The Epidemiology of Severe Injuries Sustained by National Collegiate Athletic Association Student-Athletes, 2009-2010 Through 2014-2015

Injury incidence among adolescent and senior basketball players: a prospective study in 19 teams across an entire season

OBJECTIVE

To quantify and compare injury incidence between national-level, adolescent and regional-level, senior, male basketball players competing in Serbia overall and according to injury mechanism (contact, non-contact, or overuse), exposure setting (training or games), and history (new or recurrent).

METHODS

A total of 218 male basketball players from 19 teams (106 senior and 112 adolescent players) volunteered to participate in the study. Descriptive data regarding game and training injury incidence were gathered across all players and reported per 10,000 athlete-exposures (AE) with 95% confidence intervals.

RESULTS

Overall, 26 injuries were reported across 52,509 AE. Ankle (n = 10, incidence rate [IR] = 1.90 [0.97, 3.40]) and knee injuries (n = 8, IR = 1.52 [0.71, 2.89]) accounted for 69% of all reported injuries, with only 1-2 injuries documented for other body regions. Ankle injuries were attributed to contact (60%, IR = 1.14 [0.46, 2.38]) or non-contact mechanisms (40%, IR = 0.76 [0.24, 1.84]). Most knee injuries occurred due to overuse (50%, IR = 0.76 [0.24, 1.84]) or non-contact mechanisms (38%, IR = 0.57 [0.15, 1.56]). Comparisons according to exposure setting revealed significantly higher knee (incidence rate ratio [IRR] = 9.95 [1.85, 53.41], p = 0.004) and ankle (IRR = 39.79 [7.94, 384.67], p < 0.001) injuries per 10,000 AE during games compared to training. Recurrent injuries were most prominent in the ankle (30% of all ankle injuries, p = 0.11). Total contact (p = 0.04), non-contact (p = 0.04), and recurrent IR (p = 0.005) were significantly higher in senior than adolescent players.

CONCLUSION

The players examined were most susceptible to ankle and knee injuries, particularly during games compared to training. Ankle injuries were mostly attributed to player contact, while knee injuries were mostly attributed to overuse and non-contact mechanisms. Senior players were at a greater risk of sustaining contact, non-contact and recurrent injuries than adolescent players.

Descriptive Epidemiology of Musculoskeletal Injuries During Marine Corps Recruit Training in Gender-Integrated and Male-Only Training Units

INTRODUCTION

Musculoskeletal injuries (MSIs) occur frequently in military personnel. U.S. Marine Corps (USMC) recruits participate in an intense 13-week training program designed to transform civilians into basically trained Marines, during which they are susceptible to MSIs. Previous injury epidemiology research with USMC recruits was conducted in a non-gender-integrated training. Data for the current study were derived from a larger study, the USMC Gender-Integrated Recruit Training study, that was initiated to provide data-driven recommendations for gender integration during USMC recruit training. The purpose of the current analysis was to describe the unique profile of MSIs during USMC recruit training and compare MSIs between female and male recruits in gender-integrated training.

MATERIALS AND METHODS

Medical record-reviewed MSI data were obtained for recruits in three models of USMC recruit training: two models of gender-integrated recruit training at Marine Corps Recruit Depot (MCRD) Parris Island-the older Series Track (ST) model and the newer Integrated Company (IC) model, and a Male-Only (MO) cohort at MCRD San Diego. Incidence, anatomic region and subregion, event at the time of MSI, MSI type and onset, and disposition following MSI were described for each model. Group comparisons were conducted using Fisher's exact tests or independent samples t tests, as appropriate.

RESULTS

MSI data were available for 584 recruits (ST: 98 female recruits, 95 male recruits; IC: 85 female recruits, 106 male recruits; MO: 200 male recruits). The cumulative incidence of MSIs was significantly higher among female compared to male recruits in the ST (59.2% vs. 29.5%, P < .001) and in the IC (25.9% vs. 12.3%, P = .023) cohorts. The most frequent anatomic location for MSIs was the lower extremity (female recruits: ST: 76.5% of MSIs, IC: 88.6%; male recruits: ST: 81.1%, IC: 80.0%, MO: 83.8%). The most frequent body part affected was the hip among female recruits (ST: 26.5% of MSIs, IC: 37.1%). The most frequent body part affected by MSIs among the male recruits was the knee in the ST (32.4%) and IC (53.3%) cohorts and the lower leg (27.0%) in the MO cohort. A significantly greater percentage of female compared to male recruits sustained a hip MSI in the ST (23.5% vs. 2.1%, P < .001) and IC (12.9% vs. 0.0%, P < .001) cohorts. There was no significant difference in knee MSI incidence between sexes in the ST (P = .323) or IC (P = .757) cohorts. A large percentage of MSIs resulted in light duty (female recruits: ST: 69.4% of MSIs, IC: 74.3%; male recruits: ST: 64.9%, IC: 73.3%, MO: 94.6%).

CONCLUSIONS

This was the first study to assess the burden of MSIs concurrently among female and male USMC recruits in gender-integrated training. MSIs, especially those affecting the lower extremity, continue to occur frequently in this population. Female recruits are more susceptible to MSIs during USMC recruit training compared to male recruits and are especially prone to hip MSIs. Future research should focus on identifying modifiable risk factors for MSIs in this population, with a focus on reducing lower-extremity MSIs in all recruits and hip MSIs in female recruits.

Epidemiology and patterns of gymnastics-related head & neck trauma injuries: A NEISS database study

OBJECTIVE

To describe the epidemiology and patterns of gymnastics-related Head & Neck trauma injuries using the NEISS database from 2001 to 2020.

STUDY DESIGN AND SETTING

Cross-sectional analysis of a national database.

METHODS

Gymnastics-related ED visits between 2001 and 2020 were queried from the NEISS database. Bivariate chi-squared analyses were used to compare injury demographics, location, type, and disposition. Fracture location was identified using the narrative description of each case and were divided into subtypes for further analysis.

RESULTS

1455 gymnastics-related head and neck traumatic injuries were identified. The majority were in females (65.8%). The most common presenting age group was pediatric (≤18 years) (92.7%), and the largest racial group was Caucasian (51.5%). Of all location subtypes, facial injuries were the most common presenting injury type overall (45.2%). Regarding injury types, lacerations were most common (36.8%), followed by dental injury (30.7%) and fractures (21.2%). The most common location of head and neck fractures was the nose (45.8%), followed by cervical spine (16.7%) and orbit (13.3%). The majority (95.7%) of gymnastics-related head and neck traumatic injuries presenting to the ED were treated and discharged.

CONCLUSION

This study characterizes gymnastics-related head and neck injuries which is a topic that is under-studied. The findings from this study are helpful for gymnasts and those who care for them including providers, coaches and guardians, and this data may help inform future guidelines for treatment and injury prevention.

Midlife health crisis of former competitive athletes: dissecting their experiences via qualitative study

Sports participation confers many health benefits yet greatly increases injury risk. Long-term health outcomes in former athletes and transition to life after competitive sports are understudied. Ending a sport may pose physical and psychosocial challenges. The purpose was to determine the lived experiences of former competitive athletes and how their sports participation impacted their long-term health and well-being. Former college varsity athletes participated in semistructured interviews focusing on their experiences, including past and current health, the impact of injuries, activity, exercise, diet and transition to life after competitive sport. Thematic analysis was completed using a collaborative, iterative process. Thirty-one (16 female, 15 male) former college athletes aged 51.3±7.4 years were interviewed. Six themes emerged: (1) lifelong athlete identity; (2) structure, support and challenges of the college athlete experience; (3) a big transition to life beyond competitive sport; (4) impact of competitive sport on long-term health; (5) facilitators and barriers to long-term health after sport and (6) transferable life skills. Continuing sports eased the transition for many but often delayed their postathlete void. Challenges included managing pain and prior injury (eg, If I didn't have my knee injury, I would definitely be more active), reducing energy needs and intake (eg, When I was an athlete, I could eat anything; and unfortunately, that's carried into my regular life), lack of accountability, changed identity and lost resources and social support. Participants suggested a programme, toolkit, mentoring or exit course to facilitate the transition. While former athletes benefit from transferrable life skills and often continue sports and exercise, they face unique challenges such as managing pain and prior injury, staying active, reducing energy intake and changing identity. Future research should develop and evaluate a toolkit, programme and other resources to facilitate life after ending competitive sports under 'normal' conditions (eg, retirement) and after a career-ending injury.

Concussion diagnosis and recovery in relation to collegiate athletic department classification: a LIMBIC MATARS consortium investigation

PURPOSE

We investigated time to reach concussion diagnosis and recovery milestones in collegiate athletes relative to their schools' National Collegiate Athletic Association (NCAA) classification.

METHODS

We retrospectively examined 849 (43.1% female) concussion cases from 11 NCAA institutions (Division I Power 5 [n = 4], Division I Non-Power 5 [n = 4], and Division II/III [n = 3]) from the 2015-16 to 2019-20 athletic seasons. Our primary outcome measures were days to reach specific clinical milestones following concussion.

RESULTS

Median (IQR) time from injury to diagnosis was significantly longer at Division II/III institutions (1 [0-4] days) compared to Division I Power 5 (0 [0-1] days) and Division I Non-Power 5 (0 [0-1] days) institutions (p < 0.001). Likewise, Division II/III athletes (15 [11-22] days) took significantly longer to return to sport after concussion than Division I Power 5 (10 [7-16] days) and Division I Non-Power 5 (11 [7-18.5] days) athletes (p < 0.001).

