Ice hockey injuries in Finland. A prospective epidemiologic study

Injury rate and characteristics in Japanese male professional ice hockey players: prospective study of 60 players over 10 seasons

Objectives

We aimed to assess the injury rate and characteristics in Japanese male professional ice hockey players.

Methods

This study involved an inclusive cohort of male ice hockey players from a Japanese professional team competing in the 2010-2011 through the 2019-2020 seasons. An injury was defined as the 'time-loss and medical attention' definition of the International Ice Hockey Federation. All injuries that occurred during games and practice sessions were recorded daily on injury charts by the team athletic trainers and/or physician. Game-related injury rates were analysed using both the athlete-at-risk (AAR) and time on ice (TOI) methods.

Results

Sixty players were included in the study. A total of 479 injuries were recorded, with 307 (64%) occurring during 451 games and 172 (36%) occurring during the practice sessions. The game-related injury rates obtained using the AAR and TOI methods were not statistically different (p>0.05): 115.3 (95% CI 107.1 to 123.1) and 116.8 (95% CI 109.9 to 124.7) per 1000 player-game hours, respectively. Most injuries involved the upper extremities (39.9% game-related, 32.6% practice-related), followed by the lower extremities (23.5% game-related, 32.5% practice-related). The most frequent mechanism of game-related injury was body checking (45.4%).

Conclusion

We observed a higher injury rate in a Japanese male professional team compared with rates reported in other leagues. The reported injury characteristics should help to improve injury prevention strategies that should target shoulder dislocations caused by body checking, and finger or wrist fractures resulting from contact with a hockey stick or puck impact.

Exploring the Epidemiology of Injuries in Athletes of the Olympic Winter Games: A Systematic Review and Meta-Analysis

This study sought to provide a comprehensive assessment of the incidence of sports injuries among athletes participating in the Olympic Winter Games and to investigate contributing factors. We gathered injury data from athletes participating in the recent four Olympic Winter Games, incorporating details on the sports event, sex, injury location, and type. Through a meta-analysis, we calculated the injury incidence rates for each sport and examined the influence of sex and the type of sport on these incidence rates. Out of 11,197 registered athletes, we documented 1,304 sports injuries. The sports events with the highest injury rates were freestyle skiing, snowboarding, alpine skiing, bobsleigh, and ice hockey, with the most frequent injury locations being the knees, thoracic/lumbar/back regions, and the wrist/hand/fingers. Contusions, hematomas, and bruises were the most prevalent injuries, followed by strains (including muscle rupture, tearing, or tendon rupture) and sprains (covering dislocations, subluxations, and ligament ruptures). In the Olympic Winter Games, events such as freestyle skiing, snowboarding, alpine skiing, bobsleigh, and ice hockey pose a particularly high risk. Predominant injury sites include the knee, spine/back, and wrist and hand, with injuries ranging from contusions and hematomas to strains and sprains. For effective injury prevention, it is crucial to emphasize proper medical resource allocation, specialized training for medical personnel, and meticulous venue maintenance.

The 'Bauer bump:' ice hockey skates as a common cause of Haglund syndrome

Ice hockey is a fast-paced contact sport with a high rate of injury. While many of the injuries are acute and related to high skating speeds, frequent collisions, and sharp skates, the clinician must also be aware of the chronic injuries that commonly arise from playing this sport. The "Bauer bump" is one such chronic injury, which is the onset of Haglund syndrome in ice hockey players occurring in the context of wearing ice hockey skates. With this condition, players notice a bony enlargement of their posterosuperior calcaneus with or without the accompanying symptoms of retrocalcaneal bursitis and insertional Achilles tendinopathy. It is important for clinicians to understand the nature of Haglund syndrome in hockey players so that it can be appropriately diagnosed, managed, and ultimately, prevented.

Injury patterns of non-fatal accidents related to ice hockey, an analysis of 7 years of admission to a Level-1 Emergency Centre in Switzerland

OBJECTIVE

This study was carried out to identify the frequency and types of injuries in adult ice hockey, in order to better understand injury patterns and identify potential areas for injury prevention.

METHODS

We conducted a retrospective database review of acute injuries reported in ice hockey in patients presenting to a Level-1 adult Emergency Centre in Switzerland. Patients between January 1, 2013 and December 31, 2019 and over 16 years of age were identified in our computerised patient database. Each consultation was reviewed to derive information on demographics, playing level and the features of the injury, including location, type, mechanism and consequences. Different age groups were compared, as were amateur and professional players. A statistical analysis was performed.

RESULTS

A total of 230 patients were identified. The most common diagnoses were fracture (28.3%), contusion/abrasion (23.9%), laceration (12.6%) and concussion (10.4%). The most commonly affected body parts were the face (31.3%), the shoulder/clavicle (13.0%) and the head (12.2%). Most lesions were caused by player-player contact (37.4%), contact with the puck (24.3%) and falls (10.9%). In comparison to the younger cohorts, patients >36 years of age more frequently suffered injuries caused by falls, (p < 0.001) and were less frequently injured by player-player contact (p = 0.01813). In amateur players, significantly more injuries were caused by stick contact (OR 0, 95% CI (0.00-0.83), p = 0.02) and surgery was more rarely performed (OR 2.35, 95% CI 0.98-5.46, p = 0.04).

CONCLUSIONS

Injuries continue to play a major role in ice hockey, especially in the face and due to player-player contact. Future investigations should focus on player-player contact and possible effective preventive measures. Players must be encouraged to employ face protection and to wear a mouth guard at all times.

Which sports have a higher risk of maxillofacial injuries?

OBJECTIVES

Sports etiology is one of the most common causes of maxillofacial injuries. This work aimed to provide an up-to-date review of sports-related maxillofacial injuries.

METHODS

An updated review was conducted on Pubmed and Google Scholar. No publication year and language restrictions were applied. Two different search strategies were performed, the first addressed which sports, generally associated with maxillofacial injuries, and the second search was conducted to determine the frequency of maxillofacial injuries associated with each sport individually.

RESULTS

The first search returned 26 articles distributed across different sports, from different countries, and with varied age distribution. The second search displayed 85 articles on individual sports group. Papers were rated and categorized according by the sport associated to the reported injury. A useful sports risk scale for maxillofacial injuries has been developed. Peculiar themes from all participating sports were evaluated. The use of protective equipment and other preventive measures were highlighted.

