Quantifying Emergency Department Visits From Sport and Recreation: Focus on the Lower Extremity and Knee, 1997-2009

Epidemiology and Sex-Specific Analysis of Basketball-Related Lower Extremity Fractures: A 10-Year Analysis of National Injury Data

BACKGROUND

Basketball-related fractures involving the lower extremities frequently present to emergency departments (ED) in the United States (US). This study aimed to identify the primary mechanisms, distribution, and trends of these injuries.

HYPOTHESIS

We hypothesize that (1) lower extremity fracture frequency will decrease from 2013 to 2022, (2) the ankle will be the most common fracture site, and (3) noncontact twisting will be the most common injury mechanism.

STUDY DESIGN

Descriptive epidemiological.

LEVEL OF EVIDENCE

Level 3.

METHODS

The National Electronic Injury Surveillance System (NEISS) was queried for lower extremity fractures from basketball presenting to US EDs from January 1, 2013 to December 31, 2022. Patient demographics, injury location, and disposition were recorded. The injury mechanism was characterized using the provided narrative. National estimates (NEs) were calculated using the NEISS statistical sample weight. Injury trends were evaluated by linear regression.

RESULTS

There were 6259 cases (NE: 185,836) of basketball-related lower extremity fractures. Linear regression analysis of annual trends demonstrated a significant decrease in lower extremity fractures over the study period (2013-2022: P = 0.01; R2 = 0.64). The most common injury mechanism was a noncontact twisting motion (NE: 49,897, 26.9%) followed by jumping (NE: 39,613, 21.3%). The ankle was the most common fracture site (NE: 69,936, 37.6%) followed by the foot (NE: 49,229, 26.49%). While ankle and foot fractures decreased significantly (P < 0.05), fractures of the lower leg, knee, toe, and upper leg showed no significant trends (P = 0.09, 0.75, 0.07, and 0.85, respectively).

CONCLUSION

Basketball-related lower extremity fractures decreased from 2013 to 2022, with the ankle being the most common fracture site and most fractures arising from a noncontact twist. Increasing utilization of outpatient clinics may have contributed to the decline, particularly for ankle and foot fractures. The prevalence of ankle fractures and twisting-related injuries reinforces the importance of protective footwear and targeted strengthening protocols.

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.

Rates and Patterns of Lower Extremity Sports Injuries in All Gender-Comparable US High School Sports

Background:

High school athletes with lower extremity sports injuries (LESIs) frequently present to the emergency department in the United States. Previous epidemiological studies have presented rates and mechanisms of LESIs in these athletes. No studies, however, have looked at LESIs in gender-comparable sports in an attempt to evaluate what differences exist between LESIs in boys and girls.

Purpose:

To describe the epidemiology of LESIs among US high school athletes using a large national database of athletes in sports that could be considered gender comparable, given the rules of play and protective equipment.

Study Design:

Descriptive epidemiology study.

Methods:

Descriptive data from 2005 to 2016 were collected using the internet-based High School Reporting Information Online (High School RIO), a national high school sports injury surveillance system, for athletes participating in 8 gender-comparable sports (soccer, volleyball, basketball, baseball/softball, swimming and diving, track and field, cross-country, and tennis). Rates and patterns of injury were evaluated, with injury rates calculated as ratio of injuries per 10,000 athlete-exposures. Rate ratios (RRs) were calculated to compare the LESI rates in girls and boys.

Results:

In both genders, LESI rates (per 10,000 athlete-exposures) were highest in soccer (girls, 15.87; boys, 11.68) followed by basketball (girls, 11.51; boys, 9.35), and were lowest in swimming and diving (girls, 0.70; boys, 0.39). Although injury rates were significantly higher in girls compared with boys in all sports, only in tennis was the RR greater than 2 (RR, 2.03; 95% CI, 1.17-3.54). Girls had a greater proportion of severe LESIs and injuries that received radiographic evaluation, such as magnetic resonance imaging, compared with boys for all sports except volleyball. Consistency in the mechanism of injury was demonstrated between genders within each sport.

Conclusion:

This study demonstrated that LESIs are common among high school athletes and disproportionately affect girls more than boys, especially when looking at severe injuries and resource utilization. Further studies are needed to elucidate the cause of these findings. We hope that the awareness of gender-based differences in LESIs will lead to improvements in targeted efforts to decrease injury rates and injury severity.

Hip position and sex differences in motor unit firing patterns of the vastus medialis and vastus medialis oblique in healthy individuals

Weakness of the vastus medialis oblique (VMO) has been proposed to explain the high prevalence of knee pain in female subjects. Clinicians commonly use exercises in an attempt to preferentially activate the VMO. Recently, our group found evidence to support clinical theory that the VMO is neurologically distinct from the vastus medialis (VM). However, the ability to voluntarily activate these muscle subsections is still disputed. The aim of this study was to determine if VM and VMO activation varies between sexes and if control of the two muscles is different between rehabilitation exercises. Thirteen men and 13 women performed isometric straight leg raises in two hip positions, neutral hip rotation and 30 degrees lateral hip rotation. Bipolar intramuscular fine-wire electrodes were inserted into the VM and VMO to obtain motor unit recruitment thresholds and initial firing rates at recruitment. Linear mixed models and Tukey post hoc tests were used to assess significant differences in 654 motor units. Women demonstrated faster motor unit firing rate at recruitment, 1.18 ± 0.56 Hz higher than men. Motor units fired 0.47 ± 0.19 Hz faster during neutral hip rotation compared with lateral hip rotation. The VMO motor units were recruited 2.92 ± 1.28% earlier than the VM. All motor units were recruited 3.74 ± 1.27% earlier during neutral hip rotation than lateral hip rotation. Thus the VM and the VMO can be activated differentially, and their motor unit recruitment properties are affected by sex and hip position.

NEW & NOTEWORTHY This is the first study to reveal differential activation of the vastus medialis oblique from the vastus medialis in clinical exercise protocols. Our research group used fine-wire electrodes to examine EMG signals of the vastus medialis oblique and vastus medialis to avoid possible cross talk. We also consider the effect of sex on motor unit firing patterns because of higher prevalence of knee pain in women, and yet few studies evaluating the sex differences in neuromuscular control.

Sport injuries treated at a physiotherapy center specialized in sports

Abstract Introduction: The risk of injuries related to physical activity and sports may increase if there is predisposition, inappropriate training and/or coach guidance, and absence of sports medicine follow-up. Objective: To assess the frequency of injuries in athletes treated at a physiotherapy center specialized in sports. Methods: For the data collection was carried out the survey of injuries in records of athletes treated in eight years of activities. The data collected included: characteristics of patients, sport, injury kind, injury characteristics and affected body part. Results: From 1090 patient/athlete records, the average age was 25 years old, the athletes were spread across 44 different sports modalities, being the great majority men (75%). The most common type of injury was joint injury, followed by muscular and bone injuries. Chronic injury was the most frequent (47%), while the most common body part injured was the knee, followed by ankle and shoulder. Among all the sports, soccer, futsal, and track and field presented the highest number of injured athletes, respectively. Conclusion: Soccer was the most common sport among the injured athletes, injury kind most frequent was joint injuries and knee was the body part most injured. Chronic injuries were the most common.