Badminton injuries

Anterior cruciate ligament injuries in elite badminton athletes: 84% Return to sport, half return to performance

PURPOSE

Badminton requires fast and pivoting movements, putting athletes at risk of sustaining an anterior cruciate ligament (ACL) injury. The primary purpose is to investigate the return to sport (RTS) and the return to performance (RTP) after an ACL injury in elite badminton athletes. The secondary purpose is to describe ACL injury mechanisms in elite badminton players.

METHODS

Athletes within the top 200 of the Badminton World Federation World Ranking who sustained an ACL injury between January 2001 and December 2021 were retrospectively included. An anonymous online survey was created in eight languages. RTS, RTP and contributing factors were analysed among athletes aiming to RTP. The injury mechanism was analysed in all participants.

RESULTS

Sixty-six athletes from 32 countries were included. Fifty-seven athletes (86.4%) aimed to RTP. Forty-eight out of 57 (84.2%) did RTS. Twenty-nine (50.9%) managed to successfully RTP. Forty-nine (74.2%) of ACL injuries occurred during a competition, 14 (21.2%) occured during training. Thirty-one (49.2%) occurred in the rear court backhand side and 47 (74.6%) occurred during landing after a jump.

CONCLUSION

Forty-eight out of 57 (84.2%) athletes managed to RTS. Half of the athletes managed to successfully RTP. Most of the ACL injuries occurred during competition, in the rear court backhand side and during landing after a jump.

LEVEL OF EVIDENCE

Level III.

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.

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.

Management of Injury Risk for Continuous Participation in Badminton

The Article Abstract is not available.

Intelligent prediction of lower extremity loadings during badminton lunge footwork in a lab-simulated court

Introduction: Playing badminton has been reported with extensive health benefits, while main injuries were documented in the lower extremity. This study was aimed to investigate and predict the knee- and ankle-joint loadings of athletes who play badminton, with "gold standard" facilities. The axial impact acceleration from wearables would be used to predict joint moments and contact forces during sub-maximal and maximal lunge footwork. Methods: A total of 25 badminton athletes participated in this study, following a previously established protocol of motion capture and musculoskeletal modelling techniques with the integration of a wearable inertial magnetic unit (IMU). We developed a principal component analysis (PCA) statistical model to extract features in the loading parameters and a multivariate partial least square regression (PLSR) machine learning model to correlate easily collected variables, such as the stance time, approaching velocity, and peak accelerations, with knee and ankle loading parameters (moments and contact forces). Results: The key variances of joint loadings were observed from statistical principal component analysis modelling. The promising accuracy of the partial least square regression model using input parameters was observed with a prediction accuracy of 94.52%, while further sensitivity analysis found a single variable from the ankle inertial magnetic unit that could predict an acceptable range (93%) of patterns and magnitudes of the knee and ankle loadings. Conclusion: The attachment of this single inertial magnetic unit sensor could be used to record and predict loading accumulation and distribution, and placement would exhibit less influence on the motions of the lower extremity. The intelligent prediction of loading patterns and accumulation could be integrated to design training and competition schemes in badminton or other court sports in a scientific manner, thus preventing fatigue, reducing loading-accumulation-related injury, and maximizing athletic performance.

The Effect of Ice on Shoulder Proprioception in Badminton Athletes

This study aims to analyze the influence of the application of cryotherapy on shoulder proprioception in badminton athletes. Thirty federated badminton athletes were included in this study, all of whom belonged to three of the teams currently competing in national competitions (Portugal). Their mean ages were 21.00 ± 5.60 years, and their experience in the modality was 8.40 ± 6.93 years. They practiced in an average of 2.93 ± 1.26 training sessions per week. All of them used their right hand to hold the racket. Each participant's dominant shoulder joint position and force senses were evaluated for four consecutive time points through the isokinetic dynamometer Biodex System 3. The experimental procedure consisted of applying ice for 15 min and the control procedure consisted of no therapeutic intervention. The proprioception outcomes were expressed using the absolute error, relative error, and variable error. All statistical analysis was performed using PASW Statistics 18 software (IBM-SPSS Statistics). There were no statistically significant changes in the joint position and force senses after the intervention, as well as during the subsequent 30 min. We conclude that, after this cryotherapy technique, there is no increased risk of injury associated with a proprioception deficit that prevents athletes from immediately returning to badminton practice.