CONCLUSIONS

Some sports with ball and cycling can be considered riskier sports for maxillofacial injuries. Athlete education and the mandatory use of mouthguards, helmets, and eye protection, among other things, are crucial to prevent these injuries. Tailor-made mouthguards and protective masks, which are becoming cheaper, are in vogue. The Sports-related Maxillofacial Injuries Risk scale can be useful for athletes, athletic coaches, and maxillofacial surgeons.

Hip Adduction and Abduction Strength Profiles Among Bantam, High School, Juniors, and Collegiate American Ice Hockey Players

Background

Adductor strains are the most common non-contact musculoskeletal injury sustained in ice hockey. Systematic reviews have determined higher level of play and lower hip adduction to abduction strength ratios to be associated with an increased risk of adductor strain across multiple sports. Limited research exists regarding hip adduction and abduction strength profiles across various levels of ice hockey players.

Purpose

To compare isometric hip adduction and abduction strength profiles among bantam, high school, tier one juniors, and NCAA Division I collegiate ice hockey players. A secondary purpose was to identify whether differences in strength profiles between dominant and non-dominant limbs exist.

Study Design

Cross-sectional cohort study.

Methods

A questionnaire of demographic data, hockey, and injury specific information was completed by all subjects. The mean of three reps of maximal hip isometric adduction and abduction strengths were quantified using a handheld dynamometer with external belt-fixation. Ratios of hip adduction-to-abduction strength were calculated and normalized for body weight.

Results

A total of 87 uninjured skaters were included in this study with a mean age of 17 years. Mean hip adductor-to-abductor ratios for Bantam hockey players were 121% followed by collegiate (115%), Juniors (111%), and high school (109%) hockey players. No statistically significant differences were found between peak hip adduction and abduction isometric strength and playing level. In addition, there was no difference between unilateral hip strength ratios and shooting hand or leg dominance. While 34.5% of subjects reported a history of adductor injury, no significant differences existed regarding strength ratios during bilateral comparison or when compared to their team norms. Three subjects were found to have unilateral ratios of less than 80%, while two subjects demonstrated bilateral ratios of less than 80%.

Conclusions

Symmetry is illustrated between dominant and non-dominant legs in ice hockey players with and without a history of adductor injury. Results align well with previously established cross-sectional data from Australian football, with ratios of 103% in high school players, 107% in semi-professional players, and 113% in collegiate players.

Level of Evidence

Level 3.

A Scoping Review of Injuries in Amateur and Professional Men's Ice Hockey

Background

Orthopaedic injuries are common in ice hockey at all levels and can result in physical and psychological adverse effects on these athletes.

Purpose

Primarily, to summarize published data on orthopaedic hockey injuries at the junior through professional level. Secondarily, to characterize the literature based on anatomic site injured, return-to-play rates, cause/mechanism of injury, time lost, and treatments used.

Study Design

Scoping review; Level of evidence, 4.

Methods

PubMed, EMBASE, Cochrane library, and SCOPUS were searched using the terms "hockey" and "injuries" using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and 4163 studies involving orthopaedic injuries were identified. Our inclusion criteria consisted of accessible full-text articles that evaluated orthopaedic injuries in men's ice hockey athletes of all levels. We excluded case reports and articles evaluating women's ice hockey injuries, as well as those evaluating nonorthopaedic injuries, such as concussions; traumatic brain injuries; and facial, dental, and vascular injuries, among others. Studies were divided based on level of play and anatomic site of injury. Level of evidence, year published, country of corresponding author, method of data collection, incidence of injury per athlete-exposure, and time lost were extracted from each article.

Results

A total of 92 articles met the inclusion criteria and were performed between 1975 and 2020, with the majority published between 2015 and 2020. These were divided into 8 anatomic sites: nonanatomic-specific (37%), intra-articular hip (20.7%), shoulder (9.8%), knee (8.7%), trunk/pelvis (7.6%), spine (7.6%), foot/ankle (6.5%), and hand/wrist (2.2%). Of these studies, 71% were level 4 evidence. Data were obtained mostly via surveillance programs and searches of publicly available information (eg, injury reports, player profiles, and press releases).

Conclusion

This scoping review provides men's hockey players and physicians taking care of elite ice hockey athletes of all levels with a single source of the most current literature regarding orthopaedic injuries. Most research focused on nonanatomic-specific injuries, intra-articular hip injuries, knee injuries, and shoulder injuries, with the majority having level 4 evidence.

Imaging Review of Hockey-related Lower Extremity Injuries

Hockey is a fast-paced contact sport with a high incidence of injuries. Although injuries are more frequent among elite players, recreational hockey injuries are a common issue faced by primary care and emergency physicians. Lower extremity injuries in hockey are particularly important because they account for approximately a third of all injuries and > 60% of all overuse injuries. This pictorial review provides the general and specialty trained radiologist with a knowledge of the patterns of lower extremity injury that occur in ice hockey.

Imaging Review of Hockey-Related Upper Extremity Injuries

Ice hockey is a fast-paced contact sport with a high incidence of injuries. Upper extremity injury is one of the most common regions of the body to be injured in hockey. This imaging review will equip the radiologist with a knowledge of the more common and severe upper extremity injuries that occur in this sport.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Ice Hockey: 2014-2015 Through 2018-2019

CONTEXT

The National Collegiate Athletic Association (NCAA) has sponsored women's ice hockey championships since 2001, and sponsorship has grown over time.

BACKGROUND

Routine examinations of injuries sustained by athletes are important for identifying and understanding patterns that can be used to inform sport safety practices.

METHODS

Exposure and injury data collected in the NCAA 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 were used to examine differential injury rates.

RESULTS

The overall injury rate was 5.89 per 1000 athlete-exposures; preseason injury incidence rose sharply during 2016-2017 through 2018-2019. Head/face injuries (15.2%), knee injuries (13.2%), and shoulder injuries (12.9%) were the most commonly injured body parts, and injuries were most often classified as contusions (18.9%), strains (18.7%), and sprains (15.5%). Concussion (11.9%) was the most commonly reported specific injury, and concussion rates notably increased during 2017-2018 through 2018-2019.

SUMMARY

Study findings were generally consistent with the existing epidemiological evidence. Injury incidence in preseason and the etiology of strains warrant further attention in this population.

