Injuries in extreme sports

Endurance Sporting Events

Endurance sports encompass a broad range of events from marathons and triathlons to ultramarathons, long-distance cycling, skiing, and swimming. As these events have experienced a surge in popularity, we have a greater need to understand the associated medical risks. This article reviews the history of endurance races, reviews the most critical and common causes of cardiovascular, heat, electrolyte, and musculoskeletal injuries/illnesses, and discusses considerations for medical directors/personnel associated with such events.

Death Following a Skiing Incident: Severe Exsanguination Due to Rupture of the Left Renal Artery

With the growing popularity of winter sports, it is necessary to pay more attention to the types of traumatic injuries that a person can sustain in various incidents related to their practice. We present a case in which an adult man died as a result of a collision with a tree while skiing. Although the deaths are associated with different types and severity of craniocerebral injuries in the majority of the cases, here we are dealing with an abdominal injury with rupture of the stomach, pancreas, and left renal artery. The exact localization of the resulting traumatic injuries and the mechanism of their occurrence were examined. Both macroscopic autopsy findings (gross pathology) and histologically proven ones are presented and described. Presenting this case, we want to raise awareness of the different types of injuries received while skiing, as well as to emphasize the possibility of death in the absence of visible external injuries over the victim's body.

Telemedicine in Sports under Extreme Conditions: Data Transmission, Remote Medical Consultations, and Diagnostic Imaging

Telemedical technologies provide significant benefits in sports for performance monitoring and early recognition of many medical issues, especially when sports are practised outside a regulated playing field, where participants are exposed to rapidly changing environmental conditions or specialised medical assistance is unavailable. We provide a review of the medical literature on the use of telemedicine in adventure and extreme sports. Out of 2715 unique sport citations from 4 scientific databases 16 papers met the criteria, which included all research papers exploring the use of telemedicine for monitoring performance and health status in extreme environments. Their quality was assessed by a double-anonymised review with a specifically designed four-item scoring system. Telemedicine was used in high-mountain sports (37.5%; n = 6), winter sports (18.7%; n = 3), water sports (25%; n = 4), and long-distance land sports (18.7%; n = 3). Telemedicine was used for data transfer, teleconsulting, and the execution of remote-controlled procedures, including imaging diagnostics. Telemedical technologies were also used to diagnose and treat sport-related and environmentally impacted injuries, including emergencies in three extreme conditions: high mountains, ultraendurance activities, and in/under the water. By highlighting sport-specific movement patterns or physiological and pathological responses in extreme climatic conditions and environments, telemedicine may result in better preparation and development of strategies for an in-depth understanding of the stress of the metabolic, cardiorespiratory, biomechanical, or neuromuscular system, potentially resulting in performance improvement and injury prevention.

An investigation of the effects of sensation seeking and impulsivity on extreme sport participation and injury using path analysis

OBJECTIVE

Extreme sport participation and injury rates have increased in recent decades. This study aimed to investigate sub-dimensions of impulsivity and sensation seeking that contribute to participation and injury risk in extreme sports.

PARTICIPANTS

Data included cross-sectional survey responses from 7,109 college students (Mage = 19.68, SD = 2.31).

METHODS

This study utilized path analysis to investigate sub-dimensions of sensation seeking and impulsivity as predictors of extreme sport participation and injury across 3 models.

RESULTS

Results of the final model identify risk seeking and lack of perseverance as the two strongest predictors of extreme sports injury, risk seeking, experience seeking, and lack of premeditation as the strongest positive predictors of extreme sports participation, and lack of perseverance as the strongest negative predictor of extreme sports participation.

CONCLUSIONS

These results will contribute to targeted prevention and intervention efforts for extreme sports injury among young adults based on identified individual personality factors.

Comparison and analysis of skiing injuries at ski resorts in Chongli, China and Japan

PURPOSE

The rapid development of winter sports requires investigation on injuries in Chongli district, Zhangjiakou city, one of the ski sites of the 2022 Winter Olympics. Careful evaluation is required to observe which injuries are caused under what circumstances, and then we can make corresponding preventive measures and recommendations based on the results.

