The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Soccer (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Soccer (2004-2005 Through 2013-2014)

Epidemiology of injuries in U.S. high school track and field throwing events from 2008 to 2019

BACKGROUND

Injury characteristics of high school track and field throwing athletes in the United States are not well studied. Understanding epidemiology of injuries is important to identify treatment and prevention strategies.

OBJECTIVE

To describe injury rates and patterns in U.S. high school track and field throwing events from a longitudinal national sports injury surveillance system.

DESIGN

Descriptive epidemiology study.

SETTING

Data were provided by the National High School Sports Related Injury Surveillance System, High School RIO (Reporting Information Online).

METHODS

Athletic trainers reported injury and exposure data through the High School RIO website on a weekly basis. An athlete exposure (AE) was defined as one athlete participating in one school-sanctioned practice or competition. Throwing events of discus, shot put, and javelin were analyzed in this study.

MAIN OUTCOME MEASURES

Injury rate, rate ratios (RR), injury proportion ratios (IPR).

PARTICIPANTS

U.S. high school athletes.

RESULTS

A total of 267 track and field throwing injuries occurred during 5,486,279 AEs. Overall, the rate of injuries in competition was higher than in practice (RR 1.35, 95% confidence interval [CI] 1.01-1.80). In practice, the rate of injuries was higher for girls than boys (RR 1.53, 95% CI 1.12-2.08). The most frequently injured body part was the shoulder (21.7%), followed by the ankle (16.5%) and knee (12.0%). The most common types of injury were muscle strains (26.14%) and ligament sprains (25%). Recurrent injuries accounted for a higher proportion of chronic injuries compared to new injuries (IPR 1.85, 95% CI 1.16-2.97).

CONCLUSION

This study described injury characteristics of high school track and field throwing athletes from 2008 to 2019. Based on our results, injury prevention may be particularly important for female throwers with prior injury.

The impact of whole-body vibration training and proprioceptive neuromuscular facilitation on biomechanical characteristics of lower extremity during cutting movement in individuals with functional ankle instability: A parallel-group study

BACKGROUND

We compared the effects of whole-body vibration training and proprioceptive neuromuscular facilitation on the biomechanical characteristics of the lower limbs in functional ankle instability patients during cutting movement to ascertain the superior rehabilitation method.

METHODS

Twenty-two male College students with unilateral functional ankle instability volunteered for this study and were randomly divided into whole-body vibration training group and proprioceptive neuromuscular facilitation group. Kinematics data and ground reaction forces were collected using infrared motion capture system and 3-D force plates synchronously during cutting. Repeated measures two-way ANOVA was performed to analyze the data.

FINDINGS

Both training methods reduced the maximum hip abduction angle (p = 0.010, effect size: proprioceptive neuromuscular facilitation = 0.69; whole-body vibration training = 0.20), maximum knee flexion angle (p = 0.008, effect size: proprioceptive neuromuscular facilitation = 0.39, whole-body vibration training = 1.26) and angular velocity (p = 0.014, effect size: proprioceptive neuromuscular facilitation = 0.62, whole-body vibration training = 0.55), maximum ankle inversion angular velocity (p = 0.020, effect size: proprioceptive neuromuscular facilitation = 0.52, whole-body vibration training = 0.81), and knee flexion angle at the time of maximum vertical ground reaction forces (p = 0.018, effect size: proprioceptive neuromuscular facilitation = 0.27, whole-body vibration training = 0.76), and increased the maximum ankle dorsiflexion moment (p = 0.049, effect size: proprioceptive neuromuscular facilitation = -0.52, whole-body vibration training = -0.22). Whole-body vibration training reduced the maximum ground reaction forces value in the mediolateral directions (p = 0.010, effect size = 0.82) during cutting movement.

INTERPRETATION

These findings suggested that the two types of training might increase neuromuscular conduction function around the ankle. After these two types of training, functional ankle instability patients showed a similar risk of injury to the lateral ankle ligaments during cutting.

