Pre-competition habits and injuries in Taekwondo athletes

Effects of Taekwondo Training on Growth Factors in Normal Korean Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The growth of children and adolescents is both an important health indicator and a major public health issue. Many recent studies have investigated the effects of taekwondo on growth factors, but no consensus has yet been reached. This meta-analysis aimed to determine the effects of taekwondo on the growth factors in children and adolescents (aged 8 to 16 years). Randomized controlled trials from PubMed, Web of Science, Cochrane Library, the Research Information Sharing Service, the Korea Citation Index, and the Korean-studies Information Service System were analyzed. The effect sizes (standardized mean differences, SMD) were calculated, the risk of bias and publication bias were assessed, and the effect size and subgroup analyses were pooled. We found that the taekwondo group had significantly higher levels of growth hormones (SMD 1.78, 95% confidence interval [CI] 0.98-2.58, and p < 0.001) and insulin-like growth factors (SMD 1.76, 95% CI 0.60-2.92, and p < 0.001) than the control group. For height, a medium effect size was observed (SMD 0.62, 95% CI -0.56-1.80, and p = 0.300), but the between-group difference was not significant. Thus, taekwondo had significant positive effects on the secretion of growth hormones and insulin-like growth factors in Korean children and adolescents. A longitudinal follow-up is necessary to determine the effect on height. This suggests that taekwondo can be recommended as an appropriate physical exercise for maintaining normal growth in children and adolescents.

Differences in Sports Injury Types According to Taekwondo Athlete Types (Sparring, Poomsae, and Demonstration)

The objective of this study was to investigate the range of injuries according to the competition format type of Taekwondo (sparring, poomsae, and demonstration) and compare the level of injuries to provide basic data for preventing injuries among Taekwondo athletes. Data were collected through a survey of 472 Taekwondo athletes using convenience sampling and self-administration methods. The most frequently injured body part was the ankle for sparring (54.03%) and demonstration (55.09%) athletes and the pelvis for poomsae (36.36%) athletes (x² = 111.556, p < 0.001). The most frequent injury type was sprain for poomsae (36.40%) and demonstration (52.30%) athletes and fracture for sparring (49.40%) athletes (x² = 127.752, p < 0.001). The most frequently reported cause of injury was excessive training and chronic fatigue (x² = 50.251, p < 0.001). All three types of athletes showed a higher proportion of injury at the training location than at the competition location. The period for the return to training was ≤1 week for sparring (40.80%) and poomsae (64.10%) athletes but 2-3 weeks for demonstration (27.8%) athletes (x² = 45.582, p < 0.001). Diverse strategies, ranging from wearing protective gear to adopting a conditioning strategy and psychological training, are needed for each competition format of Taekwondo to prevent injuries in daily training.

Sports injuries in amateur recreational Taekwondo athletes

ABSTRACT Combat sports are very common in sport mega-events. Taekwondo is a combat sport that prioritizes direct contact between participants, specially by kicks and punches, and provides ambiguity in the health-sport relationship, as its practice could be harmful. This study aimed to quantify the prevalence of injuries in amateur Taekwondo athletes, from training or competitions, and assess their association with intrinsic and extrinsic factors. This is a descriptive, observational, and retrospective study that assessed injuries by a reported morbidity inquiry. Information on sports injuries considered the last six months of 2018. Participants were athletes aged from 12 to 25 years old, of both sexes, practicing Taekwondo in the city of Pelotas, Rio Grande do Sul, Brazil. The prevalence of sports injuries in amateur Taekwondo athletes in Pelotas was 26.2% (n=1), without significant differences between sexes. The main reason for the practice was physical conditioning (35.7%). The main mechanism of injury was kick when attacking (45.4%), followed by impact when defending (27.3%). The most frequent type of injury was sprain (27.3%). followed by contusion (18.2%), and the most injured body parts were knees (36.4%) and ankles (36.4%). The prevalence of sports injuries in amateur Taekwondo athletes in Pelotas was lower than the one found in the literature, and it may be due to the nature of the practice, as they are recreational amateur athletes aiming to improve physical conditioning.

Lesões desportivas em atletas recreacionais amadores de taekwondo

RESUMO As modalidades esportivas de combate (MEC) são muito frequentes em megaeventos esportivos e, dentre elas, destaca-se o taekwondo, que prioriza o contato direto entre os participantes principalmente a partir de chutes e socos, e proporciona ambiguidade na relação saúde-desporto, pois sua prática pode ser lesiva. O objetivo do estudo foi quantificar a prevalência de lesões em atletas recreacionais de taekwondo, oriundas de treinos ou competições, e testar sua associação a fatores intrínsecos e extrínsecos. Trata-se de estudo observacional descritivo, de natureza retrospectiva, que empregou inquérito de morbidade referida para registro dos agravos. As informações quanto à lesão desportiva foram registradas considerando os últimos seis meses de 2018. Participaram atletas com idade entre 12 e 25 anos, de ambos os sexos, praticantes de taekwondo na cidade de Pelotas, no Rio Grande do Sul. A prevalência de lesões desportivas em praticantes recreacionais de taekwondo na cidade de Pelotas é 26,2% (n=11), sem diferenças significantes entre sexos. O principal motivo de prática é o condicionamento para saúde (35,7%); o principal mecanismo de lesão foi chute atacando (45,4%), seguido de impacto ao realizar defesa (27,3%); o tipo de lesão mais frequente foi entorse (27,3%), seguido de contusão (18,2%); e os segmentos corporais mais lesionados foram joelho (36,4%) e tornozelo (36,4%). A prevalência de lesões desportivas em praticantes recreacionais de taekwondo da cidade de Pelotas é inferior à encontrada na literatura, e isto pode decorrer da natureza da prática, dado que eles são atletas recreacionais amadores, com a prática direcionada ao condicionamento para a saúde.