METHODS

In this retrospective study, the data of injury cases at ski resorts in China (Chongli district) and Japan were analyzed to provide a reference for the ongoing injury prevention at ski resorts. We collected data on injuries at Wanlong and Fulong ski resorts in Chongli district during the 2017-2018 and 2018-2019 ski seasons. We referred to the skiing injury report issued in February 2020 of a nationwide ski safety statistical service - Japan Ski Safety Association. The causes of injury and specific injured body parts were analyzed based on the data of Chinese and Japanese ski resorts. Statistical significance has been calculated using the Chi-square test.

RESULTS

During the 2019-2020 ski season in Japanese ski resorts, the number of reported injuries per 10,000 skiers was 0.93, of which 457 (17.3%) were over 50 years old, accounting for a large proportion of injuries, meanwhile in Chongli ski resort, the injury rate of skiers aged 50 and over was 7.1%. The knee joint (23.7% at Wanlong ski resort and 28.4% in Japanese ski resorts) was the most injured body part among Chongli and Japanese skiers. Among snowboarders, shoulder joint injury (17.7% in Japanese ski resorts) was the most common, and injury on hands and fingers (16.3% in Wanlong ski resorts) was the most common. Head injury rates are similar in Chongli, China and Japanese ski resorts (8.2% and 8.7%, respectively).

CONCLUSION

Our analysis demonstrated that injury data recorded among young skiers was higher in Chinese ski resorts (Chongli district) than that in Japanese ski resorts, and elderly skiers made up a larger proportion of skiing injuries in Japanese resorts. Thus, according to our research, the protection of knee joints, shoulder joints, and hands and fingers should be taken seriously. It should pay attention to the teaching of ski poles (for finger protection), and use protective devices such as knee pads, helmets, etc.

[Winter sports injuries of the thoracic and lumbar spine : Etiology, classification and stage-specific therapy]

BACKGROUND

Overall, spinal injuries in winter sports are extremely rare. The incidence is given as approximately 0.01/1000 ski days. While falls and collisions at high speed are the main concerns for skiers, spinal injuries for snowboarders occur primarily on landing after a jump. The age of a typical spinally injured skier is 40, which is older than that of the average snowboarder at 23.

CLASSIFICATION

Primarily, the thoracolumbar junction is injured and hereby mainly anterior compression fractures (type A1) and burst fractures (types A3 and A4) occur. Injuries caused by flexion or distraction mechanisms (Type B) or rotation injuries (Type C) are less common. Injuries to the cervical spine are rare overall, but they are also represented in the very few cases with neurological deficits.

THERAPY

With appropriate X‑ray diagnostics, including CT and, if necessary, MRI, the appropriate therapy can be initiated so that a return to sport is possible in most cases. Furthermore, there is ongoing scientific discussion as to when conservative therapy is superior and when surgery is superior.

Are individual risky behaviours relevant to healthcare allocation decisions? An exploratory study

Purpose

The problematic surrounding patients' prioritization decisions are currently at the centre of political leaders' concerns. How to define whom to treat when there are not enough resources to treat everybody is the key question. This exploratory study aims to investigate the views of Bulgarian citizens regarding the relevance of the information concerning eight individual health-related behaviours in priority setting decisions: smoking, excess of alcohol, illegal drug use, overweight/obesity, speed driving, extreme sports practice, unsafe sex and overuse of internet and/or mobile devices.

Design/methodology/approach

Data were collected through a questionnaire where 322 respondents faced hypothetical rationing dilemmas comprising option pairs of the eight risky behaviours. Descriptive statistics and non-parametric tests were performed to define the penalization of each of the risky behaviours and to test for the association between this penalization and the respondent's health habits and sociodemographic characteristics.