Sex differences in lower extremity kinematics during overhead and single leg squat tests

The Overhead Squat (OHS) and Single-Leg Squat (SLS) are two clinical tests used by practitioners to identify high-risk biomechanical movement patterns. Several published studies have reported sex differences in SLS performance; however, few have investigated variations during the OHS and none has measured kinematics with a marker-less motion capture system. Therefore, this study aimed to compare biomechanical movement patterns between male and female collegiate athletes during OHS and SLS testing. Seventy-five females and 58 male athletes completed OHS and SLS . A Microsoft Kinect sensor using Athletic Movement Assessment software (PhysiMax®) was used to measure kinematics. For the OHS, males displayed greater peak knee frontal plane projection angles (FPPA) (M:26°±10°, F:20°±8°; P < 0.05), peak hip flexion (M:-94°±14°, F:-87°±15°; P < 0.05), and peak trunk flexion angles (M:11°±11°, F:6°±9°; P < 0.05). For the SLS (dominant-limb), males displayed greater peak trunk flexion (M:32°±6°, F:27°±7°; P < 0.05). For the non-dominant limb, females displayed greater peak knee FPPA (F:-12°±9°, M:-8°±9°; P < 0.05) whereas males displayed greater peak trunk flexion angles (M:32°±5°, F:27°±7°; P < 0.05). These findings suggest the need for practitioners to develop sex-specific corrective exercise programmes in effort to improve lower extremity kinematics in athletes.

Pulsed Red and Blue Photobiomodulation for the Treatment of Thigh Contusions and Soft Tissue Injury: A Randomized Controlled Trial

CONTEXT

Contusion and soft tissue injuries are common in sports. Photobiomodultion, light and laser therapy, is an effective aid to increase healing rates and improve function after various injury mechanisms. However, it is unclear how well photobiomodulation improves function after a contusion soft tissue injury. This study aimed to determine the effects of a pulsed red and blue photobiomodulation light patch on muscle function following a human thigh contusion injury.

DESIGN

Single-blinded randomized control trial design.

METHODS

We enrolled 46 healthy participants. Participants completed 5 visits on consecutive days. On the first visit, participants completed a baseline isokinetic quadriceps strength testing protocol at 60°/s and 180°/s. On the second visit, participants were struck in the rectus femoris of the anterior thigh with a tennis ball from a serving machine. Immediately following, participants were treated for 30 minutes with an active or placebo photobiomodulation patch (CareWear light patch system, CareWear Corp). Following the treatment, participants completed the same isokinetic quadriceps strength testing protocol. Participants completed the treatment and isokinetic quadriceps strength test during the following daily visits. We normalized the data by calculating the percent change from baseline. We used a mixed model analysis of covariance, with sex as a covariate, to determine the difference between treatment groups throughout the acute recovery process.

RESULTS

We found the active photobiomodulation treatment significantly increased over the placebo group, quadriceps peak torque during the 180°/s test (P = .030), and average power during both the 60°/s (P = .041) and 180°/s (P ≤ .001) assessments. The mean peak torque and average power of 180°/s, at day 4, exceeded the baseline levels by 8.9% and 16.8%, respectively.

CONCLUSIONS

The red and blue photobiomodulation light patch improved muscle strength and power during the acute healing phase of a human thigh contusion injury model.

Injury-Inciting Activities in Male and Female Football Players: A Systematic Review

BACKGROUND

A comprehensive examination of the sport-specific activities performed around the time of injury is important to hypothesise injury mechanisms, develop prevention strategies, improve management, and inform future investigations. The aim of this systematic review is to summarise the current literature describing the activities performed around the time of injury in football (soccer).

METHODS

A systematic search was carried out in PubMed, Web of Science, SPORTDiscus, and OpenGrey. Studies were included if participants were football players aged > 13 years old and the activities performed at the time of injury were reported together with the total number of injuries. Risk of bias was assessed using an adapted version of checklists developed for prevalence studies. The activities reported by the studies were grouped to account for inconsistent reporting, and the proportion of each injury activity was calculated. Data were not meta-analysed due to high heterogeneity of methods and classification criteria.

RESULTS

We included 64 studies reporting on 56,740 injuries in total. ACL injures were analysed by 12 studies, ankle/foot and knee injuries were analysed by five studies, thigh injuries were analysed by four studies, hip/groin injuries were analysed by three studies, and hamstring injuries were analysed by two studies. Five studies analysed more than one type of injury and 38 studies did not specify the type of injuries analysed. Running and kicking were the predominant activities leading to thigh and hamstring injuries. Changing direction and kicking were the predominant activities leading to hip and groin injuries and duels were the predominant activities leading to ankle injuries. Duels and pressing seem the predominant activities leading to ACL injuries, while results for other knee and general injuries were inconsistent.