Frequency of overtime and consecutive games and their impact on injury rate in the National Hockey League (NHL)

OBJECTIVES

Ice hockey is a high-intensity contact sport that places athletes at an elevated risk for injury relative to other sports. The purpose of the current study was to analyze factors contributing to fatigue and decreased recovery time and their associations with injury incidence among professional athletes in the National Hockey League (NHL).

METHODS

A retrospective review of all injuries suffered by NHL athletes during six consecutive seasons from 2013 to 2019 was performed. Team schedules were analyzed to assess (1) the number of instances with games on consecutive calendar days, (2) the number of overtime games, and (3) the number of overtime games within three calendar days of a previous overtime game. A Spearman's rank correlation coefficient was calculated from this data to assess the association between these factors and injury rates.

RESULTS

In total, 4886 injuries were suffered by NHL players during the period of study, with the 2013-2014 regular season highest injury rate per 1000 athletic exposures (15.8). The lower body was the most frequently injured body area (25.0% of all injuries), followed by injuries to the upper body (23.7%). In an analysis of the number of overtime games and games on consecutive days and their relationships to injury rate, only overtime games within three calendar days and total injuries were found to have a significant association (ρ = 0.19, p = 0.01).

CONCLUSION

The weak positive correlation between the number of overtime games within threedays of a previous overtime game and total injuries in professional ice hockey players suggests that overtime games played within a short period of time place athletes at increased risk for injury. Further studies are necessary to address this on an athlete-by-athlete level.

Epidemiology of Traumatic and Overuse Injuries in Swiss Professional Male Ice Hockey Players

Background:

Ice hockey injury patterns in Europe were last evaluated in the 1990s.

Purpose:

The aim of this study was to assess the frequency, type, location, and incidence of traumatic injuries, as well as the prevalence and relative effect of overuse injuries in professional male ice hockey players.

Study Design:

Descriptive epidemiology study.

Methods:

Traumatic injuries were assessed using a standardized injury report form over a 1-year period (including the preparatory phase and season). The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire was used to determine overall and substantial overuse injuries and their relative effect on ice hockey players.

Results:

Five Swiss National League teams participated in the study. From a total of 321 recorded injuries, 179 led to time loss from sport. The game-related time-loss injury incidence during the season was 88.6/1000 player-game hours.Time-loss injuries affected mainly the hip/groin/thigh region (23%), followed by the head (17%). Most time-loss injuries were classified as muscle strains (24%), followed by concussions (18%). The most common injury mechanism involved collision with an opponent’s body (31%), and right forward players (23%) were most likely to report a game-related injury. Most injuries (27%) occurred within the defending zone along the boards. The average prevalence rates of all overuse and substantial overuse injuries were 49% and 13%, respectively. The hip/groin displayed the highest average prevalence for all overuse problems (16%), translating to the highest relative effect.

Conclusion:

Muscle strains and concussions were the most frequent time-loss injuries in Swiss professional ice hockey players. The hip/groin was the most affected region for both traumatic and overuse injuries.

[Injuries in inline skater hockey]

In Germany, Inline Skater Hockey (ISH) is played by about 7500 active players on inline skates with equipment comparable to ice hockey using a hard-plastic ball. The aim of this retrospective epidemiological cross-sectional study is to record the frequency and types of injuries in this sport, for which there is a lack of medically adequate studies in the literature. A questionnaire comprising 112 items was used to collect demographic data, injuries in eight body regions and defined overuse injuries. 274 ISH players with an average age of 24.5 ± 6.2 years and an exposure time of 2787 ± 2063 hours were examined. 5701 injuries were recorded, 60.5 % of which were minor bruises, abrasions and wounds. The total injury rate per 1000 hours was 9.6 ± 17.7, with an injury-related break of 12.8 ± 21.8 weeks per player. Field players with visors had highly significantly fewer head injuries (2.8 ± 6.1 vs. 8.9 ± 13.1; p < 0.001) with highly significantly (p < 0.001) fewer lacerations, nasal bone fractures, eye injuries and dental injuries. There was a weak negative correlation between facial protection and number of head injuries (r = -0.386, p < 0.001). In conclusion, frequency and types of injuries in ISH are comparable to ice hockey during training. In accordance with ice hockey, protective equipment in ISH can significantly reduce the occurrence of head injuries. Preventive attention should be paid to the wearing of a full visor and to education about the occurrence of concussions despite the use of a protective helmet.

Lower-Limb Flexibility Profile Analysis in Youth Competitive Inline Hockey Players

During puberty, the growth of the bones is faster than that of the muscles, which may result in muscular tightness. Muscular tightness and asymmetry have been associated with an increase in injury incidence. The assessment of a joint range of motion (ROM) could help to identify athletes classified as high injury risk. The objectives of the present study were to describe the lower-extremity flexibility profile (LEFP) of youth competitive inline hockey players using the ROM-SPORT battery (I) and to identify muscular tightness and asymmetry (II). Seventy-four young players were examined for maximum passive ankle, knee, and hip ROMs. Muscle asymmetry or tightness was classified according to cutoff scores previously described. The LEFP of the 74 players was 10.8° for hip extension, 26° for hip adduction, 33.6° for ankle dorsiflexion, 38.6° for ankle dorsiflexion with knee flexed, 36.7° for hip abduction, 46° for hip internal rotation, 60.6° for hip external rotation, 65.1° for hip abduction with the hip flexed, 66.3° for hip flexion with the knee extended, 119.7° for knee flexion, and 133.7° for hip flexion. The individual analysis of the flexibility values identified tightness in all players for one or more movement, except for hip abduction. A low prevalence of asymmetries was observed (range: 5.4% to 17.6% of players) depending on the ROM.

Anterior Cruciate Ligament Injuries in the National Hockey League: Epidemiology and Performance Impact

OBJECTIVE

To determine the incidence of anterior cruciate ligament (ACL) injuries in the National Hockey League (NHL) and to examine the effects of this injury on return-to-play status and performance.

DESIGN

Case series; level of evidence, 4.

METHODS

This was a 2-phase study. Phase I used the NHL electronic injury surveillance system and Athlete Health Management System to collect data on ACL injuries and man games lost over 10 seasons (2006/2007-2015/2016). Data collected in phase I were received in deidentified form. Phase II examined the performance impact of an ACL injury. Players were identified through publically available sources, and performance-related statistics were analyzed. Data collected in phase II were not linked to data collected in phase I. A paired t test was used to determine any difference in the matching variables between controls and cases in the preinjury time period. A General linear model (mixed) was used to determine the performance impact.

