A survey of badminton injuries

Aetiology, epidemiology and treatment of musculoskeletal injuries in badminton players: a systematic review and meta-analysis

The present study has two main goals: to conduct a systematic review of musculoskeletal injuries experienced by badminton players, and to examine the management of such injuries. Searches were conducted of the PROSPERO, PubMed, Scopus, and SPORTDiscus databases, from their inception until March 2023. The papers analysed were all based on a study population consisting of individuals aged 18 years or more, diagnosed with badminton-related injuries. The methodological quality assessments was using the Newcastle-Ottawa Scale and REVMAN. A total of 28 studies were included in the systematic review. In total, the analysis included 2435 participants. Of these athletes, 35.6% (1012) were female and 64.4% (1503) were male. By type of injury, sprains were the most commonly studied and the most prevalent, accounting for 36.06% of the sample. These were followed by muscle injuries, representing 23.86% of the total. Injuries to the joints were the least prevalent, accounting for 4.97% of the sample. Lower limb injuries accounted for 52.15% of the total. Of these, ankle injuries were the most common. Despite the generally low quality of the studies considered, the evidence suggests that musculoskeletal injuries, especially to the lower limb, most commonly affect badminton players of all levels.

Impact of specialized fatigue and backhand smash on the ankle biomechanics of female badminton players

During fatigued conditions, badminton players may experience adverse effects on their ankle joints during smash landings. In addition, the risk of ankle injury may vary with different landing strategies. This study aimed to investigate the influence of sport-specific fatigue factors and two backhand smash actions on ankle biomechanical indices. Thirteen female badminton players (age: 21.2 ± 1.9 years; height: 167.1 ± 4.1 cm; weight: 57.3 ± 5.1 kg; BMI: 20.54 ± 1.57 kg/m2) participated in this study. An 8-camera Vicon motion capture system and three Kistler force platforms were used to collect kinematic and kinetic data before and after fatigue for backhand rear-court jump smash (BRJS) and backhand lateral jump smash (BLJS). A 2 × 2 repeated measures analysis of variance was employed to analyze the effects of these smash landing actions and fatigue factors on ankle biomechanical parameters. Fatigue significantly affected the ankle-joint plantarflexion and inversion angles at the initial contact (IC) phase (p < 0.05), with both angles increasing substantially post-fatigue. From a kinetic perspective, fatigue considerably influenced the peak plantarflexion and peak inversion moments at the ankle joint, which resulted in a decrease the former and an increase in the latter after fatigue. The two smash landing actions demonstrated different landing strategies, and significant main effects were observed on the ankle plantarflexion angle, inversion angle, peak dorsiflexion/plantarflexion moment, peak inversion/eversion moment, and peak internal rotation moment (p < 0.05). The BLJS landing had a much greater landing inversion angle, peak inversion moment, and peak internal rotation moment compared with BRJS landing. The interaction effects of fatigue and smash actions significantly affected the muscle force of the peroneus longus (PL), with a more pronounced decrease in the force of the PL muscle post-fatigue in the BLJS action(post-hoc < 0.05). This study demonstrated that fatigue and smash actions, specifically BRJS and BLJS, significantly affect ankle biomechanical parameters. After fatigue, both actions showed a notable increase in IC plantarflexion and inversion angles and peak inversion moments, which may elevate the risk of lateral ankle sprains. Compared with BRJS, BLJS poses a higher risk of lateral ankle sprains after fatigue.

Eye injuries in badminton - players' perspective toward the usage of personal protective equipment

OBJECTIVE

We conducted a survey between April to September 2021 to understand the perspective of badminton players on the usage of personal protective equipment to avoid eye injuries.

METHODS

The survey was conducted online. It was disseminated through various social media platforms and via e-mail. The survey was initially shared with university-level badminton players. Both recreational and professional players were included. They were further encouraged to circulate the survey questionnaire among their colleagues.

RESULTS

In total, the survey received 372 responses. After removing possible duplicates and incomplete responses (n = 28), 92.5% (n = 344) of the responses were included in the final analysis. Among the 344 included responses, recreational and professional players accounted for 77.6% (n = 267) and 22.4% (n = 77), respectively. The mean age ± SD of the recreational and professional players were 24.1 ± 6.3 years (range 14-60 years) and 25.7 ± 6.0 years (range 14-61 years), respectively. A significant difference was noted for self-reported eye injuries between recreational and professional players while playing badminton (χ2 value = 5.321, p = 0.02). Among the recreational and professional players, 93.6% (n = 250) and 88.3% (n = 68) did not use protective eyewear while playing badminton. Professional players were at higher risk of eye injuries than recreational players (OR = 2.9, 95% CI = 1.1-7.8).

CONCLUSION

The majority of badminton players in both groups agreed that PPE usage would lower the risk of sustaining eye injuries; however, they are ambiguous about the usage of protective eyewear. In contrast, players with self-reported eye injuries were aware of its impacts and encouraged the usage of PPEs associated with badminton. Further studies are warranted to understand and educate badminton players about the causes and impacts of eye injuries in badminton.

