Martial Arts

A Legal and Forensic Medicine Approach to Police Physical Intervention Techniques in High-Risk Situations

Background: The physical intervention techniques (PITs) typically used by the police in troublesome situations are examined in terms of injuring potential depending on whether they target a body zone of high, medium or low vulnerability. Based on legal and forensic considerations, and principles of congruence, opportunity and proportionality, a need exists to favor opponent locking and arrest techniques targeting non-vulnerable zones to minimize the risk of severe damage. Methods: A search of the training manuals for the different kind of law of enforcement officers was carried out. Revision of injuries was available from electronic databases of academic o medical journals. Results: Three different locking and arrest PITs based on operational tactical procedures (OTP) that avoid zones of high or medium vulnerability are proposed. The new techniques use blocking, diverting and grabbing of the upper and lower limbs, followed by dislocation and locking of the same targets. Conclusions: The damaging potential of such PITs was assessed in terms of anatomical region and most were found to have a high risk of severe damage. The alternative PITs proposed here, which rely on OTP, improve in legal and forensic medical terms on existing choices and dramatically reduce the risk of injuring arrestees.

Injury rates in Iranian taekwondo athletes; a prospective study

Purpose

Taekwondo, as the most popular martial art among Iranian sportsmen, might lead to injury for the athletes of this sport during competitions. We decided to report the incidence rate of injuries sustained by the athletes of this sport during national competitions.

Methods

All competitions of Iran national championship taekwondo league in 2006-2007 with 204 athletes were observed prospectively to detect the occurrence of injuries. The severity of injuries was classified into four groups (mild, moderate, severe, and critical) according to the involvement of medical care team in the contest, ability of the athletes to resume and duration of probable absence of injured athletes from future competitions and training sessions. Athlete-Exposure (A-E) was defined as the number of competitions multiplied by two. On this base, the rate of injury incidence per 1000 A-Es, the rate of injuries per time unit and the rate of injury occurred for each 100 athletes were considered as the major outcomes of this study.

Results

Of totally 1,338 A-Es, 93 injuries were recorded during the competitions. The rate of injury incidence was found to be 69.5 injuries per 1000 A-Es and the rate of injuries per minute of competitions was 0.023 which corresponded to 23.3 injuries per 1000 minutes of competitions. 45.6 injuries were occurred for each 100 athletes during the course of competitions. The most frequent injuries were mild (68.8%) and critical injuries (24.7%), followed by moderate and severe injuries; 4.3% and 2.1%, respectively.

Conclusion

The rate of injury we found was lower than that of western countries. In spite of finding the lower limbs as the most frequent place of injuries in other studies, we found the upper limbs as the most predisposed place of injuries which might be due to difference in the method of combat of Iranian athletes with other athletes.

Incidência de lesões e desvios posturais em atletas de taekwondo

Com o objetivo de analisar a incidência de lesões e desvios posturais no taekwondo foram avaliados 10 atletas do sexo masculino da seleção catarinense. O histórico de lesões relacionadas à prática desta modalidade foi obtido por aplicação de questionário. A postura foi analisada por meio do protocolo do software SAPO. Os resultados indicaram lesões mais frequentes nos membros inferiores (7/10), principalmente no pé, por fratura e entorse. Houve diferença significativa entre os hemicorpos no ângulo Q (p = 0,037), ângulo perna/retropé (p = 0,001), alinhamento horizontal da pelve (p = 0,016) e comprimento entre membros (p = 0,02). Sugere-se a implementação de treinamento preventivo e exercícios compensatórios para prevenir lesões e desvios posturais em atletas de taekwondo.

Jujitsu kick to the abdomen: a case of blunt abdominal trauma resulting in hematochezia and transient ischemic colitis

Blunt abdominal trauma is a common presentation to the emergency department. Ischemic colitis is a rare complication of this and its possible sequelae are important for an emergency physician to recognize. A 21-year-old man presented to the emergency department with abdominal pain and hourly episodes of bright red blood per rectum shortly after being kicked in the stomach at his jujitsu class. He had no significant medical history, and results of his systems review were otherwise unremarkable. On examination, he appeared well, with normal vital signs. He had mild lower abdominal tenderness, but there were no peritoneal signs present. There was blood on the digital rectal examination. His hemoglobin, platelet, and international normalized ratio levels were normal and his abdominal radiograph was unremarkable. The gastroenterology service was contacted because of the hematochezia and a flexible sigmoidoscopy was performed. The sigmoidoscopy showed erythema, ulceration, and edema of a segment in the left colon, consistent with ischemic colitis. This was later confirmed on biopsy. A computed tomography (CT) scan of the abdomen was conducted, which revealed left colonic inflammation consistent with colonic ischemia. There was no mesenteric vascular thrombosis or mesenteric hematoma found on CT. His hematochezia and abdominal pain subsided spontaneously, and he was discharged home. This case illustrates transient ischemic colitis as a potential presentation of blunt abdominal trauma, and emergency physicians should consider this uncommon diagnosis in the differential diagnosis of patients presenting after abdominal trauma.