RESULTS

Phase I: 67 ACL injuries occurred over 10 seasons. The incidence for all players was 0.42/1000 player game hours (forward, 0.61; defenseman, 0.32, goalie, 0.08) and by game exposure was 0.2/1000 player game exposures (forward, 0.33; defenseman, 0.11; goalie, 0.07). Forwards had a greater incidence rate of ACL tears with both game hours and game exposures when compared with defensemen and goalies (P < 0.001, <0.001; P = 0.008, <0.001, respectively). Phase II: 70 ACL tears (60 players) were identified. Compared with controls, players who suffered an ACL tear demonstrated a decrease in goals/season (P < 0.04), goals/game (P < 0.015), points/season (0.007), and points/game (0.001). Number of games and seasons played after an ACL injury did not differ compared with controls (P = 0.068, 0.122, respectively).

CONCLUSIONS

Anterior cruciate ligament injuries occur infrequently, as it relates to other hockey injuries. Despite a high return to play, the performance after an ACL injury demonstrated a decrease in points and goals per game and per season.

Field-based evaluation of hip adductor and abductor strength in professional male ice hockey players: Reference values and influencing factors

OBJECTIVES

To provide reference values and examine the influence of hip/groin pain on hip adductor and abductor strength in professional male ice hockey players, by using a straightforward 5-min procedure.

DESIGN

Cross-sectional study.

SETTING

On-field assessment of hip/groin muscle strength with dynamometry, together with the concomitant level of hip/groin pain with a visual analogue scale.

PARTICIPANTS

Professional male ice hockey players competing in the Swiss National League (n = 187).

MAIN OUTCOME MEASURES

Hip abductor strength, hip adductor strength and hip adductor:abductor ratio.

RESULTS

Reference values by playing position (goalkeepers, defenders and forwards) are provided for asymptomatic athletes. Players with hip/groin pain during adduction displayed lower hip adductor strength (p = 0.001) and hip adductor:abductor ratio (p = 0.012) than their symptom-free peers.

CONCLUSIONS

The presence of hip/groin pain during adductor testing may contribute to selective hip adductor weakness, whose cause-effect relation with possible groin problems remains to be demonstrated.

What Is Injury in Ice Hockey: An Integrative Literature Review on Injury Rates, Injury Definition, and Athlete Exposure in Men's Elite Ice Hockey

Injuries in men's elite ice hockey have been studied over the past 40 years, however, there is a lack of consensus on definitions of both injury and athlete exposure. These inconsistencies compromise the reliability and comparability of the research. While many individual studies report injury rates in ice hockey, we are not aware of any literature reviews that have evaluated the definitions of injury and athlete exposure in men's elite ice hockey. The purpose of this integrative review was to investigate the literature on hockey musculoskeletal injury to determine injury rates and synthesize information about the definitions of injury and athlete exposure. Injury rates varied from 13.8/1000 game athlete exposures to 121/1000 athlete exposures as measured by player-game hours. The majority of variability between studies is explained by differences in the definitions of both injury and athlete exposure. We were unable to find a consensus injury definition in elite ice hockey. In addition, we were unable to observe a consistent athlete exposure metric. We recommend that a consistent injury definition be adopted to evaluate injury risk in elite ice hockey. We recommend that injuries should be defined by a strict list that includes facial lacerations, dental injuries, and fractures. We also recommend that athlete exposure should be quantified using player-game hours.

Sports injury and illness incidence in the PyeongChang 2018 Olympic Winter Games: a prospective study of 2914 athletes from 92 countries

Objective

To describe the incidence of injuries and illnesses sustained during the XXIII Olympic Winter Games, hosted by PyeongChang on 9–25 February 2018.

Methods

We 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.

Results

In 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.

Conclusion

Overall, 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.

Epidemiology of Injuries in Ice Hockey

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.

Return to Play After Hip Arthroscopic Surgery for Femoroacetabular Impingement in Professional Soccer Players

BACKGROUND

Arthroscopic hip surgery has been shown to be effective in returning professional athletes back to play at a high level of performance in different sports. Limited information exists regarding professional soccer players and their return to play.

PURPOSE

To determine the rate and time to return to sport for professional soccer players after hip arthroscopic surgery for the treatment of femoroacetabular impingement (FAI) and to identify possible risk factors associated with a delay in returning to play.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Professional soccer players who underwent hip arthroscopic surgery for FAI by a single surgeon between 2005 and 2015 were evaluated. Data retrieved from www.mlssoccer.com , www.fifa.com , www.transfermarkt.co.uk , and www.wikipedia.org included information on each player's professional career, participation on the national team, length of professional career before surgery, number of appearances (games) before surgery, time between surgery and first appearance in a professional game, and number of appearances after surgery. Other data were obtained from the patient's medical records.

RESULTS

Twenty-four professional soccer players (26 hips) were included. The mean age at surgery was 25.0 ± 4.0 years (range, 19-32 years). A total of 96% of patients were able to return to play at the professional level. The mean time between surgery and the first professional game played was 9.2 months (range, 1.9-24.0 months). On average, players played in 70 games after surgery (range, 0-224). National team players were able to return to play significantly earlier than the rest of the players (median, 5.7 months vs 11.6 months, respectively; P = .018). Severe chondral damage and microfracture did not interfere with return to play.

CONCLUSION

The arthroscopic management of FAI in symptomatic professional soccer players allowed 96% of them to return to play. Players with national team experience were able to return to play earlier than those without it. Severe chondral damage and microfracture did not interfere with return to play.

Prevalence of FAI radiographic hip abnormalities in elite soccer players: are there differences related to skeletal maturity?

Background

Femoroacetabular impingement (FAI) can be a source of hip pain in young adults. Some reports have revealed that participation in high-impact sports may play a role in the development of cam deformity, and there is a higher prevalence of signs of cam impingement in asymptomatic adolescents who participate in soccer and basketball than in non-athlete controls; however, current evidence is scarce regarding the initiation and development of deformities.

Purpose

The aim of this study was to evaluate the prevalence of radiographic hip abnormalities related to FAI in young elite soccer players and compare this with findings in a group of adult elite soccer players.