Rapid Weight Loss of Up to Five Percent of the Body Mass in Less Than 7 Days Does Not Affect Physical Performance in Official Olympic Combat Athletes With Weight Classes: A Systematic Review With Meta-Analysis

Given the relevance of the effects that weight loss can generate on the physical performance in athletes, this study performed a systematic review with meta-analysis of the published literature on rapid weight loss (RWL) and examined its impact on the physical performance in Official Olympic combat sports athletes. The “Preferred Reporting Items for Systematic Reviews and Meta-Analysis” (PRISMA) guidelines were followed to ensure an ethical and complete reporting of the findings. PubMed, SPORT Discus, and EBSCO were the electronic databases explored for article retrieval and selection. The following string was applied: “RWL” OR “weight loss” OR “weight reduction” AND “judo” OR “wrestling” or “taekwondo” or “boxing” AND “performance.” Based on the quality analysis, conducted according to the “Tool for the assessment of study quality and reporting in exercise training studies” (TESTEX), ten articles achieved a score >6 points. The meta-analysis showed a significant difference in pre- vs. post-weight loss (p = 0.003) and no effects in pre- vs. post-power and strength performance analysis (p > 0.05 for both results). Based on our systematic review and meta-analysis of the literature, RWL up to ≤5% of the body mass in less than 7 days does not influence performance outcomes in Official Olympic combat athletes with weight classes, considering the strength and power measures.

Foot and Ankle Injuries in Elite Taekwondo Athletes: A 4-Year Descriptive Analysis

Background:

Foot and ankle injuries are a common but underestimated problem in taekwondo. Detailed data on injury incidence rates (IIRs), patterns, and injury mechanism are missing.

Purpose:

The primary aims were to evaluate the prevalence of foot and ankle injuries and the exposure-adjusted IIR of elite taekwondo athletes during matches while training (ie, sparring) and in competitions. The secondary aims were to evaluate injury site, type, sport-specific mechanism, and time loss.

Study Design:

Descriptive epidemiology study.

Methods:

Athletes from a single national Olympic taekwondo training center were assessed prospectively for foot and ankle injuries over 4 years (between January 1, 2016, and December 31, 2019). Data were collected regarding number and type of injuries, anatomic location, and total exposure time during training and competition for each athlete. Injury mechanism and dominant foot were assessed via personal interview. Time loss from sport was analyzed retrospectively. The injury prevalence and IIR were calculated. Correlation between mechanism and injury type, location, and dominant foot was evaluated. Time loss according to location and injury type was assessed. The chi-square test and Fisher exact test were used to test for differences in sex, age, and taekwondo experience and for comparison of injury location and type, injury mechanism, and side dominance, respectively. Training and competition IIRs and prevalence were calculated with 95% CIs (for Poisson rates).

Results:

From an initial 107 athletes, 79 (73.8%) were included in the final data set. Of these athletes, 38 were injured (n = 112 injuries) for a prevalence of 48.1% (95% CI, 43%-52%). The overall IIR of the ankle joint was 13.14 injuries per 1000 athletes (95% CI, 1.5-25.9) and was significantly higher during competition versus training (P < .001). Ankle joint injuries were most common (n = 71; 63%). Significantly more noncontact versus contact ankle ligament injuries (n = 46; 83%) occurred (P < .001). The forefoot (n = 18; 66%) was mainly affected by contact injuries (P < .001). Time loss was the highest for midfoot fractures (mean ± SD, 23.0 ± 0.6 days; range, 23-24 days).

Conclusion:

Noncontact ligamentous ankle injuries were most common, with a higher incidence during competition. Improvement of strength, endurance, and postural stability under strain is recommended for prevention.

Nutritional Considerations for Injury Prevention and Recovery in Combat Sports

Sports participation is not without risk, and most athletes incur at least one injury throughout their careers. Combat sports are popular all around the world, and about one-third of their injuries result in more than 7 days of absence from competition or training. The most frequently injured body regions are the head and neck, followed by the upper and lower limbs, while the most common tissue types injured are superficial tissues and skin, followed by ligaments and joint capsules. Nutrition has significant implications for injury prevention and enhancement of the recovery process due to its effect on the overall physical and psychological well-being of the athlete and improving tissue healing. In particular, amino acid and protein intake, antioxidants, creatine, and omega-3 are given special attention due to their therapeutic roles in preventing muscle loss and anabolic resistance as well as promoting injury healing. The purpose of this review is to present the roles of various nutritional strategies in reducing the risk of injury and improving the treatment and rehabilitation process in combat sports. In this respect, nutritional considerations for muscle, joint, and bone injuries as well as sports-related concussions are presented. The injury risk associated with rapid weight loss is also discussed. Finally, preoperative nutrition and nutritional considerations for returning to a sport after rehabilitation are addressed.

Rapid Weight Loss Practices in Elite Kickboxers

The aim of this observational cross-sectional survey was to determine the prevalence of rapid weight loss (RWL) in elite kickboxers. Kickboxers (61 males; age = 24.2 ± 4.6 years, weight = 73.9 ± 12.8 kg, and height = 179.2 ± 7.9 cm) from eight European countries completed a Rapid Weight Loss Questionnaire regarding prevalence, magnitude, and methods of RWL. All athletes (100%) were practicing RWL before the competition with a Rapid Weight Loss Questionnaire score of 52.4 ±12.9. Most kickboxers 'usually lose between 2% and 5% of their body mass, whereas ∼30% lose between 6% and 8%. However, it is alarming that almost 30% reported cutting 10% of body weight or more sometime during their kickboxing career. Almost half of the athletes always practice gradual dieting (45.9%) and increased exercising (44.3%) to reduce body mass. Kickboxers usually reduce weight three to four times during a year, usually 7-15 days before a competition. More than a third (34.4%) started with RWL practice under the age of 17. There was no significant difference between weight divisions in weight management behaviors (p = .5, F = 0.6; η2 = .0) and no relation between the main characteristics of elite kickboxing athletes and the total RWL score. In conclusion, RWL practices in kickboxing athletes are somewhat specific and different when compared with other combat sports, which can be explained by greater number of weight classes and specific weigh-in protocol.

