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Merrigan JJ, Stone JD, Kraemer WJ, Vatne EA, Onate J, Hagen JA. Female National Collegiate Athletic Association Division-I Athlete Injury Prediction by Vertical Countermovement Jump Force-Time Metrics. J Strength Cond Res 2024; 38:783-786. [PMID: 38513181 DOI: 10.1519/jsc.0000000000004758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
ABSTRACT Merrigan, JJ, Stone, JD, Kraemer, WJ, Vatne, EA, Onate, J, and Hagen, JA. Female National Collegiate Athletic Association Division-I athlete injury prediction by vertical countermovement jump force-time metrics. J Strength Cond Res 38(4): 783-786, 2024-Vertical countermovement jump (CMJ) assessments on force plates have been purported to screen for musculoskeletal injury risk (MSKI) but with little scientific support. Thus, this study aimed to identify associations and noncontact lower-body injury predictability with CMJ force-time metrics in female athletes. The study entailed a retrospective analysis of routine injury and performance monitoring from 155 female National Collegiate Athletics Association Division I athletes. Noncontact lower-body injuries included in analysis were confirmed by medical staff, occurred during competition or training, resulted in time loss from training, and occurred within 3 months following CMJ testing (2 maximal effort, no arm swing, jumps on dual force plates). A total of 44 injuries occurred within 3 months following CMJ baseline testing and resulted in an average of 24.5 missed days from training. Those who sustained an injury were more likely to sustain another injury (15 of 44 injuries [33.1%]; odds ratio = 3.05 [95% CI = 1.31-6.99]). For every 1-unit increase from the mean in eccentric mean power and minimum eccentric force, there was a decrease in odds of sustaining a MSKI. Despite high overall model accuracy (85.6%), the receiving operating characteristic area under the curve (65.9%) was unacceptable and the true positive rate (recall) was 0.0%. Thus, no injuries in the testing data set were correctly classified by the logistic regression model with CMJ force-time metrics as predictors. Baseline CMJ assessment may not be useful for noncontact lower-body musculoskeletal injury screening or predictability in National Collegiate Athletics Association female athletes.
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Affiliation(s)
- Justin J Merrigan
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio
| | | | - William J Kraemer
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | - Emaly A Vatne
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio
| | - James Onate
- James Crane Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio; and
- Division of Athletic Training, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio
| | - Josh A Hagen
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio
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Cattaneo M, Ramponi C, Thorborg K. What is the Injury Incidence and Profile in Professional Male Ice Hockey? A Systematic Review. Int J Sports Phys Ther 2024; 19:1398-1409. [PMID: 38179586 PMCID: PMC10761628 DOI: 10.26603/001c.90591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/17/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Professional male ice hockey is characterized by a congested in-season match schedule and by different scenarios where the whole body is exposed to great internal and external forces. Consequently, injuries occur from head to toe. However, there is a lack of data synthesis regarding the injury incidence and profile in this population. PURPOSE The aim of this study was to conduct a systematic review to quantify the injury incidence rates in professional male ice hockey. STUDY DESIGN Systematic Review. METHODS The electronic databases PubMed, CINAHL, Web of Science, ProQuest-Sport medicine & Education Index, and Pro-Quest Dissertation and Thesis were searched utilizing terms related to ice hockey and injuries. Studies were included if they provided the incidence of injury in professional male hockey players and reported injuries in terms of time lost. The modified Newcastle Ottawa Scale for cohort studies and the Strengthening the Reporting of Observational Studies in Epidemiology - Sports Injury and Illness Surveillance Statement were used to assess the methodological quality of the studies. RESULTS Eleven studies were included in the review. Match injury incidence ranged from 38 to 88.6 injuries/1000 hours of exposure, whereas training injury incidence varied from 0.4 to 2.6 injuries/1000 hours of exposure. Injuries of traumatic origin accounted for 76% to 96.6% of all injuries, with contusions and lacerations being the most common. Severe injuries accounted for 7.8% - 20% of all injuries. The lower extremities were the most susceptible to injury, comprising 27% to 53.7% of all reported injuries. CONCLUSION Professional male ice hockey players are exposed to a substantial risk of injury during competitions, with lower extremities being the most commonly affected body part. The majority of injuries are traumatic and severe injuries account for a notable portion of overall injury cases.
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Affiliation(s)
- Marco Cattaneo
- DEASS University of Applied Sciences and Arts of Southern Switzerland
- Hockey Club Lugano, Switzerland
| | - Carlo Ramponi
- Physiotherapy Università Campus Bio-Medico
- Physiotherapy University of Padua
- Kiné Rehab Center, Treviso, Italy
| | - Kristian Thorborg
- Department of Orthopedic Surgery Copenhagen University Hospital
- Department of Clinical Medicine University of Copenhagen
- Physical Medicine & Rehabilitation Research-Copenhagen Copenhagen University Hospital
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Bailey SJ, Martindale R, Engebretsen L, Robson JP, Palmer D. Epidemiology of International Match Injuries in Scottish Rugby: A Prospective Cohort Study. Int J Sports Med 2023; 44:805-812. [PMID: 37279793 DOI: 10.1055/a-2038-3452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Fifteen-a-side rugby union ("rugby") is a full-contact sport played separately by men and women, with large injury incidences reported previously. Context specific injury surveillance fulfils governing bodies' duty of care to understand risks to player welfare, yet no contemporary match injury epidemiology studies exist for international players in Scotland. The current study therefore aimed to describe the incidence, severity, burden and nature of match injuries sustained by Scotland's men's and women's national teams. A prospective cohort study of injuries recorded in matches across the 2017/18 and 2018/19 seasons was undertaken, with injury and exposure definitions in line with the international consensus for injury surveillance in rugby. Injury incidence was 120.0 (men) and 166.7/1,000 player match hours (women), injury severity was 12.0 (median) and 31.2 days (mean) for men, and 11.0 (median) and 30.2 days (mean) for women. Injury burden was 3,745 (men) and 5,040 days absence/1,000 player match hours (women). Concussion was the most common specific injury for men (22.5/1,000 hours) and women (26.7/1,000 hours). No statistical differences were found for incidence or severity measures between sexes. Injury incidence was greater than recent Rugby World Cup studies. High incidences of concussion reinforces the need for prevention strategies targeting this injury.