Subjects and methods

Anteroposterior pelvic and cross-table hip radiographs were obtained for 75 young elite soccer players with skeletal immaturity (group 1) and for 75 adult elite soccer players (group 2), all of whom were previously asymptomatic and had no history of hip disease. After exclusion, group 1 included 72 patients, and group 2 included 70 patients. Radiological signs of FAI were evaluated.

Results

34 subjects in groups 1 and 2 demonstrated cam morphology. The prevalence of pincer morphology was 30 in group 1 and 36 in group 2. However, these differences were not statistically significant.

Conclusion

We found no differences in the prevalence of FAI radiological signs between soccer players in their late adolescence and adult soccer players.

Evaluation, management and prevention of lower extremity youth ice hockey injuries

Ice hockey is a fast-paced sport played by increasing numbers of children and adolescents in North America and around the world. Requiring a unique blend of skill, finesse, power and teamwork, ice hockey can become a lifelong recreational activity. Despite the rising popularity of the sport, there is ongoing concern about the high frequency of musculoskeletal injury associated with participation in ice hockey. Injury rates in ice hockey are among the highest in all competitive sports. Numerous research studies have been implemented to better understand the risks of injury. As a result, rule changes were adopted by the USA Hockey and Hockey Canada to raise the minimum age at which body checking is permitted to 13–14 years (Bantam level) from 11–12 years (Pee Wee). Continuing the education of coaches, parents and players on rules of safe play, and emphasizing the standards for proper equipment use are other strategies being implemented to make the game safer to play. The objective of this article was to review the evaluation, management and prevention of common lower extremity youth hockey injuries.

Sports injuries and illnesses in the Sochi 2014 Olympic Winter Games

BACKGROUND

Systematic surveillance of injuries and illnesses is the foundation for developing preventive measures in sport.

AIM

To analyse the injuries and illnesses that occurred during the XXII Olympic Winter Games, held in Sochi in 2014.

METHODS

We recorded the daily occurrence (or non-occurrence) of 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 Sochi 2014 medical staff.

RESULTS

NOC and Sochi 2014 medical staff reported 391 injuries and 249 illnesses among 2780 athletes from 88 NOCs, equalling incidences of 14 injuries and 8.9 illnesses per 100 athletes over an 18-day period of time. Altogether, 12% and 8% of the athletes incurred at least one injury or illness, respectively. The percentage of athletes injured was highest in aerial skiing, snowboard slopestyle, snowboard cross, slopestyle skiing, halfpipe skiing, moguls skiing, alpine skiing, and snowboard halfpipe. Thirty-nine per cent of the injuries were expected to prevent the athlete from participating in competition or training. Women suffered 50% more illnesses than men. The rate of illness was highest in skeleton, short track, curling, cross-country skiing, figure skating, bobsleigh and aerial skiing. A total of 159 illnesses (64%) affected the respiratory system, and the most common cause of illness was infection (n=145, 58%).

CONCLUSIONS

Overall, 12% of the athletes incurred at least one injury during the games, and 8% an illness, which is similar to prior Olympic Games. The incidence of injuries and illnesses varied substantially between sports.

Ability of preseason body composition and physical fitness to predict the risk of injury in male collegiate hockey players

Background:

Injuries in collegiate ice hockey can result in significant time lost from play. The identification of modifiable risk factors relating to a player’s physical fitness allows the development of focused training and injury prevention programs targeted at reducing these risks.

Purpose:

To determine the ability of preseason fitness outcomes to predict in-season on-ice injury in male collegiate ice hockey players.

Study Design:

Prognostic cohort study.

Level of Evidence:

Level 3.

Methods:

Athlete demographics, percentage body fat, aerobic capacity (300-m shuttle run; 1-, 1.5-, 5-mile run), and strength assessment (sit-ups, push-ups, grip strength, bench press, Olympic cleans, squats) data were collected at the beginning of 8 successive seasons for 1 male collegiate ice hockey team. Hockey-related injury data and player-level practice/game athlete exposure (AE) data were also prospectively collected. Seventy-nine players participated (203 player-years). Injury was defined as any event that resulted in the athlete being unable to participate in 1 or more practices or games following the event. Multivariable logistic regression was performed to determine the ability of the independent variables to predict the occurrence of on-ice injury.

Results:

There were 132 injuries (mean, 16.5 per year) in 55 athletes. The overall injury rate was 4.4 injuries per 1000 AEs. Forwards suffered 68% of the injuries. Seventy percent of injuries occurred during games with equal distribution between the 3 periods. The mean number of days lost due to injury was 7.8 ± 13.8 (range, 1-127 days). The most common mechanism of injury was contact with another player (54%). The odds of injury in a forward was 1.9 times (95% CI, 1.1-3.4) that of a defenseman and 3 times (95% CI, 1.2-7.7) that of a goalie. The odds of injury if the player’s body mass index (BMI) was ≥25 kg/m² was 2.1 times (95% CI, 1.1-3.8) that of a player with a BMI <25 kg/m². The odds ratios for bench press, maximum sit-ups, and Olympic cleans were statistically significant but close to 1.0, and therefore the clinical relevance is unknown.

Conclusion:

Forwards have higher odds of injury relative to other player positions. BMI was predictive of on-ice injury. Aerobic fitness and maximum strength outcomes were not strongly predictive of on-ice injury.

Injuries in men's international ice hockey: a 7-year study of the International Ice Hockey Federation Adult World Championship Tournaments and Olympic Winter Games

BACKGROUND

Information on ice hockey injuries at the international level is very limited. The aim of the study was to analyse the incidence, type, mechanism and severity of ice hockey injuries in men's international ice hockey tournaments.

METHODS

All the injuries in men's International Ice Hockey Federation World Championship tournaments over a 7-year period were analysed using a strict definition of injury, standardised reporting strategies and an injury diagnosis made by a team physician.

RESULTS

528 injuries were recorded in games resulting in an injury rate of 14.2 per 1000 player-games (52.1/1000 player-game hours). Additionally, 27 injuries occurred during practice. For WC A-pool Tournaments and Olympic Winter Games (OWG) the injury rate was 16.3/1000 player-games (59.6/1000 player-game hours). Body checking, and stick and puck contact caused 60.7% of the injuries. The most common types of injuries were lacerations, sprains, contusions and fractures. A laceration was the most common facial injury and was typically caused by a stick. The knee was the most frequently injured part of the lower body and the shoulder was the most common site of an upper body injury. Arenas with flexible boards and glass reduced the risk of injury by 29% (IRR 0.71, (95% CI 0.56 to 0.91)).