The Characteristics of Badminton-Related Pain in Pre-Adolescent and Adolescent Badminton Players

Body pain, often considered as an early sign of injury in young players, warrants thorough study. This study aimed to examine the distribution of badminton-related pain and prevalence in pre-adolescent and adolescent badminton players. Profiles of badminton-related pain were surveyed using a questionnaire among 366 pre-adolescent and adolescent badminton players aged 7-12 years. The distribution of badminton-related pain was described, and the pain incidence was calculated. Proportions of pain per 1000-training-hour exposures were the main outcome measures. The analysis considered various age groups (7-8, 9-10, and 11-12 years) and years of badminton experience (≤2, 2-3, and > 3 years). In total, 554 cases of badminton-related pain were reported. The ankle was the most common site, followed by knee, plantar, shoulder, and lower back. The overall pain rate per 1000-training-hour exposure was 3.06. The 11-12-year-old group showed the highest pain rate, significantly greater than the 7-8-year-old group and the 9-10-year-old group. Additionally, the prevalence of pain exhibited an increasing trend with age. Finally, regardless of the age groups, participants with 2-3 years of badminton experience had the highest pain rate. These findings might help inform targeted interventions to reduce the high prevalence of pain in various body regions across pre-adolescent and adolescent badminton players.

Badminton-related eye injuries: a systematic review

OBJECTIVES

To report the nature of badminton-related eye injuries in the published literature.

METHODS

A review of the literature with key word and MeSH terms: 'Eye injury', 'Ocular trauma', 'Badminton' 'Shuttlecock' using CENTRAL, MEDLINE, EMBASE and Informit Health Collection databases. Papers were reviewed to assess the circumstances of the injury, patient demographics and clinical data.

RESULTS

19 studies from 1974 to 2020 from 12 countries reported 378 monocular badminton-related eye injuries from 378 patients with a male-to-female ratio of 2.5:1. A closed globe injury was sustained in 97% of eyes and a shuttlecock responsible for 85% of injuries. Doubles play, the shuttlecock and a lack of eye protection were associated with eye injury.

CONCLUSION

Vision impairment was associated with the majority of badminton-related eye injuries, and doubles play, the shuttlecock and a lack of eye protection were risk factors.

Acute injuries in Badminton from 10 to 66 years of age: an epidemiological study of 140 cases among all types of practice

PURPOSE

The main objective of this retrospective study was to establish an epidemiological overview of patients admitted to an Emergency department specialized in musculo-skeletal trauma for acute lesions related to Badminton practice in the period from January 1st 2010 to January 1st 2015.

METHODS

There were 135 patients with 140 admissions and 146 total number of injuries. There were 67 females (48%) and 73 males (52%). The mean age was 28 ± 13.8 years, ranging 10-66 years. 91 patients (65%) could be contacted by telephone to fill a questionnaire aimed at completing the information provided by the medical records.

RESULTS

129 lesions (88.3%) were located to the lower limbs, 16 (11%) to the upper limbs, and one (0.7%) at the head. For the whole series, there were 89 sprains (60.9%), 32 tendino-muscular lesions (21.9%), 13 fractures (8.9%), 5 dislocations (3.4%), 3 painful contusions (2.1%), 3 meniscal injuries (2.1%) and one wound (0.7%). In the lower limbs, lateral ankle sprain was the most frequent diagnosis (43.4%), followed successively by rupture of the Achilles tendon (13.9%), tennis leg (8.5%), and mid-foot sprain (6.9%). Of the 146 lesions, 117 (80.1%) received non-operative treatment, 28 (19.1%) received surgical treatment in the operation room, and one simple wound (0.7%) was sutured in the emergency room.

CONCLUSIONS

Lateral ankle sprains followed by tendino-muscular lesions of the calf are by far the most frequent lesions of badminton. Modification of the shoes of badminton players should be considered to decrease the high incidence of ankle injuries.

Longitudinal study on locations of injury among junior high school, high school, and university badminton athletes at Japanese national-level competitions

[Purpose] The aim of study was to examine incidence of injury according to location of injury to develop an injury prevention program for elite badminton players of junior high school, high school, and university. [Participants and Methods] We conducted a prospective longitudinal study, between April 2012 and March 2013, on 133 national-level badminton players attending junior high school, high school, and university. Injury rates in athletes per 1,000 exposures were calculated based on gender and school age for the five most common injury locations, in addition, severity, type and circumstance were investigated. [Results] Injury rates in athletes per 1,000 exposures were the highest in the racket-side (RS) shoulder/clavicle among the female university students (4.35), RS thigh of high school females (2.21), and lumbar spine/lower back of males of all school ages and junior high school females (1.83–1.25). Significantly higher injury rates were noted for the overuse of the lumbar spine/lower back and RS shoulder/clavicle, trauma of the RS thigh and ankle, and injury, when compared with slight injury of the RS ankle. [Conclusion] Injury prevention programs should be developed for RS shoulder/clavicle overuse in university females, RS thigh trauma in high school females, and lumbar spine/lower back in males of all school ages and junior high school females.

Risk Prediction of Injury Among Recreational Badminton Players in India

BACKGROUND/PURPOSE

Since badminton has emerged as a frequently played non-contact recreational sport in India, it is essential to document the injury patterns and incidence. However, there is no existing literature on this topic among Indian players.

MATERIALS AND METHODS

A web-based questionnaire was circulated among recreational badminton players across North India, enquiring about demographic details, injury characteristics, and factors associated with an injury like BMI, warm-up practice, and physical training.

RESULTS

Data of 237 eligible participants revealed an injury incidence rate of 57.1%. The ankle and dominant-side shoulder were the most common anatomical regions affected. The most common injury types were ligament sprain and muscle/tendon strain. Factors like age, frequency, duration of play, type of footwear, BMI, prior warm-up, court surface, and physical training were significantly associated with injury incidence on univariate logistic regression analysis. On multivariate logistic regression analysis, we found male gender, a lack of prior warm-up, inadequate physical training, and age group between 26 and 30 years to be four independent risk factors for injury.