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Affiliation(s)
- Stuart John Bailey
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Russell Martindale
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Lars Engebretsen
- Orthopedic Clinic, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
| | - James Peter Robson
- Sport Medicine, Scottish Rugby Union, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Debbie Palmer
- Edinburgh Sports Medicine Research Network, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, United Kingdom of Great Britain and Northern Ireland
- School of Medicine, University of Nottingham School of Medicine, Nottingham, United Kingdom of Great Britain and Northern Ireland
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White CA, O'Connor SJ, Sestak TR, Fox ES, Cagle PJ. Shoulder injuries in ice hockey players: Prevalence, common management, and return to play. J Orthop 2023; 35:145-149. [PMID: 36483481 PMCID: PMC9723655 DOI: 10.1016/j.jor.2022.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Background The sport of ice hockey has reached worldwide popularity, and it continues to grow. With this growth, however, there has also been an increase in the number of injuries related to the high-speed physical nature of the sport. Upper extremity related traumas and maladies are amongst the most commonly experienced injuries in this population of athletes. The objective of this narrative review is to appraise the current literary landscape as to the epidemiology, treatment, and return to play experienced with the most common upper extremity orthopedic injuries related to ice hockey play. Methods PubMed, Google Scholar, and OVID were searched individually using the filtered terms "shoulder", "injury", and "ice hockey". Articles that were published after 2000 were analyzed. Notably, the concepts of athlete sex, compete level, and post injury productivity were explored in detail. Results It is evident in the literature that upper extremity injury rates increased as level of play increased, were more common in males, and occurred more often during in-game situations. Acromioclavicular joint separations, shoulder instability, and clavicle fractures were amongst the most commonly cited ice hockey upper extremity injury presentations; acromioclavicular joint injuries were considered the most common upper extremity injury in ice hockey players. Return to play depends on injury type and severity. Overall, performance decreased upon initial return from injury. Conclusion Ultimately, further research needs to be conducted on shoulder related ice hockey injuries, their prevention, and the accurate management of specific presentations in order to ensure efficient and safe return to play.
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Affiliation(s)
| | | | - Timothy R. Sestak
- University of California San Diego School of Medicine, San Diego, CA, USA
| | - E. Spencer Fox
- University College Dublin School of Medicine, Dublin, Ireland
| | - Paul J. Cagle
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
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Sports-Related Shoulder Injuries Among Female Athletes. Curr Rev Musculoskelet Med 2022; 15:637-644. [PMID: 36469281 PMCID: PMC9789246 DOI: 10.1007/s12178-022-09802-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW The objectives of this review are to explore the recent literature evaluating sports-related shoulder injuries among female athletes. RECENT FINDINGS Recent literature has highlighted sex-related differences in injury trends and patterns among athletes. Increased participation of women in both recreational and professional sports has resulted in increased exposure to injury. While men experience greater rates of shoulder injury overall, women tend to experience more overuse-related injuries. Evidence also suggests women are more susceptible to shoulder laxity and rotator cuff tears. In comparison to their male counterparts, women note poorer function, increased pain, and decreased activity level following shoulder injuries. Women may also be more likely to experience worse outcomes following surgical intervention. Sex-related differences in injury patterns and outcomes results from a combination of molecular and environmental influences, including hormone pathways, shoulder morphology, and differing rates of participation in, and athletic regulations among, certain sports. Sex-related differences occur in how athletes sustain, experience, and recover from sports-related injuries. A comprehensive understanding of sex-related injuries enhances clinical decision making, treatment, and recovery. Further research is needed to clarify sex as an independent variable when evaluating sports-related shoulder injuries.
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Esser T, Gruber C, Bürkner A, Buchmann N, Minzlaff P, Prodinger PM. [Traumatic brain injuries in winter sports : An overview based on the winter sports skiing, snowboarding and ice hockey]. ORTHOPADIE (HEIDELBERG, GERMANY) 2022; 51:920-928. [PMID: 36227361 DOI: 10.1007/s00132-022-04318-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
In winter sports, skiers, snowboarders and ice hockey players have the highest risk of traumatic brain injuries (TBI). In skiing/snowboarding severe TBIs are of concern; in ice hockey, repetitive minor TBIs are frequent. The main causes of TBI in recreational skiing are collisions with trees; in professionals falls due to technical or tactical mistakes are the main causes. In ice hockey 10-15% of all injuries are due to a sports-related concussion (SRC), mostly caused by player-opponent contact. The pathomechanism in TBI is a combination of rotational and linear acceleration during head impact, which causes a diffuse axonal injury. Long-term complications such as neurodegenerative diseases and functional deficits are of relevance. Prevention by wearing helmets is effective, but less effective in TBI/SRC than in focal injuries.
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Affiliation(s)
- T Esser
- Abteilung für Unfallchirurgie und Orthopädie, Krankenhaus Agatharied, Norbert Kerkel Platz, 83734, Hausham, Deutschland
| | - C Gruber
- Abteilung für Unfallchirurgie und Orthopädie, Krankenhaus Agatharied, Norbert Kerkel Platz, 83734, Hausham, Deutschland
| | - A Bürkner
- Abteilung für Unfallchirurgie und Orthopädie, Krankenhaus Agatharied, Norbert Kerkel Platz, 83734, Hausham, Deutschland
| | - N Buchmann
- Abteilung für Unfallchirurgie und Orthopädie, Krankenhaus Agatharied, Norbert Kerkel Platz, 83734, Hausham, Deutschland
| | - P Minzlaff
- Abteilung für Unfallchirurgie und Orthopädie, Krankenhaus Agatharied, Norbert Kerkel Platz, 83734, Hausham, Deutschland
| | - P M Prodinger
- Abteilung für Unfallchirurgie und Orthopädie, Krankenhaus Agatharied, Norbert Kerkel Platz, 83734, Hausham, Deutschland.
