The relationship between ground conditions and injury: what level of evidence do we have?

Cricket injury in New Zealand: a study of injury insurance claims from 2008 to 2018

OBJECTIVES

This study aimed to quantify injury claims in organised community cricket in New Zealand over a 10-year period, 1 July, 2008 to June 30, 2018.

DESIGN

Retrospective analysis of administrative insurance claims data from the Accident Compensation Corporation (ACC), New Zealand.

METHODS

Injury claims relating to cricket in males and females in New Zealand were identified from coded data and relevant text searches of routinely collected claims data. Summary statistics for key variables (age, body part, injury type, and injury factors) are presented together with annual injury claim incidence rates (ICR) calculated using population-based denominators.

RESULTS

There were 62,776 claims for cricket injury occurring at a place of recreation/sports. Most claims were in males (91.4%) and those aged 15-19 year old age group. There was an increase in the total number of injury claims over the 10-year period (1.5%, p = 0.04), but the ICR was consistent (males: varying between 258.8-304.8, and females: 22.6-28.3 claims annually per 100,000 population). Soft tissue injury claims were the most common injury type. Lumbosacral claims were most common for bowlers (78%). Lower limb injury claims were the predominant claim from batting (36%) and fielding (42%), with knee injury claims (34%) being the most common lower-limb injury location.

CONCLUSIONS

Lumbosacral, shoulder and knee injuries were common amongst all playing positions and worthy of preventative attention. Strategies targeting prevention of these injuries may reduce the ICR within the ACC.

Injury prevention knowledge, beliefs and strategies in elite female footballers at the FIFA Women's World Cup France 2019

OBJECTIVES

This study assessed knowledge, beliefs and practices of elite female footballers regarding injury prevention.

METHODS

A survey was sent to players participating in the FIFA Women's World Cup France 2019. Questions covered three injury prevention domains: (1) knowledge; (2) attitudes and beliefs; (3) prevention practices in domestic clubs. Additionally, ACL injury history was assessed.

RESULTS

Out of 552 players, 196 women responded (35.5%). More than 80% of these considered injury risk to be moderate or high. Players listed knee, ankle, thigh, head and groin as the most important injuries in women's football. The most important risk factors identified were low muscle strength, followed by poor pitch quality, playing on artificial turf, too much training, reduced recovery and hard tackles. In these elite players, 15% did not have any permanent medical staff in their domestic clubs, yet more than 75% had received injury prevention advice and more than 80% performed injury prevention exercises in their clubs. Players identified the two most important implementation barriers as player motivation and coach attitude. Two-thirds of players used the FIFA 11+ programme in their clubs.

CONCLUSIONS

This diverse group of elite players demonstrated good knowledge of risk level and injury types in women's football. Of the risk factors emphasised by players, there was only one intrinsic risk factor (strength), but several factors out of their control (pitch quality and type, training volume and hard tackles). Still players had positive attitudes and beliefs regarding injury prevention exercises and indicated a high level of implementation, despite a lack of medical support.

Evaluation of the advanced artificial athlete and Hall effect sensors for measuring strain in multi-layer sports surfaces

Computer models are a useful means to explore the loading behaviour of third generation (3G) artificial turf sports surfaces; however, measuring the material stress–strain behaviour under realistic high loading rates is challenging. Therefore, the purpose of this study was two-fold: to evaluate the advanced artificial athlete (AAA) for measuring strain behaviour of polymeric sports surfaces under high loading rates typical of player interactions; and to evaluate Hall effect sensors (HES) for measuring strain behaviour of an individual layer within multi-layer sports surfaces. An independent optical measurement system (GOM) provided gold standard sample deformation and strain. Forty-five impacts onto three test samples were measured simultaneously using the three systems. Poor agreement was found between AAA and GOM peak sample deformations and strain (systematic bias 2.4 mm, 95% confidence intervals ± 1.3 mm, strain RMSD 29%), largely attributable to errors in the AAA time of initial contact. Using a regression equation to correct this time led to much better agreement in AAA peak deformations and strain (systematic bias 0.1 mm, 95% confidence intervals ± 0.7 mm, strain RMSD 8%). Good agreement was found between the HES and GOM (systematic bias 0.2 mm, 95% confidence intervals ± 0.4 mm, strain RMSD 11%). The corrected AAA and HES methods can measure deformation of polymeric sports surfaces under realistic loading rates to an accuracy of < 1 mm. In terms of strain, errors increase with decreasing peak sample deformation indicating that both systems should be used with caution for peak deformations < ~ 4–5 mm.