CONCLUSION

Division II/III athletes had delayed concussion diagnoses and return to sport timelines compared to Division I athletes. Our results suggest that differences in sports medicine resources across NCAA divisions may influence injury recognition and recovery in collegiate athletes with concussion.

Prevalence of and Factors Associated with Sports Injuries in 11,000 Japanese Collegiate Athletes

BACKGROUND

To establish the 1-year prevalence of sports injuries and explore associations of various factors with a sports injury in Japanese collegiate athletes.

METHODS

The data were collected through a web-based survey of Japanese collegiate athletes associated with UNIVAS (Japan Association for University Athletics and Sport). The survey questions asked about athletes' personal characteristics, sports participation, and injuries sustained within the previous year. Follow-up questions on the details regarding the three most serious injuries were asked. Differences in proportions of athlete characteristics between males and females and between injured and uninjured were explored with the chi-square test. Factors associated with sustaining an injury were determined with regression analysis.

RESULTS

The prevalence of injuries among Japanese collegiate athletes is high, and most of the sustained injuries require athletes to take a considerable time off training and competition indicating their severity. Athletes from year two and higher at the university, overweight or obese, training more often per week, and with longer sports experience were more likely to sustain an injury within the previous year.

CONCLUSIONS

There is compelling evidence to suggest that excessive training and insufficient recovery may be contributing to their increased risk of injury. These findings underscore the importance of implementing evidence-based training programs and recovery strategies to mitigate injury risk and optimize performance outcomes among this population.

Long-term function, body composition and cardiometabolic health in midlife former athletes: a scoping review

While sports medicine has traditionally focused on recovering from injury and returning athletes to sport safely after injury, there is a growing interest in the long-term health of athletes. The purpose of this scoping review was to (1) summarise the literature (methodologies and findings) on physical function, body composition and cardiometabolic health in midlife (age 40-65 years) former competitive athletes compared with non-athlete controls, (2) identify areas for future study in long-term health in athletes and (3) determine outcomes that could be evaluated in a future systematic review(s). We searched PubMed, CINAHL, Web of Science and SPORTDiscus for studies published between 2000 and 2022 evaluating former athletes and controls on physical function, body composition and/or cardiometabolic measures using MeSH terms. We identified 20 articles that met our criteria. Outcomes varied considerably across studies, most of which were cross-sectional and evaluated only males. Limited data suggest that former endurance athletes have leaner body compositions, higher aerobic capacity and better cardiometabolic indicators than controls; former athletes who maintain higher physical activity (ie, self-reported exercise) are healthier than those who do not; and former team sport athletes, who have higher injury prevalence, may have poorer functional performance than controls who were recreationally active in college. Studies rarely evaluated functional performance, did not control for prior injury or diet and seldom assessed current physical activity levels. Future research should include females and evaluate sex differences, control for prior sports-related injury(ies), quantify physical activity, use standardised outcome measures including performance-based functional assessments and incorporate longitudinal designs.

Epidemiology of injuries in elite Women's Artistic Gymnastics: a retrospective analysis of six seasons

Background

Women's Artistic Gymnastics (WAG) is a sport well known for requiring a heavy and difficult training load from a younger age to reach a high level of performance. This also is associated with an injury risk. Epidemiological studies are thus needed to improve injury prevention strategies.

Objective

We aimed to determine the injury epidemiology in French high-level WAG.

Methods

We conducted a retrospective analysis of injury data collected prospectively over six seasons from the 2014-2015 season to the 2019-2020 season among French high-level Women's Artistic Gymnasts from the France Gymnastics National Centre of Saint-Etienne. We performed descriptive analyses, including the calculation of the 1-year injury prevalence.

Results

43 gymnasts were included in this study, representing 111 gymnast-seasons. A total of 285 injuries were collected over the study period, that was, an average of 2.6 injuries per gymnast per season. On average, 91.4% of gymnasts had at least one injury per season. The estimated injury incidence rate was 1.8 injuries per 1000 hours of gymnastics practice. The knee was the most affected joint (16%), followed by the elbow (12%) and the ankle (12%). The most frequent injury type was physis pathologies (16%) and bone injuries (15%). Eighty-eight per cent of injuries required a modification of the gymnastics practice.

Conclusions

The results of this study allowed a description of the epidemiology of injuries in this population of young and elite gymnasts. This very high injury prevalence supports the need to improve injury risk reduction strategies in WAG.

Jump-landing kinetic asymmetries persisted despite symmetric squat kinetics in collegiate athletes following anterior cruciate ligament reconstruction

The purpose was to determine the differences/correlations in anterior cruciate ligament (ACL) loading variables and bilateral asymmetries between injured/uninjured legs and among ascending/descending phases of double-leg squats and jumping/landing phases of countermovement jumps (CMJ) in the collegiate athletes following ACL reconstruction (ACLR). Fourteen collegiate athletes performed squats and CMJ 6-14 months following ACLR. The bilateral knee/hip flexion angles, peak vertical ground reaction force (VGRF) and knee extension moments (KEM), and kinetic asymmetries were calculated. Squats showed the greatest knee/hip flexion angles, while the landing phase of CMJ showed the least (P<0.001). The uninjured leg demonstrated greater VGRF (P≤0.010) and KEM (P≤0.008) than the injured leg in CMJ. Kinetic asymmetries were less than 10% for squats but were greater for the jumping (P≤0.014, 12%-25%) and landing (P≤0.047, 16%-27%) phases of CMJ. Significant correlations were found for KEM asymmetries between phases of CMJ (P=0.050) and squats (P<0.001). Kinetic asymmetries persisted in CMJ, while kinetic symmetries were achieved in squats in collegiate athletes 6-14 months following ACLR. Therefore, the CMJ appears to be a more sensitive assessment to monitor the bilateral kinetic asymmetries compared to squats. It is suggested to assess and screen kinetic asymmetries in different phases and tasks.

Demographic Factors and Instantaneous Lower Extremity Injury Occurrence in a National Collegiate Athletic Association Division I Population

CONTEXT

Temporal prediction of the lower extremity (LE) injury risk will benefit clinicians by allowing them to better leverage limited resources and target those athletes most at risk.

OBJECTIVE

To characterize the instantaneous risk of LE injury by demographic factors of sex, sport, body mass index (BMI), and injury history.

DESIGN

Descriptive epidemiologic study.

SETTING

National Collegiate Athletic Association Division I athletic program.

PATIENTS OR OTHER PARTICIPANTS

A total of 278 National Collegiate Athletic Association Division I varsity student-athletes (119 males, 159 females; age = 19.07 ± 1.21 years, height = 175.48 ± 11.06 cm, mass = 72.24 ± 12.87 kg).

MAIN OUTCOME MEASURE(S)

Injuries to the LE were tracked for 237 ± 235 consecutive days. Sex-stratified univariate Cox regression models were used to investigate the association between time to first LE injury and sport, BMI, and LE injury history. The instantaneous LE injury risk was defined as the injury risk at any given point in time after the baseline measurement. Relative risk ratios and Kaplan-Meier curves were generated. Variables identified in the univariate analysis were included in a multivariate Cox regression model.

RESULTS

Female athletes displayed similar instantaneous LE injury risk to male athletes (hazard ratio [HR] = 1.29; 95% CI= 0.91, 1.83; P = .16). Overweight athletes (BMI >25 kg/m2) had similar instantaneous LE injury risk compared with athletes with a BMI of <25 kg/m2 (HR = 1.23; 95% CI = 0.84, 1.82; P = .29). Athletes with previous LE injuries were not more likely to sustain subsequent LE injury than athletes with no previous injury (HR = 1.09; 95% CI = 0.76, 1.54; P = .64). Basketball (HR = 3.12; 95% CI = 1.51, 6.44; P = .002) and soccer (HR = 2.78; 95% CI = 1.46, 5.31; P = .002) athletes had a higher risk of LE injury than cross-country athletes. In the multivariate model, instantaneous LE injury risk was greater in female than in male athletes (HR = 1.55; 95% CI = 1.00, 2.39; P = .05), and it was greater in male athletes with a BMI of >25 kg/m2 than that in all other athletes (HR = 0.44; 95% CI = 0.19, 1.00; P = .05), but these findings were not significantly different.

CONCLUSIONS

In a collegiate athlete population, previous LE injury was not a contributor to the risk of future LE injury, whereas being female or being male with a BMI of >25 kg/m2 resulted in an increased risk of LE injury. Clinicians can use these data to extrapolate the LE injury risk occurrence to specific populations.

Using trunk kinematics to predict kinetic asymmetries during double-leg jump-landings in collegiate athletes following anterior cruciate ligament reconstruction

BACKGROUND

Bilateral vertical ground reaction force (VGRF) and knee extension moment asymmetries are commonly observed during jumping and landing tasks following anterior cruciate ligament (ACL) reconstructions (ACLR) in collegiate athletes. Kinetic asymmetries during landings are associated with increased ACL re-injury risk. Efforts have been made to predict bilateral kinetic asymmetries using trunk kinematics during squats but not during jump-landings.

RESEARCH QUESTION

To determine the correlations between trunk kinematics (medial-lateral shoulder positions, medial-lateral hip positions, and lateral trunk bending angles) and bilateral kinetic asymmetries (VGRF and knee extension moments) during double-leg jump-landings in collegiate athletes following ACLR.