An Investigation of Knee Injury Profiles among Iranian Elite Karatekas: Observations from a Cross-Sectional Study

Karate training, despite the many positive health benefits, carries a risk of injury for participants. The current cross-sectional study aimed to investigate knee injury profiles among Iranian elite karatekas. Participants who attended the national team qualifiers, which included 390 male Kumite karatekas (age 24 ± 3 years old and weight 63 ± 12 kg), participated in this study. Information on knee injuries (injury history, type of injury mechanisms, and effects of knee symptoms on the ability to perform daily activities and recreational activities) were obtained using the Knee Outcome Survey (KOS). Using Pearson's correlation coefficient, the study examined the relationships between different variables, including KOS subscales and levels of self-reported knee joint function. Our findings indicated that 287 karatekas (73.6%) experienced knee injuries. The anterior cruciate ligament (ACL) rupture (6.9%), articular cartilage (5.4%), and meniscus damage (3.8%) were the main typology of injury. In addition, there were no differences in knee injuries between the non-dominant and dominant legs. Most injuries occurred during the preparatory period (n = 162, 50%), especially during training periods. The KOS subscales scores (Mean ± Sd) for activities of daily living (ADL) and sports activity (SAS) were, respectively, 89 ± 11 and 91 ± 9. The self-reported scores for both the ADL and SAS subscales were, respectively, 89 ± 11 and 90 ± 10. Pearson coefficients of ADL and SAS subscales with their self-reported score were r = 0.761 (p < 0.0001) and r = 0.782 and (p < 0.0001), respectively. The profile of knee injuries in the current investigation is similar to previous surveys that reported lower extremity injury patterns. The findings of this study could be adopted to inform practice aimed at planning interventions for the reduction and prevention of knee injuries among karatekas.

FLUID BALANCE DURING TAEKWONDO TRAINING

ABSTRACT Introduction Dehydration has been described as one of the main factors of reduced performance in combat sports activities, leading to death in extreme cases. Objective To investigate the pre-training hydration status and changes in fluid homeostasis during two taekwondo training sessions. Methods Eighteen male college athletes (age 22.6 ± 3.37 years) were assessed. The study design aimed to reproduce the conditions of a 90-minute taekwondo training session, divided into three stages: a) warm-up exercises (20 min); b) poomsae (30 min) and c) technical training (40 min). The athletes had ad libitum water intake during training. To assess the hydration status we considered body mass (BM), the amount of liquid consumed and urine output, which enabled us to establish absolute and relative fluid loss in kg and percentage as well as the sweating rate. We also considered urine specific gravity (USG), urine color (U-COL), and subjective sensation of thirst (Sthirst) before and after the training session. Pre- and post-training results were compared separately in each session and between sessions. Results There was a significant difference (P<0.05) in pre-training BM between the two days of training. There was a significant difference (P<0.05) in the final BM on both days of the experiment. Most subjects had relative dehydration below 2%. A significant difference (P<0.05) was recorded pre and post training for U-COL and Sthirst, with the highest rates obtained at the end of each session. Participants always started training at a low dehydration status (USG >1,020g.ml-1). Conclusions The athletes tended to start the training sessions in dehydration status, which increases over the course of the training. Ad libitum water intake was not sufficient to balance fluid loss. Changes in fluid levels between sessions were similar. Level of Evidence II; Therapeutic Studies Investigating the Results Level of Treatment.

Musculoskeletal injuries in taekwondo athletes: a nationwide study in Portugal

OBJECTIVE

Taekwondo is a martial art that emphasizes blows using the feet and fists, and it is characterized by direct and continuous body contact, which subjects their practitioners to a higher number of injuries. This study aimed to determine the incidence of musculoskeletal injuries in Portuguese taekwondo athletes and analyze its associated factors.

METHODS

The sample included 341 taekwondo athletes, aged between 4 and 62 years (18.77±12.77 years), 237 (69.5%) were male, and 104 (30.5%) female. A questionnaire was administered at a national level in taekwondo training and competitions via interview.

RESULTS

One hundred and thirty-two (38.7%) taekwondo athletes reported having suffered an injury since they began their practice, totaling 294 injuries. Seventy-six (22.3%) athletes had an injury in the previous 12-months period, with a total of 112 injuries. There were 2.15 injuries per 1,000 hours of taekwondo training. The most common of all injuries was muscle injury (strain, contusion) (58.6%), in the foot and fingers (18.9%). The attack technique (28.8%) was the most prevalent injury mechanism. Adult athletes presented a higher risk of sustaining taekwondo-related injuries than adolescents (odds ratio = 3.91; 95%CI: 1.13-13.55; p=0.032), and athletes who trained more than 1 hour had a risk 4.20 times greater (95%CI: 1.44-12.29; p=0.009) than those who trained up to 1 hour per session.

CONCLUSIONS

Injuries were frequent among Portuguese taekwondo athletes, with specific body areas affected, mainly caused by the attack technique. It is necessary to create injury prevention strategies, including specific training and the use of protective equipment.

A Legal and Forensic Medicine Approach to Police Physical Intervention Techniques in High-Risk Situations

Background: The physical intervention techniques (PITs) typically used by the police in troublesome situations are examined in terms of injuring potential depending on whether they target a body zone of high, medium or low vulnerability. Based on legal and forensic considerations, and principles of congruence, opportunity and proportionality, a need exists to favor opponent locking and arrest techniques targeting non-vulnerable zones to minimize the risk of severe damage. Methods: A search of the training manuals for the different kind of law of enforcement officers was carried out. Revision of injuries was available from electronic databases of academic o medical journals. Results: Three different locking and arrest PITs based on operational tactical procedures (OTP) that avoid zones of high or medium vulnerability are proposed. The new techniques use blocking, diverting and grabbing of the upper and lower limbs, followed by dislocation and locking of the same targets. Conclusions: The damaging potential of such PITs was assessed in terms of anatomical region and most were found to have a high risk of severe damage. The alternative PITs proposed here, which rely on OTP, improve in legal and forensic medical terms on existing choices and dramatically reduce the risk of injuring arrestees.

Rapid Weight Loss in Competitive Judo and Taekwondo Athletes: Attitudes and Practices of Coaches and Trainers

Fasting, skipping meals, and dehydration are common methods of rapid weight loss used prior to competition in weight category sports. This study examines coaches' attitudes, perceptions, and practices regarding rapid weight loss among judo and taekwondo athletes. A convenience sample of experienced coaches and trainers (n = 68) completed structured questionnaires. Participants in this study were 33.8 ± 9.3 years old; 57 were males and 11 were females; and 59% were certified coaches, with 71% reporting over 20 years of involvement in sports and 68% having more than 10 years of teaching experience. The majority (90%) reported that they usually supervised athletes through the weight loss process. Interventions for weight loss began at 12.7 ± 1.9 years of age, with a recommended precompetition weight loss duration of 16.2 ± 8.2 days and an average reduction of 1.5 ± 0.7 kg. The majority of the responders (92%) recommended that their athletes practice gradual weight loss methods using a combination of dehydration or increased physical activity (80.3%), sweat suits (50.8%), restricted fluid intake (39.3%), training in heated rooms (27%), and sauna (26.2%). Recommendations of spitting (27.8%) or using laxatives, diuretics, diet pills, or vomiting (21.3%) were also reported. Coaches and trainers often encouraged athletes to cut weight before competition. The methods recommended are potentially harmful with severe health risks, including compromised nutritional status and diminished athletic performance. This is of particular concern in young athletes who are still growing and developing physically. Enhancing knowledge and awareness for coaches, athletes, and parents regarding potential dangers, along with improved nutrition education, is critical for reducing the magnitude and misuse of rapid weight loss methods.