The effects of ankle dorsiflexor fatigue on lower limb biomechanics during badminton forward forehand and backhand lunge

Background: Local muscle fatigue may have an adverse effect on the biomechanics of the lunge movement and athletic performance. This study analyzed the biomechanical indicators of the forward lunge in badminton players before and after fatigue of the ankle dorsiflexors. Methods: Using the isometric muscular strength testing system, 15 badminton players underwent an ankle dorsiflexor fatigue test. Before and after the fatigue experiment, five lunges were done in both the forehand forward (FH) and backhand forward (BH) directions, five in each direction. A Vicon motion capture system and an AMTI force measuring station were used to record lower limb kinematic and ground reaction force (GRF). Pre-fatigue and post-fatigue variability were determined using paired-samples t-tests, Wilcoxon signed rank test, and Statistical Non-parametric Mapping (SNPM). Result: The results showed that after fatigue, the peak angle of ankle dorsiflexion was significantly reduced (p = 0.034), the range of motion (ROM) of the ankle sagittal plane (p = 0.000) and peak angle of ankle plantarflexion (p = 0.001) was significantly increased after forehand landing. After fatigue, ankle inversion was significantly increased after forehand and backhand landings (FH: p = 0.033; BH: p = 0.015). After fatigue, peak knee flexion angles increased significantly (FH: Max: p = 0.000, Min: p = 0.000; BH: Max: p = 0.017, Min: p = 0.037) during forehand and backhand landings and ROM in knee flexion and extension increased (p = 0.009) during forehand landings. Knee inversion range of motion was significantly increased after fatigue (p = 0.024) during forehand landings. Peak hip flexion angle (p = 0.000) and range of motion (p = 0.000) were significantly reduced in forehand landings after fatigue. The mean loading rate (p = 0.005) and the maximum loading rate (p = 0.001) increased significantly during backhand landings after fatigue. Post-fatigue, the center of pressure (COP) frontal offset increased significantly (FH: p = 0.000; BH: p = 0.000) in the forehand and backhand landings. Conclusion: These results indicate that when the ankle dorsiflexors are fatigued, the performance of the forehand is significantly negatively affected, and the impact force of the backhand is greater.

Assessing the Association of Shoulder Pain Risk with Physical Fitness in Badminton Players at National Tournament Level

Background: Shoulder pain which affects sports performance and activities of daily life, is a common musculoskeletal problem experienced by badminton players. Objectives: This study aimed to identify the association of shoulder pain with physical fitness in elite university badminton players participating in the national tournament via medical check-ups. Methods: Physical fitness evaluations were performed among fifty-two 18 - 22 years old university badminton players participating in the national tournament. Handgrip strength, heel buttock distance, angle of straight leg raise, single leg stance, shoulder range of motion, and trunk range of motion were assessed. The prevalence of present shoulder pain was described. Multivariable logistic regression was used to examine the association of present shoulder pain with physical fitness. Results: Sixteen badminton players (30.8%) sustained present shoulder pain related to badminton. Dominant trunk rotation (adjusted OR: 0.91, 95% CI: 0.84 - 0.99, P-value = 0.028) and single leg stance of the nondominant leg (adjusted OR: 0.97, 95% CI: 0.94 - 1.00, P-value = 0.048) were significantly associated with the presence of present shoulder pain. Conclusions: Decreased trunk rotation and deficit in single-leg stance balance might be potential risk factors associated with physical fitness for shoulder pain in university badminton players at national tournament level. These findings can help draw the attention of badminton coaches, players, and team members to facilitate physical fitness promotion for badminton pain/injury prevention.

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.

Prevalence, patterns and factors associated with injury: comparison between elite Malaysian able-bodied and para-badminton players

OBJECTIVES

This study aimed to determine and compare the prevalence, patterns and factors associated with injury between elite Malaysian able-bodied and para-badminton players.

METHODS

Medical records from July 2007 to December 2017 were reviewed.

RESULTS

Among 209 able-bodied players, 1010 injuries were reported. The injuries affected the lower limb (67.2%), sustained during training (94.2%), overuse in nature (38.7%), and involving mostly junior players (62.4%). The injury rate was 94/year, lower than previously reported. Patellar tendinopathy and muscle strain to the upper limb and torso were the commonest. Age, sex and history of injury were predictors of injury. Lower limb injury was a predictor of upper limb and torso injuries, while history of injury to the upper limb and/or torso was a predictor of lower limb injury. Meanwhile, among 18 para-badminton players, 62 injuries were reported from July 2014 to December 2017, which involved the lower limb (45.2%), sustained during training (87.1%), overuse in nature (54.8%), and involved mostly standing-class players (77.8%). The injury rate was 10/year. Patellar tendinopathy, rotator cuff tendinopathy and back muscle strain were the commonest. The patterns of injury (site, occasion and nature) were similar between groups, except for the shoulder where nature was overuse in para-badminton players compared to acute in able-bodied players.