METHODS

Fifteen National Collegiate Athletic Association Division I athletes who had ACLR in the past 24 months participated. Eleven of them performed two assessments over the study period for a total of 26 assessments for data analyses. Athletes performed three double-leg countermovement jumps. Kinematics and kinetics data were collected. Medial-lateral shoulder and hip positions relative to ankle positions, lateral trunk bending angles, and kinetic asymmetries were calculated during the jumping (the lowest hip position until takeoff) and landing (the first 100 ms after initial contact) phases.

RESULTS

Medial-lateral shoulder positions correlated with VGRF (r = 0.63, p < 0.001) and knee moment asymmetries (r = 0.53, p = 0.006) in the jumping phase. Medial-lateral hip positions correlated with VGRF (r = 0.61, p < 0.001; r = 0.52, p = 0.006) and knee moment asymmetries (r = 0.55, p = 0.004; r = 0.61, p < 0.001) in both jumping and landing phases.

SIGNIFICANCE

Medial-lateral hip positions correlated with kinetic asymmetries during double-leg jump-landings in collegiate athletes following ACLR. A 2D assessment using a standard video camera might be used as a low-cost and clinically applicable tool to assess bilateral kinetic asymmetries by quantifying medial-lateral hip positions during jump-landings following ACLR.

Diagnostic Imaging for Distal Extremity Injuries in Direct Access Physical Therapy: An Observational Study

Background

Military physical therapists practicing direct-access routinely utilize diagnostic imaging and numerous published case reports demonstrate the ability of physical therapists to diagnose and appropriately disposition patients with foot/ankle and wrist/hand fractures. However, no larger cohort studies have explored the utilization of diagnostic imaging by physical therapists to detect fractures.

Hypothesis/Purpose

To describe the utilization of diagnostic imaging in foot/ankle and wrist/hand injuries by physical therapists in a direct-access sports physical therapy clinic.

Study Design

Retrospective cohort study.

Methods

The Agfa Impax Client 6 image viewing software (IMPAX) was searched from 2014 to 2018 for patients with diagnostic imaging ordered for foot/ankle and wrist/hand injuries. The Armed Forces Health Longitudinal Technology Application (AHLTA) electronic medical record was independently reviewed by the principal and co-investigator physical therapists. Data extracted were demographics and elements from the patient history and physical examination.

Results

In foot/ankle injuries, physical therapists diagnosed a fracture in 16% of the 177 cases and waited for an average of 3.9 days and 1.3 visits before ordering imaging. In wrist/hand injuries, physical therapists diagnosed a fracture in 24% of the 178 cases and waited for an average of 3.7 days and 1.2 visits before ordering imaging. The time to definitive care from the initial physical therapy evaluation was significantly different (p = 0.04) for foot/ankle fractures (0.6 days) compared to wrist/hand fractures (5.0 days). The Ottawa Ankle Rules demonstrated a negative likelihood ratio (-LR) of 0.11 (0.02, 0.72) and a positive likelihood ratio (+LR) of 1.99 (1.62, 2.44) for the diagnosis of foot/ankle fracture.

Conclusions

Physical therapists utilizing diagnostic imaging in a direct-access sports physical therapy clinic diagnosed fractures in similar proportions for foot/ankle and wrist/hand injuries and quickly dispositioned patients to definitive care for those fractures. The diagnostic accuracy of the Ottawa Ankle Rules was similar to previously reported values.

Level of Evidence

Level 3.

Similar Clinical, Return to Sports, Recurrence, and Revision Outcomes Between Female and Male Athletes Following Arthroscopic Bankart Repair

PURPOSE

To compare return to sports, functional outcomes, and recurrences rates between female and male athletes following arthroscopic Bankart repair (ABR).

METHODS

A retrospective comparative study was performed between male and female athletes who underwent an ABR between January 2008 and December 2019. Sports practiced primarily by men in our practice (including rugby, soccer, boxing, and martial arts) were excluded. Functional outcomes included the Rowe score, visual analog scale (VAS) for pain, and shoulder-dependent sports ability measured with the Athletic Shoulder Outcome Scoring System (ASOSS). Return to sport, recurrence, and revisions were evaluated. Additionally, we assessed the period (months) between surgery and recurrence events.

RESULTS

A total of 58 female and 106 male patients were available for analysis at a median follow-up of 60 (interquartile range [IQR], 36-84) months. Ninety-one percent of the patients (n = 150) returned to sports and 84% (n = 126) returned to their preinjury level at a median of 6 months (IQR, 5-8) postoperatively. There were no differences in the rate of return to sports between females and males (91 vs 92% respectively, P = .997). There were no differences between the groups regarding postoperative functional outcomes, with most patients achieving the minimal clinically significant difference (Rowe: 98% female and 99% male, P = .584; ASOSS: 100% female and 99% male, P = .646). The overall recurrence rate was 9.7% (n = 16), with a rate of 10.3% (n = 6) in female and 9.4% (n = 10) in male athletes (P = .851). Time to event analysis showed that the median time to recurrence was 48 months in both groups (P = .848). The overall revision rate was 3% (n = 4), without significant differences between groups (P = .556).

CONCLUSIONS

When compared within similar sports, there does not appear to be sex-related differences in functional outcomes, recurrence, or return to play following ABR.

LEVEL OF EVIDENCE

III, retrospective comparative study.

REHABILITATION OF KNEE INJURIES IN BASKETBALL PLAYERS

ABSTRACT Introduction Basketball games are extremely combative, and the knee joint is severely impacted between runs and jumps inherent to the sport, and its injury is often inevitable. Objective Investigate the rehabilitation processes for knee joint injuries in basketball players. Methods In this paper, six athletes were questioned about the rehabilitation approach used for their injuries. In all, the centrifugal training system was used. The frequency of the exercises was three times a week, with one-day intervals. The overall training lasted nine weeks. Before and after the experiment, the athletes’ knee joint mobility and pain scores were measured, and the data were compared and analyzed. Results After nine weeks of training, the pain score by the visual analog scale was 2-4 points, corresponding to the score of mild pain without expressive impacts on activities of daily living. Conclusion The form of lower limb centrifugal training proposed in this study may help the recovery of functional status in the athletes’ knee joint, improve their joint mobility and reduce pain, presenting itself as an effective training method to be incorporated into rehabilitation. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

EPIDEMIOLOGICAL PROFILE OF AMATEUR ATHLETES AT A MEDICAL SCHOOL IN THE CITY OF SÃO PAULO

ABSTRACT Introduction: Epidemiologic data about sports injuries among college athletes in Brazil is scarce. The aim of this study was to analyze the epidemiology of sports injuries in a single center. Methods: We interviewed 262 athletes from 10 different sports retrospectively about injuries sustained in their university careers and whose injuries sustained during one season were monitored prospectively. The characterization of the injuries included data on the location of the injury, type of injury, time of year, injury mechanism, and the moment of the injury during training or a game. Results: In the university history, the incidence of injuries was higher in men (81.5%) than in women (67.8%). Lower limb injuries were the most frequent both in the university history and the season. The sports with the highest injury rate for the season was handball (34.2%) and for the university history was basketball (80.8%). The main injury mechanism was non-contact. The months with the highest incidence of injuries were those at the beginning of the season (53.3%). The most frequent diagnoses were ligament injuries, followed by fractures. Both the presence of a previous injury in the same region and the practice of weight training were predictive factors for injury. Conclusion: College athletes at this center are more likely to suffer injuries during the first months of the season, especially in contact sports involving lower limbs. Level of Evidence III; Study of non-consecutive patients, without uniformly applied “gold” reference standard .

Epidemiology of Emergency Medical Services Activations for Sport-Related Injuries in the United States

Background

Literature examining emergency medical services (EMS) activations for sport-related injuries is limited to the pediatric, high school, and collegiate student-athlete populations, excluding older individuals and recreational athletes. The purpose of this study was to examine EMS activations for sport-related injuries using the National EMS Information System Database from 2017-2018.

Methods

Data were obtained using the National EMS Information System Database from 2017-2018. EMS activations were limited to 9-1-1 responses for individuals aged 3-99 who sustained a sports-related injury. Independent variables included patient age group: pediatric (<18 years old) vs. adult (≥18 years old). Dependent variables were patient age, gender, and chief complaint anatomic location. Frequencies and proportions were calculated for each variable. Injury proportion ratios (IPRs) with 95% confidence intervals were calculated to compare chief complaint anatomic location by age group.

Results

There were 71,322 sport-related injuries. Patients were 36.6±22.9 years and most (58.1%, n=41,132) were male. Adults had higher proportions of injuries affecting the abdomen (IPR: 2.05, 95%CI: 1.83, 2.31), chest (IPR: 1.90, 95%CI: 1.75, 2.05), general/global (IPR: 1.54, 95%CI: 1.50, 1.58), and genitalia (IPR: 2.40, 95%CI: 1.39, 4.15), and lower proportions of injuries affecting the back (IPR: 0.55, 95%CI: 0.50, 0.60), lower extremity (IPR: 0.63, 95%CI: 0.60, 0.65), upper extremity (IPR: 0.50, 95%CI: 0.47, 0.53), head (IPR: 0.73, 95%CI: 0.70, 0.77), and neck (IPR: 0.18, 95%CI: 0.16, 0.20) compared to pediatric patients.

Conclusion

Injuries sustained differed between adult and pediatric patients, indicating sport-related emergencies may change across the lifespan. General/global chief complaints likely indicate sport-related injuries affecting multiple anatomic locations and organ systems. Stakeholders planning large or high-risk athletic events should consider arranging standby or dedicated advanced life support units for their events.