Effects of martial arts on health status: a systematic review

OBJECTIVE

To systematically summarize the evidence for the effects of martial arts on health and fitness, to show the strengths of different types of martial arts, and to get a more complete picture of the impacts of martial arts on health, and also to provide a basis for future research on martial arts as an exercise prescription in exercise therapy.

METHOD

We searched for "martial arts""health" and "random" in eight databases (n= 5432). Randomized controlled trials and controlled clinical trials on the health effects of martial arts were included in the study.

RESULTS

The final analysis included 28 papers (one general martial arts, one kung fu, sixteen tai chi, six judo, three karate, and one taekwondo). Among the disciplines of martial arts, tai chi was the most well-studied, followed by judo, karate, and taekwondo. Research topics varied widely, and included health, injuries, competition, morals and psychology, and herbal medicine. Most found positive effects on health. Tai chi is no-contact, low-impact, soft body and mindfulness exercise, which has been widely adopted by elderly people and proven to be a beneficial health promotion exercise. Research on judo, karate, and taekwondo mainly focused on improvements to athletes' competitive abilities, rather than on health effects. We did not find any published randomized controlled trials or controlled clinical trials on aikido, kendo, sumo, kyudo, qi gong, or other disciplines.

DISCUSSION AND CONCLUSION

Since martial arts are widely practiced, their effects on physiology, morphology, immunology, and neurology should be further studied in order to help people to select the best discipline or style to accomplish their purposes. This necessitates categorizing and classifying the disciplines and styles according to their effects on different body systems and levels of contact, as well as standardizing evaluation criteria for martial arts. Martial arts as an exercise prescription can then move from an experience-based to an evidence-based treatment.

Neurologic injuries in boxing and other combat sports

Many sports have neurologic injury from incidental head contact; however, combat sports allow head contact, and a potential exists for acute and chronic neurologic injuries. Although each combat sport differs in which regions of the body can be used for contact, they are similar in competitor exposure time. Their acute injury rates are similar; thus their injuries can appropriately be considered together. Injuries of all types occur in combat sports, with injuries in between one fifth to one half of all fights in boxing, karate, and tae kwon do. Most boxing injuries are to the head and neck region. In other combat sports, the head and neck region are the second (after the lower limbs) or the first most common injury site.

Epidemiology of injuries in competition taekwondo: a meta-analysis of observational studies

This paper aims to review and collate the epidemiological data of injuries in competition taekwondo as reported in the literature, make recommendations, and suggest further research. The electronic databases AMED, AusportMed, CINAHL, MEDLINE, PubMed, and SPORTDiscus were searched from inception to March 2008. Fourteen prospective cohort studies reporting the incidence of injuries in taekwondo were included. Two reviewers independently extracted data and assessed trial quality using the STROBE statement. Homogenous studies were combined in a pooled analysis using a Poisson random effects regression model. Poisson regression showed an overall mean injury rate of 79.3 per 1000 athlete-exposures (95% confidence interval 22.8, 275.4). Neither age, gender nor level of play were significant in the analysis. The most common injury location and type were found to be the lower limb and contusion, respectively, and were invariably associated with contact. Although taekwondo players are exposed to a substantial risk of sustaining injuries, the majority of injuries appeared to be of minimal severity. Modifications to the competition rules and protective equipment may be warranted. Future studies should adhere to recommended operational definitions, utilise a standardised injury classification system, and report injury rates using multiple denominators in order to facilitate inter- and cross-sport comparisons.

The Martial Arts

Given the increasing popularity of the martial arts, it is likely that physicians in all specialties encounter patients who participate. From pediatric patients, to geriatric patients, to those living with various disabilities, the martial arts may offer physical, psychologic, and therapeutic benefits. An appreciation of the physical demands of the martial arts is crucial to understanding the pathogenesis of injury as well as to planning treatment and prevention strategies and to determining safe return to participation after injury.