CONCLUSIONS

A qualitative summary of the activities performed at the time of injury has been reported. The results need to be interpreted carefully due to the risk of bias observed in the included studies. If we are to meaningfully progress our knowledge in this area, it is paramount that future research uses consistent methods to record and classify injuries and activities leading up to and performed at the time of injury.

REGISTRATION

The protocol of this systematic review was registered at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/U96KV ).

The Epidemiology of Youth Sport-Related Shoulder Injuries: A Systematic Review

Background

Youth around the globe place their shoulders at risk for injury when participating in sports. Shoulder injuries may vary in severity, produce the potential for time-loss from sport, and result in functional disability. We sought to explore sport-related shoulder injuries in youth by identifying injury rates, risk factors, injury mechanisms, and injury prevention strategies.

Methods

All relevant full-text articles were identified by searching MEDLINE, EMBASE, CINAHL, Sport Discus, and the Cochrane Controlled Trials Registry. No date restrictions were used. All full-text studies reporting original research describing sport-related shoulder injury among female and/or male youth from 5 to 18 years old were included.

Results

Of 3,889 studies screened, 97 described shoulder injury in youth sports. Shoulder injuries were identified in 24 unique sports. The median seasonal prevalence of shoulder injury was 10.9% (range 1.2-28.2%). The most common injury mechanisms identified were contacted with another player, contact with the playing environment, and falling to the ground. Risk factors for shoulder injury identified were side-to-side strength imbalances, weak external rotator muscles, and scapular dyskinesia. One study evaluated a successful training strategy to prevent shoulder injuries, but two other interventions demonstrated no effect.

Conclusions

Sport-related shoulder injuries are prevalent among youth athletes. Injury risk factors identified included modifiable intrinsic factors such as strength, range of motion, and training load. The most common injury mechanism was direct contact with either another person or an object in the playing environment. Innovative shoulder-specific strategies are needed to reduce shoulder injuries in this population. Trial Registration: PROSPERO ID: CRD42020189142.

In National Collegiate Athletic Association Men’s and Women’s Soccer Athletes There Is a Low Rate of Lumbar Spine Injury, Women Suffer More Recurrent Injuries than Men, and Most Injuries Occur in the Preseason

Purpose

To use the National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) from the 2009-2010 through the 2014-2015 seasons to report lumbar spine injury rates, characteristics, and time lost from sport in soccer players.

Methods

Characteristics of lumbar spine injuries by season, competition/practice, and time lost from sport were determined using the NCAA-ISP database. Rates of injury were calculated as the number of injuries divided by the number of athlete exposures (AEs). AEs are any athlete participation in a competition or practice. Incidence rate ratios (IRRs) were calculated to compare rates between event types and time of season. Injury proportion ratios (IPRs) were used to evaluate differences in injury rates between men and women.

Results

The NCAA-ISP estimated 4,464 LSIs over 5 years. The rate of LSI in men was 2.1/10,000 AEs and 3.0/10,000 AEs in women. Women were 1.43 times more likely to suffer an LSI compared to men. Women were 2.15 times as likely to suffer an LSI in competition compared to in practice while men were 1.10 times as likely. Women were 2.15 times as likely to be injured in the preseason compared to the regular season, while men were 3.76 times as likely. Non-contact injuries were the most common cause of lumbar spine injuries (LSIs) in men (35%); however, contact injuries were more common in women (33%). Most athletes both male (57%) and female (59%) returned to play within 24 hours.

Conclusion

This study provides information on the characteristics of LSIs in NCAA soccer. The overall injury rate to the lumbar spine is relatively low. Injury rates are highest in the preseason and in competition. Women suffer from more recurrent LSI’s than men, and men acquired more injuries through non-contact mechanisms. More than one-half of athletes returned to sport within 24 hours.

Fair Play as an Injury Prevention Intervention: Do Yellow Card Accumulation Policies Reduce High School Soccer Injuries?

OBJECTIVES

Evaluate yellow card policies' (YCPs) effectiveness in reducing competition contact injuries (CCIs).