Investigation of the Influence of Reduced Graphene Oxide Flakes in the Dielectric on Surface Characteristics and Material Removal Rate in EDM

Background: Touch (rugby/football) is a minimal contact sport for which the type and incidence of injuries remains unknown in Europe. Objectives: To establish the incidence, severity and nature of injuries sustained during a four-day European Touch Championship competition. Methods: A prospective cohort design was adopted to record match-related injuries during the European Touch Championships 2016. Injuries were collected from five countries and classified using the Orchard Sports Injury Classification (OSICS-10). Data were combined from all participating countries and injury incidence was recorded as number of injuries/1000 player hours. Results: A total of 135 injuries were recorded during the tournament with injury incidence calculated as 103.5 injuries per 1000 player match hours. Injuries were mainly recorded as transient (76%) occurring most frequently in the lower limb (69%). Injuries occurred more frequently on successive days, with exception to the final day of the tournament. The number of injuries was not different between the first and second half of matches and there was no relationship between the day of the tournament and the half of the match that injury occurred. Conclusion: Match injury incidence was 103.5 injuries per 100 player match hours. The most injured site was that of the lower limb, with the most common injury type reported as muscle/tendon injury. It is postulated that fatigue plays a role in injury incidence during a multiday tournament.

Perceived Links Between Playing Surfaces and Injury: a Worldwide Study of Elite Association Football Players

Background

Injuries in association football (soccer) are debilitating for players and can also be detrimental to the success of a team or club. The type or condition of a playing surface has been empirically linked to injuries, yet results are inconclusive. The overall purpose of this study was to analyse elite football players’ perceived links between playing surfaces and injury from a worldwide cohort of players. The results of this study can help to inform areas for future playing surface research aimed at trying to alleviate user concerns and meet user (i.e. the player) needs.

Methods

Quantitative data were collected from 1129 players across the globe to address the aim of this study.

Results

Ninety-one percent of players believed the type or condition of a surface could increase injury risk. Abrasive injuries, along with soreness and pain, were perceived to be greater on artificial turf. Surface type, surface properties and age were all potential risk factors identified by the players and linked to the playing surfaces.

Conclusions

The results identified three areas where future research should be focussed to help develop surfaces that alleviate user concerns and meet user (i.e. player) needs: (i) current reporting of soreness, pain or fatigue as injuries, (ii) contribution of surface properties to injury; and (iii) surface experience of players from different countries differentiates their views of injury risk.

Does variability within natural turfgrass sports fields influence ground-derived injuries?