CONCLUSIONS

The incidence of injury during international ice hockey competition is relatively high. Arena characteristics, such as flexible boards and glass, appeared to reduce the risk of injury.

The epidemiology of professional ice hockey injuries: a prospective report of six NHL seasons

BACKGROUND

There is a paucity of literature examining injury and illness rates in men's professional ice hockey. This study aimed to determine injury and illness rates in the NHL over six seasons, and identify predictors of injury-related time loss in this population.

METHODS

This study involved an inclusive cohort of hockey players from all NHL teams competing in the 2006-2007 through 2011-2012 seasons. A standardised electronic injury surveillance system was used to report injury and illness events. The primary outcome was regular season and postseason time-loss injury/illness. The secondary outcome was man-games lost from the competition.

RESULTS

On the basis of the estimated athlete exposures (AEs), the overall regular season incidence density was 15.6 injuries/1000 AEs and 0.7 illnesses/1000 AEs. Based on recorded time on ice, the injury rates were roughly threefold higher at 49.4 injuries/1000 player game-hours and 2.4 illnesses/1000 player game-hours. There was a reduction in injury rates over the 6-year period, with the greatest reduction between the 2007-2008 and 2008-2009 seasons. Multivariate predictors of time loss greater than 10 days were being a goalie (OR=1.68, 95% CI 1.18 to 2.38), being injured in a road game (OR=1.43, 95% CI 1.25 to 1.63) and the mechanism of injury being a body check (OR=2.21, 95% CI 1.86 to 2.62).

CONCLUSIONS

There was an overall reduction in the time-loss injury and illness rates over six seasons. Being a goaltender, being injured on the road and being injured by a body check were the risk factors for time loss greater than five 'man games'.

Incidence and injury characteristics of medial collateral ligament injuries in male collegiate ice hockey players

Background:

Medial collateral ligament (MCL) injuries are the second most common injury resulting in player lost time in elite-level ice hockey.

Purpose:

To determine the incidence and injury characteristics of knee MCL sprain in male collegiate ice hockey players.

Study Design:

Case control.

Methods:

Athlete exposure data demographics, mechanism of injury, player position, time of injury occurrence (game vs practice), grade of MCL sprain, concomitant injuries, and lost time for cases were extracted from a computerized injury database of 8 college hockey seasons at 1 university. MCL injury rates were calculated. Injury characteristics were descriptively summarized. Simple linear regression was utilized to determine the relationship between the grade of MCL injury and player lost time.

Results:

There were 13 MCL injuries in 10 players. The overall incidence rate was 0.44 injuries per 1000 athlete exposures. Two players suffered reinjuries. Defensemen and forwards were equally represented. Contact with another player or the ice was the mechanism of injury in 77% of players. Grade 2 injuries were most common. The grade of injury predicted time lost from play (P < 0.01).

Conclusion and Clinical Relevance:

The lost time relates directly to the severity of injury.

Review of sport-induced groin injuries

CONTEXT

Groin injuries are among the most common injuries co-existing with sports. The aim of this review was to outline the epidemiology and identify risk factors, as well as examine preventative and interventional measures for reducing the occurrence of this form of injury among athletes.

EVIDENCE ACQUISITION

An electronic, systematic search for relevant keywords, either separately or in combination was sought in the academic scientific databases.

RESULTS

Groin injuries, acute or chronic, consist of a high percentage of injuries that manifest with pain. Despite the specific tendency for injury among some sports, such injuries make up 2-5% of sport-induced injuries. There are few available reports on lower limb injuries, especially groin injuries, in Iran. Numerous factors predispose to groin injuries. A lengthy list of preventive/ treatment measures, from preliminary to sophisticated, have been proposed.

CONCLUSIONS

Although using a programmed strategy designed to decrease the risk of groin injuries by taking a strategic approach to exercise may alleviate complications, in some cases the chronic nature of the injury may threaten the professional life of the athlete. More research is required to plan suitable programs for reducing the risk of this type of injury in athletes.

Intra-articular hip injuries in national hockey league players: a descriptive epidemiological study

BACKGROUND

Intra-articular hip injuries are thought to be common in professional ice hockey; however, injury incidence and missed playing time have not been previously documented. Furthermore, it is not known if injury incidence differs between player positions.

HYPOTHESIS

The incidence of symptomatic intra-articular hip injuries in goaltenders is higher than that of other position players.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

A database containing the injury surveillance of National Hockey League (NHL) players from the years 2006 to 2010 was used to identify athletes who had sustained a hip or groin injury. From this database, players diagnosed with an intra-articular hip injury were identified. The incidence of intra-articular hip injuries per 1000 player-hours played and per 1000 player-game appearances was compared between goaltenders, defensemen, and forwards.

RESULTS

Ninety-four hip injuries, accounting for 10.6% (94/890) of all hip and groin injuries, were identified as intra-articular in nature during the time of the surveillance. Most injuries occurred during the regular season (71.2%; 67/94) and during a game (44.6%; 42/94). Players who sustained intra-articular hip injuries had significantly higher total man-games missed compared with those with all other groin injuries (mean ± SD, 8.5 ± 23.0 vs. 1.2 ± 4.2 missed games; P = .0001). The most frequent intra-articular hip diagnoses made in this cohort were hip labral tear (69.1%), followed by hip osteoarthritis (13.8%), hip loose body (6.3%), and hip femoroacetabular impingement (5.3%). The incidence of intra-articular hip injuries per 1000 player-game hours was not different between goaltenders (1.97) and other on-ice players (defensemen, 1.43; forwards, 1.38) (relative risk [RR], 1.40; 95% CI, 0.86-1.40; P = .22). However, injuries per 1000 player-game appearances were significantly higher in goaltenders (1.84) compared with other on-ice players (defensemen, 0.47; forwards, 0.34) (RR, 4.78; 95% CI, 2.94-7.76; P < .0001).

CONCLUSION

Hip labral tears are the most frequently encountered intra-articular hip injury in the NHL player and can lead to an average of 8 man-games missed per injury. Goaltenders were not at higher risk when measuring injuries per hours played but were at significantly greater risk of an intra-articular hip injury than other on-ice players (RR, 4.7) when measured per game played.