Findings

Most respondents would refuse to grant access to healthcare based on patients' personal responsibility for the disease. Nevertheless, respondents were more willing to consider illegal drug use, excessive alcohol consumption, engagement in unsafe sex behaviours and smoking. Respondent's own interest or advantage seems to be somehow relevant in explaining the penalization of risk behaviours in priority setting.

Practical implications

This study shows that most respondents support the lottery criterion and thus do not want to see lifestyle prioritization in action.

Originality/value

This study is the first attempt to awaken attention to the impact that personal responsibility for health may have on intergenerational access to healthcare in Bulgaria.

Pediatric Hand Trauma: An Analysis of 3,432 Pediatric Hand Trauma Cases Over 15 Years

PurposePediatric hand trauma is common and sometimes causes deformity or disability. The incidence and etiologies of hand trauma in children are different from those in adults. This study analyzed the characteristics of pediatric hand trauma cases and patients over a 15-year period. MethodsWe conducted a retrospective medical record review of 3,432 children (2,265 boys, 1,167 girls, under 18 years of age) with hand injuries from January 2005 to December 2019. We evaluated the sex distribution and injury etiologies. Injuries were classified by type as burns, amputations, crushing injuries, lacerations, extensor and flexor tendon injuries, open and closed fractures, and nerve injuries. ResultsAmong the pediatric hand injury patients, males were predominant (1.94:1). Simple lacerations (58.4%) were the most common injury type, followed by fractures (22.8%). Lacerations and burns tended to be common in younger age groups, while tendon injuries, nerve injuries, and crushing injuries were more frequently encountered in older age groups. ConclusionsHand trauma prevention strategies should be established considering the frequent trauma etiologies in specific age groups. An awareness of age-specific characteristics of pediatric hand trauma patients will be helpful to prevent hand trauma.

Dental and general injuries among ski and snowboard instructors in Switzerland, Germany, and Austria-A questionnaire-based study

Objectives

Data on the injury rate of skiers and snowboarders are currently limited. The aim of this study was, therefore, to assess the frequency of general and dental injuries among snow sports instructors, to investigate the use of protective gear and mouthguards, and to evaluate snow sports instructors' dental first aid know‐how.

Material and Methods

A questionnaire‐based, cross‐sectional study comprising 603 ski and snowboard instructors from Austria, Germany, and Switzerland was conducted in the timeframe December 2019 to May 2020. The survey gathered data on general and dental injuries sustained by instructors, protective gear usage, and know‐how in dental first aid. The statistical analysis included χ² tests, Wilcoxon rank‐sum and Kruskal–Wallis tests, and linear regression analysis. The level of significance was set at α = .05.

Results

Out of the 603 instructors, 326 (54.1%) sustained an injury while skiing or snowboarding. Forty (6.6%) reported a snow sports‐related dental injury. The rates of injuries related to skiing and snowboarding showed no significant difference (p = .0952). Compared with snowboarding on slopes, backcountry snowboarding entailed fewer risks of injury for snowboard instructors (p = .012). Knowledge of dental first aid was limited, with 45.8% of instructors uninformed about the possibility of replanting avulsed teeth. 10.1% of instructors were familiar with tooth rescue boxes. None of the instructors surveyed had a tooth rescue box in their first aid equipment. Helmet usage was high (95.6%) among snow sports instructors, whereas mouthguard usage was rare (3.5%).

Conclusions

Protective gear usage among snow sports instructors is high. The risk of dental injury while skiing or snowboarding is lower compared with other sports. Dental first aid know‐how ought to be enhanced in snow sports communities to ensure that appropriate first aid is provided in case of a dental injury related to skiing or snowboarding.

Epidural hematoma from impact while zorbing

Injuries suffered while participating in extreme sports account for numerous emergency department visits. Isolated head injuries are a common presentation. Zorbing is an activity native to New Zealand. Like many emerging extreme sports there is little information regarding its safety. We conservatively managed a patient who suffered a skull fracture and epidural hematoma while zorbing. Publications (especially in the medical literature) are lacking regarding zorbing-related injuries. We hope that presenting this case will help elucidate the possibility of severe head injury despite the protective bubble offered by the sport.