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Tanaka MJ, LiBrizzi CL, Rivenburgh DW, Jones LC. Changes in U.S. girls' participation in high school sports: implications for injury awareness. PHYSICIAN SPORTSMED 2021; 49:450-454. [PMID: 33210569 DOI: 10.1080/00913847.2020.1852861] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONTEXT The number of female athletes has grown exponentially since Title IX. However, little data exists on the proportion of women and girls who play each sport. OBJECTIVE To quantify changes in female sports participation in high school sports from 1973 to 2018. DESIGN Retrospective analysis of data from the National Federation of State High School Associations Participation Survey. SETTING US high schools. PARTICIPANTS US high school athletes from 1973 to 2018. MAIN OUTCOME MEASURES Percentage of female participation for each high school sport in 5-year intervals; and changes in rates of participation by player gender and sport at designated intervals. RESULTS From 1973 to 2018, the percentage of high school sports played by girls increased from 24.2% to 42.9% ([95%CI, 18.6,18.8], p < 0.0001). In the 14 sports included in our study, all had an increase in the percentage of female participation between 1973 and 2018. >80% of the increases occurred between 1973 and 1998 for all sports except lacrosse, ice hockey, football, and wrestling. Between 1998 and 2018, the percentage of girls playing each sport increased by less than 5% in all sports, except for ice hockey (11.5%, 95% CI 11.0, 12.0, p < 0.001) and wrestling (7.1%, 95% CI 6.9, 7.1, p < 0.001). CONCLUSIONS Girls' participation in high school sports continues to grow not only in numbers but in the types of sports played. Between 1998 and 2018, the greatest increases were noted in ice hockey and wrestling, which had fewer than 1% female participation before 1998. Physicians providing care for female athletes should be aware of these changes and understand the potential injuries associated with these sports.
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Affiliation(s)
- Miho J Tanaka
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Christa L LiBrizzi
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Dennis W Rivenburgh
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Lynne C Jones
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
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Boltz AJ, Nedimyer AK, Chandran A, Robison HJ, Collins CL, Morris SN. Epidemiology of Injuries in National Collegiate Athletic Association Men's Ice Hockey: 2014-2015 Through 2018-2019. J Athl Train 2021; 56:703-710. [PMID: 34280280 PMCID: PMC8293892 DOI: 10.4085/1062-6050-611-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The National Collegiate Athletic Association has supported men's ice hockey, a distinct sport that mandates high-velocity gamesmanship, since 1974. BACKGROUND Injury surveillance systems are designed to identify evolving injury trends and their temporal qualities. Continual monitoring of collegiate men's ice hockey athletes remains essential. METHODS Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program from 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios (IRR) were used to examine differential injury rates. RESULTS The overall injury rate was 7.65 per 1000 athlete-exposures. Injuries from competition occurred at a rate nearly 7 times that from practice injuries (IRR = 6.54, 95% CI = 6.08, 7.04). The most common specific injury diagnoses were concussions (9.6%), acromioclavicular sprains (7.3%), and medial collateral ligament tears (3.7%). SUMMARY Injury rates by event type and season segment were higher than previously reported. Contusions accounted for nearly a quarter of all injuries, and acromioclavicular sprain rates increased notably across the study period.
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Affiliation(s)
- Adrian J. Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Aliza K. Nedimyer
- Human Movement Science Curriculum and Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
- Curriculum in Human Movement Science, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Hannah J. Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Christy L. Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Sarah N. Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
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Van Pelt KL, Caccese JB, Eckner JT, Putukian M, Brooks MA, Cameron KL, Houston MN, Posner MA, Jackson JC, McGinty GT, Hillis CJ, McAllister TW, McCrea MA, Broglio SP, Buckley TA. Detailed description of Division I ice hockey concussions: Findings from the NCAA and Department of Defense CARE Consortium. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:162-171. [PMID: 33453430 PMCID: PMC7987562 DOI: 10.1016/j.jshs.2021.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/25/2020] [Accepted: 12/29/2020] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Since concussion is the most common injury in ice hockey, the objective of the current study was to elucidate risk factors, specific mechanisms, and clinical presentations of concussion in men's and women's ice hockey. METHODS Ice hockey players from 5 institutions participating in the Concussion Assessment, Research, and Education Consortium were eligible for the current study. Participants who sustained a concussion outside of this sport were excluded. There were 332 (250 males, 82 females) athletes who participated in ice hockey, and 47 (36 males, 11 females) who sustained a concussion. RESULTS Previous concussion (odds ratio (OR) = 2.00; 95% confidence interval (95% CI): 1.02‒3.91) was associated with increased incident concussion odds, while wearing a mouthguard was protective against incident concussion (OR = 0.43; 95%CI: 0.22‒0.85). Overall, concussion mechanisms did not significantly differ between sexes. There were specific differences in how concussions presented clinically across male and female ice hockey players, however. Females (9.09%) were less likely than males (41.67%) to have a delayed symptom onset (p = 0.045). Additionally, females took significantly longer to reach asymptomatic (p = 0.015) and return-to-play clearance (p = 0.005). Within the first 2 weeks post-concussion, 86.11% of males reached asymptomatic, while only 45.50% of females reached the same phase of recovery. Most males (91.67%) were cleared for return to play within 3 weeks of their concussion, compared to less than half (45.50%) of females. CONCLUSION The current study proposes possible risk factors, mechanisms, and clinical profiles to be validated in future concussions studies with larger female sample sizes. Understanding specific risk factors, concussion mechanisms, and clinical profiles of concussion in collegiate ice hockey may generate ideas for future concussion prevention or intervention studies.
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Affiliation(s)
- Kathryn L Van Pelt
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY 40536-0230, USA.
| | - Jaclyn B Caccese
- College of Medicine School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH 43210, USA
| | - James T Eckner
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI 48108, USA
| | - Margot Putukian
- University Health Services, Princeton University, McCosh Health Center, Princeton, NJ 08544, USA
| | - M Alison Brooks
- Department of Orthopedics and Rehabilitation, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705-2281, USA
| | - Kenneth L Cameron
- Keller Army Hospital, United States Military Academy, West Point, NY 10996, USA
| | - Megan N Houston
- Keller Army Hospital, United States Military Academy, West Point, NY 10996, USA
| | - Matthew A Posner
- Keller Army Hospital, United States Military Academy, West Point, NY 10996, USA
| | - Jonathan C Jackson
- 10th Medical Group, United States Air Force Academy, Colorado Springs, CO 80840-4000, USA
| | - Gerald T McGinty
- Sports Medicine, Athletic Department, United States Air Force Academy, U.S. Air Force Academy, CO 80840-9500, USA
| | - Cameron J Hillis
- Novant Health, Charlotte Independence Soccer Club, Cornelius, NC 28031, USA
| | | | - Michael A McCrea
- Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Thomas A Buckley
- Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
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Abstract
Female athletes are participating in collision sports in greater numbers than previously. The overall incidence of concussion is known to be higher in female athletes than in male athletes participating in similar sports. Evidence suggests anatomic, biomechanical, and biochemical etiologies behind this sex disparity. Future research on female athletes is needed for further guidance on prevention and management of concussion in girls and women.