Groin injuries in sports medicine

Context:

An in-season groin injury may be debilitating for the athlete. Proper diagnosis and identification of the pathology are paramount in providing appropriate intervention. Furthermore, an adductor strain that is treated improperly can become chronic and career threatening. Any one of the 6 muscles of the adductor muscle group can be involved. The degree of injury can range from a minor strain (grade 1), where minimal playing time is lost, to a severe strain (grade 3), in which there is complete loss of muscle function. Persistent groin pain and muscle imbalance may lead to athletic pubalgia.

Evidence Acquisition:

Relevant studies were identified through a literature search of MEDLINE and the Cochrane database from 1990 to 2009, as well as a manual review of reference lists of identified sources.

Results:

Ice hockey and soccer players seem particularly susceptible to adductor muscle strains. In professional ice hockey and soccer players throughout the world, approximately 10% to 11% of all injuries are groin strains. These injuries have been linked to hip muscle weakness, a previous injury to that area, preseason practice sessions, and level of experience. This injury may be prevented if these risk factors are addressed before each season.

Conclusion:

Despite the identification of risk factors and strengthening intervention for athletes, adductor strains continue to occur throughout sport. If groin pain persists, the possibility of athletic pubalgia needs to be explored, because of weakening or tears in the abdominal wall muscles. A diagnosis is confirmed by exclusion of other pathology.

The prevalence of radiographic hip abnormalities in elite soccer players

BACKGROUND

Hip injuries, both intra- and extra-articular, are becoming a more commonly recognized, diagnosed, and treated injury in athletes of all competitive levels. Our goal is to establish a previously undefined value in this athletic population--the prevalence of radiographic hip abnormalities in elite soccer athletes.

PURPOSE

To provide a foundation for the future body of literature regarding hip pathologic abnormalities and "at-risk" hips in athletes of all ages and levels of participation.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

We retrospectively reviewed the anteroposterior pelvis and frog-leg lateral radiographs of 95 elite male and female soccer players to determine the prevalence of hip abnormalities. Athletes with a history of hip or groin injuries were included. Multiple radiographic parameters were used to assess the presence of cam and pincer-type femoroacetabular impingement. Measurements were conducted by a blinded, sports medicine fellowship-trained orthopaedic surgeon with experience in treating hip disorders.

RESULTS

In total, 72% (54/75) of male and 50% (10/20) of female players demonstrated some evidence of radiographic hip abnormality. Cam lesions were present in 68% (51/75) of men (76.5% [39/51] bilateral involvement) and 50% (10/20) of women (90% [9/10] bilateral involvement). Pincer lesions were present in 26.7% (20/75) of men and 10% (2/20) of women. The average male alpha angle overall was 65.6°. Cam-positive hips averaged 70.7°. The average female alpha angle overall was 52.9°, with cam-positive hips averaging 60.8°.

CONCLUSION

The prevalence of radiographic hip abnormalities in elite soccer athletes is considerable, particularly in young male athletes. The establishment of the prevalence of these findings represents the first step in identifying the relationship between radiographic abnormalities and injuries of the hip and groin in athletes.

Sports hernia: diagnosis and treatment highlighting a minimal repair surgical technique

Groin injuries are a common occurrence in elite-level athletes. These injuries can cause significant pain and disability, leading to prolonged periods of inactivity and consternation among athletes, coaches, athletic trainers, and physicians alike. The differential diagnosis for groin pain is vast and spans multiple disciplines, including orthopaedics, general surgery, urology, gynecology, and neurology. Sports hernias are one cause of chronic groin pain in athletes and are distinct entities from classic hernias. They are often caused by a deficient posterior wall of the inguinal canal, but may also involve concurrent injuries, such as conjoint and adductor tendinopathies and nerve entrapment. Understanding the complex lower abdominal, pelvic, and hip anatomy and pathophysiology of sports hernias is crucial to making an accurate diagnosis and providing appropriate treatment options. Newer, less invasive surgical repair techniques show promising early results in improving pain and decreasing recovery time.

Physiological variables and mouthguard use in women during exercise

Although mouthguards have been found to reduce injury, many athletes choose not to use them because of the belief of negative effects on breathing with mouthguard use. Therefore, this study investigated the effects of mouthguard use on physiological variables in women using a self-adapted mouthguard made for women and a universal self-adapted mouthguard. Eleven subjects (mean +/- SD; age: 22 +/- 3.3 y; height: 159.8 +/- 4.3 cm; body mass: 63.7 +/- 8.9 kg) performed 3 separate maximal cycle ergometer tests with either 1 mouthguard or no mouthguard. Heart rate (HR), rating of perceived exertion (RPE), oxygen consumption VO2), minute ventilation VE), and respiratory exchange ratio (RER) were measured at each exercise intensity and at the end of each test. HR, RPE, and VO2 increased for each mouthguard condition across power levels. VE and RER increased more from 110W to max with the no mouthguard condition than for either mouthguard. However, there was no significant difference in VE or RER at any given power level between mouthguard conditions. The results indicated mouthguard use did not affect HR, RPE, VE, VO2, or RER at any given power level during exercise, including the guard made specifically for women. Therefore, athletes are encouraged to use mouthguards without fear of negative aerobic performance effects.

Rehabilitation of the hip following sports injury

An athlete often presents to the rehabilitation specialist with either a nonspecific referral, such as "hip pain," or with a diagnosis of a more specific hip pathology. The highly skilled clinician is trained to look at the "linkage" between the trunk and all parts of the lower extremity. Why is the hip not transferring the load well? Where is the breakdown? The gluteus medius, pelvic stability, and supportive muscular slings are of great importance when optimizing the function of the hip. The hip is subjected to forces equal to multiples of the body weight and requires osseous, articular and myofascial integrity for stability. This is the mind set when devising an athlete's rehabilitative program, looking at all influential factors that affect joint movement and integrity.

Ice hockey injuries in a Japanese elite team: a 3-year prospective study

CONTEXT

As the Asian Ice Hockey League gradually expands and becomes more competitive, ice hockey-related injuries may increase. However, no reports have been published on ice hockey injuries in Japan, including the method of injury and the daily supervision of the players during the regular season.

OBJECTIVE

To prospectively study the incidence, types, and mechanisms of ice hockey injuries in an elite Japanese ice hockey team.