[Comparison of acute sports injury between recreational skiers and skiers]

OBJECTIVE

To compare and analyze the difference between the injuries of recreational skiers in public ski resorts and those of skiing athletes in official competitions, and to explore the suggestions of medical insurance for these two types of skiers.

METHODS

The injury data of recreational skiers in Chongli District, Zhangjiakou City, Hebei Province during 2018-2019 and 2019-2020 snow seasons, and the injury data of skiers in two official international skiing competitions during 2019-2020 snow season and domestic test events in Chongli District of 2021 Winter Olympic Games were analyzed retrospectively, and the similarities and differences were compared.

RESULTS

A total of 1 187 injuries occurred to recreational skiers in the two public ski resorts during the 2018-2019 snow season, with an injury rate of 0.3%.There were 1 277 injury sites in total, and the most frequent injury sites were head and neck (230 cases, 18.0%), followed by knee joint (204 cases, 16.0%) and lower extremity (131 cases, 10.3%). Thirty-one skiers were injured in the two official international skiing competitions in the 2019-2020 and 2020-2021 snow season, and in the domestic test competitions in the 2021 Winter Olympic Games, and the injury rates were 11.5%, 17.2% and 12.0%, respectively. There were 37 injury sites in total, among which 11 (29.7%) were in the head and neck, followed by 6 (16.2%) in the knee joint and 5 (13.6%) in the chest, rib and abdomen.

CONCLUSION

In order to better guarantee the safety of skiers and timely provide corresponding medical help, safety facilities and technical guidance should be added to the snow resort for leisure skiing, and medical stations should be set up in the snow resort. As the formal ski racing for skiing athletes during the game has 30 to 80 times higher injury ratesthan recreational skiers, and compared with the recreational skiing, head and neck injury rate is higher, and the damage is much heavier, more complete first aid facilities and experienced medical workers are, needed so the field should be equipped with the circuit inside the quantities, track fixed outside the clinic, surrounding referral hospitals set up trauma centers to provide athletes with more timely medical care.

[Role of ski injury treatment system between the ski resort medical station of Winter Olympics and the nearby medical care hospital]

OBJECTIVE

To make a retrospective analysis of the situation and process of treating skiers' injuries in the medical station of the Wanlong ski resort in Chongli and the nearest treatment hospital, and to provide a basis for the establishment and optimization of the treatment process between the medical station of the Winter Olympics ski resort and the nearest treatment hospital, and to gain experience for medical security of mass skiing.

METHODS

The data of all ski injuries in Chongli District were collected from the medical station of the Wanlong ski resort during the 2018-2019 snow season (November 2018 to April 2019) and the nearest treatment hospital during two periods (March 2019, and November 2019 to January 2020). The differences of injury causes, injury types, injury sites, and treatment effects of the injured skiers were analyzed.

RESULTS

A total of 755 cases of ski injuries were recorded in the medical station of Wanlong ski resort, the estimated incidence of injury was 2.02‰ per day. The nearest treatment hospital treated a total of 838 injured skiers from different ski resorts in Chongli District in the two periods. In the records of the ski resort medical station, the main causes of injury were technical defects and turnovers (53.6%). Knee joint injury rate was the highest (18.7%), followed by head and neck (12.9%) and lower limb (11.9%). The number of injuries on intermediate roads was the highest (40.0%), the greatest number of injuries (81.2%) occurred when the age of skiing was less than 5 years. In the records of the nearest treatment hospital, the injury types were fracture or fissure fracture, contusion and trauma, and muscle and soft tissue injury, accounting for 30.5%, 27.4%, and 21.2% respectively. 9.6% of the injured took the snow field ambulance to the hospital, and 50% of them suffered from fractures or fissure fractures.