Sports Training Strategy and Interactive Control Method Based on Digital Twins and Wireless Sensor Networks

By combining virtual reality, the digital twin system has been deeply applied in many places. Especially with the upsurge of national sports and more attention to sports, people have also begun a more in-depth study on the strategy of sports training. This paper aims to explore the application of the Brazilian jujitsu training strategy and interactive control method in the new era. Based on the sports skills of Brazilian jujitsu, combined with digital twin technology and wireless sensor network technology, this paper develops a sports training system based on Brazilian jujitsu. It can collect the action information of the trainer and twin it into the simulation system so as to carry out better and more effective confrontation training. The experimental results show that the average delay time is 5.2 ms and the maximum delay time is 6.5 ms, which is less than the limit delay time of 20 ms. Compared with the control group, it achieved quite good results. It shows the effectiveness of the system designed in this paper for trick jujitsu training.

Video Analysis and System Construction of Basketball Game by Lightweight Deep Learning under the Internet of Things

With the explosive growth of sports video data on the internet platform, how to scientifically manage this information has become a major challenge in the current big data era. In this context, a new lightweight player segmentation algorithm is proposed to realize the automatic analysis of basketball game video. Firstly, semantic events are expressed by extracting group and global motion features. A complete basketball game video is divided into three stages, and a basketball event classification method integrating global group motion patterns and domain knowledge is proposed. Secondly, a player segmentation algorithm based on lightweight deep learning is proposed to detect basketball players, segment the players, and finally extract players' spatial features based on deep learning to realize players' pose estimation. As the experimental results indicate, when a proposed 2-stage classification algorithm is used to classify the videos, the accuracy of identifying layup, the shooting, and other 2-pointers are improved by 21.26% and 6.41%, respectively. And the accuracy of average events sees an improvement of 2.74%. The results imply that the 2-stage classification based on event-occ is effective. After comparing the four methods of classifying players, it is found that there is no significant difference among these four methods about the accuracy of segmenting. Nevertheless, when judged with the time that these methods take separately, FCN-CNN (Fully Convolutional Network-Convolutional Neural Network) based on superpixels has overwhelming advantages. The event analysis method of basketball game video proposed here can realize the automatic analysis of basketball video, which is beneficial to promoting the rapid development of basketball and even sports.

Epidemiology and Outcomes of Maxillofacial Injuries in NCAA Division I Athletes Participating in 13 Sports

Background:

Maxillofacial injuries account for an estimated 11% of National Collegiate Athletic Association (NCAA) sport-related injuries and occur at a rate of 0.2-1.5 injuries per 1000 athletic events/exposures.

Purpose:

The purpose of this study was to report the epidemiology, treatment, and outcomes of maxillofacial injuries in NCAA Division I athletes participating in 13 sports. It was hypothesized that the rate of maxillofacial injuries would be greater than previously reported in national registry studies.

Study Design:

Descriptive epidemiology study.

Methods:

A single-institution registry was utilized to retrieve the maxillofacial injuries and surgical procedures recorded over 4 athletic seasons, for the years 2015 through 2019, across 13 NCAA Division I sports. The incidence of injuries per sport was reported as the number per 1000 athlete-exposure (AE) hours. The time lost from participation and time to complete injury resolution per sport were reported as the mean and range.

Results:

A total of 193 maxillofacial injuries occurred over 4 seasons. The overall incidence of maxillofacial injuries was 2.06 injuries per 1000 AE hours. The injury incidence for male and female athletes was 1.92 and 2.43 injuries per 1000 AE hours, respectively. Men’s basketball (8.30 injuries per 1000 AE hours) and men’s water polo (8.15 injuries per 1000 AE hours) had the highest rates of all sports. Overall, 20 athletes (10.4%) required surgery. The mean time to resolution across all sports was 33.3 days (range, 0-336 days) per injury. The mean time lost across all sports was 17.1 days (range, 0-336 days) per injury.

Conclusion:

At a single NCAA Division I institution, maxillofacial injuries occurred at a higher rate than previously thought and could lead to significant time lost from sport participation. Basketball players were at the highest risk of this injury. Across all sports, male athletes took longer to return to sport after a maxillofacial injury compared to female athletes, but the latter required more time to fully recover. Maxillofacial injuries may require surgical treatment, and their prevention is critical.

Emotion mapping: Exploring creative methods to understand the psychology of long-term injury

This methodological study details the effectiveness of emotion mapping as a method to explore the lived experiences of professional male athletes ( n = 9) with a long-term injury. This represents the first use of emotion mapping to garner phenomenal knowledge on long-term injury within a sport psychology context, and as such is a departure from traditional approaches in this field. Following an orientation meeting, each participant was asked to produce an emotion map in the privacy of their home of two critical spaces occupied during their rehabilitation. Using video conferencing software, they were then asked to narrate their map, to facilitate understanding of their lived experiences of injury. Overall, the method was found to be efficacious in supporting existing literature on injury and revealing previously unknown aspects of long-term injury. In particular, the study provided phenomenal knowledge that was previously absent. As such, recommendations are made for the use of emotion mapping both as an effective research technique, and as a therapeutic tool.

What Makes Parkour Unique? A Narrative Review Across Miscellaneous Academic Fields

Parkour is a growing sport that mostly involves jumping, vaulting over obstacles, and climbing in a non-dedicated setting. The authors gathered all known relevant literature across miscellaneous academic fields in order to define parkour with regard to other sports disciplines. Parkour is a lifestyle sport, and as such provides an alternative to mainstream sports, away from strict rules, standardized settings, and necessary competitions. Traceurs (parkour adepts) consider the city as a playground and as an outlet for their creativity, but they also have a strong taste for hard and individualized challenges. They usually train on non-specific structures, at ground level. Although their social background is not clear, they are mostly young and male. Traceurs are stronger than recreational athletes, especially in eccentric exercises. However, their endurance skills may be below average. One of the core specificities of parkour is its precision constraint at landing, which turns a standing long jump into a precision jump, regulated in flight so as to prepare for landing. The running precision jump follows the same landing pattern, and its flight phase contrasts with long jump techniques. Injuries, which are not more frequent than in other sports, often occur at landing and to lower limb extremities. This risk is mitigated by targeting the landing area with the forefoot instead of letting the heel hit the ground like in gymnastics, or with rolling in order to dissipate the impact. Overall, parkour focuses on adaptability to new environments, which leads to specific techniques that have not yet been extensively addressed by the literature.

Specificity of isokinetic assessment in noncontact knee injury prevention screening: A novel assessment procedure with relationships between variables in amateur adult agility-sport athletes

OBJECTIVES

To present a new knee isokinetic assessment procedure linked to noncontact knee injury mechanisms and examine correlations between variables relevant to noncontact knee injury prevention screening (peak torque [PT, Nm], time-to-peak torque [TTPT, ms], angle-of-peak torque [APT, °], mean PT [MPT, Nm]).

DESIGN

Cross-sectional.

SETTING

Sports medicine laboratory.

PARTICIPANTS

Thirty-four agility-sport athletes (male/female n = 18/16, age 24.1 ± 3.5yr, height 171.8 ± 9.6 cm, mass 70.6 ± 12 kg).

MAIN OUTCOME MEASURES

Pearson's/Spearman's correlation (r/r_s), coefficient of determination (r²/r_s²).

RESULTS

Most correlations were statistically non-significant or statistically-significant with only weak-to-moderate coefficients. For both knee extension and flexion, PT and MPT were significantly and strongly correlated (r = 0.99, r² = 0.98, p = 0.001). Graphical analyses revealed two datapoint clusters for knee flexion TTPT and APT. One cluster indicated some participants could generate knee flexor PT rapidly (<150 ms) at low knee flexion angles (<45°) and the other cluster indicated that other participants could not (>200 ms, >50°).

CONCLUSIONS

In this study, most isokinetic variables represented distinct knee neuromuscular characteristics. For both knee extension and flexion, only PT or MPT need be used to represent isokinetic maximal strength. Knee flexion TTPT and APT may have utility in noncontact knee injury prevention screening with amateur adult agility-sport athletes.

The Relationship between Landing Error Scoring System Performance and Injury in Female Collegiate Athletes

BACKGROUND

The Landing Error Scoring System (LESS) is a standardized tool used to identify aberrant biomechanical movement patterns during a jump-landing task. Prior authors have examined the value of the LESS in identifying ACL injury risk in athletic populations. Yet, no study has evaluated the association between LESS performance and incidence of any type of lower extremity injury in female collegiate athletes across multiple sports.

PURPOSE

The purpose of this study was to examine the association between LESS performance as measured with a markerless motion-capture system and lower extremity injury in female collegiate athletes.

STUDY DESIGN

Prospective cohort study.

METHODS

One hundred and ten DI female collegiate athletes (basketball, n=12; field hockey, n=17; gymnastics, n=14; lacrosse, n=27; softball, n=23; volleyball, n=17) completed a jump-landing test prior to the start of their sport seasons. The LESS was automatically scored using a Microsoft Kinect sensor and Athletic Movement Assessment software (PhysiMax®). Participants were tracked throughout one competitive season for incidence of time-loss lower extremity injury. A Receiver Operating Characteristic curve determined the optimal cutpoint for the total LESS score for predicting injury. Pearson's Chi squared statistics examined the association between injury and LESS total scores >5. The Fisher exact test evaluated group differences for the frequency of receiving an error on individual LESS test items.