CONCLUSION

The recreational badminton player of India had a relatively higher incidence of injury compared with the limited published data from other countries. Modifiable factors like a proper warm-up before the game, regular physical fitness training, and injury awareness programs can reduce the injury rates.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s43465-022-00663-y.

Fatigue increases ankle sprain risk in badminton players: A biomechanical study

Ankle sprains are the most common injury in regular badminton players and usually occur at the end of a match or training. The purpose of the present study was to examine the influence of fatigue produced by badminton practice on the lower limb biomechanics of badminton players. It was hypothesized that fatigue induces ankle kinematic and lower leg muscle activity changes which may increase the risk of ankle sprain. Ankle kinematics, ankle kinetics and muscles activities of 17 regular badminton players were recorded during lateral jumps before and after an intense badminton practice session. Post-fatigue, ankle inversion at foot strike and peak ankle inversion increased (+2.6°, p = 0.003 and +2.5°, p = 0.005, respectively). EMG pre-activation within 100 ms before foot landing significantly decreased after fatigue for soleus (-23.4%, p = 0.031), gastrocnemius lateralis (-12.2%, p = 0.035), gastrocnemius medialis (-23.3%, p = 0.047) and peroneus brevis (-17.4%, p = 0.036). These results demonstrate impaired biomechanics of badminton players when fatigue increases, which may cause a greater risk of experiencing an ankle sprain injury.

Incidence of injuries among amateur badminton players: A cross-sectional study

The main aims of this study were, firstly, to investigate the frequency, location, and severity of injuries in amateur badminton players, and then to determine risk factors that may be associated with a higher incidence of injuries.A cross-sectional study, composed of 150 players drawn from the 2018 BWF European Senior Championships, was analyzed. The definitions and types of injury included in the study are based on those published in previous epidemiology studies.Among the 150 players analyzed, 221 injuries were observed, of which the highest proportion (40.3%, n = 89) affected the lower limb. Of these 22.44% were to the knee and 18.3% to the leg. In the upper limb, the shoulder was most frequently affected (11.8%). The mean rate of injuries per 1000 hours of play was 0.134 (standard deviation [SD]: 0.1), with 0.138 (SD: 0.1) among the male players and 0.131 (SD: 0.08) among the female players (P = .981: F = 0.001). The average duration of the injuries suffered exceeded 28 days in 34.5% of the cases.The incidence of injury varied according to sex and age. Most injuries affected the muscles, especially those of the knee (in the lower limbs) and the shoulder (in the upper limbs).

The effect of match fatigue in elite badminton players using plantar pressure measurements and the implications to injury mechanisms

The purpose of this study was to investigate the differences in plantar pressure under the lead and trail foot between two lunge tasks to the net in the dominant (LD) and non-dominant (LND) directions, and to explore how fatigue affects the plantar pressure patterns whilst performing movements before and after a competitive match. Peak and mean pressure were measured with the Biofoot-IBV in-shoe system from five repetitions of each task, with sensors positioned under the calcaneus, midfoot and phalanges on the lead and trail foot. Data were collected pre and immediately post-playing an official first national league competition match. The study was conducted with a sample of thirteen first league badminton players. A 2 × 2 repeated ANOVA found significant differences between the two tasks and between pre- and post-match (fatigued state). Players also had different foot pressure distributions for the LD and LND tasks, which indicated a difference in loading strategy. In a fatigued state, the plantar pressure shifted to the medial aspect of the midfoot in the trail limb, indicating a reduction in control and a higher injury risk during non-dominant lunge tasks.

Badminton Injuries in Elite Athletes: A Review of Epidemiology and Biomechanics

Badminton is a popular sport in India and with multiple medal prospects will be closely followed at the Tokyo 2020 Olympics. Considered the fastest of the racquet sports, players require aerobic stamina, agility, strength, speed, and precision, besides requiring good motor coordination and complex racquet movements. Injuries in badminton are common despite it not being a contact sport, and include overuse injuries, and acute traumatic events. The game is physically challenging and demands complex repetitive upper and lower extremity movements with constant postural variations and poses a high risk of overuse injuries to both the appendicular and axial musculoskeletal systems. Badminton also necessitates short bursts of movement with sudden sharp changes in direction, which places players at risk of non-contact traumatic injuries to joints and muscle-tendon units. Preventing injuries and decreasing time away from training and competition are critical in an elite badminton player's sporting career. This analytical review identifies the incidence, severity, and profile of badminton injuries in elite players, and discusses the biomechanical basis of these injuries.

Beneficial effects of a negative ion patch on eccentric exercise-induced muscle damage, inflammation, and exercise performance in badminton athletes