CONCLUSIONS

All players are susceptible to training-related injuries, particularly to the lower limb. Over the last decade, an increase in the injury index for the lower limb and a shift from chronic to acute for the upper limb were observed among able-bodied players. Age, sex and history of injury expose able-bodied players to greater risk. Meanwhile, for para-badminton players, overuse shoulder and knee injuries are commonest. These findings necessitate a comprehensive injury prevention program that encompasses all body regions with an emphasis on the lower limb among elite Malaysian able-bodied and para-badminton players.

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.

Descriptive Epidemiology of Injuries in Professional Speedball Athletes

CONTEXT

Speedball is an increasingly popular racquet sport played in more than 25 countries. Our objective was to describe injury incidence and patterns among Egyptian national-level speedball athletes.

DESIGN

Descriptive epidemiological.

METHODS

We conducted a survey of athletes who were registered with the Egyptian Speedball Federation during the 2018-2019 professional season. The survey inquired about injury types and athlete exposures (AEs). The response rate was 63% (100/160 athletes). Respondent ages ranged from 18 to 41 years. We analyzed demographic characteristics; number, location, and mechanism of injuries; treatment; and speedball participation time lost because of injury.

RESULTS

Of 100 respondents, 65 reported having sustained at least one injury during the season for a total of 90 injuries and a rate of 4.7 injuries per 1000 AEs (95% confidence interval, 3.7 to 5.7). More injuries occurred during practice (77%) than during competition (23%). Thirty percent of respondents reported having missed a competition because of injury. The most frequent anatomic locations of injury were the shoulder (50%; 2.4/1000 AEs), elbow (14%; 0.68/1000 AEs), and low back (9%; 0.4/1000 AEs). The most frequently cited causes of injury were increased intensity of training (40%) and lack of warming up (18%). Seventy-seven percent of injured respondents underwent treatment by a health care professional, and 9% of these respondents underwent surgery.

CONCLUSION

The shoulder was the most common anatomic location for injuries in speedball athletes. Our results suggest that attention should be directed toward sport-specific injury prevention and intervention strategies because speedball is a fast-growing sport in several countries.

Elite Badminton Is Getting Older: Ages of the Top 100 Ranked Badminton Players from 1994 to 2020

The purpose of this study was to determine the evolution of the age of badminton players in the top 100 of the World Ranking for men and women from 1994 to 2020. Data were collected from badminton players participating in the top 100 World Rankings (4800 entries: 1233 players; 595 men and 638 women) from 1994 to 2020. The mean age of the top 100 and the average highest ranking of the players were analysed for both genders. The mean age of the male players in the World Ranking increased from 23.7 ± 3.2 years in 1994 to 26.3 ± 4.4 years in 2020 (p < 0.001) and in female players, from 22.8 ± 3.8 years in 1994 to 24.7 ± 3.3 years in 2020 (p < 0.001). In addition, women recorded a younger age at entry into the top 100 and when reaching their best ranking. Additionally, there has been a clear increase in Asian players in the top 100 of the World Ranking in recent years, reaching over 60%. These data could be used to develop and organise training plans in this sport, optimising and maximising players’ performance.

Epidemiology and pain in elementary school-aged players: a survey of Japanese badminton players participating in the national tournament

Pain is common in athletes which should be well managed. To identify risk factors for shoulder pain, and the association between shoulder pain, lower back pain and knee pain among elementary school-aged badminton players, we conducted a cross-sectional study to collect data of the past year among 611 elementary school age (7-12 years old) badminton players belonging to the Japan Schoolchildren Badminton Federation using a questionnaire. Odds ratio (OR) and 95% confidence interval (CI) were estimated by multivariate logistic regression analysis. The overall incidence rate of shoulder injuries, lower back injuries and knee injuries was 0.38 injuries per 1000 h of badminton training. Players with training time per day > 2.5 h were 2.64 times (95% CI 1.03-6.78, p = 0.043) more likely to sustain shoulder pain than those with training time per day ≤ 2.5 h. A significant association was revealed between shoulder pain and knee pain as well as between lower back pain and knee pain as training hours per day > 2.5 h. Moreover, lower back pain was significantly associated with shoulder pain independent of training hours per day (≤ 2.5 h: p = 0.001; > 2.5 h: p < 0.001). These findings indicate that training time per day is risk factor, and shoulder pain, lower back pain and knee pain were associated with each other in elementary school-aged badminton players.