RESULTS

Female collegiate athletes with LESS scores >5 were not more likely to be injured than those with scores ≤5 (χ2=2.53, p=0.111). The relative risk of injury to this group was 1.78 (95% CI=0.86, 3.68) while the odds ratio was 2.10 (95% CI=0.83, 5.27). The uninjured group was more likely to receive an error on lateral trunk flexion at initial contact than the injured group (p=0.023).

CONCLUSION

The LESS total score was not associated with an increased odds of lower extremity injury in this cohort of female collegiate athletes. Future studies to examine the association between individual LESS item scores and injury are warranted.

LEVEL OF EVIDENCE

1b.

Medial-lateral hip positions predicted kinetic asymmetries during double-leg squats in collegiate athletes following anterior cruciate ligament reconstruction

ACL re-injury rates are high in collegiate athletes, and double-leg squats have been used as a functional weight-bearing exercise to strengthen the lower extremities and assess bilateral kinetic asymmetries. The primary purpose was to quantify the correlations between medial-lateral shoulder/hip positions and lateral bending angles and bilateral asymmetries in vertical ground reaction forces (VGRF) and knee extension moments during double-leg squats in collegiate athletes at two assessments following anterior cruciate ligament reconstruction (ACLR). Seventeen National Collegiate Athletic Association Division I athletes performed double-leg squats between 0 and 6 months and/or between 6 and 12 months following their ACLR while kinematic and kinetic data were collected. Medial-lateral shoulder positions strongly and significantly correlated with VGRF asymmetries at both assessments (p ≤ 0.007, r ≥ 0.68). Medial-lateral hip positions strongly and significantly correlated with VGRF asymmetries and knee moment asymmetries at both assessments (p ≤ 0.018, r ≥ 0.62). Additionally, participants demonstrated decreased VGRF asymmetries and knee moment asymmetries, more neutral shoulder and hip positions, and increased knee moments for the injured leg at the second assessment compared to the first assessment with large effect sizes (p ≤ 0.008, Cohen's d ≥ 1.06). In conclusion, medial-lateral hip positions correlated and predicted VGRF and knee moment asymmetries during double-leg squats in collegiate athletes at two assessments (0-6 and 6-12 months) following ACLR. The bilateral asymmetries support the need for an individual approach for kinetic asymmetry assessments. A commercially available camera can be utilized as a low-cost and convenient tool to monitor and potentially train bilateral kinetic symmetries during double-leg squats in patients following ACLR.

Epidemiology of Musculoskeletal Injuries in Adult Athletes: A Scoping Review

Background and Objectives: Sport-related musculoskeletal injuries (MSK-Is) are a common health issue in athletes that can lead to reduced performance. The aim of this scoping review was to synthetize available evidence on injury incidence rates (IIRs), types, and sites that affect the musculoskeletal (MSK) system of adult athletes. Materials and Methods: We performed a scoping review on the Pubmed database limiting our search to 33 Olympic sports. Results: We identified a total of 1022 papers, and of these 162 were examined in full for the purpose of this review. Archery was the sport with the highest risk of injuries to the upper extremities, marathons for the lower extremities, and triathlon and weightlifting for the body bust. In the majority of the sports examined, muscle/tendon strain and ligament sprain were the most common MSK-Is diagnoses, while athletics, karate, and football were the sports with the highest IIRs, depending on the methods used for their calculations. Conclusions: Our scoping review highlighted the general lack and dishomogeneity in the collection of data on MSK-Is in athletes.

Implementation of an Injury Prevention Program in NCAA Division I Athletics Reduces Injury-Related Health Care Costs

Background:

The estimated cost per year of injuries in collegiate athletics has been reported to be billions of dollars in the United States. Injury prevention programs are often assessed only by their ability to reduce injuries, and there is little evidence of any potential reduction in associated health care costs.

Purpose:

To investigate changes in injury-related health care costs at a National Collegiate Athletic Association (NCAA) Division I university after the implementation of an injury prevention program.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 12 sports teams that used the injury prevention program (user group) and 16 teams that did not implement the program (nonuser group). The injury surveillance and prevention system (Sparta Science) utilized a commercially available force-plate system to assess kinematic variables, flag high-risk athletes, and guide individual conditioning programs. Data were obtained from 3 academic years before (2012-2014) and 2 academic years after (2015-2016) implementation of the Sparta Science system. The number of injuries and associated health care costs (surgery, clinic visits, imaging, and physical therapy) were compared between users and nonusers.

Results:

Total average annual injuries did not change significantly between users and nonusers after implementation of the program; however, users demonstrated a 23% reduction in clinic visits as compared with a 14% increase for nonusers (P = .049). Users demonstrated a 13% reduction in associated health care encounters, compared with a 13% increase for nonusers (P = .032). Overall health care costs changed significantly for both groups, with an observed 19% decrease ($2,456,154 to $1,978,799) for users and an 8% increase ($1,177,542 to $1,270,846) for nonusers (P < .01 for both). Costs related to associated health care encounters also decreased by 20% for users as compared with a 39% increase for nonusers (P = .027).

Conclusion:

This study demonstrated the ability to significantly reduce injury-related health care costs in NCAA Division I athletes via a comprehensive injury surveillance and prevention program utilizing force-plate technology. Given the substantial and appropriate focus on value of care delivery across the US health care system, we recommend the continued study of sports injury surveillance and prevention programs for reducing injury-related health care costs.

Epidemiology of Spine Injuries in National Collegiate Athletic Association Men's Wrestling Athletes

Background:

Spine injuries are common in collegiate wrestlers and can lead to reinjury, persistent pain, and time lost from participation.

Purpose:

To describe the epidemiology of spine injuries in National Collegiate Athletic Association (NCAA) wrestlers between academic years 2009 to 2010 and 2013 to 2014.

Study Design:

Descriptive epidemiology study.

Methods:

The incidence and characteristics of spine injuries were identified utilizing the NCAA–Injury Surveillance Program database. Spine injuries were assessed for injury type, injury mechanism, time of season, event type, recurrence, participation restriction, and time lost from participation. Rates of injury were calculated as the number of injuries divided by the total number of athlete-exposures (AEs). Injury rate ratios (IRRs) were calculated for event type and time of season, and results with 95% confidence intervals that did not include 1.0 were considered statistically significant.

Results:

There were an estimated 2040 spine injuries reported in the database over the 4-year period, resulting in an injury rate of 0.71 per 1000 AEs.  Spine injuries were over twice as likely to occur in competitions as in practices (IRR, 2.02; 95% confidence interval, 1.10-3.69). More injuries occurred in both the preseason (0.94 per 1000 AEs) and the postseason (1.12 per 1000 AEs) compared with the regular season (0.55 per 1000 AEs). Contact injuries (42%) were the most common mechanism of injury, and brachial plexus injury (20%) was the most common diagnosis. Only 1.3% of injuries required surgery, and athletes most commonly returned to sport within 24 hours (33%) or within 6 days (25%).

Conclusion:

This investigation found an overall injury rate of 0.71 per 1000 AEs in wrestling athletes between academic years 2009 to 2010 and 2013 to 2014. The majority of these injuries were new, and athletes most commonly returned to sport within 24 hours. The injury rate was highest in competition, and both the preseason and the postseason showed a higher injury rate than that in season. Efforts to improve injury prevention and management should be informed by these findings.

Intersection of surgical injuries and pain interference among former female collegiate gymnasts

BACKGROUND

Gymnastics is a competitive sport with numerous health benefits. However, few data exist that examine the lasting effects of injuries in retired gymnasts.

OBJECTIVE

To examine pain interference among former collegiate gymnasts. Specifically, we focused on the relationship between gymnastics-related injuries sustained during middle/high school or college that required surgery and former collegiate gymnasts' current pain. We hypothesized that injuries requiring surgery would be associated with increased pain and reduced function after retirement.

DESIGN

Cross-sectional survey.

SETTING

An online questionnaire was distributed to former female collegiate gymnasts via social media.

PARTICIPANTS

A total of 447 former female collegiate gymnasts completed the survey and were grouped according to whether they indicated an injury during their middle/high school or collegiate gymnastics career that required surgery.

MAIN OUTCOME MEASURES

The association between current pain interference (Patient-Reported Outcomes Measurement Information System [PROMIS] scale) and injuries in middle/high school or college that resulted in surgery. Pain interference elements included current enjoyment of life, ability to concentrate, participation in day-to-day activities, enjoyment of recreational activities, ability to perform errands, and ability to socialize with others.

RESULTS

Those who reported an injury that resulted in surgery (n = 260; mean current age ± SD = 32.8 ± 9.5 years) were younger than those who did not at the time of survey completion (n = 187; current age: 37.0 ± 11.0 years) and reported beginning gymnastics at an earlier age (4.4 ± 2.0 years vs. 5.1 ± 2.5 years; p = .001). There were no statistically significant differences between the groups on any PROMIS questions. In secondary analyses, we found a small but significant association between beginning gymnastics at an earlier age and the odds of requiring surgery (odds ratio = 1.11, 95% confidence interval [CI] = 1.02-1.21; p = .02).

CONCLUSIONS

Most retired gymnasts reported a gymnastics-related injury that required surgery. Gymnasts who start gymnastics at a younger age were more likely to sustain an injury that required surgery, but surgery was not associated with higher levels of pain interference.