Complementary and alternative medicines (CAMs) are widely applied and accepted for therapeutic purposes because of their numerous benefits. Negative ion treatment belongs to one of the critical categories defined by the National Center for CAM, with such treatment capable of air purification and ameliorating emotional disorders (e.g., depression and seasonal affective disorder). Negative ions can be produced naturally and also by a material with activated energy. Exercise-induced muscle damage (EIMD) often occurs due to inadequate warm up, high-intensity exercise, overload, and inappropriate posture, especially for high-intensive competition. Few studies have investigated the effects of negative ion treatment on muscular injury in the sports science field. In the current study, we enrolled badminton athletes and induced muscle damage in them through eccentric exercise in the form of a high-intensity squat program. We evaluated the effects of negative ion patches of different intensities at three points (preexercise, postexercise, and recovery) by analyzing physiological indexes (tumor necrosis factor [TNF]-α, interleukin [IL]-6, IL-10, creatine kinase [CK], and lactate dehydrogenase [LDH] levels) and performing a functional assessment (a countermovement jump [CMJ] test). We found that a high-intensity negative ion patch could significantly reduce the levels of TNF-α, an injury-associated inflammatory cytokine, and related markers (CK and LDH). In addition, muscular overload-caused fatigue could be also ameliorated, as indicated by the functional CMJ test result, and related muscular characteristics (tone and stiffness) could be effectively improved. Thus, the negative ion treatment could effectively improve physiological adaption and muscular fatigue recovery after EIMD in the current study. The negative ion patch treatment can be further integrated into a taping system to synergistically fulfill exercise-induced damage protection and functional elevation. However, the effects of this treatment require further experimental validation.

Deformation of coracoacromial ligament during overhead movement as an early indicator of subacromial impingement in elite adolescent badminton players

Objectives: Deformation of the coracoacromial ligament during overhead movement has been linked to shoulder pathologies such as impingement and rotator cuff tear. We, therefore, explored this relationship in a group of elite adolescent badminton players.Method: We performed bilateral shoulder physical and ultrasonographic examination in 35 adolescent asymptomatic badminton players, 13 players with unilateral shoulder pain, and 15 non-athletes of similar age. Coracoacromial ligament deformation, defined as the maximal vertical distance between the ligament apex to a line connecting the acromion and coracoid process, was measured during shoulder abduction and internal rotation and compared within and between groups. Other ultrasonographic measurements and the incidence of shoulder pathologies were also evaluated.Result: Among badminton athletes who reported dominant shoulder pain, coracoacromial ligament deformation was significantly larger in their dominant shoulder than in their non-dominant shoulder (3.5 and 2.0 mm, respectively; p = 0.013); this difference was not present in other groups. Regardless of the presence or absence of pain, athletes displayed more coracoacromial ligament deformation and increased supraspinatus tendon thickness in their dominant shoulder than did the control group. Abnormal ultrasound findings were noted in all groups; however, the incidence was not significantly different.Conclusion: Increased coracoacromial ligament deformation during overhead movement is associated with shoulder pain in elite adolescent badminton players. Our findings may help clinicians identify athletes at risk of subacromial impingement syndrome.

Single leg landing movement differences between male and female badminton players after overhead stroke in the backhand-side court

Females showed higher anterior cruciate ligament (ACL) injuries rate on the opposite side of dominant hand compared with males during single leg landing in the backhand-side court after overhead stroke. The purpose of this study was to conduct biomechanics testing including kinematics and kinetics to provide some insights on the ACL injuries risks during single leg landing in the backhand-side court after overhead stroke between females and males. Twenty collegiate badminton players (10 females, 10 males) voluntarily participated in this study. Sagittal plane kinematic and kinetic data of the lower limb, and their ground reaction forces during the single leg landing in the backhand-side court after overhead stroke were collected. Results shown that, at the peak posterior ground reaction force (GRF) moment, the ankle dorsiflexion, knee and hip flexion angles of the female were lower than that of male. Meantime, the knee extension moment of the female was lower than that of males but the hip extension moment of the female was larger compared to males at the peak posterior GRF moment. The peak vertical and posterior GRF of female badminton players were larger than that of males. Decreased hip, knee, and ankle flexion angles at the peak posterior GRF moment and greater peak vertical and posterior GRF may expose female badminton players to the higher risk ACL injuries compared to males during single leg landing after overhead stroke in the backcourt-side. Preventative training programs designed to prevent the ACL injuries rate of female badminton players should take these factors into consideration.

Comparison of Joint Loading in Badminton Lunging between Professional and Amateur Badminton Players

The knee and ankle are the two most injured joints associated with the sport of badminton. This study evaluates biomechanical factors between professional and amateur badminton players using an injury mechanism model. The aim of this study was to investigate the kinematic motion and kinetic loading differences of the right knee and ankle while performing a maximal right lunge. Amateur players exhibited greater ankle range of motion (p < 0.05, r = 0.89) and inversion joint moment (p < 0.05, r = 0.54) in the frontal plane as well as greater internal joint rotation moment (p < 0.05, r = 0.28) in the horizontal plane. In contrast, professional badminton players presented a greater knee joint moment in the sagittal (p < 0.05, r = 0.59) and frontal (p < 0.05, r = 0.37) planes, which may be associated with increased knee ligamentous injury risk. To avoid injury, the players need to forcefully extend the knee with internal rotation, strengthen the muscles around the ankle ligament, and maximise joint coordination during training. The injuries recorded and the forces responsible for the injuries seem to have developed during training activity. Training programmes and injury prevention strategies for badminton players should account for these findings to reduce potential injury to the ankle and knee.

Knocked by the shuttlecock: twelve sight-threatening blunt-eye injuries in Australian badminton players

BACKGROUND

Non-penetrating ocular injuries from badminton shuttlecocks can result in severe damage and life-long complications. This case series highlights the morbidity of such injuries, particularly in regard to post-traumatic glaucoma.

METHODS

This is a retrospective case series of 12 patients with shuttlecock-related blunt eye injuries sustained during badminton play without eye protection. By approaching colleagues through conference presentations and networking, the authors have attempted to gather all known cases of shuttlecock ocular injury managed in tertiary ocular emergency departments or private ophthalmological clinics in Victoria and New South Wales, Australia in 2015.

