olympic Games were lower than previous reports. No serious and catastrophic injury was recorded, and most injuries were minor.

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.