Injuries in World Cup telemark skiing: a 5-year cohort study

Differences in Injury Profiles Between Female and Male Athletes Across the Participant Classification Framework: A Systematic Review and Meta-Analysis

BACKGROUND

Female sex is a significant determinant of anterior cruciate ligament (ACL) injury. It is not understood if sex is a key determinant of other sports-related injuries.

OBJECTIVE

The aim of this systematic review was to identify where differences in injury profiles are most apparent between the sexes in all sports across the six-tiered participant classification framework.

METHODS

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the 'implementing PRISMA in Exercise, Rehabilitation, Sport medicine and SporTs science'(PERSiST) guidance. The databases PubMed, CINAHL, Web of Science, SPORTDiscus, Medline, Scopus, Cochrane Library and EBSCO were searched from database inception to 24 April 2023. Longitudinal, prospective and retrospective cohort studies and cross-sectional and descriptive epidemiology studies that used standard injury data collection were included. Studies were excluded if injuries were not medically diagnosed and if injuries were not reported and/or analysed by sex. Two reviewers independently extracted data and assessed study quality using the Downs and Black checklist.

RESULTS

Overall, 180 studies were included (8 tier-5, 40 tier-4, 98 tier-3, 30 tier-2, 5 tier-1 studies; one study included data in two tiers). Of those, 174 studies were of moderate quality and six studies were of limited quality. In sex-comparable sports, there was moderate evidence that female athletes had greater risk of knee injury (relative risk (RR) 2.7; 95% CI 1.4-5.5), foot/ankle injuries (RR 1.25; 95% CI 1.17-1.34), bone stress injury (RR 3.4; 95% CI 2.1-5.4) and concussion (RR 8.46; 95% CI 1.04-68.77) than male athletes. Male athletes were at increased risk of hip/groin injuries (RR 2.26; 95% CI 1.31-3.88) and hamstring injuries (RR 2.4; 95% CI 1.8-3.2) compared with females, particularly in dynamic sports. Male athletes were 1.8 (1.37-2.7) to 2.8 (2.45-3.24) times more likely to sustain acute fractures than female athletes, with the highest risk in competition.

DISCUSSION

Most studies in all cohorts were of moderate quality (mean/range of scores tier-5: 17 ± 2.2 [14-20], tier-4: 16.9 ± 1.9 [11-21], tier-3: 16.9 ± 1.5 [11-20], tier-2: 16.3 ± 2.2 [11-20], tier-1 studies: 15.6 ± 1.3 [14-17] out of 28 on the Downs and Black checklist), with only six studies of limited quality. Female athletes' propensity for bone stress injuries highlights opportunities to reinforce development of optimal bone health during adolescence and to outline the effects of energy availability. Earlier strength development and exposure to neuromuscular training programmes and modification of skill development in female athletes may be effective strategies for reducing lower limb injury risk. Key components of neuromuscular training programmes could be beneficial for reducing hip/groin and hamstring injury risk in male athletes. There may be a need for sex-specific prevention and return-to-sport protocols for sports-related concussion in female athletes.

CONCLUSIONS

Female sex was a key determinant of sports-related injuries beyond ACL injury including foot/ankle injury, bone stress injury and sports-related concussion. Male sex was a key determinant of hip/groin, hamstring injury and upper limb injury.

TRIAL REGISTRY

PROSPERO registration number: CRD42017058806 (last updated on 7th June 2023).

[Injuries of the foot and ankle in winter sports]

Winter sports injuries of the foot and ankle are a relevant entity due to the high enthusiasm for alpine skiing and snowboarding. The condition of the footwear and rigidity of the binding have a significant influence on the pathobiomechanics of fracture development and have been shown to influence the frequency of knee and ankle injuries. Foot injuries are rare due to the sport-specific footwear with good padding and frequent hard shell casings.

Injuries in elite women's ski jumping: a cohort study following three International Ski Federation (FIS) World Cup seasons from 2017-2018 to 2019-2020

OBJECTIVES

To define incidence and injury patterns of International Ski Federation (FIS) World Cup (WC) women ski jumpers over three seasons.