RESULTS

This is the first multicentre case series to describe badminton-related ocular injuries in Australia. Our case series demonstrates, in particular, long-term glaucoma-related morbidity for patients over a large age range (16 to 77 years), with one patient requiring ongoing management 26 years following their initial injury. The cases reported further add to the literature promoting awareness of badminton-related ocular injury.

CONCLUSIONS

We encourage player education and advocacy on badminton-related eye injuries and appropriate use of eye protection to reduce associated morbidity.

The science of badminton: game characteristics, anthropometry, physiology, visual fitness and biomechanics

Badminton is a racket sport for two or four people, with a temporal structure characterized by actions of short duration and high intensity. This sport has five events: men's and women's singles, men's and women's doubles, and mixed doubles, each requiring specific preparation in terms of technique, control and physical fitness. Badminton is one of the most popular sports in the world, with 200 million adherents. The decision to include badminton in the 1992 Olympics Game increased participation in the game. This review focuses on the game characteristics, anthropometry, physiology, visual attributes and biomechanics of badminton. Players are generally tall and lean, with an ectomesomorphic body type suited to the high physiological demands of a match. Indeed, a typical match characteristic is a rally time of 7 s and a resting time of 15 s, with an effective playing time of 31%. This sport is highly demanding, with an average heart rate (HR) of over 90% of the player's maximal HR. The intermittent actions during a game are demanding on both the aerobic and anaerobic systems: 60-70% on the aerobic system and approximately 30% on the anaerobic system, with greater demand on the alactic metabolism with respect to the lactic anaerobic metabolism. The shuttlecock has an atypical trajectory, and the players perform specific movements such as lunging and jumping, and powerful strokes using a specific pattern of movement. Lastly, badminton players are visually fit, picking up accurate visual information in a short time. Knowledge of badminton can help to improve coaching and badminton skills.

Kinetics of Badminton Lunges in Four Directions

The lunge is the most fundamental skill in badminton competitions. Fifteen university-level male badminton players performed lunge maneuvers in four directions, namely, right-forward, left-forward, right-backward, and left-backward, while wearing two different brands of badminton shoes. The test compared the kinetics of badminton shoes in performing typical lunge maneuvers. A force plate and an insole measurement system measured the ground reaction forces and plantar pressures. These measurements were compared across all lunge maneuvers. The left-forward lunge generated significantly higher first vertical impact force (2.34 ± 0.52 BW) than that of the right-backward (2.06 ± 0.60 BW) and left-backward lunges (1.78 ± 0.44 BW); higher second vertical impact force (2.44 ± 0.51 BW) than that of the left-backward lunge (2.07 ± 0.38 BW); and higher maximum anterior-posterior shear force (1.48 ± 0.36 BW) than that of the left-backward lunge (1.18 ± 0.38 BW). Compared with other lunge directions, the left-forward lunge showed higher mean maximum vertical impact anterior-posterior shear forces and their respective maximum loading rates, and the plantar pressure at the total foot and heel regions. Therefore, the left-forward lunge is a critical maneuver for badminton biomechanics and related footwear research because of the high loading magnitude generated during heel impact.

An unusual mechanism of ocular trauma in badminton players: two incidental cases

Badminton is a famous sport usually played without any protective eyewear. Ocular injury from one's own partner in a doubles game, with the shuttlecock, is rare. Two untrained badminton players presented with severe ocular trauma during a smash shot from the partner in a 'doubles' game. Both the players developed blind eye (vision <3/60) in spite of immediate treatment. This article describes an unusual mode of severe blunt trauma with a shuttlecock while playing a 'doubles' game, leading to coup-countercoup injury. In addition, the article highlights the need for awareness of the fatal ocular complications and life-long visual disability, especially in untrained badminton enthusiasts.

An unusual mechanism of ocular trauma in badminton players: two incidental cases

Badminton is a famous sport usually played without any protective eyewear. Ocular injury from one's own partner in a doubles game, with the shuttlecock, is rare. Two untrained badminton players presented with severe ocular trauma during a smash shot from the partner in a 'doubles' game. Both the players developed blind eye (vision <3/60) in spite of immediate treatment. This article describes an unusual mode of severe blunt trauma with a shuttlecock while playing a 'doubles' game, leading to coup-countercoup injury. In addition, the article highlights the need for awareness of the fatal ocular complications and life-long visual disability, especially in untrained badminton enthusiasts.

Evidence of accumulated stress in Achilles and anterior knee tendons in elite badminton players

Tendon-related injuries are a major problem, but the aetiology of tendinopathies is unknown. In tendinopathies as well as during unaccustomed loading, intra-tendinous flow can be detected indicating that extensive loading can provoke intra-tendinous flow. The aim of present study is to evaluate the vascular response as indicated by colour Doppler (CD) activity in both the Achilles and patella tendon after loading during high-level badminton matches. The Achilles tendon was subdivided into a mid-tendon, pre-insertional, and insertional region and the anterior knee tendons into a quadriceps-, patella- and tuberositas region. Intra-tendinous flow was measured using both a semi-quantitative grading system (CD grading) and a quantitative scoring system (CF) on colour Doppler. Intra-tendinous flow in the Achilles and anterior knee tendons was examined in fourteen single players before tournament and after 1st and 2nd match, respectively on both the dominant and non-dominant side. All players had abnormal intra-tendinous flow (Colour Doppler ≥ grade 2) in at least one tendon in at least one scan during the tournament. At baseline, only two of the 14 players had normal flow in all the tendons examined. After 1st match, tendencies to higher intra-tendinous flow were observed in both the dominant patella tendon and non-dominant quadriceps tendon (P-values n.s.). After 2nd match, intra-tendinous flow was significant increased in the dominant patella tendon (P = 0.009). In all other locations, there was a trend towards a stepwise increase in intra-tendinous flow. The preliminary results indicate that high amount of intra-tendinous flow was found in elite badminton players at baseline and was increased after repetitive loading, especially in the patella tendon (dominant leg). The colour Doppler measurement can be used to determine changes in intra-tendinous flow after repetitive loading.