Natural turfgrass sports fields exhibit within-field variations due to climatic conditions, field construction, field management, and foot traffic patterns from field usage. Variations within a field could influence the playing surface predictability and require athletes to make abrupt or frequent adjustments that lead to increased ground-derived injury occurrence. This study introduces a new methodology aimed at evaluating the potential relationship between within-field variations of turfgrass sports field properties and ground-derived athlete injuries. Collegiate Club Sport athletes self-reported ground-derived injuries over two years. Soil moisture, turfgrass quality, surface hardness, and turfgrass shear strength were quantified from their two home fields. Hot spot analysis identified significantly high (hot spots) and low (cold spots) values within the fields. Injury locations were compared to hot spot maps each month. Binomial proportion tests determined if there were differences between observed injury proportions and expected proportions. Twenty-three ground-derived injuries were reported overall. The observed injury proportions occurring in turfgrass quality cold spots [0.52 (95% CI 0.29-0.76)] and soil moisture hot spots [0.43 (95% CI 0.22-0.66)] was significantly higher than expected [0.20 (p < .001) and 0.21 (p < .05), respectively]. Most injuries in significant areas of turfgrass quality, soil moisture, and surface hardness were along edges of hot and cold spots. These results suggest a potential relationship between within-field variations and ground-derived injuries, particularly in transition areas between non-significant and significant high and low values. Future larger-scale studies can incorporate the reported methodology to validate this relationship and implement strategies that reduce ground-derived injuries.

Can the natural turf pitch be viewed as a risk factor for injury within Association Football?

OBJECTIVES

A review of the current literature is used to propose a 'conceptual model for relative pitch hardness' and how this may affect incidence of injury within Association Football. Based upon the injury risk and causation model of Meeuwisse et al. (Clin J Sport Med 2007; 17(3):215), it may provide researchers a necessary framework to guide future research investigations.

DESIGN

A literature review.

METHODS

A comprehensive search of electronic databases available until October 2014, and supplemental hand searching was conducted to identify relevant studies. Studies were deemed relevant if they met the following criteria: published in English, presented or referenced in an epidemiological study or provided data directly and/or related to the surface of the football pitch, ball or boot to surface interaction and injury. Further information was sourced on surface hardness, players' movement patterns and physiological demands within football.

RESULTS

Papers varied in methodological quality, with comparative studies examining injury rates on artificial versus natural turf pitches being most prevalent. No prospective studies were found that objectively measured the relationship between hardness of natural turf and injury risk within football.

CONCLUSIONS

The literature review into natural turf pitches and injury within football has largely been unable to confirm that pitch hardness can be viewed as a significant extrinsic risk factor. Methodological concerns, including objectivity in pitch assessment and uniformity in defining injuries undermine the efficacy of available work. Future studies are needed utilising objective assessment tools to draw more definitive conclusions regarding pitch hardness as an extrinsic factor for injury within football.

Ground condition as a risk factor in sports injury aetiology studies: the level of concordance between objective and subjective measures

Background

It is well known that the condition and type of sporting ground influences the risk of sports injury. However, the lack of evidence on the relationship between subjective and objective sporting ground condition assessments in sports injury aetiology studies has implications for the development of effective injury prevention strategies. This paper aims to examine concordance between subjectively rated and objective ground hardness and moisture measurements to inform data collection methods for future sports injury aetiology studies.

Methods

Subjective, observational assessments of ground hardness and soil moisture were recorded on 36 occasions during an Australian football season using two four-point scales of ‘very soft’ to ‘very hard’ and ‘very wet’ to ‘very dry’, respectively. Independent, objectively measured hardness and soil moisture were also undertaken at nine locations on the same grounds. The maximum and minimum ground values and the computed average of ground hardness and soil moisture were analysed. Somer’s d statistic was calculated to measure the level of concordance between the subjective and objective measures.

Results

A significant, moderate to substantial level of agreement was found between the subjective ratings and the average objective hardness values (d = 0.467, p <0.001), but there was perfect agreement on just less than half of the occasions. The level of concordance between the subjective and objective moisture ratings was low to moderate or trivial for all moisture measures (0.002 < d <0.264, p >0.05).

Conclusions

Compared to objective measures, the subjective assessments were more accurate for ground hardness than for soil moisture levels and raters were just as likely to underestimate or overestimate the condition under review. This has implications for future sports injury aetiology studies that include ground condition assessments and particularly the use of subjective measures to underpin the development of future injury prevention strategies.

Electronic supplementary material

The online version of this article (doi:10.1186/s40621-014-0027-y) contains supplementary material, which is available to authorized users.