Changes of body composition, physical fitness, and blood variables according to the short-term weight reduction in college ssireum athletes

The purpose of the study was to investigate the influence of short-term weight loss on body shape, physical fitness, and blood variables in college ssireum (one of the Korean traditional martial art) athletes. Six college ssireum athletes participated as subjects. The weight loss program includes 50% of limited diet, 5.5 hr of physical and skill training. Body composition such as weight, body fat, muscle mass, and body mass index (BMI) was determined. Fitness test such as shuttle run, sit-up, trunk extension test, grip test, sitting reach test, and side step test was measured. Blood variables such as total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein, glucose, reactive oxygen species (ROS), malondialdehyde (MDA), and superoxide dismutase (SOD) were checked before and after the short-term weight reduction. The results revealed significant decrease in body composition such as weight, body fat, muscle mass, and BMI. Fitness test also showed significant decrease in sit-up, trunk extension test, and grip test. The results demonstrated positive significant change in side step test, shuttle run, and sitting reach test. The results of blood variables showed significant decrease in total cholesterol, LDL, glucose and SOD. In contrast, MDA revealed significant increase and no significant change was found in ROS. Finally, it is assumed that a proposal of weight loss without decrease of muscle mass, muscle force, and muscle endurance is necessary because of the negative effects on muscle force and muscle endurance which should be used during actual games.

Can Match-Mimicking Intermittent Practice Be Used as a Simulatory Training Mode of Competition Using Olympic Time Frame in Elite Taekwondo Athletes?

Aim: The physiological realities between Taekwondo (TKD) simulation kicking training and TKD competition according to the Olympic time frame remain unclear. The purpose of this study is to establish an Olympic match-simulated kicking model and compare its effects with real TKD competition on physiological challenges and hormonal responses during serial matches in elite athletes.

Method: Sixteen elite TKD athletes randomly were assigned into either a TKD match-simulated kicking group (TMSK; N = 8, age: 21.3 ± 0.2 years) or a simulated TKD competition group (STC; N = 8, age: 21.6 ± 0.5 years). Both groups performed either simulated kicking or TKD competitions in the same time-course order, and all physiological parameters and blood sampling time-points were identical between groups. The heart rate (HR) and rating of perceived exertion (RPE) were recorded during each match-simulated kicking and TKD competition session. Blood samples were obtained before competition (Pre-Comp.), after competition—in ths case meaning four consecutive matches (End-Comp.), and 24 h after the first match (Next day) for determination of biomarkers of muscle damage (myoglobin and CK), hematological profiles, and hormonal profiles (testosterone and cortisol).

Results: The responses of HR, RPE, and blood lactate levels during the consecutive testing sessions showed no differences between TMSK and STC. The changes in CK and myoglobin were greater in STC (p < 0.05), and a greater decrease in red blood cell (RBC) loss was observed in the STC group (p < 0.05). Compared with TMSK, the inflammatory state, reflected by the ratios of neutrophils-to-lymphocyte (NLR) and platelets-to-lymphocyte (PLR), was higher in STC (p < 0.05). Moreover, the catabolic state (cortisol/testosterone) was greater in STC than in TMSK (p < 0.05).

Conclusion: We demonstrated that, compared with TMSK, the STC produced greater muscle damage, inflammatory responses, and catabolic stress in the Olympic competition time frame in elite male TKD athletes. Although TMSK is capable of eliciting similar physiological challenges as TKD competition, the muscle damage and hormonal profiles provoked by TMSK were not comparable to TKD competition. Our findings provide science-based data and better understanding for coaches, athletes, and sports scientists to develop TKD-specific training programs for Olympic preparation.

Prevalence, techniques and knowledge of rapid weight loss amongst adult british judo athletes: a questionnaire based study

Background

No investigation has analysed the RWL approaches since new rules by the International Judo Federation (IJF) regarding weigh-ins have been implemented in international competitions in 2014. The current study analyses the prevalence, most common methods and knowledge surrounding the effects of rapid weight loss (RWL) amongst adult UK judo athletes. Additionally, it examines differences in rapid weight loss behaviour (RWLB) between gender, weight-class, competitive level, age RWL began and "high"/"low" knowledge athletes.

Methods

A previously validated questionnaire developed to assess RWL in judo athletes was modified by adding a knowledge section and revalidated for content. The questionnaire provided a RWLB score (higher score equated to more aggressive RWL) and a knowledge score (out of 10). 256 athletes (189 males and 66 females, aged 18-67 years) completed the questionnaire between February and April 2015. Unpaired t test, one-way ANOVA-tests and Chi-squared tests were used to test differences of mean RWLB scores and prevalence between groups.

Results

The prevalence of RWL was 84%. The most common methods of RWL were increased exercise and decreased food/fluid intake. The mean knowledge score was 6.2±2.8, with most incorrect answers regarding physiological effects of RWL. No significant differences in RWLB scores were found between gender, "high"/"low" knowledge athletes or weight-classes. Statistically significant differences in RWLB scores were found between different competitive levels (p=0.014) and age RWL began (p<0.01) in males but not in females.

Conclusion

RWL is highly prevalent in the UK adult judo population and athletes have moderate knowledge surrounding its effects. In males, RWLB is most aggressive in elite level athletes and those that began RWL at a younger age. Therefore, updated rulings to target elite and youth level athletes should be implemented to reduce dangerous RWL.

Level of evidence

IV.

Analysis of Injuries and Risk Factors in Taekwondo during the 2014 Italian University Championship

Purpose  This study aims to analyze the risk factors and type of injuries occurring in Taekwondo athletes participating in a national competition.