Penetrating missile-type head injury from a defective badminton racquet

Injuries occurring during badminton are rarely serious and primarily involve the lower extremities. We report an instance wherein a patient suffered serious brain injury related to playing with a defective badminton racquet. The possibility of similar injuries following the separation of the racquet head and shaft from the handle needs to be disseminated.

Bilateral ground reaction forces and joint moments for lateral sidestepping and crossover stepping tasks

Racquet sports have high levels of joint injuries suggesting the joint loads during play may be excessive. Sports such as badminton employ lateral sidestepping (SS) and crossover stepping (XS) movements which so far have not been described in terms of biomechanics. This study examined bilateral ground reaction forces and three dimensional joint kinetics for both these gaits in order to determine the demands of the movements on the leading and trailing limb and predict the contribution of these movements to the occurrence of overuse injury of the lower limbs. A force platform and motion-analysis system were used to record ground reaction forces and track marker trajectories of 9 experienced male badminton players performing lateral SS, XS and forward running tasks at a controlled speed of 3 m·s(-1) using their normal technique. Ground reaction force and kinetic data for the hip, knee and ankle were analyzed, averaged across the group and the biomechanical variables compared. In all cases the ground reaction forces and joint moments were less than those experienced during moderate running suggesting that in normal play SS and XS gaits do not lead to high forces that could contribute to increased injury risk. Ground reaction forces during SS and XS do not appear to contribute to the development of overuse injury. The distinct roles of the leading and trailing limb, acting as a generator of vertical force and shock absorber respectively, during the SS and XS may however contribute to the development of muscular imbalances which may ultimately contribute to the development of overuse injury. However it is still possible that faulty use of these gaits might lead to high loads and this should be the subject of future work. Key pointsGround reaction forces and joint moments during lateral stepping are smaller in magnitude than those experienced during moderate running.Force exposure in SS and XS gaits in normal play does not appear to contribute to the development of overuse injuryThe leading and trailing limbs perform distinct roles, acting as a generator of vertical force and shock absorber respectively.This distinct contribution may contribute to the development of muscular imbalances which may ultimately contribute to the development of overuse injury.

Epidemiology of Injuries in Hong Kong Elite Badminton Athletes

This study retrospectively reviewed the injury epidemiology on 44 Hong Kong elite badminton players in 2003. Team training records were reviewed to retrieve the training and competition hours, while the medical records from the physiotherapy department were reviewed to obtain information regarding injuries. A total of 253 injuries (128 recurrent and 125 new injuries) were recorded, which accounted for an overall incidence rate of 5.04 per 1,000 player hours. Elite senior athletes had a higher incidence rate of recurrent injuries, while elite junior and potential athletes had a higher incidence rate of new injuries. A total of 1,219 visits (4.82 per athlete) to the physiotherapy department were recorded, which cost HK$487,600 (HK$1,928 per injury). Most new injuries were strain (80 injuries), and the most frequently injured body sites were the back (17 injuries), the shoulder (15 injuries), the thigh (15 injuries), and the knee (15 injuries). One-sided exact test showed that a previous injury experience significantly associated with the occurrence of new injury.

Ultrasonographic investigation of the Achilles tendon in elite badminton players using color Doppler

BACKGROUND

The most frequent injuries in badminton players are in the lower extremities, especially in the Achilles tendon.

HYPOTHESIS

The game of badminton may be related to abnormal intratendinous flow in the Achilles tendon as detected by color Doppler ultrasound. To a certain extent, this blood flow might be physiological, especially when examined after match.

STUDY DESIGN

Cohort study (prevalence); Level of evidence, 3.

METHODS

Seventy-two elite badminton players were interviewed regarding Achilles tendon pain (achillodynia) in the preceding 3 years. Color Doppler was used to examine the tendons of 64 players before their matches and 46 players after their matches. Intratendinous color Doppler flow was graded from 0 to 4. The Achilles tendon was divided into dominant (eg, right side for right-handed players and vice versa) and nondominant side and classified as midtendon, preinsertional, and calcaneal areas.

RESULTS

Of 72 players, 26 had experienced achillodynia in 34 tendons, 18 on the dominant side and 16 on the nondominant side. In 62% of the players with achillodynia, the problems had begun slowly, and the median duration of symptoms was 4 months (range, 0-36 months). Thirty-five percent had ongoing pain in their tendons for a median duration of 12 months (range, 0-12 months). Achillodynia was not associated with the self-reported training load or with sex, age, weight, singles or doubles players, or racket side. Forty-six players were scanned before and after match. At baseline, color Doppler flow was present in the majority of players, and only 7 (16%) players had no color Doppler flow in either tendon. After match, all players had some color Doppler flow in 1 or both tendons. Achillodynia and color Doppler flow were related in the nondominant Achilles tendon (chi-square, P = .008). The grades of Doppler flow also increased significantly after match in the preinsertional area in both the nondominant (P = .0002) and dominant (P = .005) side tendons.