Clinical Estimation of the Use of the Hip and Knee Extensors During Athletic Movements Using 2D Video

Given that increased use of the knee extensors relative to the hip extensors may contribute to various knee injuries, there is a need for a practical method to characterize movement behavior indicative of how individuals utilize the hip and knee extensors during dynamic tasks. The purpose of the current study was to determine whether the difference between sagittal plane trunk and tibia orientations obtained from 2D video (2D trunk-tibia) could be used to predict the average hip/knee extensor moment ratio during athletic movements. Thirty-nine healthy athletes (15 males and 24 females) performed 6 tasks (step down, drop jump, lateral shuffle, deceleration, triple hop, and side-step-cut). Lower-extremity kinetics (3D) and sagittal plane video (2D) were collected simultaneously. Linear regression analysis was performed to determine if the 2D trunk-tibia angle at peak knee flexion predicted the average hip/knee extensor moment ratio during the deceleration phase of each task. For each task, an increase in the 2D trunk-tibia angle predicted an increase in the average hip/knee extensor moment ratio when adjusted for body mass (all P < .013, R2 = .17-.77). The 2D trunk-tibia angle represents a practical method to characterize movement behavior that is indicative of how individuals utilize the hip and knee extensors during dynamic tasks.

Cost and Treatment Characteristics of Sport-Related Knee Injuries Managed by Athletic Trainers: A Report From the Athletic Training Practice-Based Research Network

CONTEXT

Knee injuries are common during sport participation. However, little is known about the overall management and estimated direct costs of care associated with these injuries when under the care of athletic trainers.

OBJECTIVE

To describe the treatment characteristics and direct costs of care for athletic training services provided for patients with knee injuries.

DESIGN

Descriptive study.

SETTING

Ninety-five athletic training facilities across 24 states.

PATIENTS OR OTHER PARTICIPANTS

A total of 117 athletic trainers (females = 56.4%, age = 29.4 ± 8.7 years, years certified = 4.7 ± 6.0, years employed at site = 1.6 ± 4.1).

MAIN OUTCOME MEASURE(S)

Complete patient cases were identified using International Classification of Disease-10 diagnostic codes between 2009 and 2020. Summary statistics were calculated for patient demographics, treatment characteristics, and direct costs of care. Treatment characteristics included the type of athletic training service, duration, amount (eg, number of visits), and direct costs of care.

RESULTS

A total of 441 patient cases were included. The most common injuries reported were cruciate ligament sprain (18.1%, n = 80), medial collateral ligament sprain (15.4%, n = 68), and knee pain (14.1%, n = 62). Injuries occurred most frequently during football (35.4%, n = 156), basketball (14.7%, n = 65), and soccer (12.7%, n = 56). A total of 8484 athletic training services were recorded over 4254 visits, with therapeutic exercise (29.8%, n = 2530), hot or cold pack (25.8%, n = 2189), and therapeutic activities (11.2%, n = 954) being the most frequently reported services. The median duration of care was 23 days and number of visits was 8. The median total cost of care was $564 per injury and $73 per visit.

CONCLUSIONS

Patients with knee injuries demonstrated greater time loss than those with other lower extremity injuries. Thus, it is unsurprising that knee injuries were associated with a longer duration and higher cost of care than other lower extremity injuries such as ankle sprains. Future researchers should examine the effectiveness of common treatment strategies and aim to identify treatments that can reduce costs and improve patient outcomes.

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

CONTEXT

College athletes have been competing in championship track and field events since 1921; the numbers of competing teams and participating athletes have expanded considerably.

BACKGROUND

Monitoring injuries of men's track and field athletes using surveillance systems is critical in identifying emerging injury-related patterns.

METHODS

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

RESULTS

Overall, men's track and field athletes were injured at a rate of 2.37 per 1000 athlete-exposures; injuries occurred at a higher rate during competition compared with practice. Most injuries were to the thigh (26.2%), lower leg (17.3%), or knee (10.7%) and were caused by noncontact (37.2%) or overuse (31.5%) mechanisms. The most reported injury was hamstring tear (14.9%).

SUMMARY

The etiologies of thigh and lower-leg injuries warrant further attention in this population. Future researchers should also separately examine injury incidence during indoor and outdoor track and field seasons.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Track and Field: 2014-2015 Through 2018-2019

CONTEXT

Women's track and field events at the National Collegiate Athletic Association level have grown in popularity in recent years, and track and field athletes are vulnerable to a broad range of potential injuries.

BACKGROUND

Routine examination of track and field injuries is important for identifying emerging patterns in injury incidence.

METHODS

Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 to 2018-2019 academic years 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 2.20 per 1000 athlete exposures; the competition injury rate was higher than the practice injury rate (injury rate ratio = 1.73; 95% confidence interval = 1.51, 1.97). Hamstring tears (8.9%), medial tibial stress syndrome (5.4%), and lateral ligament complex tears (4.2%) were the most reported injuries.

CONCLUSIONS

Given the results of this study, further attention may be directed toward factors associated with noncontact injury risk in the competitions. The changing injury rates of most reported injuries also warrant monitoring post 2018-2019.

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

CONTEXT

The first men's wrestling National Collegiate Athletic Association (NCAA) Championship was sponsored in 1928; since then, participation has increased.

BACKGROUND

Continued study of wrestling injury data is essential to identify areas for intervention based on emerging trends.

METHODS

Exposure and injury data collected in the NCAA Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios (IRRs) were used to examine differential injury rates.

RESULTS

The overall injury rate was 8.82 per 1000 athlete exposures. The competition injury rate was significantly higher than practice injury rate (IRR = 4.11; 95% CI = 3.72, 4.55). The most commonly injured body parts were the knee (21.4%), shoulder (13.4%), and head/face (13.3%), and the most prevalently reported specific injury was concussion.

SUMMARY

These findings provide the most current update to injury incidence and outcomes in NCAA men's wrestling. We identify notable trends that warrant consideration in future research.

Injury Reduction Programs for Reducing the Incidence of Sport-Related Head and Neck Injuries Including Concussion: A Systematic Review

BACKGROUND

Sport-related head and neck injuries, including concussion, are a growing global public health concern with a need to explore injury risk reduction strategies such as neck exercises.

OBJECTIVES

To systematically review the literature to investigate: (1) the relationship between neck strength and sport-related head and neck injuries (including sport-related concussion (SRC); and (2) whether neck exercise programs can reduce the incidence of (a) sport-related head and neck injuries; and (b) SRC.

METHODS

Five databases (Ovid MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science) and research lists of included studies were searched using a combination of medical subject headings and keywords to locate original studies which reported the association between incidence of head and/or neck injury and neck strength data, or included a neck exercise intervention either in isolation or as part of a more comprehensive exercise program.

RESULTS

From an initial search of 593 studies, six were included in this review. A narrative synthesis was performed due to the heterogeneity of the included studies. The results of two observational studies reported that higher neck strength, but not deep neck flexor endurance, is associated with a lower risk of sustaining a SRC. Four intervention studies demonstrated that injury reduction programs that included neck exercises can reduce the incidence of sport-related head and neck injuries including SRC.

CONCLUSION

Consideration should be given towards incorporating neck exercises into injury reduction exercise programs to reduce the incidence of sport-related head and neck injuries, including SRC.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO (registration number: 194217).

The Relationship Between Workload and Non-Contact Musculoskeletal Injury in College Swimmers: A Prospective Cohort Study

CONTEXT

Swimmers are known for high training loads and overuse injuries, but few studies have investigated the relationship between the two at the college level.

OBJECTIVE

To determine the association between workload and non-contact musculoskeletal injury in college swimmers. We hypothesized (1) higher overall workload (kilometers swum throughout the season) would be associated with increased odds of injury and (2) the ratio of the current week's (acute) workload divided by the current month's (chronic) workload (i.e., the acute:chronic workload ratio (ACWR)) would be more strongly associated with odds of injury than acute or chronic workloads alone.

DESIGN

Prospective cohort study.

SETTING

College natatorium.

PATIENTS OR OTHER PARTICIPANTS

Thirty-seven Division III college swimmers.

MAIN OUTCOME MEASURES

Logistic regression using generalized estimating equations was used to calculate odds ratios (OR) with 95% confidence intervals (CI) for injury relative to high workloads and high ACWRs. Injury rates for several ranges of workloads and ACWRs were also calculated.

RESULTS

Eleven participants (29.7%) sustained 12 injuries, with seven injuries occurring during the participants' winter training trip. Injury was associated with high acute workloads (OR = 27.1 [95% CI = 8.2, 89.8]) and high ACWRs (OR = 25.1 [95% CI = 7.7, 81.4]) but not high chronic workloads (OR = 2.6 [95% CI = 0.3, 20.0]) or overall workloads (OR = 1.00 [95% CI = 0.99, 1.01]). High acute workloads (>37.2 km/week) and high ACWRs (>1.56) increased injury rate from ≤1% to 15% and 14%, respectively, compared to all lower acute workloads and ACWRs.

CONCLUSIONS

College swimmers can tolerate high workloads spread out over the season. However, caution should be used when prescribing high acute workloads and high ACWRs (e.g., winter training trip) due to increased odds of injury.

Epidemiology of Severe Foot Injuries in US Collegiate Athletes

Background

The effects of foot injuries on collegiate athletes in the United States are of interest because of the short 5-year eligibility period in the National Collegiate Athletic Association (NCAA).

Purpose

To discuss the epidemiology of severe NCAA foot injuries sustained over 10 years in 25 sports.

Study Design

Descriptive epidemiology study.