Methods  Out of the 127 competitors, 18 athletes got injured during a Taekwondo championship who were analyzed for the following parameters: modality of training; age, weight; belt color; and the type of injury.

Results  Around 89% of the injuries were due to bruising and were found mainly on the lower limbs (61%) during the elimination rounds and during the first match of the day. The higher probability of injury was in the second round (56%), and during the first match of the day (72%). Nearly all the athletes were able to complete the game in which they were injured (83%). Comparing the average age of the athletes suffering an injury (23.6 ± 2.06 years) with their average years of training (8.4 ± 7.05 years) it can be noted that these athletes began this discipline rather late. The more is the training age and the weekly hours of training, the more are the numbers of matches completed, even as injured. Beginners with a low-level belt suffered more injuries than the experienced subjects did.

Conclusion  The following risk factors for injury were found: starting to practice in late age, weekly training sessions with a few number of hours, male sex, low-level belt, elimination rounds, the first match of the day, and second round.

Level of Evidence  Level III, observational analytic study without a control group.

Hand and Wrist Injuries in Boxing and the Martial Arts

Hand and wrist injuries in martial arts are typically a reflection of the combat nature of this discipline. In striking sports, the axial load mechanism of injury is common and causes fractures and dislocations; in grappling sports, sprain injuries and degenerative changes predominate. There is clear evidence to support that hand protection reduces the risk of hand injury. Traditional training in martial arts on proper technique and target selection in striking sports reduces the risk of hand injury, and is an important component of hand and wrist injury prevention.

Rapid weight gain in professional boxing and correlation with fight decisions: analysis from 71 title fights

OBJECTIVES

Boxing is a sport where athletes compete in several weight categories. Professional boxers typically dehydrate to cut their weight for the weigh-in (24 h before the contest) and then rehydrate before the fight. The International Boxing Federation (IBF) mandates a second weigh-in 12 h before the fight. Our objectives were: 1) To quantify the weight gain (WG) from the 1st to the 2nd weigh-in; 2) to investigate whether rapid WG affects boxing performance (win/loss rate) and 3) whether weight discrepancy (WD) 15 between boxers exposes them to increased health risks (rate of fights ended before time limit).

METHODS

From official weigh-in reports of 71 IBF fights (142 fighters) the following data were gathered/calculated for each boxer: age, weight division, 1st weight, 2nd weight, WG between weigh-ins (kg and %), WD between opponents, and fight decision.

RESULTS

Between the weigh-ins, the average WG was 2.52 ± 1.37 kg (range -0.3/6.4 kg) and 3.8 ± 2.2% of the initial body weight (range -0.4/9.3%) and the average WD 1.94 ± 1.50 kg (maximum 7.10 kg). Both WG and WD did not affect match outcomes. We observed tendencies for higher loss rate among boxers gaining more weight, and for higher victory rate in boxers with larger WD, however without reaching significance. A significant negative correlation was found between the 1st weight and the WG, both in absolute (r = -0.278, p = 0.001) and relative value (r = -0.497, p < 0.0001).

CONCLUSIONS

Although correlations between WG, WD and boxing performance were not found, single cases with an alarming high WG and WD were noted.

Morphological optimization of female combat sports athletes as seen by the anthropologists

Body build and proportions are key determinants of athletic success. The effects of the athlete selection process and discipline-specific training are differentiated body dimensions. The aim of the study was to examine the physical characteristics of female combat athletes. The results of anthropometric measurements of 154 females aged 21.2±1.79 years competing in judo, jiu-jitsu, karate, taekwondo, and fencing for 7.5±3.43 years.

Significant differences were observed between the judo and karate, taekwondo and fencing practitioners in chest, hip, arm and forearm girths. More variance was observed in body proportions. Fencers had the slimmest body shape, a more massive body size in the judokas. Longer upper extremities relative to lower extremity length were found in the jiu-jitsu group. Relative to body height, a larger torso and greater girths were observed in the judokas compared with the fencing, karate, and taekwondo practitioners. The groups did not differ in the level of endomorphy. Mesomorphy was highest in judokas and the lowest in fencers, although ectomorphy was most dominant in the latter group.

Females practitioners of combat sports exhibit differences in physical characteristics as an effect of optimizing body type and build via the training and athlete selection process of a given discipline. The anthropometric measures could play a role in talent identification programmes for martial arts and help the trainers to optimize the motoric effectiveness of athletes.

The relationship between Taekwondo training habits and injury: a survey of a collegiate Taekwondo population

Objective

To correlate training habits of Taekwondo (TKD) athletes to risk for injury.

Background

TKD is a Korean marital art that has been growing in popularity, with nearly 2 million individuals practicing the sport in the United States. Because of the combative nature of the sport, injuries are an inherent risk. However, data on proper training habits, types of injuries sustained during training, and recommendations for athletes to avoid injury are lacking. Frequently, studies of TKD evaluate athletes’ injuries during tournaments, but most do not evaluate athletes in training.

Hypothesis

Increased training would potentially create more injuries secondary to increased exposure.

Methods

This is a cross-sectional observational survey of 72 collegiate TKD athletes from the Pacific West Sanctioned Taekwondo Tournaments in the 2008–2009 season. Variables analyzed during training and competitions were training sessions per week, workout habits, belt level, years of experience, and characteristics of injury (location, type, mechanism, situation, treatment, and days missed).

Results

TKD training habits of individuals who practiced four or more times per week (odds ratio [OR], 4.5; P=0.005) or sparred for more than 2 hours (OR, 8.7; P=0.003) were associated with significantly increased odds (risk) of sustaining an injury. Those who had more than 3 years of tournament experience were more likely to sustain an injury (OR, 0.198; P=0.020).

Conclusion

Increased risk for injury with more frequent practice and longer sparring should remind coaches and trainers that monitoring and adjusting the athletes’ training schedules and exposure time could decrease the chance of injury. An athlete that has spent more years in tournaments along with high-frequency and long-duration training was associated with greater risk for injuries. Prevention and education about the risk for exposure to injury may may help athletes and trainers promote prevention strategies and adjust an athletes’ training and tournament schedules to decrease the risk for injury.