CONCLUSION

A large proportion of the players had experienced achillodynia and habitually played with a degree of pain that demanded medication. The self-reported pain was associated with increased intratendinous color Doppler flow in the nondominant Achilles tendon. Doppler flow was found in most players before and in all players after the match and therefore may in part be a physiological response to activity.

Shoulder pain -- a common problem in world-class badminton players

Badminton is a sport that requires a lot of over-shoulder motion, with the shoulder in abduction/external rotation. This questionnaire study on 188 international top-level badminton players during the World Mixed Team Championships showed that previous or present shoulder pain on the dominant side was reported by 52% of the players. Previous shoulder pain was reported by 37% of the players and on-going shoulder pain by 20% of the players. There were no significant differences in the prevalence of shoulder pain between men and women. The majority of the shoulder pain had started gradually. The pain was usually associated with shoulder activity, and stiffness was a common, associated symptom. Furthermore, the shoulder pain was associated with consequences such as sleeping disturbances, changes in training and competition habits, and it also affected activities of daily living. The majority of the players had sought medical advice and had been given different kinds of treatment. The study showed that shoulder pain is a common and significant problem in world-class badminton players, and the consequences are most likely of importance for their training and playing capacity.

Decreased shoulder function and pain common in recreational badminton players

The aim of this study was to describe the prevalence and consequences of painful conditions in the shoulder region in recreational badminton players. A questionnaire study was performed on 99 players, of whom 57 were also assessed with Constant score. Previous or present pain in the dominant shoulder was reported by 52% of the players. Sixteen percent of the players had on-going shoulder pain associated with badminton play. A majority of these players reported that their training habits were affected by the pain. Total Constant score was lower in the painful shoulders. Furthermore, range of active pain-free shoulder abduction was decreased. However, isometric shoulder strength test showed no differences when compared with pain-free shoulders. Even though the pain caused functional problems, the players were still playing with on-going symptoms. The diagnoses were mostly unknown, although history and clinical tests indicate problems resembling subacromial impingement.

The severity of sports injuries

In order to assess the extent of the sports injury problem, it is necessary to identify both the incidence and severity of sports injuries. In the literature, the severity of sports injuries is usually described on the basis of 6 criteria: (i) nature of sports injury; (ii) duration and nature of treatment; (iii) sporting time lost; (iv) working time lost; (v) permanent damage; and (vi) monetary cost. It is important to include information on the severity of injuries in a sports injury registration system. This kind of information will help to set targets for preventive strategies. The more severe the injuries sustained, the higher the priority will be to prevent these injuries regardless of the injury incidence. When assessing injury severity one should take into account that, in order to enhance the comparability of research data, uniform definitions are also important in this area of sports injury surveillance. This paper briefly discusses the 6 criteria used to describe the severity of sports injuries.

Badminton injuries--a prospective epidemiological and socioeconomic study

During a 1-year period 100 badminton players were registered and treated in the casualty ward of Randers City Hospital, Denmark. The injuries to the badminton players constituted 5% of all sports injuries registered during the same period in the casualty ward. At follow-up questionnaires were sent to all participants. Replies were received from 89 patients. Over the same period all sports participants in the hospital catchment area (30,254) were registered according to their sport affiliation (2620 badminton players-1650 men and 970 women). Of those injured 58% were men (mean age 31 years) and 42% were women (mean age 25 years). Of the injuries 55% occurred in club players, the remainder occurring during company and school sports activities. The active players were classified into three groups according to age: Group 1 under 18 years (31%); Group 2 18-25 years (16%); Group 3 more than 25 years (53%). According to the Abbreviated Injury Scale (AIS) 17% of the injuries were classified as minor, 56% as moderate, and 27% as severe, respectively. Of the severe injuries (AIS = 3) 56% were found in the oldest age group. AIS correlated with time absent from sport (P < 0.001). Nine players (9%) reported that earlier injuries had influenced the actual accident. Most players (96%) trained one to three times a week. Sprains were the injury most commonly diagnosed (56%), fractures accounted for 5%, torn ankle ligaments were found in 10%, and 13% had ruptures to the Achilles tendon. Overall, 21% were admitted to hospital. None of the patients treated as inpatients was kept in hospital for more than 7 days. The injury caused 56% of players to be absent from work of whom 23% were absent for more than 3 weeks. After the injury 12% of the players gave up their sport, and only 4% restarted their training/sport within 1 week. As many as 28% had to avoid training and playing in matches for 8 weeks or more.

Incidence, severity, aetiology and prevention of sports injuries. A review of concepts