DESIGN

Prospective observational cohort study design.

SETTING

An elite ice hockey team, Tokyo, Japan.

PATIENTS OR OTHER PARTICIPANTS

Ninety-four players during the 2002-2005 seasons.

MAIN OUTCOME MEASURE(S)

Data were collected for 3 consecutive seasons using an injury reporting form.

RESULTS

The overall game injury rate was 74.3 per 1000 player-game hours and 11.7 per 1000 player-game hours for injuries resulting in any time loss. The overall practice injury rates were 11.2 per 1000 player-practice hours and 1.1 per 1000 player-practice hours for injuries resulting in any time loss. Forwards had the highest rate of injury, followed by defensemen and then goalkeepers. Contusions were the most common injury, followed by strains, lacerations, and sprains.

CONCLUSIONS

Most injuries among Japanese ice hockey players occurred during games. Game or play intensity may influence the injury rate during games.

Hip injuries and labral tears in the national football league

BACKGROUND

Injuries to the hip account for approximately 10% of all injuries in football, but definitive diagnosis is often challenging. Although these injuries are often uncomplicated contusions or strains, intra-articular lesions are increasingly found to be sources of hip pain.

PURPOSE

The objective was to define the incidence and etiologic factors of intra- and extra-articular hip injuries in the National Football League (NFL).

STUDY DESIGN

Descriptive epidemiology study.

METHODS

The NFL Injury Surveillance System was used to define all hip-related injuries from 1997 to 2006. Injuries were included if the athlete missed more than 2 days. All hip and groin injuries were included for evaluation. The authors also report on NFL players with intra-articular injuries seen at their institution outside of the NFL Injury Surveillance System.

RESULTS

There were a total of 23 806 injuries from 1997 to 2006, of which 738 were hip injuries (3.1%) with an average of 12.3 days lost per injury. Muscle strains were the most common injury. Intra-articular injuries resulted in the most time lost. Contact injuries most likely resulted in a contusion, and noncontact injuries most often resulted in a muscle strain. In the authors' institutional experience, many of the athletes with labral tears have persistent adductor strains that do not improve despite adequate therapy.

CONCLUSION

Hip injuries represent a small but substantial percentage of injuries that occur in the NFL. A majority of these injuries are minor, with a return to play within 2 weeks. Intra-articular injuries are more serious and result in a significant loss of playing time. The "sports hip triad" (labral tear, adductor strain, and rectus strain) is described as a common injury pattern in the elite athlete.

Incidence of anterior cruciate ligament injuries among elite ballet and modern dancers: a 5-year prospective study

BACKGROUND

Ballet and modern dance are jump-intensive activities, but little is known about the incidence of anterior cruciate ligament (ACL) injuries among dancers.

HYPOTHESIS

Rigorous jump and balance training has been shown in some prospective studies to significantly reduce ACL injury rates among athletes. Dancers advance to the professional level only after having achieved virtuosic jump and balance technique. Therefore, dancers on the elite level may be at relatively low risk for ACL injury.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

Dance exposure, injuries, and injury conditions were systematically recorded at 4 dance organizations over 5 years. Select neuromuscular and psychometric variables were compared between and within ACL-injured and noninjured dancers.

RESULTS

Of 298 dancers, 12 experienced an ACL injury over the 5-year period. The incidence of ACL injury was 0.009 per 1000 exposures. Landing from a jump onto 1 leg was the mechanism of injury in 92% of cases. Incidence was not statistically different between gender or dance groups, although women modern dancers had a 3 to 5 times greater relative risk than women ballet dancers and men dancers. No difference between ACL-injured and noninjured dancers emerged with regard to race, oral contraceptive use, or select musculoskeletal measures.

CONCLUSION

Dancers suffer considerably fewer ACL injuries than athletes participating in team ball sports. The training dancers undertake to perfect lower extremity alignment, jump, and balance skills may serve to protect them against ACL injury. Anterior cruciate ligament injuries happened most often late in the day and season, suggesting an effect of fatigue.

Fatigue alters lower extremity kinematics during a single-leg stop-jump task

To examine the kinematic characteristics of the hip and knee during a single-leg stop-jump task before and after exercise-to-fatigue, and to determine if the fatigue response is gender-dependent. Lower extremity kinematic measurements were taken of male and female subjects while they performed a sports functional task before and after fatigue developed from exhaustive running. Thirty healthy, physically active subjects (15 males and 15 females) Knee and hip joint kinematics were calculated utilizing three-dimensional video analysis. Each subject performed five single-leg stop-jumps before and after an exercise-to-fatigue bout. All subjects underwent a fatigue protocol using the modified Astrand protocol. Fatigue was verified using the Rating of Perceived Exertion along with the subject's heart rate. All data were analyzed using two factor (test x gender) repeated measures ANOVA (P<0.05). Both males and females demonstrated significantly less maximal knee valgus (P=0.038) and decreased knee flexion at initial contact (P=0.009) post-fatigue. No significant differences were identified in hip joint angles between sessions or between sexes. The results show that fatigue developed from exhaustive running alters lower extremity kinematics during a single-leg stop-jump task. The more neutral position in the frontal plane might be an effort to protect the knee. The decrease in knee flexion at initial contact may be an attempt to increase knee stability following fatigue. Our results did not reveal any gender differences in this specific task.

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.

Central nervous system injuries in sport and recreation: a systematic review

Many sports have been associated with a variety of neurological injuries affecting the central nervous system (CNS), with some injuries specific to that sport. A systematic review of sport-specific CNS injuries has not been attempted previously, and could assist in the understanding of morbidity and mortality associated with particular sporting activities, either professional or amateur. A systematic review of the literature was performed using PubMed (1965-2003) examining all known sports and a range of possible CNS injuries attributable to that sport. Numerous sporting activities (45) have associated CNS injuries as reported within the literature. The sports most commonly associated with CNS injuries are: football, boxing, hockey, use of a trampoline, and various winter activities. A number of sporting activities are associated with unique CNS injuries or injury-related diseases such as heat stroke in auto racing, vertebral artery dissection in the martial arts, and dementia pugilistica in boxing. Neurological injuries of the CNS due to sport comprise a wide collection of maladies that are important for the neurologist, neurosurgeon, orthopaedic surgeon, physiatrist, sports medicine doctor, athletic trainer and general physician to recognise.