DESIGN

Retrospective cohort.

SETTING

High schools.

PARTICIPANTS

Soccer players from High School (HS) Reporting Information Online participating schools, 2005/06 to 2017/18.

INDEPENDENT VARIABLES

Athlete exposure (AE), CCIs from HS competitions collected from states with/without YCPs.

MAIN OUTCOME MEASURES

Rate and rate ratio (RR) of athlete-athlete CCIs recorded by athletic trainers were compared between states with/without YCPs and pre-YCPs/post-YCPs among the states with YCPs using Poisson regressions. Proportions of severe athlete-athlete CCIs were also described in states with/without YCPs.

RESULTS

Fifteen states implemented YCPs between 2005/06 and 2017/18; 901 athlete-athlete CCIs occurred during 352 775 competition AEs in states with YCPs, and 3525 injuries during 1 459 708 competition AEs in states without YCPs. There was no significant difference in injury rates between schools in states with/without YCPs (RR 1.07; 95% confidence interval [CI]: 0.97-1.17). Among state with YCPs, injury rates were not significantly different between pre-YCP and post-YCP implementation (RR 1.15; 95% CI: 0.98-1.34). Although a significantly lower proportion of injuries resulting in >3 weeks' time loss (TL) occurred in states with YCPs (injury proportion ratio 0.81; 95% CI: 0.66-0.997), no significant differences were observed in proportions of other severe athlete-athlete CCIs between states with/without YCPs.

CONCLUSIONS

Yellow card policies were ineffective in lowering HS soccer athlete-athlete CCI rates, although injuries resulting in >3 weeks' TL were less prevalent in states with YCPs. Implementation of YCPs alone, without proper enforcement, may not be a sufficient injury prevention strategy.

Epidemiology of NCAA Track and Field Injuries From 2010 to 2014

Background:

Track and field (T&F) athletes compete in a variety of events that require different skills and training characteristics. Descriptive epidemiology studies often fail to describe event-specific injury patterns.

Purpose:

To describe the epidemiology of injuries in National Collegiate Athletic Association (NCAA) T&F by sex, setting (practice vs competition), and time of season (indoor vs outdoor) and to compare injury patterns by events within the sport.

Study Design:

Descriptive epidemiology study.

Methods:

Data were obtained from the NCAA Injury Surveillance Program for all indoor and outdoor T&F injuries during the academic years 2009-2010 to 2013-2014. Injury rates, injury rate ratios, and injury proportion ratios (IPRs) were reported and compared by sex, injury setting, season, and event. Analysis included time-loss as well as no-time loss injuries.

Results:

Over the 5 seasons, the overall injury rate was 3.99 injuries per 1000 athletic-exposures (95% CI, 3.79-4.20). After controlling for injury diagnoses, women’s T&F athletes experienced an 18% higher risk of injury (95% CI, 7% to 31%) and missed 41% more time after an injury (95% CI, 4% to 93%) when compared with men. Among all athletes, the injury risk during competition was 71% higher (95% CI, 50% to 95%) compared with practice and required 59% more time loss (95% CI, 7% to 135%). Distance running accounted for a significantly higher proportion of overuse injuries (IPR, 1.70; 95% CI, 1.40-2.05; P < .05) and required 168% more time loss (95% CI, 78% to 304%) than other events. The hip and thigh were the body regions most commonly injured; injury type, however, varied by T&F event. Sprinting accounted for the greatest proportion of hip and thigh injuries, distance running had the greatest proportion of lower leg injuries, and throwing reported the greatest proportion of spine and upper extremity injuries.

Conclusion:

Injury risk in NCAA T&F varied by sex, season, and setting. Higher injury rates were found in women versus men, indoor versus outdoor seasons, and competitions versus practices. The hip and thigh were the body regions most commonly injured; however, injury types varied by event. These findings may provide insight to programs aiming to reduce the risk of injury and associated time loss in collegiate T&F.

Hand and wrist injuries among collegiate athletes vary with athlete division

BACKGROUND

The rates, severity and consequences of hand and wrist injuries sustained by National Collegiate Athletic Association athletes are not well characterized. This study describes the epidemiology of hand and wrist injuries among collegiate athletes competing in different divisions.