Epidemiology of training injuries in amateur taekwondo athletes: a retrospective cohort study

The objectives of this study were to estimate the incidence and describe the pattern and severity of training injuries in taekwondo, and to compare pattern and severity of training injuries with competition injuries. One hundred and fifty-two active Australian amateur taekwondo athletes, aged 12 years or over, completed an online survey comprising questions on training exposure and injury history over the preceding 12 months. The main outcome measures were: overall injury incidence rate per athlete-year; training injury incidence rate per athlete-year, per 1000 athlete-training-sessions, and per 1000 athlete-hours of training; injury severity; and injury proportions by anatomical region and by type of injury. Injury incidence rates were calculated with 95% confidence intervals using standard methods, while injury proportions were compared using Fisher's exact test. The vast majority (81.5%) of taekwondo injuries in an average athlete-year occurred during training. The training injury incidence rate was estimated to be 1.6 (95% CI: 1.4, 1.9) per athlete-year, 11.8 (95% CI: 10.4, 13.4) per 1000 athlete-training-sessions, and 7.0 (95% CI: 6.1, 7.9) per 1000 athlete-hours of training. Among athletes with five or fewer injuries, the severity and injury pattern of training injuries were, by and large, the same as for competition injuries. Approximately sixty percent (60.3%) of training injuries required treatment by a health professional. Considering the burden of training injuries exceeds that of competition injuries, taekwondo governing bodies and stakeholders are encouraged to devote more efforts towards the identification of risk factors for, and prevention of, training injuries in the sport of taekwondo.

Physical and physiological profiles of taekwondo athletes

Taekwondo has evolved into a modern-day Olympic combat sport. The physical and physiological demands of modern-day taekwondo competition require athletes to be competent in several aspects of fitness. This review critically explores the physical and physiological characteristics of taekwondo athletes and presents implications for training and research. International taekwondo athletes possess low levels of body fat and a somatotype that characterises a blend of moderate musculoskeletal tissue and relative body linearity. While there is some variation in the maximum oxygen uptake of taekwondo athletes, moderate to high levels of cardio-respiratory fitness are necessary to support the metabolic demands of fighting and to facilitate recovery between consecutive matches. Taekwondo athletes demonstrate high peak anaerobic power characteristics of the lower limbs and this attribute appears to be conducive to achieving success in international competition. The ability to generate and sustain power output using both concentric and 'stretch-shortening cycle' muscle actions of the lower limbs may be important to support the technical and tactical actions in combat. Taekwondo competitors also display moderate to high maximum dynamic strength characteristics of the lower and upper extremities, and moderate endurance properties of the trunk and hip flexor musculature. The dynamic nature of the technical and tactical actions in the sport demand high flexibility of the lower limbs. More extensive research is required into the physical and physiological characteristics of taekwondo athletes to extend existing knowledge and to permit specialised conditioning for different populations within the sport.

Assessment of Injuries During Brazilian Jiu-Jitsu Competition

Background:

Brazilian jiu-jitsu (BJJ) is a unique style of martial arts with rapid growth in the United States and internationally. Although studies have examined injuries in other martial arts and combat sports, to date, no published medical study has examined injuries in BJJ competitions.

Purpose:

(1) To estimate the incidence of injuries in BJJ competitions and (2) to identify and describe the types and mechanisms of injuries associated with competitive BJJ.

Study Design:

Descriptive epidemiology study.

Methods:

Injury data were obtained from records of on-site medical coverage at 8 statewide BJJ tournaments in Hawaii, USA, between 2005 and 2011.

Results:

The identified injury incidence on the day of matches was 9.2 per 1000 exposures (46 injuries out of 5022 exposures, ie, match participations). Orthopaedic injuries were the most common and accounted for 78% of all injuries (n = 36), followed by costochondral or rib injuries (n = 7) and lacerations requiring medical care (n = 3). The elbow was found to be the joint most commonly injured during BJJ competitions, with the arm bar being the most common mechanism. We propose that this BJJ-specific injury mechanism, the “arm bar,” be recognized as another mechanism of hyperextension injury to the elbow in sports.

Conclusion:

Comparison of the BJJ injury data with injury data reported for judo, taekwondo, wrestling, and mixed martial arts showed that BJJ competitors were at substantially lower risk of injury compared with these other sports. With orthopaedic injuries being most common and the elbow being the area most vulnerable to injury in BJJ, it is important that participants, referees, and physicians be properly educated about the unique mechanisms of injury that can occur, particularly to the elbow.

Epidemiology of injuries in elite taekwondo athletes: two Olympic periods cross-sectional retrospective study

OBJECTIVE

Taekwondo injuries differ according to the characteristics of the athletes and the competition. This analytical cross-sectional retrospective cohort study aimed to describe reported taekwondo injuries and to determine the prevalence, characteristics and possible risk factors for injuries sustained by athletes of the Spanish national team. In addition, we compared each identified risk factor-age, weight category, annual quarter, injury timing and competition difficulty level-with its relation to injury location and type.

SETTINGS

Injury occurrences in taekwondo athletes of the Spanish national team during two Olympic periods at the High Performance Centre in Barcelona were analysed.

PARTICIPANTS

48 taekwondo athletes (22 male, 26 female; age range 15-31 years) were studied; 1678 injury episodes occurred. Inclusion criteria were: (1) having trained with the national taekwondo group for a minimum of one sports season; (2) being a member of the Spanish national team.

RESULTS

Independently of sex or Olympic period, the anatomical sites with most injury episodes were knee (21.3%), foot (17.0%), ankle (12.2%), thigh (11.4%) and lower leg (8.8%). Contusions (29.3%) and cartilage (17.6%) and joint (15.7%) injuries were the prevalent types of injury. Chronological age, weight category and annual quarter can be considered risk factors for sustaining injuries in male and female elite taekwondists according to their location and type (p≤0.001).

CONCLUSIONS

This study provides epidemiological information that will help to inform future injury surveillance studies and the development of prevention strategies and recommendations to reduce the number of injuries in taekwondo competition.

Practices of weight regulation among elite athletes in combat sports: a matter of mental advantage?

CONTEXT

The combination of extensive weight loss and inadequate nutritional strategies used to lose weight rapidly for competition in weight-category sports may negatively affect athletic performance and health.

OBJECTIVE

To explore the reasoning of elite combat-sport athletes about rapid weight loss and regaining of weight before competitions.

DESIGN

Qualitative study.

SETTING

With grounded theory as a theoretical framework, we employed a cross-examinational approach including interviews, observations, and Internet sources. Sports observations were obtained at competitions and statements by combat-sport athletes were collected on the Internet.