METHODS

Ski jump athletes competing in the Women's FIS WC were recruited for prospective injury surveillance from 2017-2018 to 2019-2020. Team representatives recruited the athletes annually and prospectively recorded all injuries requiring medical attention. Retrospective end-of-season interviews corroborated injury surveillance. Medical doctors collected and processed the data. The 4-month competitive season was used to calculate the annual incidence of injuries per 100 athletes per season. Injury type, location, severity and aetiology were reported.

RESULTS

Athletes from 19 nations were enrolled equalling 205 athlete-seasons. Mean age was 21.2 years (SD=3.8). Thirty-nine injury events resulted in 54 total injuries (26.3 injuries/100 athletes/season). Injuries were mostly acute (83%) and occurred on the ski jump hill (78%). The most common injury location was the knee (n=18, 33%). Crash landings were the most common cause of injury events (70%). Nearly half of the acute ski jump injury events occurred in snowy, windy or cloudy conditions (44%) and/or during telemark landings (46%), and most jumps (96%) were shorter than hill size. One third of the injuries were severe, and 78% of severe injuries involved the knee.

CONCLUSION

Acute injury events occur relatively frequently in elite women ski jumpers, most resulting in time-loss from sport and a significant proportion involving serious knee injuries. Crash landing was the leading cause of injury. This baseline information can be used to guide and evaluate future efforts at injury prevention.

Prevalence and Treatment Outcomes of Hand and Wrist Injuries in Professional Athletes: A Systematic Review

BACKGROUND

Injuries to the hand and wrist constitute up to 25% of all athletic injuries, yet not much information is available on the effects of such injuries on the careers of professional athletes. Understanding whether elite athletes can return to sport and at what level has value for athletes, coaches, managers, and others, including athletes at other levels of play.

QUESTIONS/PURPOSES

The purpose of this study was to systematically review the literature on injuries of the hand and wrist in professional athletes to determine the prevalence and types of injuries sustained in professional sports, the management and clinical outcomes of such injuries, and the statistics regarding return to play.

METHODS

A systematic review was conducted of PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials to identify all studies reporting on hand and wrist injuries in professional athletes that were published between January 1970 and April 2019. Inclusion criteria were injuries of the upper extremity distal to the elbow that occurred in professional athletes during athletic competition, English language, and a study cohort consisting of four or more subjects. Details of injury sustained, sport, treatment, clinical outcome, and return to sport were extracted.

RESULTS

We identified 32 nonoverlapping studies involving a total of 4299 hand and wrist injuries. The most common sport studied was baseball (eight studies), followed by football (seven), boxing (six), and basketball (five). Specific injury type was included in 29 of 32 studies and totaled 792 injuries. Metacarpal fractures were the most common injuries (n = 273; 34.5%), followed by thumb collateral ligament injuries (n = 110; 13.9%), phalangeal fractures (n = 87; 11.0%), and scaphoid fractures (n = 56; 7.1%). The overall operative rate was 18.3% (n = 708 of 3867). One-half of the studies reported the return to play (average, 2.8 months; range, 0.5 to 9 months). Seven studies reported sport-specific objective performance measures, with six describing consistent return to preinjury levels of performance among athletes.

CONCLUSIONS

Based on the available evidence, a large majority of hand and wrist injuries in professional athletes are treated conservatively. Athletes frequently return to preinjury levels of performance after surgery. Additionally, return to play after a hand injury appears to be faster than that after other bony injuries. Further research is needed into the impact of these injuries on athletic performance, as well as how surgical intervention affects validated patient-reported outcome measures in professional athletes.

Injuries in elite women's ski jumping: surveillance through the 2017-18 FIS World Cup season

OBJECTIVES

To describe the incidence, type, aetiology and severity of injuries sustained by the International Ski Federation World Cup level female ski jumpers during the 2017-18 season.

DESIGN

Prospective cohort study.