METHODS

The National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) was accessed from 2004 to 2015 for the following sports: baseball, basketball, football, ice hockey, lacrosse, soccer, wrestling, field hockey, gymnastics, softball and volleyball. The data were used to identify all hand and wrist injuries, the specific injury diagnosis, mean time loss of activity following injury, and need for surgery following injury. These were then stratified by gender. Descriptive statistics were performed to examine the association between sports, event type and division. Student's t test was used to calculate p-values for independent variables. Chi-Square test was used to calculate odds ratio. P < 0.05 was considered significant.

RESULTS

103,098 hand and wrist injuries were reported in in the studied NCAA sports from 2004 to 2015. Male athletes sustained 72,423 injuries (6.01/10,000 athlete exposure) and female athletes sustained 30,675 injuries (4.13/10,000 athlete exposure). Division I athletes sustained significantly more injuries compared to divisions II and III. Overall, 3.78% of hand and wrist injuries required surgical intervention. A significantly higher percentage of division I athletes (both male and female) underwent surgical intervention compared to divisions II and III. The mean time lost due to hand and wrist injury was 7.14 days for all athletes. Division I athletes missed the fewest days due to injury at 6.29 days though this was not significant.

CONCLUSIONS

Hand and wrist injuries are common among collegiate athletes. Division I athletes sustain higher rates of injuries and higher surgical intervention rates, while tending to miss fewer days due to injury. Improved characterization of divisional differences in hand and wrist injuries can assist injury management and prevention.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Soccer: 2014-2015 Through 2018-2019

CONTEXT

The National Collegiate Athletic Association has sponsored men's soccer programs since 1959, and the popularity of the sport has grown over time.

BACKGROUND

Routine examinations of athlete injuries are important for identifying emerging temporal patterns.

METHODS

Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program from 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates.

RESULTS

The overall injury rate was 8.51 per 1000 athlete exposures. Lateral ligament complex tears (ankle sprains) (9.2%), hamstring tears (7.0%), and concussions (5.2%) were the most commonly reported injuries. Rates of lateral ligament complex tears remained stable from 2014-2015 through 2018-2019, whereas hamstring tear rates decreased and concussion rates increased.

SUMMARY

The findings of this study were in line with the existing epidemiological evidence, although notable temporal patterns were observed. Incidence trajectories of commonly observed injuries warrant particular attention in the future.

Injuries in Irish male and female collegiate athletes

OBJECTIVE

To understand the incidence and burden of injury of student-athletes in four of the most popular collegiate sports.

DESIGN

Prospective cohort study.

SETTING

Collegiate sport.

PARTICIPANTS

Gaelic football, hurling/Camogie, soccer and Rugby (n = 672; male = 416, female = 256) student-athletes.

MAIN OUTCOME MEASURE

Injury incidence, burden of injury and total, match and training injury rates, and their 95% confidence intervals were calculated. The frequencies and proportions were also calculated. An injury was defined as any physical condition that prevents a student-athlete from full participation for a period greater than 24 h.

RESULTS

Over a quarter (0.266) of student-athletes sustained an injury in the academic season. Male student-athletes had a higher injury rate than females (21.6 vs 11.3 injuries/1000 h). Rugby (20.8 injuries/1000 h) had the highest injury rates with hurling/Camogie (6.3 injuries/1000 h) the lowest. Lower extremity injuries were predominant (68.8%) with ankle sprains demonstrating a large burden for all sports (20.6-280.2 days absent/1000 h). Hamstring strains (13.7-118.4 days absent/1000 h) had a large burden for all sports except male Rugby. Knee sprains had a large burden on the female Gaelic footballer (84.8 days absent/1000 h). Sprinting (27.4%) and the tackle (20.1%) were the most common mechanism of injury. Injuries were predominantly moderate (8-28 days) or severe (>28 days) (84.7%).

CONCLUSION

Injury reduction needs to be prioritised in the student-athlete, particularly in males. Specific focus is required on the lower extremity, especially in the hamstring muscles and ankle joint owing to the large burden of injury.