PATIENTS OR OTHER PARTICIPANTS

Participants in the interviews were 14 Swedish national team athletes (9 men, 5 women; age range, 18 to 36 years) in 3 Olympic combat sports (wrestling, judo, and taekwondo).

DATA COLLECTION AND ANALYSIS

Semistructured interviews with 14 athletes from the Swedish national teams in wrestling, judo, and taekwondo were conducted at a location of each participant's choice. The field observations were conducted at European competitions in these 3 sports. In addition, interviews and statements made by athletes in combat sports were collected on the Internet.

RESULTS

Positive aspects of weight regulation other than gaining physical advantage emerged from the data during the analysis: sport identity, mental diversion, and mental advantage. Together and individually, these categories point toward the positive aspects of weight regulation experienced by the athletes. Practicing weight regulation mediates a self-image of being "a real athlete." Weight regulation is also considered mentally important as a part of the precompetition preparation, serving as a coping strategy by creating a feeling of increased focus and commitment. Moreover, a mental advantage relative to one's opponents can be gained through the practice of weight regulation.

CONCLUSIONS

Weight regulation has mentally important functions extending beyond the common notion that combat-sport athletes reduce their weight merely to gain a physical edge over their opponents.

Weight loss in combat sports: physiological, psychological and performance effects

Background

The present article briefly reviews the weight loss processes in combat sports. We aimed to discuss the most relevant aspects of rapid weight loss (RWL) in combat sports.

Methods

This review was performed in the databases MedLine, Lilacs, PubMed and SciELO, and organized into sub-topics: (1) prevalence, magnitude and procedures, (2) psychological, physiological and performance effects, (3) possible strategies to avoid decreased performance (4) organizational strategies to avoid such practices.

Results

There was a high prevalence (50%) of RWL, regardless the specific combat discipline. Methods used are harmful to performance and health, such as laxatives, diuretics, use of plastic or rubber suits, and sauna. RWL affects physical and cognitive capacities, and may increase the risk of death.

Conclusion

Recommendations during different training phases, educational and organizational approaches are presented to deal with or to avoid RWL.

Injury rates in Iranian taekwondo athletes; a prospective study

Purpose

Taekwondo, as the most popular martial art among Iranian sportsmen, might lead to injury for the athletes of this sport during competitions. We decided to report the incidence rate of injuries sustained by the athletes of this sport during national competitions.

Methods

All competitions of Iran national championship taekwondo league in 2006-2007 with 204 athletes were observed prospectively to detect the occurrence of injuries. The severity of injuries was classified into four groups (mild, moderate, severe, and critical) according to the involvement of medical care team in the contest, ability of the athletes to resume and duration of probable absence of injured athletes from future competitions and training sessions. Athlete-Exposure (A-E) was defined as the number of competitions multiplied by two. On this base, the rate of injury incidence per 1000 A-Es, the rate of injuries per time unit and the rate of injury occurred for each 100 athletes were considered as the major outcomes of this study.

Results

Of totally 1,338 A-Es, 93 injuries were recorded during the competitions. The rate of injury incidence was found to be 69.5 injuries per 1000 A-Es and the rate of injuries per minute of competitions was 0.023 which corresponded to 23.3 injuries per 1000 minutes of competitions. 45.6 injuries were occurred for each 100 athletes during the course of competitions. The most frequent injuries were mild (68.8%) and critical injuries (24.7%), followed by moderate and severe injuries; 4.3% and 2.1%, respectively.

Conclusion

The rate of injury we found was lower than that of western countries. In spite of finding the lower limbs as the most frequent place of injuries in other studies, we found the upper limbs as the most predisposed place of injuries which might be due to difference in the method of combat of Iranian athletes with other athletes.

Weight cycling in adolescent Taekwondo athletes

BACKGROUND

Weight reduction cycles are used by weight classed athletes in Taekwondo to make a weight category. Tension, dizziness, headaches, and confusion have been associated with rapid weight loss (RWL). There is a lack of research in weight cycling and its benefits among Taekwondo athletes.

PURPOSE

To investigate the rate of weight cycling in Junior Taekwondo athletes and its effect on performance.

METHODS

Athletes were weighed prior to competition, then again before their first match. Body mass difference in relation to winning was compared.

RESULTS

A significant increase from weigh-in to pre-match measurements was consistently found in both genders with no significant difference between them. Winners had a mean body mass gain (1.02 kg) which was non-significantly less than the non-winners (1.09 kg).

CONCLUSIONS

RWL practices do not define which athlete will perform better. Negative effects of weight cycling coupled with RWL has unclear performance benefits which indicates a need for further research.

Prevalence and patterns of combat sport related maxillofacial injuries

Aim:

This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes.

Materials and Methods:

A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai) who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referred to us by the physician team. The type of injury (facial laceration, facial fractures, jaw dislocation, etc.), site of facial injury (jaw, nose, malar bone, teeth, etc.), dental injuries (tooth fracture, displacement, luxation, and avulsion), causative sport (boxing, taekwondo, kickboxing, and Muay Thai) as well as demographic data were recorded. Injuries were examined clinically and radiographically, and treated accordingly by a specialist. Treatment data and demographics were recorded for each subject. Recorded data were assessed, and χ², ANOVA, and Kruskal–Wallis tests were used to statistically analyze and compare the data.

Results:

Of 120 subjects, 95 male subjects (79.2%), aged 18–25 years (avg. 20 years), had at least one traumatic injury to the face requiring medical treatment. These injuries included facial laceration, bone fractures (nose, mandible, and zygoma), dental injuries (displacement, luxation, fracture, and avulsion), and mandibular dislocation which were recorded in 83 (69.2%), 55 (45.1%), 53 (44.2%), and 8 (6.7%) cases respectively. Statistically significant differences were encountered among various injuries and the sports; kickboxing caused the most maxillofacial injuries and was identified as more injurious. Tooth fractures (59.7%) were the most common dental injuries, and the nose (84.7%) was the most frequently fractured facial bone. Lacerations were more common in Thai-boxers (93.3%). Injuries were significantly greater in professional rather than amateur athletes.