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Mountjoy M, Moran J, Ahmed H, Bermon S, Bigard X, Doerr D, Lacoste A, Miller S, Weber A, Foster J, Budgett R, Engebretsen L, Burke LM, Gouttebarge V, Grant ME, McCloskey B, Piccininni P, Racinais S, Stuart M, Zideman D. Athlete health and safety at large sporting events: the development of consensus-driven guidelines. Br J Sports Med 2020; 55:191-197. [PMID: 33184113 DOI: 10.1136/bjsports-2020-102771] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 11/04/2022]
Abstract
All sport events have inherent injury and illness risks for participants. Healthcare services for sport events should be planned and delivered to mitigate these risks which is the ethical responsibility of all sport event organisers. The objective of this paper was to develop consensus-driven guidelines describing the basic standards of services necessary to protect athlete health and safety during large sporting events. By using the Knowledge Translation Scheme Framework, a gap in International Federation healthcare programming for sport events was identified. Event healthcare content areas were determined through a narrative review of the scientific literature. Content experts were systematically identified. Following a literature search, an iterative consensus process was undertaken. The outcome document was written by the knowledge translation expert writing group, with the assistance of a focus group consisting of a cohort of International Federation Medical Chairpersons. Athletes were recruited to review and provide comment. The Healthcare Guidelines for International Federation Events document was developed including content-related to (i) pre-event planning (eg, sport medical risk assessment, public health requirements, environmental considerations), (ii) event safety (eg, venue medical services, emergency action plan, emergency transport, safety and security) and (iii) additional considerations (eg, event health research, spectator medical services). We developed a generic standardised template guide to facilitate the planning and delivery of medical services at international sport events. The organisers of medical services should adapt, evaluate and modify this guide to meet the sport-specific local context.
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Affiliation(s)
- Margo Mountjoy
- Bureau-Sport Medicine Liaison, McMaster University Michael G DeGroote School of Medicine, Hamilton, Ontario, Canada .,Medical and Scientific Commission-Games Group-Sport Medicine, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Jane Moran
- Medical and Scientific Commission-Games Group-Sport Medicine, International Olympic Committee, Lausanne, Vaud, Switzerland.,Medical Commission, International Skating Union, Victoria, British Columbia, Canada
| | - Hosny Ahmed
- ADU, International Handball Federation, Basel, Switzerland
| | | | - Xavier Bigard
- Sport Medicine, Union Cycliste Internationale, Aigle, Vaud, Switzerland
| | - Dominik Doerr
- International Weightlifting Federation (IWF), Budapest, Hungary
| | - Alain Lacoste
- Sports Medicine, World Rowing, Lausanne, Vaud, Switzerland
| | - Stuart Miller
- Science & Technical Department, International Tennis Federation, Roehampton, UK
| | | | - Jeremy Foster
- Association of Summer Olympic International Federations (ASOIF), Lausanne, Switzerland
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Louise M Burke
- Nutrition Working Group, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Vincent Gouttebarge
- Mental Health Working Group, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Marie-Elaine Grant
- Medical and Scientific Commission Games Group-Physiotherapy, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Brian McCloskey
- Medical and Scientific Commission-Games Group-Public Health, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Paul Piccininni
- Medical and Scientific Commission-Dental, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Sebastien Racinais
- Medical and Scientific Commission-Games Group Sport Science: adverse weather impact, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - Mark Stuart
- Medical and Scientific Commission Games Group-Pharmacy, International Olympic Committee, Lausanne, Vaud, Switzerland
| | - David Zideman
- Medical and Scientific Commission-Games Group Anaesthesiologist and Emergency Pre-Hospital Care Consultant, International Olympic Committee, Lausanne, Vaud, Switzerland
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Pradeep T, Arun S, Ravipati A, Poudel B, Aradhya A, Pradeep K. Eye injuries in the National Hockey League from 2010 to 2018: an analysis of injury rates, mechanisms, and the National Hockey League visor policy. Can J Ophthalmol 2020; 56:17-23. [PMID: 32919999 DOI: 10.1016/j.jcjo.2020.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/03/2020] [Accepted: 08/13/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We aim to assess the efficacy of widespread visor adoption by assessing eye injury rates during the 2010-2018 seasons. We also compare injury rates, missed games, and financial losses to previously reported data in order to track progress over time. Lastly, we characterize the mechanism and type of eye injuries sustained by National Hockey League (NHL) players to examine risk areas within NHL games. DESIGN We performed a retrospective review of NHL player injuries using official NHL team reports, ProSportsTransactions, and TSN Sports. PARTICIPANTS All NHL players who suffered an eye injury from 2010 to 2018 were included; 31 injuries matched this criterion. METHODS Trends in injuries, missed games, and financial losses over time were analyzed using Pearson's correlation coefficients. Wilcoxon-Mann-Whitney tests were performed to compare our data with eye injury data. Fisher's exact test was performed to assess significance between mechanism and type of eye injury and outcome. RESULTS There were 31 total eye injuries causing 233 missed games and a total of US$8 951 000 in financial losses across the 2010-2018 seasons. There was a strong decrease in the number of eye injuries (r = -0.83, p = 0.01) and a moderate decrease in number of missed games (r = -0.62, p = 0.09). Injuries due to direct puck strikes contributed to over US$6.5 million in financial losses and led to significantly more missed games compared with stick injuries (14.6 vs 4.3). CONCLUSION We tangibly demonstrate the financial and physical effects of recent safety interventions and indicate areas for improved safety in the NHL.