Data-Driven Risk Classification of Concussion Rates: A Systematic Review and Meta-Analysis

BACKGROUND

Concussion is a growing public health concern and generating concussion prevention programs depends on identifying high-risk sports and characteristics. Identifying the roles of sport, sex, and participation level (e.g., high school versus collegiate athletics) in concussion risk would facilitate more informed decision-making regarding sports participation and generate better targeted prevention strategies.

OBJECTIVES

The current study's objectives were to: (1) determine the magnitude and hierarchy of sports-related concussion (SRC) risk across an array of events and (2) evaluate the modifying roles of sex, participation level, and session type on SRC rates.

METHODS

A literature search was conducted on PubMed, searching concussion studies published between 2001 and December 2019. Inclusion criteria for studies required: (1) concussion occurred during sport, (2) that the SRC was clinically diagnosed, and (3) athlete exposures and concussions could be extracted or estimated. A study was excluded if it: (1) was not an original research article, (2) was not written in English language, (3) was an animal study, (4) did not have enough data to calculate SRC rates, (5) included professional or youth sample, and/or (6) contained data collected prior to 2001. The meta-analysis and meta-regression analyses were fit using a random effects model.

RESULTS

Search results returned 2695 unique research articles, with 83 studies included in analyses. Sport, sex, participation level, and session type all significantly influenced SRC rates. Overall, rugby had the highest concussion rate and was classified as the highest risk sport (28.25 concussions per 10,000 athlete exposures). Overall, females had a higher concussion rate than males. Only lacrosse demonstrated a higher concussion rate for males compared to females. Collegiate athletes had higher concussion rates than high school athletes. Games were associated with 2.01 more concussions per 10,000 AEs than practices.

CONCLUSIONS

This meta-analysis demonstrated rugby has the highest concussion risk, followed by American Football, ice hockey, and wrestling. Concussion risk was influenced by sport, sex, participation, and session. Identifying the factors and environments that influence concussion risk can facilitate risk reduction and prevention strategies.

Abdominal Organ Injuries in Youth Soccer: A Case Series and Review of Literature

ABSTRACT

We describe 13 children who presented to the Penn State Health Milton S. Hershey Medical Center (HMC) with pediatric soccer-related abdominal organ injuries. A review of the Pennsylvania Trauma System Foundation's Trauma Registry was performed between 2001 and 2015 for children with soccer injuries hospitalized at trauma centers across Pennsylvania. Out of 52 children at Hershey Medical Center, 13 suffered abdominal organ injuries. Injuries included the spleen [5], kidney [4], liver [2], and combined organ involvement [2]. All patients presented with abdominal and/or flank pain. All patients with kidney injuries presented with hematuria. All patients presented after a player-to-player (P2P) contact. Nearly all patients (12/13) were treated nonsurgically. Our findings showed that abdominal organ injuries constitute a substantial portion of pediatric soccer injuries requiring hospitalization, with spleen being the organ injured most frequently. Soccer-related abdominal organ injuries should be suspected in players who suffer abdominal and/or flank pain, and/or hematuria after a P2P contact.

Epidemiology of Sport-Related Concussion

Sport-related concussions are common in the United States. Concussion rates have increased over time, likely due to improved recognition and awareness. Concussion rates vary across level (high school vs college), sex, and sport. Concussion rates are the highest among men, particularly in football, wrestling, ice hockey, and lacrosse where collisions and contact are inherent to the sports, although girls'/women's soccer rates are high. In gender-comparable sports, women have higher concussion rates. Continued data collection will increase understanding of sport-related concussion and provide areas for targeted prevention in the future.

Video analysis of concussion mechanisms and immediate management in French men's professional football (soccer) from 2015 to 2019

In this study, the concussion mechanisms were analyzed in male professional competition football, with the main objective to specify the frequency of head-to-head impact, and immediate management of the concussed players was described in order to check its compliance with the recommendations of football's governing bodies. Based on continuously recorded data from the French Football Federation (FFF), a retrospective database of all reported concussions during matches in the 1^st and 2^nd French Male leagues was generated comprising seasons 2015/16-2018/19. Injury mechanisms, playing action, immediate medical assessment and management of concussed players, and foul play-referee's decision, were analyzed from video recordings. In total, 41 concussions were reported (incidence rate of 0.44/1000 hours of match exposure [95% CI: 0.40 to 0.49]) of which 36 were identified and analyzed on video sequences. The commonest playing action leading to concussion was aerial challenge (61%), and the main mechanism was head-to-head impact (47%). Following the head impact, 28% of concussed players were not medically assessed on pitch and 53% returned to play the same match. Head-to-head impact was not associated with systematic medical assessment, nor with foul play. In conclusion, the main cause of concussions involved head-to-head impact occurring when two players challenge for heading the ball in the air. The detection of potential concussive head impacts and the immediate management of players possibly concussed during matches remain insufficient according to the international recommendations. Some rules changes, with particular vigilance in case of head-to-head impact, should be discussed.