Incidence and nature of karate injuries

OBJECTIVES

To determine the incidence and nature of karate injuries sustained in karate clubs and to identify risk factors for injuries.

METHODS

One hundred eighty-six individuals from three karate clubs in Brest, France, were entered in a retrospective study extending from September 2002 to June 2003. Each athlete was asked to complete a questionnaire on karate injuries sustained during the previous year (type, location, mechanism, exercise during which the injury occurred, number of days off training and work, and medical care). Injury types were described by number of injuries and risk factors per number of injured athletes.

RESULTS

Forty-eight (28.8%) of the 186 athletes sustained 83 injuries (63 while training and 20 while competing). The annual injury rate was 44.6 per 100 athletes. Incidence rates were similar in males and females and across the three clubs but increased with age, time spent training (3.6+/-1.7 vs. 2.9+/-1.5 h/week; P=0.001), rank (lower ranks vs. brown and black belts, P=0.015), and years of practice (7.3+/-5.5 years in athletes with injuries vs. 5.1+/-4.8 in those without injuries; P=0.03). Injuries consisted of 43 (53%) hematomas, 16 (19%) sprains, seven (7%) muscle lesions, six (7%) fractures, four (5%) malaise episodes, and seven (7%) miscellaneous lesions. Time off training occurred for 26 (31.3%) injuries and ranged from 8 to >30 days. The body region involved was the head in 22 (26.5%) injuries, the torso in eight injuries (9.6%), the upper limb in 24 (28.9%) injuries, and the lower limb in 29 (35%) injuries.

CONCLUSION

Karate injuries are fairly common but usually minor. They are more likely to occur during competitions than while training. The head and limbs are the main regions involved. Longer training times per week and higher rank are associated with an increased risk of injury. Prevention seems crucial.

Injury profile in competitive karate: prospective analysis of three consecutive World Karate Championships

The goal of this paper was to document the injury rate in modern competitive karate. A prospective recording of the injuries resulting from 2,837 matches in three consecutive World Karate Championships (WKC) was performed. Eight hundred and ninety-one injuries were recorded, with an incidence of 0.31 injuries per match or 157.03 injuries per 1,000 athlete exposures. Occurrence of injuries was higher among lighter categories, under 60 kg in males (0.56) and under 53 kg in females (0.42). Punches (737, 82.7%) caused more injuries than kicks (75, 7.3%). The injuries were most commonly located in the face (646, 72.5%) followed by the head (103, 11.6%) and lower limbs (57, 6.4%). The injuries consisted primarily of contusions (448, 50.3%) epistaxis (144, 16.2%) and lacerations (122, 13.7%) followed by concussions (34, 3.8%) and sprains (31, 3.5%). There was some kind of external haemorrhage in 296 injuries (33.7%). The injury rate was similar in the three WKC but the number of severe injuries declined from 1996 to 2000. We conclude that competitive karate is associated with a relatively high injury rate; in one in every three matches medical attention is required, but mainly for minor injuries. Severe injuries are rare.

Pre-competition habits and injuries in Taekwondo athletes

Background

Over the past decade, there has been heightened interest in injury rates sustained by martial arts athletes, and more specifically, Taekwondo athletes. Despite this interest, there is a paucity of research on pre-competition habits and training of these athletes. The purpose of this pilot study was to assess training characteristics, competition preparation habits, and injury profiles of Taekwondo athletes.

Methods

A retrospective survey of Canadian male and female Taekwondo athletes competing in a national tournament was conducted. Competitors at a Canadian national level tournament were given a comprehensive survey prior to competition. Items on training characteristics, diet, and injuries sustained during training and competition were included. Questionnaires were distributed to 60 athletes.

Results

A response rate of 46.7% was achieved. Of those that responded, 54% dieted prior to competition, and 36% dieted and exercised pre-competition. Sixty-four percent of the athletes practised between 4–6 times per week, with 54% practicing 2 hours per session. Lower limb injuries were the most common (46.5%), followed by upper extremity (18%), back (10%), and head (3.6%). The majority of injuries consisted of sprains/strains (45%), followed by contusions, fractures, and concussions. More injuries occurred during training, including 59% of first injuries.

Conclusion

More research needs to be conducted to further illustrate the need for appropriate regulations on weight cycling and injury prevention.