Evaluation of Shoulder and Knee Isokinetic Strength Profile Among Elite Adolescent Badminton Players

CONTEXT

Badminton continues to be a highly competitive sport where training is introduced at an early age and load has intensified. This exposes players to a greater risk of injuries, in particular when assessing related training outcomes such as strength, agonist-antagonist ratio, and bilateral deficit among adolescents where age- and sex-associated growth and development should be considered.

OBJECTIVE

To evaluate strength profile of the upper and lower limbs among adolescent elite Malaysian badminton players.

DESIGN

Cross-sectional study.

SETTING

Laboratory.

PARTICIPANTS

Forty-eight asymptomatic athletes (24 males and 24 females) were grouped into early and late adolescence (13-14 y old and 15-17 y old, respectively).

MAIN OUTCOME MEASURE(S)

Strength (absolute and normalized) of the external/internal rotators of the shoulder and flexor/extensor of the knee and strength derivatives, conventional strength ratio (CSR), dynamic control ratio (DCR), and bilateral deficits were measured.

RESULTS

Males showed greater strength in all strength indices (P < .05). The older group had greater strength compared to younger for most of the upper and lower limb indices (P < .05); these effects diminished when using normalized data. For females, there was no age group effect in the shoulder and knee strength. All players displayed lower shoulder and knee normative values for CSR and DCR. Dominant and non-dominant knee strength were comparable between sex and age groups.

CONCLUSIONS

For males, growth and maturation had a greater contribution to strength gained compared to training, whereas for females, growth, maturation, and training did not improve strength. The normalized data indicated that training did not improve all indices measured apart from external rotator strength in females. All players also displayed lower normative values of CSR and DCR. These results suggest that training in elite adolescent Malaysian badminton players lacks consideration of strength gain and injury risk factors.

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.

The influence of a badminton competition with two matches in a day on muscle damage and physical performance in elite junior badminton players

To investigate the effects of a badminton competition with 2 matches in a day on hip strength and range of motion (ROM) and exercise-induced muscle damage in elite junior badminton players. Twenty players (age: 17±0.8 years; body mass: 62.9±6.5 kg, height: 173.8±8.9 cm) participated in this study. Passive hip internal (IR) and external rotation (ER), abduction (ABD) and adduction (ADD) hip ROM, isometric hip ADD and ABD muscle strength, countermovement vertical jump (CMJ) height and blood creatine kinase concentration (CK) were measured before and after a badminton competition during an international tournament. Blood samples were collected 24 h after the end of the last match. Compared to baseline values, hip IR and ER ROM were significantly decreased at post-competition in the dominant (IR=-9.0%; p=0.007 and ER=-15.2%; p=0.002) and non-dominant limbs (IR=-9.08%; p=0.004 and ER=-19.4%; p<0.001). In contrast, hip ADD (13.5%; p<0.001) and ABD (14.6%; p<0.001) strength increased significantly after the competition in the dominant limb and ABD strength increased significantly in the non-dominant limb (9.2%; p=0.001). From baseline values, CK increased after the competition (430.1%) and values remained elevated over baseline values 24 h later (160.4%). Although hip muscle strength increased, a badminton competition with two consecutive matches reduced hip ROM and increased blood CK concentration. This study suggests the necessity of investigating recovery strategies after a badminton competition to return hip ROM to basal values before the next day of the competition.

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.