Associations between sport participation and knee symptoms: a cross-sectional study involving 3053 undergraduate students

Background

While a number of studies have investigated knee symptoms among elite athletes, few have directly compared the association between engagement in different sports and knee symptoms among young adults in the general population. The current study aimed to investigate the relation between sports participation hours, type/ number of sports engaged, self-rated competitiveness and knee symptoms among undergraduates.

Methods

Undergraduates were invited to participate in a self-administered online survey through invitation emails. Respondents were instructed to provide demographic information (e.g., age, gender, sports participation hours, types of engaged sports, self-rated competitiveness in sports and anxiety level etc.) and to report knee symptoms (current, the last 7 days, the last 12 months, and lifetime). Multiple logistic regressions were conducted to investigate the association between sports participation and current knee symptoms.

Results

Of 17,552 invitees, 3744 responded to the survey. Valid data from 3053 respondents was used for analysis. Forty-four percent of the respondents engaged in sports regularly (≥once per week). Running, cross-training and swimming were the most frequently participated sports among the respondents. The current prevalence rate of knee symptoms was 6.4%. Hours spent participating in combat sports, soccer, yoga, and basketball participation hours were significantly associated with current knee symptoms. Respondents who rated themselves as “competitive” demonstrated a higher risk of having current knee symptoms than “recreational” players. Number of engaged sports was not associated with current knee symptoms among undergraduates.

Conclusions

Certain sports types were associated with current knee symptoms. Compared to self-rated “recreational” players, self-rated “competitive” players were more likely to have current knee symptoms. Students should take preventive measures to minimize their risk of developing knee symptoms, especially when participating in combat sports, soccer, yoga, and basketball, or engaging in sports at a highly competitive level.

Acute and overuse injuries among sports club members and non-members: the Finnish Health Promoting Sports Club (FHPSC) study

Background

Physical activity in adolescence is promoted for its multi-dimensional health benefits. However, too intensive sports participation is associated with an increased injury risk. Our aim was to compare the occurrence of acute and overuse injuries in Finnish sports club members and non-members and to report training and competing habits associated with a higher injury risk in sports club members.

Methods

In this cross-sectional survey targeted at 14–16-year-old adolescents, a structured questionnaire was completed by 1077 sports club members and 812 non-members. The main outcome measures were self-reported acute and overuse injuries, their location and type.

Results

At least one acute injury in the past year was reported by 44.0% of sports club members and 19.8% of non-members (P < 0.001). The sex-adjusted odds ratio (OR) for acute injury in sports club members compared to non-members was 3.13 (95% confidence interval (95% CI) 2.54–3.87). Thirty-five percent of sports club members and 17.4% of non-members (P < 0.001) reported at least one overuse injury during the past year. The overuse injury OR for sports club members was 2.61 (95% CI 2.09–3.26). Sports club members who trained 7–14 h per week during training (OR 1.61, 95% CI 1.21–2.12, P = 0.001) or competition season (OR 1.55, 95% CI 1.18–2.06, P = 0.002) were more likely to report an injury compared to members who trained 3–6 h per week. Those sports club members who participated in forty competitions or more compared to 7–19 competitions per year were more likely to report an acute injury (OR 1.55, 95% CI 1.05–2.08, P = 0.028) or for an overuse injury (OR 1.53, 95% CI 1.02–2.30, P = 0.038).

Conclusions

Both acute and overuse injuries are common among youth sports club members, and the number increases along with increasing amounts of training and competitions. More effective injury prevention is needed both for adolescents engaging in sports club activities and for other adolescents.

Electronic supplementary material

The online version of this article (10.1186/s12891-019-2417-3) contains supplementary material, which is available to authorized users.