Notwithstanding the healthy influence of sporting activities on risk factors, in particular those of cardiovascular disease, it is becoming increasingly apparent that sports can present a danger to health in the form of sports injuries. The extent of the sports injury problem calls for preventative action based on the results of epidemiological research. For the interpretation of these facts uniform definitions are needed and limitations of research designs should be known. Measures to prevent sports injuries form part of what is called the 'sequence of prevention'. Firstly the extent of the sports injury problem must be identified and described. Secondly the factors and mechanisms which play a part in the occurrence of sports injuries have to be identified. The third step is to introduce measures that are likely to reduce the future risk and/or severity of sports injuries. This measure should be based on the aetiological factors and the mechanism as identified in the second step. Finally the effect of the measures must be evaluated by repeating the first step. In this review some aspects of the first and second step of the sequence of prevention are discussed. The extent of the sports injury problem is often described by injury incidence and by indicators of the severity of sports injuries. Sports injury incidence should preferably be expressed as the number of sports injuries per exposure time (e.g. per 1000 hours of sports participation) in order to facilitate the comparability of research results. However, one should realise that the outcome of research applying this definition of sports injury incidence is highly dependent on the definitions of 'sports injury' and 'sports participation'. The outcome of such research also depends on the applied research design and research methodology. The incidence of sports injuries depends on: the method used to count injuries (e.g. prospective vs retrospective); the method used to establish the population at risk; and on the representativeness of the sample. Severity of sports injuries can be described on the basis of 6 criteria: the nature of the sports injury; the duration and nature of treatment; sporting time lost; working time lost; permanent damage; and cost. Here also uniform definitions are important and necessary in order to enhance the comparability of research data. In the second step of the 'sequence of prevention' the aetiological factors that play a role in the occurrence of a sports injury have to be identified by epidemiological studies. Epidemiological research on the aetiology of sports injuries requires a conceptual model.(ABSTRACT TRUNCATED AT 400 WORDS)

Badminton injuries

In a one year period, from 1 January 1986 to 31 December 1986, 4303 patients with sports injuries were treated at Aarhus Amtssygehus and Aarhus Kommunehospital. The mean age was 21.6 years (range 7-72 years) and 2830 were men. Two hundred and seventeen badminton injuries occurred in 208 patients (136 men) with a mean age of 29.6 years (range 7-57 years), constituting 4.1 percent of all sport injuries in Aarhus. Joints and ligaments were injured in 58.5 percent of the patients, most frequently located in the lower limb and significantly more often among patients younger than 30 years of age. Muscle injury occurred in 19.8 percent of the patients. This type of injury was significantly more frequent among patients older than 30 years of age. Most injuries were minor. However, 6.8 percent of the patients were hospitalized and 30.9 percent received additional treatment by a physician. As the risk of injury varies with age, attempts to plan training individually and to institute prophylactic measures should be made.

Injuries in badminton

Though badminton is one of the most widely played sports in the world, it has received little sports medical interest. Based on the few existing studies on injuries in badminton, compared to other sports it is of relatively low risk and dominated by overuse injuries. The injury duration is relatively long, but only a few working days are lost. Anatomically, most injuries are localised to the foot and ankle. The single most frequent injuries are Achilles tendinitis and tennis elbow. Rupture of the Achilles tendon is a rare injury, which is typically seen in older recreational players. When the time of exposure is taken into account men are found to have a higher injury risk than women, and recreational players a higher injury risk than elite players. In contrast to most other sports the relative injury risk is higher during training than in competition. Based on suggested causes of injury and injury mechanisms, together with the known injury pattern in badminton the following preventive matters are suggested: (a) changes in the badminton shoe, towards a higher heel, with shock absorption and a stiffer anatomically fitting heel counter; (b) adjustment of the friction between the individual shoe-soles and playing surfaces; and (c) specific badminton training including stretching and strengthening of the triceps surae and the muscles involved in the internal and external rotation of the shoulder and elbow during the badminton strokes.

Racquet sports--patterns of injury presenting to a sports injury clinic

In an 8-year retrospective study, 631 injuries due to the racquet sports of squash (59%), tennis (21%) and badminton (20%) were seen in a sports injury clinic, males predominating (58 to 66%). The proportion of squash injuries was higher than expected and probably relates to higher physical stress and risk of contact in this sport. Also they occurred mainly in persons over 25 years (59%) i.e. the reverse for sport in general. Acute traumatic injuries were seen especially in squash players, a majority affecting the knee, lumbar region, muscles and ankle. Tennis injuries differed most with lateral epicondylitis, patello-femoral pain and lumbar disc prolapse being relatively common. The badminton injury pattern overlapped the others. Lower limb injuries predominated in all three. Detailed assessment of 106 cases showed many to be new, infrequent, social players. Poor warm-up was a common factor in new and established players. The importance of these findings is discussed.

Serious eye injury in badminton players

Serious eye injury can occur in badminton players and may become more frequent. The causes and nature of such injuries in this sport in six patients are discussed. All were playing competitive doubles matches. Penetrating eye injury due to a shattered glass spectacle lens occurred. Players should be advised not to wear spectacles with glass lenses. Ocular protection in this sport is desirable, and the forward player should hold the racket in front of the face.

The risks of exercise: a public health view of injuries and hazards

Relatively little is known about the incidence of the risks facing those who exercise regularly. Clinical reports suggest a variety of musculoskeletal ailments, and several pathophysiologic conditions may result from the various aerobic activities most likely to be pursued by large parts of the U.S. population. But adequate epidemiologic data are scarce. Careful epidemiologic studies are needed to develop incidence information.

Athletes attending a sports injury clinic--a review

In a prospective study over the two years 1981-1982, there were 1186 separate sporting injuries treated at a Sports Injury Clinic. Just over 75% of patients were aged between 16 and 25 years old, while 80% were male. Football, Rugby, Running, Squash and Rowing contributed over 70% of these injuries. The commonest injuries were to the lower limb and lumbar region. In 43% of knee injuries there was strain of the collateral ligaments, while another 26% had patello-femoral pain. Short distance running was associated with an increase in shin splints, tibial stress fractures and hamstring injuries. Long distance running was associated with an increase in ankle and foot injuries. Sports Injury Clinics can benefit the injured athlete and there appears to be a need for their development in major hospitals.