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Affiliation(s)
| | - Siddharth Arun
- Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Bibhav Poudel
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ahimsa Aradhya
- Johns Hopkins University School of Medicine, Baltimore, MD
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Waterworth V, Procyk A, Canetti E, Hing W, Gough S. The influence of education in decision making concerning athlete’s return to sport following a concussion injury: A systematic review. JOURNAL OF CONCUSSION 2020. [DOI: 10.1177/2059700220941985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives Concussions have emerged as one of the most prevalent and controversial injuries sustained within the sporting context. The objective of this review was to determine the influence that education has on decision making concerning athlete’s return to sport following a concussion injury and if the risk is worth it in the eyes of the athletes. Study design Systematic review. Methods A rapid literature review was performed in PubMed, CINAHL, SPORTDiscus, Embase and Web of Science looking for articles that discussed concussions and any three of the four following search terms: (a) decision making, (b) education/knowledge, (c) sport/return to sport and (d) risk. Results Sixteen of 1243 articles were included in this review based on eligibility criteria. Ten were cohort studies, four were cross-sectional studies and two were qualitative research. There was a good agreement between the authors for all studies when determining risk of bias, presenting a Cohen’s κ of 0.901 (95% CI, 0.834, 0.968), p < 0.001. Conclusion Education can make a difference in athlete’s decision making process to return to sport; however, their awareness of the health risks that they put themselves in by returning to sport too soon is clouded by other external and internal factors. What is not fully understood is why do they put themselves at this risk? Further studies should explore athletes’ risk aversion behaviour and how it impacts their decision to return to sport following a concussion.
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Affiliation(s)
- Victoria Waterworth
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Alexander Procyk
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Elisa Canetti
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Wayne Hing
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Suzanne Gough
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
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Crowley SG, Trofa DP, Vosseller JT, Gorroochurn P, Redler LH, Schiu B, Popkin CA. Epidemiology of Foot and Ankle Injuries in National Collegiate Athletic Association Men's and Women's Ice Hockey. Orthop J Sports Med 2019; 7:2325967119865908. [PMID: 31489332 PMCID: PMC6713968 DOI: 10.1177/2325967119865908] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Ice hockey is a high-speed contact sport in which athletes are prone to many different injuries. While past studies have examined overall injury rates in ice hockey, foot and ankle injuries among collegiate ice hockey players have yet to be analyzed. Purpose/Hypothesis: The purpose of this study was to elucidate the epidemiology of foot and ankle injuries among collegiate ice hockey players utilizing data from the National Collegiate Athletic Association (NCAA) Injury Surveillance Program. We hypothesized that male ice hockey players would sustain more injuries compared with female ice hockey players and that the injuries sustained would be more severe. Study Design: Descriptive epidemiology study. Methods: Data on all foot and ankle injuries sustained during the academic years 2004 through 2014 were obtained from the NCAA Injury Surveillance Program. Injury rates, rate ratios (RRs), and injury proportion ratios were reported with 95% CIs. Results: Over the study period, the overall rate of foot and ankle injuries for men was higher than that for women (413 vs 103 injuries, respectively; RR, 4.01 [95% CI, 3.23-4.97]). Injury rates were highest during the regular season for both men (358 injuries; RR, 64.78 [95% CI, 58.07-71.49]) and women (89 injuries; RR, 38.37 [95% CI, 30.40-46.35]) compared with the preseason or postseason. The most common injury in men was a foot and/or toe contusion (22.5%), while women most commonly sustained a low ankle sprain (31.1%). For men, foot and/or toe contusions accounted for the most non–time loss (≤24 hours ) and moderate time-loss (2-13 days) injuries, while high ankle sprains accounted for the most severe time-loss (≥14 days) injuries. For women, foot and/or toe contusions accounted for the most non–time loss injuries, low ankle sprains accounted for the most moderate time-loss injuries, and high ankle sprains accounted for the most severe time-loss injuries. Conclusion: Foot and ankle injuries were frequent among collegiate ice hockey players during the period studied. For men, contusions were the most commonly diagnosed injury, although high ankle sprains resulted in the most significant time lost. For women, low ankle sprains were the most common and resulted in the most moderate time lost. These findings may direct future injury prevention and guide improvements in ice skate design.
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Affiliation(s)
| | - David P Trofa
- Center for Shoulder, Elbow and Sports Medicine, Columbia University, New York, New York, USA
| | - J Turner Vosseller
- Center for Shoulder, Elbow and Sports Medicine, Columbia University, New York, New York, USA
| | | | - Lauren H Redler
- Center for Shoulder, Elbow and Sports Medicine, Columbia University, New York, New York, USA
| | - Brian Schiu
- Center for Shoulder, Elbow and Sports Medicine, Columbia University, New York, New York, USA
| | - Charles A Popkin
- Center for Shoulder, Elbow and Sports Medicine, Columbia University, New York, New York, USA
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15
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Soligard T, Palmer D, Steffen K, Lopes AD, Grant ME, Kim D, Lee SY, Salmina N, Toresdahl BG, Chang JY, Budgett R, Engebretsen L. Sports injury and illness incidence in the PyeongChang 2018 Olympic Winter Games: a prospective study of 2914 athletes from 92 countries. Br J Sports Med 2019; 53:1085-1092. [DOI: 10.1136/bjsports-2018-100236] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2019] [Indexed: 11/03/2022]
Abstract
ObjectiveTo describe the incidence of injuries and illnesses sustained during the XXIII Olympic Winter Games, hosted by PyeongChang on 9–25 February 2018.MethodsWe recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the PyeongChang 2018 medical staff.ResultsIn total, 2914 athletes (1210 women, 42%; 1704 men, 58%) from 92 NOCs were observed for occurrence of injury and illness. NOC and PyeongChang 2018 medical staff reported 376 injuries and 279 illnesses, equalling 12.6 injuries and 9.4 illnesses per 100 athletes over the 17-day period. Altogether, 12% of the athletes incurred at least one injury and 9% at least one illness. The injury incidence was highest in ski halfpipe (28%), snowboard cross (26%), ski cross (25%), snowboard slopestyle (21%) and aerials (20%), and lowest in Nordic combined, biathlon, snowboard slalom, moguls and cross-country skiing (2%–6%). Of the 376 injuries recorded, 33% and 13% were estimated to lead to ≥1 day and >7 days of absence from sport, respectively. The highest incidences of illness were recorded in biathlon (15%), curling (14%), bobsleigh (14%) and snowboard slalom (13%). Thirty per cent of the illnesses were expected to result in time loss, and 70% affected the respiratory system. Women suffered 61% more illnesses than men.ConclusionOverall, 12% of the athletes incurred at least one injury during the Games and 9% an illness, incidences that are similar to the Olympic Winter Games of 2010 and 2014.