CONCLUSION

The injury rate of skiing in the 2018-2019 snow season of the Wanlong ski resort in Chongli was higher than that reported by foreign literature. Severe trauma (including severe fractures and concussions) could occur and patients needed to be transferred to the nearest hospital for treatment. The ski resort medical station and the nearest treatment hospital should be strengthened with adequate medical staff and equipment, and promote cooperation in the timely referral of seriously injured patients, the organization and construction of ski patrols and the medical security of large-scale competitions, thus playing an important role in forming a grassroots network of medical security and treatment system for skiing.

Examining the Role of Risk Compensation in Extreme Sports

This study explored the relations between sensation seeking, impulsivity, risk compensation, and extreme-sports injury to better understand contributing factors to risk taking in extreme sports and subsequent adverse outcomes. Data included cross-sectional survey responses from 1,107 college students (Mage = 19.47, SD = 2.14). Poisson, logistic, and negative binomial regressions were used to investigate the relations of interest. Results indicate that sensation seeking and impulsivity are significantly associated with both risk compensation and extreme-sports injury. Risk compensation is significantly and positively associated with extreme-sports injury in mountain biking and snowboarding. Risk compensation did not significantly moderate the relation between the personality constructs of interest and extreme-sports injury. These results show that the role of risk compensation in extreme-sports injury is highly sport-specific. These results highlight the importance of considering both personality and risk compensation in prevention and intervention efforts.

Spinopelvic Dissociation: A Systematic Review and Meta-analysis

INTRODUCTION

Spinopelvic dissociation is a rare type of injury which occurs in approximately 2.9% of pelvic disruptions and correlates with high-energy trauma.The purpose of this study was to systematically evaluate the incidence, demographics, treatment, clinical outcome, and complication rate associated with these injuries.

METHODS

A literature review on Medline, PubMed, and Google was performed. Overall, 216 abstracts were reviewed in English, German, and French, of which 50 articles were included.

RESULTS

Within the 50 studies, 19 publications were case reports and 16 were case series with low-level evidence. Overall, 379 patients with spinopelvic dissociation were identified at a mean age of 31.6 ± 11.6 years and an injury severity score of 23.1 ± 3.8 between 1969 and 2018. Most cases were related to fall from heights (55.7%), followed by road accidents (28.5%). Two hundred fifty-eight patients (68.1%) showed neurologic impairment at initial presentation, which improved in 65.1% after surgery. The treatment of choice was surgery in 93.1% of cases with triangular fixation in 68.8%. Regardless of the technique, the healing/fusion rate was 100% with a complication rate of 29.9% (n = 96/321).

CONCLUSION

Spinopelvic dissociation is a rare type of injury with limited data in the literature. Based on our review, it is possible that a streamlined, evidence-based algorithm may improve care for these difficult patients.

LEVEL OF EVIDENCE

II.

STUDY DESIGN

Systematic Review.

[Analysis of the mass skiers' injury in a large ski resort in Chongli, China]

OBJECTIVE

To make a retrospective analysis of the injuries of skiing population in a large ski resort in Chongli, China and provide a basis for predicting the rapidly increasing medical needs for ski injuries in the context of the 2022 Winter Olympic Games.

METHODS

The basic data of all injured skiers who were treated in a medical station of a large ski resort in Chongli during the snow season from November 2017 to March 2018 and from November 2018 to March 2019 were collected. The number of skiers, the number of injuries, the causes of injuries, the types of injuries and the locations of injuries were compared.

RESULTS

A total of 753 skiers were injured in two snow seasons, and the estimated average incidence of injury was 4.53 and 4.46 per 1 000 skier days at the resort respectively. The average daily injury rate per 1 000 skiers in November of the two snow seasons was relatively low, with 2.20 and 1.38 cases respectively. The difference of injury rate in different months might have little to do with snowfall and more to do with passenger flow. In both the snow seasons, men accounted for more injuries than women, and injured skiers aged between 21 and 30 accounted for the largest proportion, reaching 36.8%. The main causes of injuries were falls (76.6%). The highest rate of injury was in the head and neck (17.9%), followed by the knee (17.4%) and wrist and fingers (13.3%). The most common types of injuries were contusion and trauma (29.5%) and joint and/or ligament injuries (22.2%). Children (2-12 years old) accounted for 12.7% of all the injured skiers. The rate of moderate to severe injuries (including fractures, concussions, etc.) was 34.8% among the injured patients over 50 years of age.