A Biomechanical Analysis of Lower Limb Movement on the Backcourt Forehand Clear Stroke among Badminton Players of Different Levels

Most of the previous studies have been focused on the upper limb biomechanical characteristic in the clear stroke among different level badminton players, but research on the lower limb is limited. The aim of this study is to explore the lower limb kinematics and foot pressure in the backcourt forehand clear stroke among badminton players to give theoretical reference in teaching and answer the questions occurring in the process of learning the actions. Ten professional badminton players (PP) and ten amateur players (AP) were recruited in this study. Plantar pressure analyses indicated that both the PP and the AP were in contact with the ground over the forefoot without the midfoot and heel. The work suggests that when designing professional badminton sports shoes, the designers should focus on strengthening footwear resistance in the metatarsal and forefoot area, especially the first metatarsal area, to meet the requirement of the movement demand and take the badminton movement characteristics in different regions of the design. The peak ankle dorsiflexion, eversion, and internal rotation angle levels of the AP are lower than those of the PP. It is important for the AP group to enhance their ankle strength to prevent injury and improve performance.

Epidemiological Patterns of Alternative Racquet-Sport Injuries in the United States, 1997-2016

Background

Racquet sports have increased in popularity over the past decade. Although research is available regarding the epidemiological characteristics of tennis injuries, little is known about the frequency and characteristics of injuries in other racquet sports.

Hypothesis

Given the increase in all racquet sport participation in the United States (US), it is hypothesized that injuries have accordingly become more frequent.

Study Design

Descriptive epidemiology study.

Methods

Using the National Electronic Injury Surveillance System database, we reviewed the numbers of badminton and squash/racquetball injuries presenting to a representative sample of US emergency departments (EDs). We used weighted estimates to extrapolate the data to the US population. Incidence estimates were compared with national participation data and stratified.

Results

A total of 4330 injuries were reported, representing an estimated 173,000 injuries presenting to US EDs from 1997 through 2016. Despite the increase in the number of players from 2006 through 2016, the annual injury rate for squash/racquetball declined significantly, including the rates for each body region assessed. No similar trend was found for badminton injuries. Within our extrapolated ED cohort, the lower extremities were the most common body region injured (37%). Strains/sprains were the most common injury type in the trunk (73%), lower extremities (65%), and upper extremities (32%), whereas lacerations were most common in the head/neck (49%). In badminton, the youngest players (age range, 5-18 years) sustained twice as many fractures (relative risk [RR], 1.96; 95% CI, 1.14-3.38) and almost 3 times as many lacerations as patients in any other age group. Similarly, the youngest squash/racquetball players were at highest risk for lacerations (RR, 1.45; 95% CI, 1.22-1.73) and head and neck injuries (RR, 1.52; 95% CI, 1.26-1.83).

Conclusion

Although declines in rates of squash/racquetball injuries were observed, the increasing popularity of badminton, squash, and racquetball necessitates further preventive measures to improve player safety, with an emphasis on the youngest players.

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.

Effects of forefoot bending stiffness of badminton shoes on agility, comfort perception and lower leg kinematics during typical badminton movements

This study investigated whether an increase in the forefoot bending stiffness of a badminton shoe would positively affect agility, comfort and biomechanical variables during badminton-specific movements. Three shoe conditions with identical shoe upper and sole designs with different bending stiffness (Flexible, Regular and Stiff) were used. Elite male badminton players completed an agility test on a standard badminton court involving consecutive lunges in six directions, a comfort test performed by a pair of participants conducting a game-like practice trial and a biomechanics test involving a random assignment of consecutive right forward lunges. No significant differences were found in agility time and biomechanical variables among the three shoes. The players wearing the shoe with a flexible forefoot outsole demonstrated a decreased perception of comfort in the forefoot cushion compared to regular and stiffer conditions during the comfort test (p < 0.05). The results suggested that the modification of forefoot bending stiffness would influence individual perception of comfort but would not influence performance and lower extremity kinematics during the tested badminton-specific tasks. It was concluded that an optimisation of forefoot structure and materials in badminton shoes should consider the individual's perception to maximise footwear comfort in performance.

Does shoe heel design influence ground reaction forces and knee moments during maximum lunges in elite and intermediate badminton players?

BACKGROUND

Lunge is one frequently executed movement in badminton and involves a unique sagittal footstrike angle of more than 40 degrees at initial ground contact compared with other manoeuvres. This study examined if the shoe heel curvature design of a badminton shoe would influence shoe-ground kinematics, ground reaction forces, and knee moments during lunge.

METHODS

Eleven elite and fifteen intermediate players performed five left-forward maximum lunge trials with Rounded Heel Shoe (RHS), Flattened Heel Shoe (FHS), and Standard Heel Shoes (SHS). Shoe-ground kinematics, ground reaction forces, and knee moments were measured by using synchronized force platform and motion analysis system. A 2 (Group) x 3 (Shoe) ANOVA with repeated measures was performed to determine the effects of different shoes and different playing levels, as well as the interaction of two factors on all variables.