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Abstract
CONTEXT Hockey is a skillful contact sport with an elevated injury risk at higher levels of play. An understanding of injury incidence, type, mechanism, and severity at various levels of competition aids the clinician treating these athletes. The purpose of this clinical review is to discuss the epidemiology of hockey injuries at various levels of participation, including youth, high school, junior, college, and professional. EVIDENCE ACQUISITION A literature search was performed by a review of PubMed, Embase, and Cochrane databases and included articles published from 1988 to 2017. Studies were included in this review if determined to be of high quality and containing injury data relevant to the levels of competition. Pertinent data regarding ice hockey injury epidemiology and prevention at various levels of competition were analyzed. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS Youth, high school, junior, college, and professional hockey players have unique injury patterns. Injuries occur much more often in a game compared with a practice, and injury risk increases with each level of competition. Preventative measures, such as mandatory facial protection and delayed body checking in games until age 13 years, are proven strategies to reduce the risk of facial injury and concussion. CONCLUSION An understanding of common injury types and mechanisms according to age and level of play aids the clinician in diagnosis and management. This information can also guide preventative strategies in the areas of education, coaching, rule enforcement, rule modifications, equipment improvement, and sportsmanship.
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Affiliation(s)
| | - Heath P Melugin
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Michael J Stuart
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
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Lynall RC, Mihalik JP, Pierpoint LA, Currie DW, Knowles SB, Wasserman EB, Dompier TP, Comstock RD, Marshall SW, Kerr ZY. The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Ice Hockey (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Men's and Women's Ice Hockey (2004-2005 Through 2013-2014). J Athl Train 2019; 53:1129-1142. [PMID: 30721630 DOI: 10.4085/1062-6050-176-17] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided efforts to collect data on ice hockey injuries. OBJECTIVE To describe the epidemiology of injuries sustained in high school boy's ice hockey in the 2008-2009 through 2013-2014 academic years and collegiate men's and women's ice hockey in the 2004-2005 through 2013-2014 academic years using Web-based surveillance. DESIGN Descriptive epidemiology study. SETTING Online injury surveillance of ice hockey teams of high school boys (annual average = 34), collegiate men (annual average = 20), and collegiate women (annual average = 11). PATIENTS OR OTHER PARTICIPANTS Boys', men's, and women's ice hockey players who participated in practices and competitions during the 2008-2009 through 2013-2014 high school academic years or the 2004-2005 through 2013-2014 collegiate academic years. MAIN OUTCOME MEASURE(S) Athletic trainers collected time-loss (≥24 hours) injury and exposure data. We calculated injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis. RESULTS The High School Reporting Information Online system documented 831 boys' ice hockey time-loss injuries during 356 997 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2611 men's ice hockey time-loss injuries during 552 642 AEs and 752 women's ice hockey injuries during 232 051 AEs. Injury rates were higher in collegiate men than in high school boys during 2008-2009 through 2013-2014 (4.38 versus 2.33/1000 AEs; IRR = 1.88; 95% CI = 1.73, 2.05) and collegiate women during 2004-2005 through 2013-2014 (IRR = 1.46; 95% CI = 1.34, 1.58). Most injuries occurred during competitions (boys = 80.0%, men = 66.9%, women = 55.3%); injury rates were higher in competitions than in practices for boys (IRR = 8.14; 95% CI = 6.87, 9.65), men (IRR = 6.58; 95% CI = 6.06, 7.13), and women (IRR = 3.63; 95% CI = 3.14, 4.19). At all levels, most injuries occurred to the head/face and shoulder/clavicle and resulted in concussions, contusions, or ligament sprains. CONCLUSIONS Injury rates varied across sports but were consistently higher in competitions than in practices. In competitions, concussions were common injuries, highlighting the need for continued development of injury-prevention strategies.
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Affiliation(s)
| | - Jason P Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Lauren A Pierpoint
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora
| | - Dustin W Currie
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora
| | | | - Erin B Wasserman
- Datalys Center for Sports Injury Research and Prevention, Inc, Indianapolis, IN
| | - Thomas P Dompier
- Department of Athletic Training, Lebanon Valley College, Annville, PA
| | - R Dawn Comstock
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora.,Department of Pediatrics, University of Colorado School of Medicine, Aurora
| | - Stephen W Marshall
- Department of Epidemiology, University of North Carolina at Chapel Hill.,Injury Prevention Research Center, University of North Carolina at Chapel Hill
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Injury Prevention Research Center, University of North Carolina at Chapel Hill
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18
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Mountjoy M, Junge A, Budgett R, Doerr D, Leglise M, Miller S, Moran J, Foster J. Health promotion by International Olympic Sport Federations: priorities and barriers. Br J Sports Med 2019; 53:1117-1125. [DOI: 10.1136/bjsports-2018-100202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2019] [Indexed: 12/21/2022]
Abstract
ObjectiveTo identify changes in International Federations’ priorities and the barriers to implementing athlete and global health initiatives. Results should influence the work of the International Federation medical committees, the IOC and the Association of Summer Olympic International Federation.MethodsThe 28 Summer and 7 Winter International Federations participating in the most recent Olympic Games (2016; 2018) were surveyed to (i) identify the importance of 27 health topics, (ii) assess their progress on implementation health-related programmes and (iii) the barriers to implementation of these programmes. We compared International Federations’ activities in 2016 and 2017.ResultsThe response rate was 83%. Health topics which most International Federations regarded as important and in which the International Federations felt insufficiently active were ‘team physician certification’, ‘prevention of harassment and abuse’, ‘eating disorders/disordered eating’, ‘mental health’ and ‘injury surveillance’. Compared with 2016, there was a decrease in International Federations’ activities in ‘injury surveillance’, ‘nutritional supplements’ and ‘hyperandrogenism’. The main barrier to implementing health-related programmes was ‘International Federation political support/willingness’, followed by ‘knowledge’. ‘Time’ and ‘coach support’ were more often reported than ‘finances’, or ‘IOC or Association of Summer Olympic International Federations partnership’.ConclusionIf International Federations are going to promote health of athletes and global health promotion through physical activity (sport), International Federation leadership must change their focus and provide greater political support for related initiatives. Improving coach and athlete knowledge of the health issues could also facilitate health programme delivery. Time constraints could be mitigated by sharing experiences among the International Federations, Association of Summer Olympic International Federations and the IOC. International Federations should focus on those health-related topics that they identified as being important, yet rate as having insufficient activity.