CONCLUSION

The snow resort should focus on injuries to children and elderly skiers and carry out targeted guidance and rescue work. In order to better ensure the medical safety of skiers, the ski resort medical station and nearby treatment hospitals should be equipped with a corresponding number of medical personnel and equipment, and the ski resort should further improve its safety management and rescue system.

Dangers beyond drowning: craniomaxillofacial trauma in adult water activities

PURPOSE

Water recreation is one of the most popular activities for both fitness and leisure. The dangers of water activities have mostly been examined in the context of drowning and general bodily injuries. Despite the existing research, little is known about adult maxillofacial injuries in these settings.

METHODS

We accessed the National Electronic Injury Surveillance System in order to identify adult patients presenting to emergency departments with traumatic maxillofacial injuries secondary to a water-based sport or activity over the most recent 10-year period (2009-2018). Data collected included demographical information, anatomical location, mechanism of injury, and visit circumstances, as well as visit disposition.

RESULTS

A total of 1350 total patients were identified as appropriate for study inclusion. Young, Caucasian male adults were the most common age group to present with maxillofacial injuries secondary to water sport activities. Surfing and water skiing were associated with lacerations, while diving board incidents posed a higher fracture risk. Patients participating in all water activities were more likely to be treated and released rather than admitted.

CONCLUSION

There appears to be a distinct pattern profile for individuals who sustain maxillofacial trauma while participating in water sports: young, Caucasian males in particular. Additionally, specific activities may be associated with varying injury types. The results of this study may increase interest in legislature and patient counseling when seeking such activities.

Epidemiology and injury patterns of aerial sports in Switzerland

BACKGROUND

Airborne sports have become more popular in recent years. The number of accidents has increased linearly as athletes take increasingly greater risks to experience the adventurous spirit of this kind of sports.

AIM

To investigate the variety of injuries in airborne sport accidents, as well as which acute treatment these patients receive, both before and after admission to a level-one-trauma center.

METHODS

We performed a retrospective chart analysis at a major level-one-trauma center in Switzerland for 235-patients who were admitted following airborne sports injuries between 2010 and 2017. Patients’ demographic data, injury patterns, emergency primary care procedures and intra-hospital care were recorded.

RESULTS

Overall, 718-injuries in 235-patients were identified; the spine was the most commonly affected region with 46.5% of injuries (n = 334/718) in 143-patients. In 69-patients (15.5%), the (non-spine) thorax was affected, followed by the lower and upper extremity, pelvis, head/face and abdominal injuries. Eleven-patients had to be intubated at the trauma site. Three patients were resuscitated after onset of pulseless-electrical-activity. Two-patients died in the resuscitation room. In 116-cases, surgery was indicated including 55-emergency surgeries. Another 19 patients (8.1%) were transferred to the intensive care unit.

CONCLUSION

Paragliders are most commonly affected, although the highest injury severities were identified for Building, Antenna, Span and Earth-jumping athletes. First responders, treating physicians and pilots should be aware of the risk for potentially serious and life-threatening injury with an in-hospital mortality of 0.9%.

Effect of Accelerated Ageing on the Mechanical and Structural Properties of the Material System Used in Protectors

Currently, there is a wide range of materials for motorcyclists available on the market that have a significant ability to absorb impact energy. Understanding the aging processes of materials is crucial for guaranteeing the long-term durability and safety of a new product. For this reason, the effect of accelerated aging on the mechanical and structural properties of the multifunctional materials used in commercial protectors was analyzed. The accelerated aging considered in this study simulated 3 years of use under real conditions. Then, DMTA and FT-IR research, as well as impact tests, were carried out on the commercially available protectors for motorcyclists, before and after the accelerated aging processes. Structural analysis using FT-IR showed no significant changes in the structure of the polymers used for producing the protectors. The DMA test results are consistent with those obtained from the impact study. Both methods showed that the samples maintain their protective properties, after accelerated aging. All of the examined protectors show that an increase in force is transferred through the sample, after the accelerated aging processes, but they still provide protection, according to the ISO standard.