Conclusion:

In this study, prevalence of facial injuries from combat sports professionals was significantly high (roughly 80%), especially in kickboxing (in part due to use of less protective gear). Because the nose and teeth sustained the most injuries, they require more attention with regard to prevention. Kickboxing was the most injurious of these combat sports and caused the most significant number of maxillofacial trauma. More safety apparel and protective guards seem warranted in athletes of combat sports if facial injury is to be prevented.

Effects of official Taekwondo competitions on all-out performances of elite athletes

This study investigated physiological and performance aspects of 15 (4 women and 11 men) elite Taekwondo athletes (24.0 ± 5.7 years) during their National Championship. The load of the competition was evaluated by means of heart rate (HR) and blood lactate (La). Pre and postmatch countermovement jump (CMJ), and handgrip performances were compared (p < 0.05). The match imposed a high load (HR > 85% of individual HRmax = 92 ± 12%; La = 6.7 ± 2.5 mmol·L⁻¹) on athletes. After the match, better (p < 0.0001) CMJ (men: 43.9 ± 5.2 cm; women: 30.8 ± 2.3 cm) and worst (p = 0.006) handgrip performances (men: 459 ± 87 N; women: 337 ± 70 N) were found with respect to prematch ones (CMJ: men = 40.8 ± 4.9 cm, women = 28.2 ± 2.5 cm; handgrip: men = 486 ± 88 N, women: 337 ± 70 N). Results indicate that the intermittent activity of the Taekwondo competition elicits a high neuromuscular activation of the lower limbs. Instead, the decreases in grip strength could be because of the repeated concussions on the upper limbs used to protect from the opponent's kicks and punches directed toward the scoring area of the torso. Practically, these results urge coaches to structure training sessions that enable athletes to maintain their upper limb strength during their match.

Chiropractic utilization in BMX athletes at the UCI World Championships: a retrospective study

OBJECTIVE

To examine paramedical (chiropractic, physiotherapy and massage therapy) utilization among high-level BMX athletes following sport-related injury at the 2007 UCI World Championships.

METHODS

Retrospective analysis was conducted on a dataset from international male and female BMX athletes (n = 110) who sustained injury in training and competition at the 2007 BMX World Championships.

RESULTS

Fifty percent of individuals aged 8-17 presented to a chiropractor versus 32% to physiotherapists and 18% to massage therapists. There was a significant difference in paramedical practitioner choice when comparing the sample across the different locations of injury. Specifically, the proportion of individuals presenting for treatment to chiropractors (84%) was much higher than to physiotherapists/massage therapists (16%) for spine or torso complaints.

CONCLUSION

Utilization of chiropractors by BMX athletes may be higher than utilization of other paramedical professionals as suggested by this study. Chiropractors appear to be the paramedical practitioner of choice in regards to spine and torso related complaints.

Weight cycling during growth and beyond as a risk factor for later cardiovascular diseases: the 'repeated overshoot' theory

In people trying to lose weight, there are often repeated cycles of weight loss and regain. Weight cycling is, however, not limited to obese adults but affects people of normal weight, particularly young women, who are unhappy with their appearance. Furthermore, the onset of a pattern of weight cycling is shifting towards younger ages, owing to the increasing prevalence of overweight and obesity in children and adolescents, and the pressure from the media and society for a slim image even for normal weight children. Although there is still controversy whether weight cycling promotes body fat accumulation and obesity, there is mounting evidence from large population studies for increased cardiovascular risks in response to a behavior of weight cycling. Potential mechanisms by which weight cycling contributes to cardiovascular morbidity include hypertension, visceral fat accumulation, changes in adipose tissue fatty acid composition, insulin resistance and dyslipidemia. Moreover, fluctuations in blood pressure, heart rate, sympathetic activity, glomerular filtration rate, blood glucose and lipids that may occur during weight cycling--with overshoots above normal values during weight regain periods--put an additional load on the cardiovascular system, and may be easily overlooked if humans or animals are studied during a state of relatively stable weight. Overshoot of those risks factors, when repeated over time, will stress the cardiovascular system and probably contribute to the overall cardiovascular morbidity of weight cycling.

Epidemiology of injuries in competition taekwondo: a meta-analysis of observational studies

This paper aims to review and collate the epidemiological data of injuries in competition taekwondo as reported in the literature, make recommendations, and suggest further research. The electronic databases AMED, AusportMed, CINAHL, MEDLINE, PubMed, and SPORTDiscus were searched from inception to March 2008. Fourteen prospective cohort studies reporting the incidence of injuries in taekwondo were included. Two reviewers independently extracted data and assessed trial quality using the STROBE statement. Homogenous studies were combined in a pooled analysis using a Poisson random effects regression model. Poisson regression showed an overall mean injury rate of 79.3 per 1000 athlete-exposures (95% confidence interval 22.8, 275.4). Neither age, gender nor level of play were significant in the analysis. The most common injury location and type were found to be the lower limb and contusion, respectively, and were invariably associated with contact. Although taekwondo players are exposed to a substantial risk of sustaining injuries, the majority of injuries appeared to be of minimal severity. Modifications to the competition rules and protective equipment may be warranted. Future studies should adhere to recommended operational definitions, utilise a standardised injury classification system, and report injury rates using multiple denominators in order to facilitate inter- and cross-sport comparisons.

Chiropractic utilization in Taekwondo athletes

The purpose of the present study was to examine chiropractic utilization following a sport-related injury among National Team members and other high level Taekwondo athletes.

METHODS

Retrospective surveys were conducted among Canadian male and female Taekwondo athletes (Group A, n = 60) competing in a national tournament and National Taekwondo team athletes (Group B, n = 16) at a training camp.

RESULTS

A response rate of 46.7% (Group A) and 100% (Group B) was achieved. Twenty five percent (n = 4) of Group A athletes reported never seen a doctor of chiropractic (DC) regarding their injuries. Over 12% (n = 2) reported visiting a DC often, while just over 6% (n = 1) reported that they usually visited the DC following an injury. When injured, over 36% (n = 7) of the National Team members visit their family physician, over 15% (n = 3) visit a chiropractor or physiotherapist and the remaining athletes (n = 6) equally visit osteopaths, massage therapists, or athletic therapist following an injury.

CONCLUSION

There is a lack of information surrounding chiropractic utilization in the majority of sports and minimal research published regarding the health care utilization of Taekwondo athletes. Chiropractors, and particularly those with extensive athlete contact, should endeavour to further utilization studies.