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Epidemiology of Head Injuries Focusing on Concussions in Team Contact Sports: A Systematic Review. Sports Med 2018; 48:953-969. [PMID: 29349651 DOI: 10.1007/s40279-017-0854-4] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although injuries to the head represent a small proportion of all sport injuries, they are of great concern due to their potential long-term consequences, which are even suspected in mild traumatic brain injuries. OBJECTIVE The aim of this review was to compare the incidence of concussions and other head injuries in elite level football, rugby, ice hockey and American Football. METHODS Four electronic databases (CINAHL, PsycINFO, Web of Science, PubMed) were searched. Prospective cohort studies on the incidence of concussion in elite athletes aged 17 years or older that were published in an English-language peer-reviewed journal since 2000 were included. Two authors independently evaluated study eligibility and quality. The extracted data on concussions were pooled in a meta-analysis using an inverse-variance fixed-effects model. The extracted data on head injuries were reported in a narrative and tabular summary. RESULTS The search yielded 7673 results of which 70 articles were included in the qualitative and 47 in the quantitative analysis. In our meta-analysis, we found the highest concussion incidences in rugby match play (3.89 and 3.00 concussions per 1000 h and athletic exposures (AEs), respectively), and the lowest in men's football training (0.01 and 0.08 per 1000 h and AEs, respectively). Overall, concussions and all head injuries were rare in training when compared to match play. Female players had an increased concussion risk in football and ice hockey when compared to male players. CONCLUSION Future research should focus on concussion in women's contact sports, as there is little evidence available in this area. Methodological deficits are frequent in the current literature, especially regarding sample size and study power, and should be avoided.
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20
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Schmitt KU, Muser MH, Thueler H, Bruegger O. Crash-test dummy and pendulum impact tests of ice hockey boards: greater displacement does not reduce impact. Br J Sports Med 2017; 52:41-46. [PMID: 29084724 PMCID: PMC5754856 DOI: 10.1136/bjsports-2017-097735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND One injury mechanism in ice hockey is impact with the boards. We investigated whether more flexible hockey boards would provide less biomechanical loading on impact than did existing (reference) boards. METHODS We conducted impact tests with a dynamic pendulum (mass 60 kg) and with crash test dummies (ES-2 dummy, 4.76 m/s impact speed). Outcomes were biomechanical loading experienced by a player in terms of head acceleration, impact force to the shoulder, spine, abdomen and pelvis as well as compression of the thorax. RESULTS The more flexible board designs featured substantial displacement at impact. Some so-called flexible boards were displaced four times more than the reference board. The new boards possessed less stiffness and up to 90 kg less effective mass, reducing the portion of the board mass a player experienced on impact, compared with boards with a conventional design. Flexible boards resulted in a similar or reduced loading for all body regions, apart from the shoulder. The displacement of a board system did not correlate directly with the biomechanical loading. CONCLUSIONS Flexible board systems can reduce the loading of a player on impact. However, we found no correlation between the displacement and the biomechanical loading; accordingly, displacement alone was insufficient to characterise the overall loading of a player and thus the risk of injury associated with board impact. Ideally, the performance of boards is assessed on the basis of parameters that show a good correlation to injury risk.
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Affiliation(s)
| | | | | | - Othmar Bruegger
- Bfu-Swiss Council for Accident Prevention, Berne, Switzerland
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21
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Åman M, Forssblad M, Larsén K. Incidence and body location of reported acute sport injuries in seven sports using a national insurance database. Scand J Med Sci Sports 2017; 28:1147-1158. [PMID: 28782303 DOI: 10.1111/sms.12956] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 01/14/2023]
Abstract
Sports with high numbers of athletes and acute injuries are an important target for preventive actions at a national level. Both for the health of the athlete and to reduce costs associated with injury. The aim of this study was to identify injuries where injury prevention should focus, in order to have major impact on decreasing acute injury rates at a national level. All athletes in the seven investigated sport federations (automobile sports, basketball, floorball, football (soccer), handball, ice hockey, and motor sports) were insured by the same insurance company. Using this insurance database, the incidence and proportion of acute injuries, and injuries leading to permanent medical impairment (PMI), at each body location, was calculated. Comparisons were made between sports, sex, and age. In total, there were 84 754 registered injuries during the study period (year 2006-2013). Athletes in team sports, except in male ice hockey, had the highest risk to sustain an injury and PMI in the lower limb. Females had higher risk of injury and PMI in the lower limb compared to males, in all sports except in ice hockey. This study recommends that injury prevention at national level should particularly focus on lower limb injuries. In ice hockey and motor sports, head/neck and upper limb injuries also need attention.
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Affiliation(s)
- M Åman
- GIH- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - M Forssblad
- Karolinska Institutet, Stockholm Sports Trauma Research Center, Stockholm, Sweden
| | - K Larsén
- GIH- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
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Abstract
Synopsis The literature pertaining to the rehabilitation of ice hockey players seeking to return to sport after anterior cruciate ligament reconstruction (ACLR) is currently limited. The purpose of this clinical commentary was to present a criterion-based progression for return to ice hockey for athletes after ACLR. First, we review pertinent literature and provide previously published guidelines on general rehabilitation after ACLR. Then, we present a 4-phase, on-ice skating progression with objective criteria to initiate each phase. During the early on-ice phase, the athlete is reintroduced to specific demands, including graded exposure to forward, backward, and crossover skating. In the intermediate on-ice phase, the emphasis shifts to developing power and introducing anticipated changes of direction within a controlled environment. During the late on-ice phase, the focus progresses to developing anaerobic endurance and introducing unanticipated changes of direction, but still without other players or contact. Finally, once objective return-to-sport criteria are met, noncontact team drills, outnumbered and even-numbered drills, practices, scrimmages, and games are progressively reintroduced during the return-to-sport phase. Recommendations for off-ice strength and conditioning exercises complement the on-ice progression. Additionally, we apply the return-to-hockey progression framework to a case report of a female collegiate defensive ice hockey player who returned to sport successfully after ACLR. This criterion-based return-to-hockey progression may guide rehabilitation specialists managing athletes returning to ice hockey after ACLR. J Orthop Sports Phys Ther 2017;47(5):324-333. Epub 29 Mar 2017. doi:10.2519/jospt.2017.7245.