Mechanical Safety of Embedded Electronics for In-body Wearables: A Smart Mouthguard Study

The growing popularity of contact sports drives the requirement for better design of protective equipment, such as mouthguards. Smart mouthguards with embedded electronics provide a multitude of new ways to provide increased safety and protection to users. Characterisation of how electronic components embedded in typical mouthguard material, ethylene vinyl acetate (EVA), behave under typical sports impacts is crucial for future designs. A novel pendulum impact rig using a hockey ball disc impactor was developed to investigate impact forces and component failure. Two sets of dental models (aluminium and plastic padding chemical metal) were used to manufacture post-thermoformed mouthguards. Seven embedding conditions with varying thickness of EVA (1.5 and 3 mm) and locations of electrical components were tested. Component failures were observed in four out of seven test conditions, and the experimental failure forces at which the electrical component had a 50% chance of failure were reported for those cases. The experimental results showed that an EVA thickness of 3 mm surrounding the electrical component gives the most comprehensive protection even under extreme surface conformity. Computational models on surface conformity of EVA showed that a block of EVA with a minimum thickness of 1.5 mm was better at reducing stress concentration than a shell with an overall thickness of 1.5 mm. This study demonstrated that the thickness of a mouthguard is important when protecting electrical components from extreme dental surface conformity, furthermore the surface geometry should not be overlooked when considering electrical component safety for in-body wearables that are impact prone.

Extreme Sports Injuries to the Pelvis and Lower Extremity

Extreme sports are growing in popularity, and physicians are becoming increasingly aware of injuries related to these activities. Imaging plays a key role in diagnosing and determining clinical management of many of these injuries. This article describes general imaging techniques and findings in various injuries specific to multiple extreme sports.

Personality differences amongst drag racers and archers: implications for sport injury rehabilitation

Personality trait of an athlete is a significant factor in sports injury rehabilitation. The aim of the present study is to investigate whether there are differences in personality traits between male and female, professional and amateur athletes from sports representing two ends of extreme to traditional namely; drag racing and archery. Overall 189 male and female, professional and amateur drag racers (n=144) and archers (n=45) took part in this study. Participants completed the personality traits of extroversion and neuroticism as measured by Eysenck's classic Personality Inventory dimensions and thrill and adventure seeking (TAS), experience seeking (ES), disinhibition (DIS), boredom susceptibility (BS), and sensation seeking (SS) as measured by Zuckerman's Sensation Seeking Scale. The results showed that professionals scored significantly lower on neuroticism compared to amateurs. Drag racers scored significantly higher on TAS, DIS, and SS compared to archers and there were gender differences amongst archers on TAS and SS with males scoring higher than females. Such differences in personality factors and the readiness to take risks, lack of caution, and adventurous spirit can influence the risk of injury in athletes and indeed may influence the outcome of rehabilitation. Practitioners would need to recognise difference in personality traits associated with the type of sport and the choice of interventions strategies.

To Analyze Thrill, Define Extreme Sports

Emotions are a signaling system, evolved by providing selective advantage through enhanced survival and reproduction. The selective advantage conferred by thrill or exhilaration, however, remains unknown. Hypotheses, as yet untested, include overcoming phobias or honing physical skills as juveniles, or exhibiting desirability during mate selection. Extreme sports can provide an ethically and experimentally feasible tool to analyze thrill. To use this tool, extreme sports must first be defined in a non-circular way, independent of participant psychology. Existing concepts, from different disciplines, focus, respectively, on drama, activity types, or consequences of error. Here, I draw upon academic and popular literature, and autoethnographic experience, to distinguish extreme from adventurous levels for a range of different outdoor sports. I conclude that extreme outdoor adventure sports can be defined objectively as those activities, conditions, and levels, where participant survival relies on moment-by-moment skill, and any error is likely to prove fatal. This allows us to examine the motivations, experiences, and transformations of individuals who undertake these activities. In particular, it will allow us to examine the emotional experience of thrill, previously studied principally as an aspect of personality, from new neurophysiological and evolutionary perspectives.