RESULTS

Shoe effect indicated that players demonstrated lower maximum vertical loading rate in RHS than the other two shoes (P < 0.05). Group effect revealed that elite players exhibited larger footstrike angle, faster approaching speed, lower peak horizontal force and horizontal loading rates but higher vertical loading rates and larger peak knee flexion and extension moments (P < 0.05). Analysis of Interactions of Group x Shoe for maximum and mean vertical loading rates (P < 0.05) indicated that elite players exhibited lower left maximum and mean vertical loading rates in RHS compared to FHS (P < 0.01), while the intermediate group did not show any Shoe effect on vertical loading rates.

CONCLUSIONS

These findings indicate that shoe heel curvature would play some role in altering ground reaction force impact during badminton lunge. The differences in impact loads and knee moments between elite and intermediate players may be useful in optimizing footwear design and training strategy to minimize the potential risks for impact related injuries in badminton.

Ground reaction forces and knee kinetics during single and repeated badminton lunges

Repeated movement (RM) lunge that frequently executed in badminton might be used for footwear evaluation. This study examined the influence of single movement (SM) and RM lunges on the ground reaction forces (GRFs) and knee kinetics during the braking phase of a badminton lunge step. Thirteen male university badminton players performed left-forward lunges in both SM and RM sessions. Force platform and motion capturing system were used to measure GRFs and knee kinetics variables. Paired t-test was performed to determine any significant differences between SM and RM lunges regarding mean and coefficient of variation (CV) in each variable. The kinetics results indicated that compared to SM lunges, the RM lunges had shorter contact time and generated smaller maximum loading rate of impact force, peak knee anterior-posterior force, and peak knee sagittal moment but generated larger peak horizontal resultant forces (Ps < 0.05). Additionally, the RM lunges had lower CV for peak knee medial-lateral and vertical forces (Ps < 0.05). These results suggested that the RM testing protocols had a distinct loading response and adaptation pattern during lunge and that the RM protocol showed higher within-trial reliability, which may be beneficial for the knee joint loading evaluation under different interventions.

A Prospective Epidemiological Study of Injuries in Japanese National Tournament-Level Badminton Players From Junior High School to University

Background:

Injury prevention programs have recently been created for various sports. However, a longitudinal study on badminton injuries, as assessed by a team’s dedicated medical staff, at the gymnasium has not been performed.

Objectives:

We aimed to perform the first such study to measure the injury incidence, severity and type as the first step in creating a badminton injury prevention program.

Patients and Methods:

A prospective, longitudinal survey was conducted between April 2012 and March 2013 with 133 national tournament-level badminton players from junior high school to university in Japan with the teams’ physical therapists at the gymnasium. Injury incidence was measured as the injury rate (IR) for every 1,000 hour (1000 hour) and IR for every 1,000 athlete exposures (1000 AE). Severity was classified in 5 levels by the number of days the athlete was absent from practice or matches. Injury types were categorized as trauma or overuse.

Results:

Practice (IR) (1,000 hour) was significantly higher in female players than in male players; the rates increased with increasing age. IR (1,000 AE) was significantly higher in matches than in practice in both sexes of all ages, except for female junior high school students and injuries were most frequent for high school students in matches. The majority of the injuries were slight (83.8%); overuse injuries occurred approximately 3 times more than trauma.

Conclusions:

This is the first study in which medical staff assessed injuries in badminton, providing value through benchmark data. Injury prevention programs are particularly necessary for female university students in practice and high school students in matches.

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.

Characteristics of Plantar Loads in Maximum Forward Lunge Tasks in Badminton

Background

Badminton players often perform powerful and long-distance lunges during such competitive matches. The objective of this study is to compare the plantar loads of three one-step maximum forward lunges in badminton.

Methods

Fifteen right-handed male badminton players participated in the study. Each participant performed five successful maximum lunges at three directions. For each direction, the participant wore three different shoe brands. Plantar loading, including peak pressure, maximum force, and contact area, was measured by using an insole pressure measurement system. Two-way ANOVA with repeated measures was employed to determine the effects of the different lunge directions and different shoes, as well as the interaction of these two variables, on the measurements.