METHODS

Sixty-seven female ski jump athletes from 16 countries were followed throughout the 17-week winter season. Preseason baseline demographic data and injury history were recorded via questionnaire. Prospective biweekly reports and retrospective end-of-season interviews provided data on all injuries requiring medical attention.

RESULTS

Seventeen injuries were recorded, corresponding to an incidence of 25.4 injuries/100 athletes/season. The incidence of time-loss and severe injuries were found to be 17.9 and 4.5, respectively. The knee was the most common site of injury (4/17; 23.5%). Fourteen injuries occurred on the ski jump hill and crash-landing was the most common mechanism of injury (10/14; 71%). Eighty-five per cent of all moderate and severe injuries occurred in snow or windy conditions. Length of jumps resulting in injury averaged 83.7% (95% CI 72.9% to 94.4%) of hill size. Moderate injuries causing 8-28 days absence from training activities were most common (7/17; 41%) and there were three severe injuries necessitating >4 weeks absence.

CONCLUSION

Injuries among elite female ski jumpers are common and the majority are acute, resulting in time loss from training and competition. The knee was the most common site of injury and poor weather conditions may be a risk factor. Future studies are needed to identify risk factors for injury and to guide injury prevention initiatives.

Is a low Functional Movement Screen score (≤14/21) associated with injuries in sport? A systematic review and meta-analysis

Objective

To assess whether Functional Movement Screen (FMS) score is associated with subsequent injuries in healthy sportspeople.

Design

Systematic review and meta-analysis.

Data sources

The following electronic databases were searched to December 2017: Medline, PubMed, PsycINFO, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature, Scopus, Embase, and Physiotherapy Evidence Database.

Eligibility criteria for selecting studies

Eligibility criteria included (1) prospective cohort studies that examined the association between FMS score (≤14/21) and subsequent injuries, (2) a sample of healthy and active participants without restrictions in gender or age, and (3) the OR was the effect size and the main outcome.

Results

Thirteen studies met the criteria for the systematic review and 12 were included in the meta-analysis. In 5 of the 12 studies, and among female athletes in 1 study, FMS score ≤14 out of 21 points was associated with subsequent injuries. The overall OR of the selected studies in the meta-analysis was 1.86 (95% CI 1.32 to 2.61) and showed substantial heterogeneity (I²=70%).

Summary/Conclusion

Whether or not a low FMS score ≤14 out of 21 points is associated with increased risk of injury is unclear. The heterogeneity of the study populations (type of athletes, age and sport exposure) and the definition of injury used in the studies make it difficult to synthesise the evidence and draw definitive conclusions.

Trial registration number

CRD42015015579.

Sports injuries and illnesses during the Granada Winter Universiade 2015

Objective

To analyse the incidence of diseases and injuries suffered by athletes participating in the 27th Winter Sports Universiade held in Granada, Spain.

Methods

The daily occurrence of injuries and diseases was registered at the point of first aid (Borreguiles, 2665 metres above sea level (masl)) and in the clinic of Pradollano (2017 masl), both in Sierra Nevada, as well as in medical services provided by the organising committee of Granada 2015 Universiade and located in sport pavilions in which indoor competitions are held.

Results

A total of 1109 athletes (650 men, 58.61%; 459 women, 41.39%). Nine diseases and 68 injuries were recorded. In total, the rate of injury was 6.13% (7.07% for men and 4.79% for women). The percentage of injury was highest in alpine skiing (10.34%) followed by freestyle skiing (8.62%). In relation to the time of exposure, freestyle skiing showed the shortest time of exposure (0.31 hours) before suffering an injury. Short track speed skating showed the longest exposure (9.80 hours), before suffering an injury. The most common anatomical areas of injury were the head, shoulder and knee (13.23%). Only nine diseases were suffered (four women and five men) of which six were infections, one was a friction burn, one was a lipothymy and one a cluster headache due to height.

Conclusion

In general, 6.13% of the athletes sustained at least one injury and 0.81% a disease, which is a much lower percentage than that recorded in similar events. The incidence of injuries and diseases varied among sport specialities.