Evaluation of severe and fatal injuries in extreme and contact sports: an international multicenter analysis

PURPOSE

The participation in extreme and contact sports has grown internationally, despite the significant risk for major and multiple injuries. We conducted this multicenter study to evaluate sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention.

METHODS

We compared demographic data, severity and patterns of injuries; and the pre- and in-hospital management from an international population-based prospective trauma database (TraumaRegister DGU®). The registry was screened for sport-related injuries, and only patients with major injuries [Injury Severity Score (ISS) ≥ 9 points] related to extreme or contact sports activities were included (January 1, 2002, to December 31, 2012). Parameters were compared for different types of sports activities: (1) Airborne sports, (2) Climbing, (3) Skateboarding/Skating, (4) Contact sports. The following countries participated: Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, New York).

RESULTS

A total of 278 athletes were identified within the study period and classified into four groups: Airborne sports (n = 105) were associated with the highest injury severity (ISS 22.4 ± 14.6), followed by climbing (n = 35, ISS 16.5 ± 12), skating (n = 67, ISS 15.2 ± 10.3) and contact sports (n = 71, ISS 10.4 ± 9.2). Especially high falls resulted in a significant rate of spinal injuries in airborne activities (68.6%, p < 0.001) and in climbing accidents (45.7%). Skating was associated with the highest rate of loss of consciousness (LOC) at scene (27.1%), the highest pre-hospital intubation rate (33.3%), and also the highest in-hospital mortality (15.2%, p < 0.001), related to major head injuries.

CONCLUSIONS

Extreme and contact sports related major injuries predominantly affect young male athletes. Especially skaters are at risk for debilitating and lethal head injuries. Individuals recognizing sport-specific hazards might modify their risk behavior.

LEVEL OF EVIDENCE

Descriptive Epidemiologic Study, Level II.

Hospital-Treated Snow Sport Injury in Victoria, Australia: A Summary of 2003-2012

INTRODUCTION

To determine the incidence rate and changes over time for ice and snow sports injury in Victoria, Australia, from 2003 to 2012 and describe the most common types and causes of these injuries.

METHODS

Retrospective data from the Victorian Injury Surveillance Unit describing hospital admissions and emergency department presentations were extracted for the 10-year period of 2003 to 2012 for all ice- and snow-related injury. Descriptive injury data and participation-adjusted trend analyses using log-linear regression modelling of data (statistical significance, P<0.05) from the Exercise, Recreation and Sport Survey 2003 to 2010 are presented.

RESULTS

Overall, there were 7387 ice- and snow-related injuries, with a significant increase in hospital-treated snowboard injuries and a (nonsignificant) decline in hospital-treated ski injuries over the 10 years. Skiing (39%) and snowboarding (37%) had the highest incidence of hospital-treated injury, with males aged 15 to 24 years injured most frequently in both sports. Falls were the most common cause of injury in both skiing (68%) and snowboarding (78%).

CONCLUSIONS

Patterns of snow sports injury in Australia during 2003 to 2012 remain similar to findings of national studies conducted decades earlier. More importantly, however, Australian injury patterns are comparable to international statistics and thus may be generalizable internationally. Head injuries, although infrequent, are associated with great injury severity due to a high frequency of hospitalization. Furthermore, research into the use of personal protective equipment and other injury prevention measures among Australian participants, particularly by young, male snowboarders, is required. Given the similar injury patterns, injury prevention measures implemented internationally could reasonably translate to an Australian setting.