Methods

We utilized the NCAA Injury Surveillance System, which prospectively collects deidentified injury data for collegiate athletes. Severe injuries were classified as season- or career-ending injuries, injuries with >30-day time loss, or injuries requiring operative treatment. Injury rates (IRs) were analyzed per 100,000 athlete-exposures.

Results

Of 3607 total foot injuries, 18.71% (n = 675) were classified as severe, with an IR of 5.73 per 100,000 athletic-exposures. For all severe injuries, the operative rate was 24.3%, the season-ending rate 37.0%, and the career-ending rate 4.4%. The proportion of recurrent injuries was 13.9%. Men's sports with the highest severe foot IRs were basketball (IR = 10.71), indoor track (IR = 7.16), and football (IR = 7.08). Women's sports with the highest severe foot IRs were cross-country (IR = 17.15), gymnastics (IR = 14.76), and outdoor track (IR = 14.65). Among all severe foot injuries, the most common was a fifth metatarsal fracture. The highest contact/noncontact injury ratios were phalangeal fracture, turf toe, and Lisfranc injury. The severe injuries with the highest operative rates were Lisfranc injuries, fifth metatarsal fractures, and midfoot fractures. The severe injuries associated with the highest season-ending IRs were Lisfranc injury, midfoot fracture, and general metatarsal fractures. Severe flexor/extensor injuries had the highest career-ending IRs, followed by turf toe. Severe injuries with the highest median time loss were sesamoidal fractures, calcaneal fractures, and plantar fascial injuries.

Conclusion

Of all collegiate foot injuries sustained over a 10-year period, 18.7% were characterized as severe, and 24.3% of severe injuries required surgery. Basketball was the men's sport with the highest severe IR, and cross-country was the women's sport with the highest severe IR. Overall, female athletes experienced slightly higher severe foot IRs as compared with male athletes.

Male collegiate soccer athletes with severe ankle laxity display increased knee abduction during side-cutting tasks compared to those with only perceived ankle instability

This study aimed to examine lower limb kinematics during a side-cutting task in male collegiate soccer athletes with severe ankle laxity. Forty-seven participants with a history of ankle sprains and perceived ankle instability were categorized into non-laxity (n = 17), laxity (n = 19), and severe laxity (n = 11) groups using stress radiography tests. Three-dimensional kinematic data during the stance phase of a 45° side-cutting task were analysed. The frontal plane kinematics of the knee significantly differed between the three groups (p < 0.05). The severe laxity group exhibited a greater abduction angle than the non-laxity group (p < 0.05). The horizontal and sagittal plane kinematics of the rearfoot differed between the three groups during the end of the stance phase (p < 0.05). Our data suggest that collegiate soccer athletes with both perceived ankle instability and severe ankle laxity exhibit greater knee abduction movement during a 45° side-cutting task compared to those with only perceived ankle instability.

Epidemiology of Foot and Ankle Injuries in NCAA Jumping Athletes in the United States During 2009-2014

Background

Foot and ankle injuries comprise a significant proportion of all injuries sustained by National Collegiate Athletic Association (NCAA) athletes. In particular, sports that combine jumping and rapid changes in direction are associated with increased lower extremity injuries.

Purpose

To describe the epidemiology of foot and ankle injuries in men's and women's jumping sports, including NCAA men's and women's basketball, women's volleyball, and women's gymnastics, during the 2009-2010 through 2013-2014 seasons.

Study Design

Descriptive epidemiology study.

Methods

Injury-surveillance data were obtained from the NCAA Injury Surveillance Program for the 2009-2010 through 2013-2014 seasons. Injuries were examined by mechanism, activity during injury, and participation restriction time. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios, and risk ratios with 95% CIs were calculated. Reported sex differences were calculated for men's and women's basketball. All 95% CIs not containing 1.0 were considered statistically significant.

Results

A total of 1136 players sustained foot and ankle injuries (483 male and 653 female) over 612,680 AEs. These injuries resulted in a combined rate of 1.85 per 1000 AEs (95% CI, 1.75-1.97). Ankle sprains were the most common injury (63.7%), with lateral ligamentous complex injuries making up 77.1% of all ankle sprains. The most common foot injury varied based on sport and sex. Ankle injury rates were higher in male versus female basketball players (injury rate ratio, 1.33 [95% CI, 1.13-1.57]), but foot injury rates did not differ. Among basketball and volleyball players, player contact during jumping was the most common injury mechanism. Female gymnasts had higher overuse injury rates than other athletes (0.49/1000 AEs [95% CI, 0.30-0.74]; P < .002). Overall, female basketball players were 1.81 times more likely to sustain an overuse injury than male basketball players (95% CI, 1.02-3.20; P = .02).

Conclusion

The most common foot and ankle injury sustained in collegiate jumping sports was a lateral ligamentous complex ankle sprain. Injury-prevention programs focusing on ankle flexibility, strength, and proprioception may help to alleviate the injury burden and lessen severity. Improving the anticipation of contact during jumping and landing may reduce injury rates and increase player safety. The increased prevalence of overuse injuries in female collegiate athletes competing in jumping sports necessitates further investigation to reduce injury rates through prevention and training programs.

Trunk motion and anterior cruciate ligament injuries: a narrative review of injury videos and controlled jump-landing and cutting tasks

The aims of this narrative review were to summarise trunk motion and external trunk perturbation observed in anterior cruciate ligament (ACL) injury videos and to review the association between trunk motion and ACL loading variables in controlled jump-landing and cutting tasks in non-injured populations. Video analyses have shown limited trunk flexion and increased trunk lateral bending towards the injured leg are associated with increased risk of ACL injuries, while trunk axial rotation away from the injured leg is more frequent than rotation towards the injured leg. Contact with the trunk before and at the time of the injury is common and might increase the risk of ACL injury. Controlled jump-landing and cutting studies have shown that limited trunk flexion and increased trunk lateral bending are associated with increased ACL loading. However, the findings of trunk axial rotation are not consistent with most video analyses. Mid-flight external trunk perturbation could increase ACL loading variables for one leg and is consistent with the videos of trunk-contact ACL injuries. These findings may help understand the role of trunk motion on primary ACL injury mechanisms and improve ACL injury screening tasks and ACL injury prevention strategies with the consideration of trunk motion.

Epidemiology of Sports-Specific Foot and Ankle Injuries

The epidemiology of any given topic sometimes is overlooked. This is true particularly with sports physicians and sports injuries. The identification of sports-specific injury patterns by collection and examination of data can help prevent injuries. Thus, as a physician involved in any sport, it is essential to have this knowledge because understanding it and imparting it may allow a valuable contribution to the health and safety of the athletes and success of the teams.

Do Normative Composite Scores on the Functional Movement Screen Differ Across High School, Collegiate, and Professional Athletes? A Critical Review

OBJECTIVE

The Functional Movement Screen (FMS) is a battery of 7 unloaded tests designed to rate human movement competency. Injury rates vary across the different level of a sport. The purpose of this critical review was to determine whether normative FMS composite scores differ across high school, collegiate, and professional athletic populations and to determine whether normative composite scores correlate with rates of severe injury across different collegiate sports.

DATA SOURCES

PubMed, Web of Science, and EBSCO databases from inception to September 2017 with the following syntax: "functional movement screen*" OR "movement screen*". Additional records were identified by citation tracking and hand search of articles.

STUDY SELECTION

A total of 708 records identified, of which 36 were included. Studies were included if they reported a FMS composite score for one of the groups.

DATA EXTRACTION

Two reviewers (T.R.P. and F.K.) screened records for the author and year; sample size; study design; sport(s); number, age, and sex of participants; testing conditions; methodological quality; and mean or median composite score(s).

DATA SYNTHESIS

Normative FMS composite scores were invariant to level of play, with 61% of reported scores falling between 14 and 16, despite injury rates increasing by level of play. Scores for high school, college, and professional athletes were 14.1, 14.8, and 15.7, respectively. There was a significant positive relationship between composite scores and rate of severe injury in college sports (r(11) = 0.66, P = 0.014).

CONCLUSIONS

Our findings potentially undermine the FMS's predictive validity. Although the FMS may have other applications, this critical review provides further evidence against the composite score for injury prediction in competitive athletes.

THE NONOPERATIVE REHABILITATION OF A TRAUMATIC COMPLETE ULNAR COLLATERAL LIGAMENT TEAR OF THE ELBOW IN A HIGH SCHOOL WRESTLER: A CASE REPORT

Background and Purpose

Injuries frequently occur in competitive wrestling, with the elbow joint representing about 25% of all injuries. Specific to the elbow, the ulnar collateral ligament (UCL) can be injured traumatically from takedowns in wrestling. In athletes with complete UCL tears, surgical management is often recommended with nonoperative management resulting in less favorable outcomes. The purpose of this case report is to present a nonoperative criterion-based rehabilitation program for a high school wrestler with a complete UCL tear of the elbow.

Case Description

A 17-year-old male wrestler presented to outpatient physical therapy with a complete UCL tear sustained from falling on an outstretched hand during a wrestling match. He presented with limited elbow range of motion (ROM), medial elbow instability, and weakness of the involved shoulder and forearm musculature. A three staged criterion-based rehabilitation protocol was developed for this subject based on specific criteria, including pain, elbow ROM, arm strength, and functional outcomes.

Outcomes

The subject was treated for nine visits over six weeks, and demonstrated improvements in all strength tests of the involved upper extremity, with elbow flexion strength improving the most by 58%. Return to sport (RTS) tests were used to assess the subject's ability to return to practice. At approximately eight weeks after initial injury, the subject was able to return to full participation in competitive wrestling with no reports of elbow pain or instability.