Results

The maximum force (MF) on the lateral midfoot was lower when performing left-forward lunges than when performing front-forward lunges (p = 0.006, 95% CI = −2.88 to −0.04%BW). The MF and peak pressures (PP) on the great toe region were lower for the front-forward lunge than for the right-forward lunge (MF, p = 0.047, 95% CI = −3.62 to −0.02%BW; PP, p = 0.048, 95% CI = −37.63 to −0.16 KPa) and left-forward lunge (MF, p = 0.015, 95% CI = −4.39 to −0.38%BW; PP, p = 0.008, 95% CI = −47.76 to −5.91 KPa).

Conclusions

These findings indicate that compared with the front-forward lunge, left and right maximum forward lunges induce greater plantar loads on the great toe region of the dominant leg of badminton players. The differences in the plantar loads of the different lunge directions may be potential risks for injuries to the lower extremities of badminton players.

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.

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.

Physiological characteristics of elite and sub-elite badminton players

The aims of this study were to establish the physical and physiological attributes of elite and sub-elite Malaysian male badminton players and to determine whether these attributes discriminate elite players from sub-elite players. Measurements and tests of basic anthropometry, explosive power, anaerobic recovery capacity, badminton-specific movement agility, maximum strength, and aerobic capacity were conducted on two occasions, separated by at least one day. The elite (n = 12) and sub-elite (n = 12) players' characteristics were, respectively: mean age 24.6 years (s = 3.7) and 20.5 years (s = 0.7); mass 73.2 kg (s = 7.6) and 62.7 kg (s = 4.2); stature 1.76 m (s = 0.07) and 1.71 m (s = 0.05); body fat 12.5% (s = 4.8) and 9.5% (s = 3.4); estimated VO(2max) 56.9 ml . kg(-1) . min(-1) (s = 3.7) and 59.5 ml . kg(-1) . min(-1) (s = 5.2). The elite players had greater maximum absolute strength in one-repetition maximum bench press (P = 0.015) compared with the sub-elite players. There were significant differences in instantaneous lower body power estimated from vertical jump height between the elite and sub-elite groups (P < 0.01). However, there was no significant difference between groups in shuttle run tests and on-court badminton-specific movement agility tests. Our results show that elite Malaysian male badminton players are taller, heavier, and stronger than their sub-elite counterparts. The test battery, however, did not allow us to discriminate between the elite and sub-elite players, suggesting that at the elite level tactical knowledge, technical skills, and psychological readiness could be of greater importance.

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.

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.

A systematic review on ankle injury and ankle sprain in sports

This article systematically reviews epidemiological studies on sports injury from 1977 to 2005 in which ankle injury was included. A total of 227 studies reporting injury pattern in 70 sports from 38 countries were included. A total of 201,600 patients were included, with 32,509 ankle injuries. Ankle injury information was available from 14,098 patients, with 11 847 ankle sprains. Results show that the ankle was the most common injured body site in 24 of 70 included sports, especially in aeroball, wall climbing, indoor volleyball, mountaineering, netball and field events in track and field. Ankle sprain was the major ankle injury in 33 of 43 sports, especially in Australian football, field hockey, handball, orienteering, scooter and squash. In sports injuries throughout the countries studied, the ankle was the second most common injured body site after the knee, and ankle sprain was the most common type of ankle injury. The incidence of ankle injury and ankle sprain was high in court games and team sports, such as rugby, soccer, volleyball, handball and basketball. This systematic review provides a summary of the epidemiology of ankle injury in sports.

A systematic review on ankle injury and ankle sprain in sports

This article systematically reviews epidemiological studies on sports injury from 1977 to 2005 in which ankle injury was included. A total of 227 studies reporting injury pattern in 70 sports from 38 countries were included. A total of 201,600 patients were included, with 32,509 ankle injuries. Ankle injury information was available from 14,098 patients, with 11 847 ankle sprains. Results show that the ankle was the most common injured body site in 24 of 70 included sports, especially in aeroball, wall climbing, indoor volleyball, mountaineering, netball and field events in track and field. Ankle sprain was the major ankle injury in 33 of 43 sports, especially in Australian football, field hockey, handball, orienteering, scooter and squash. In sports injuries throughout the countries studied, the ankle was the second most common injured body site after the knee, and ankle sprain was the most common type of ankle injury. The incidence of ankle injury and ankle sprain was high in court games and team sports, such as rugby, soccer, volleyball, handball and basketball. This systematic review provides a summary of the epidemiology of ankle injury in sports.

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.