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Pasanen K, Bruun M, Vasankari T, Nurminen M, Frey WO. Injuries during the international floorball tournaments from 2012 to 2015. BMJ Open Sport Exerc Med 2017; 2:e000217. [PMID: 28890804 PMCID: PMC5566261 DOI: 10.1136/bmjsem-2016-000217] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2017] [Indexed: 12/02/2022] Open
Abstract
Background Floorball is a running indoor team sport that has growing popularity worldwide. Some prospective studies have investigated injuries in national floorball leagues, but such studies at the international level are lacking. Objective To investigate the incidence and characteristics of injuries during 12 International Floorball Federation (IFF) events. Methods All top-level IFF events from 2012 to 2015 were included in the study. The IFF events were divided into the following groups: Men’s World Floorball Championships (2012 and 2014), Women’s World Floorball Championships (2013 and 2015), Men’s Champions Cup (2012, 2013, 2014 and 2015) and Women’s Champions Cup (2012, 2013, 2014 and 2015). The team medical personnel prospectively recorded the injuries that occurred in games and practices. The time of exposure was calculated for entire teams based on the IFF statistics. Results Sixty-eight injuries were registered among 67 players. Sixty-five of the injuries occurred in games, resulting in an injury incidence of 21.24 per 1000 game hours (95% CI 16.13 to 26.35). There was no significant difference in the incidence of game injuries between females and males (incidence rate ratio 0.68, 95% CI 0.41 to 1.11). The ankle was the most common site of injury (24%), followed by the head (18%) and the knee (18%). Almost half of the injuries (46%) involved joints or ligaments. Conclusions Risk of injury during IFF tournaments was lower than in many other team sports at the highest level of play. Preventive actions should focus on acute ankle and knee injuries as well as head and face injuries.
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Affiliation(s)
- Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, TampereFinland
| | - Merita Bruun
- International Floorball Federation, HelsinkiFinland
| | | | | | - Walter O Frey
- Balgrist Movemed, Balgrist University Hospital, ZurichSwitzerland
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Steffen K, Moseid CH, Engebretsen L, Søberg PK, Amundsen O, Holm K, Moger T, Soligard T. Sports injuries and illnesses in the Lillehammer 2016 Youth Olympic Winter Games. Br J Sports Med 2016; 51:29-35. [DOI: 10.1136/bjsports-2016-096977] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2016] [Indexed: 11/03/2022]
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Kluczynski MA, Kang JV, Marzo JM, Bisson LJ. Magnetic Resonance Imaging and Intra-articular Findings After Anterior Cruciate Ligament Injuries in Ice Hockey Versus Other Sports. Orthop J Sports Med 2016; 4:2325967116646534. [PMID: 27294167 PMCID: PMC4887880 DOI: 10.1177/2325967116646534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The prevalence of comorbid knee pathology has been examined for sports-related anterior cruciate ligament (ACL) injuries, but it has not been examined in ice hockey players. PURPOSE To compare concomitant bone bruising, collateral ligament injuries, and intra-articular injuries in ACL injuries suffered during ice hockey versus other sports. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS A total of 20 patients with ACL injuries sustained during ice hockey were identified from a prospective registry, of which 95% were male and 90% had a contact mechanism of injury (MOI). Thirteen cases and 46 controls who sustained ACL injuries from ice hockey and other sports, respectively, were included. Inclusion criteria for cases and controls were male sex, contact MOI, no prior knee surgery, magnetic resonance imaging (MRI) within 6 weeks of injury, and surgery within 3 months of injury. Age, body mass index (BMI), MRI findings (bone bruising, medial and lateral collateral ligament [MCL, LCL] injuries), and arthroscopic findings (meniscus tears, chondral injuries) were compared for cases versus controls using t tests or exact chi-square tests. RESULTS Age (22.9 ± 8.8 vs 23.4 ± 10.4 years, P = .88) and BMI ≥25 kg/m(2) (50% vs 65.9%, P = .66) did not differ between cases and controls. Cases had less lateral bone bruising (lateral femoral condyle: 54.6% vs 93%, P = .01; lateral tibial plateau: 72.7% vs 93%, P = .09) and no medial bone bruising (medial femoral condyle: 0% vs 7%, P = .06; medial tibial plateau: 0% vs 32.6%, P = .05) compared with controls. Cases had less frequent lateral meniscus tears than controls (23.1% vs 58.5%, P = .05). There were no significant differences in MCL (40% vs 31.2%, P = .77), LCL (0% vs 3.9%, P > .999), medial meniscus tears (7.7% vs 37%, P = .08), and chondral injuries (10% vs 9.4%, P > .999) for cases versus controls. CONCLUSION Male ice hockey players with ACL injuries had less lateral femoral condyle and medial tibial plateau bone bruising compared with other sports injuries. They also had fewer lateral meniscus tears, and there was a trend toward fewer medial meniscus tears. These differences may reflect different MOIs, or the ability to dissipate energy, for contact ACL injuries that occur during ice hockey versus other sports.
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Affiliation(s)
- Melissa A. Kluczynski
- University at Buffalo, The State University of New York at Buffalo, Buffalo, New York, USA
| | - Jeansol V. Kang
- University at Buffalo, The State University of New York at Buffalo, Buffalo, New York, USA
| | - John M. Marzo
- University at Buffalo, The State University of New York at Buffalo, Buffalo, New York, USA
| | - Leslie J. Bisson
- University at Buffalo, The State University of New York at Buffalo, Buffalo, New York, USA
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