Discussion

Through the utilization of a criterion-based rehabilitation protocol for the nonoperative management of an UCL injury, this high school wrestler was able to safely progress back to wrestling without pain or instability in an accelerated time frame. Previously, no detailed rehabilitation guidelines for nonoperative management of UCL injuries in contact sports have been described. Additionally, few studies exist which report on the inclusion of RTS testing following an injury to the UCL of the elbow, as RTS testing is optimal for determining readiness for sport.

Level of Evidence

4, Case Report.

Hand and Wrist Injuries Among Collegiate Athletes: The Role of Sex and Competition on Injury Rates and Severity

Background:

There is a high incidence of hand and wrist injuries in athletes participating in collegiate sports, but there is little information published characterizing them.

Purpose:

To characterize hand and wrist injuries in collegiate athletes using a large national database.

Study Design:

Descriptive epidemiology study.

Methods:

This retrospective cross-sectional analysis was designed using data from the National Collegiate Athletic Association (NCAA) Injury Surveillance Program database to identify hand and wrist injuries (exclusive of any radial or ulnar fractures) in male and female collegiate athletes participating in NCAA Division I, II, and III sports from 2004 to 2015. Descriptive analyses were performed on stratified data to examine the associations between these injuries and sport, event type, and sex.

Results:

Men’s ice hockey (8.25 per 10,000 athlete-exposures [AEs]) and women's ice hockey (8.21 per 10,000 AEs) had the highest rate of hand and wrist injuries in all exposures. In every sport except women’s gymnastics (P = .107), injuries were more commonly sustained during competition rather than during practice. Ligamentous injury to the phalynx was the most commonly sustained injury overall (1.416 per 10,000 AEs), and a metacarpal fracture was the most commonly sustained hand or wrist fracture (0.507 per 10,000 AEs). Injuries sustained during men’s wrestling (14.08 days) and women’s gymnastics (10.39 days) incurred the most time lost from sport. Surgery for hand and wrist injuries was most commonly required for men’s football (0.413 per 10,000 AEs) and women’s field hockey (0.404 per 10,000 AEs).

Conclusion:

Hand and wrist injuries were common among collegiate athletes. Male athletes experienced injuries with more frequency and severity. Injuries occurred more commonly during competition. While the majority of injuries were minor and did not require surgery, certain sports conferred a much higher risk of significant injuries requiring a surgical intervention.

Hyperbaric Oxygen Therapy in Sports Musculoskeletal Injuries

Hyperbaric oxygen therapy (HBOT) is a well-established treatment for a variety of conditions. Hyperbaric oxygen therapy is the administration of 100% oxygen breathing in a pressure vessel at higher than atmospheric pressure (1 atmosphere absolute = 101 kPa). Typically, treatment is given daily for between 1 and 2 h at pressures of 2.0 to 2.8 ATA, depending on the indication. Sporting injuries are often treated over 3 to 10 sessions. Hyperbaric oxygen therapy has been documented to be effective and is approved in 14 medical indications by the Undersea and Hyperbaric Medical Society, including, but not limited to, carbon monoxide poisoning, compromised skin grafts and flaps, crush injuries, necrotizing soft tissue infections, and nonhealing ulcers with arterial insufficiencies. Recently, HBOT for sports musculoskeletal injuries is receiving increased attention. Hyperbaric oxygen therapy may allow injured athletes to recover faster than normal rehabilitation methods. Any reduction in collegiate and professional athletes' rehabilitation period can be financially significant for top-level sports teams; however, further research is required to confirm HBOT's benefits on sports musculoskeletal injuries. The purpose of this review to discuss the current understanding of HBOT as a treatment modality for common musculoskeletal injuries in sport medicine. Moreover, we will highlight the advantages and disadvantages of this modality, as well as relevant clinical and research applications.

Effects of Psychological Interventions on the Prevention of Sports Injuries: A Meta-analysis

Background:

Studies have shown that preventive psychological interventions can reduce the occurrence of sports injuries.

Purpose:

To systematically evaluate the published literature on the effects of psychological interventions on rates of sports injuries and propose a set of psychological interventions to reduce such injuries.

Study Design:

Systematic review; Level of evidence, 1.

Methods:

A total of 11 randomized controlled trials and intervention control trials involving 1287 participants were included. A random-effects model was used to analyze the data. Pooled results were expressed as effect sizes and 95% CIs. Bias and heterogeneity among the studies were assessed, and sensitivity and subgroup analyses were performed.

Results:

Meta-analysis suggested that preventive psychological interventions effectively prevented the occurrence of sports injuries (effect size = –0.55; P < .001), although the studies showed substantial heterogeneity (I² = 94.2%; P < .001), which could not be attributed to specific variables. Nevertheless, sensitivity analysis suggested that overall results were reliable. No significant risk of publication bias was found.

Conclusion:

Preventive psychological interventions moderately reduced the risk of sports injuries. Risk screening also significantly reduced the risk of sports injuries. These interventions should focus on cognitive behavior and be administered in 1 to 6 sessions over 7 to 12 weeks for 60 minutes per session.

The Effect of Muscle Activation on Head Kinematics During Non-injurious Head Impacts in Human Subjects

In this study, twenty volunteers were subjected to three, non-injurious lateral head impacts delivered by a 3.7 kg padded impactor at 2 m/s at varying levels of muscle activation (passive, co-contraction, and unilateral contraction). Electromyography was used to quantify muscle activation conditions, and resulting head kinematics were recorded using a custom-fit instrumented mouthpiece. A multi-modal battery of diagnostic tests (evaluated using neurocognitive, balance, symptomatic, and neuroimaging based assessments) was performed on each subject pre- and post-impact. The passive muscle condition resulted in the largest resultant head linear acceleration (12.1 ± 1.8 g) and angular velocity (7.3 ± 0.5 rad/s). Compared to the passive activation, increasing muscle activation decreased both peak resultant linear acceleration and angular velocity in the co-contracted (12.1 ± 1.5 g, 6.8 ± 0.7 rad/s) case and significantly decreased in the unilateral contraction (10.7 ± 1.7 g, 6.5 ± 0.7 rad/s) case. The duration of angular velocity was decreased with an increase in neck muscle activation. No diagnostic metric showed a statistically or clinically significant alteration between baseline and post-impact assessments, confirming these impacts were non-injurious. This study demonstrated that isometric neck muscle activation prior to impact can reduce resulting head kinematics. This study also provides the data necessary to validate computational models of head impact.

Effects of an 8-week basketball-specific proprioceptive training with a single-plane instability balance platform

BACKGROUND

To avoid injuries in basketball players, they are recommended to pay more attention to improve their body balance. Therefore new training methods and equipment need to be devised. This study examined the effects of an 8-week basketball-specific proprioception training program while using a new developed one plane instability balance board during warm-up for improving balance ability in basketball players. Players who obtained basketball-specific balance training were compared to a control group.

METHODS

Thirty-one male university basketball players (age: 21.35, SD = 0.605 years; height: 190.97, SD = 1.88; body mass: 86.95, SD = 2.61) participated in this study. Seventeen participants were assigned to the basketball-specific 8-week balance training group (BTG) while 14 participants served as a control group (CG). Both groups were tested with the Y balance test (YBT) and postural stability test (PST) at baseline and 8 weeks later.

RESULTS

The results indicate significant improvements in the overall YBT for both legs in BTG, but not in CG. However, no group differences were found for dynamic balance performance, but static balance (i.e., postural stability) differed between groups after 8 weeks. A statistically significant moderate inverse correlation was computed between the total score of YBT and the total score of the overall stability index (r=-0.404; p= 0.041).

CONCLUSIONS

An 8-week basketball-specific proprioception training program with a single-plane instability balance platform improved balance ability (Y balance test and postural stability test) of basketball players.

Characteristics of Sports-Related Emergency Transport: A Population-Based Descriptive Study in Osaka City

Background

Little is known about the characteristics of emergency patients transported to hospital while participating in sports activity. Hence, we identified characteristics of emergency patients transported to hospital by emergency medical service (EMS) while participating in sports activity in Osaka City.

Methods

Population-based ambulance records of Osaka Municipal Fire Department were reviewed. All sports-related emergency transport cases (ie, patients experiencing external injury or illness during/immediately after participation in sports activity and then transported to hospital by the EMS) were enrolled, including both athletes and recreational sports participants. The study was performed from January 1, 2013 to December 31, 2015. Data of patient characteristics were described according to the type of sports.

Results

During the study, 661,190 patients required emergency transport in Osaka city; 2,642 (0.4%) were sports-related emergency transport, including 2,453 external injuries and 298 illnesses. Overall, 79.0% of patients were men and 44.4% were less than 18 years. Emergency transport during ball games accounts for the majority of cases (71.5%, 1,888/2,642), including baseball (n = 380), soccer (n = 368), and futsal (n = 209). The leading diagnosis/symptom of external injury was fracture/bone contusion (n = 701) and that of illness was heatstroke/dehydration (n = 184). Serious acute illness, such as sudden cardiac arrest, accounted for 0.6% (16/2,751) of all accidents, with half of them (n = 8) related to long-distance running.

Conclusion

Characteristics of sports-related accidents widely varied by type of sports. Measures to prevent serious accidents during sports activities should be established based on the information on patient characteristics of each type of sports.

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.