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

Diving Into Sports Specialization: The Association of Early Specialization on Injury Rates in Youth to Young Adult Divers

OBJECTIVES

This study explored the link between early sports specialization and injury rates in youth divers, a relationship that remains largely unexplored within diving.

DESIGN

Cross-sectional survey.

SETTING

Members of the USA Diving Organization and collegiate male and female divers participated in an online survey, reporting their sports involvement and injury history.

PARTICIPANTS

One hundred eighty-two male and female divers aged 8 to 25 years were recruited through USA Diving or US collegiate team databases.

INDEPENDENT VARIABLES

Early/late specialization (based on age <12 or 12 years or older), gender (M/F), springboard and/or platform divers, experience (junior/senior, regional/zone/national/international), hours of dryland/water training, and prior sport exposure.

MAIN OUTCOME MEASURES

Injury history obtained on questionnaire.

RESULTS

One hundred eighty-two divers were surveyed; 70% female. Age to start diving and age to concentrate solely on diving were significantly associated with certain injuries ( P < 0.05). Beginning diving before age 13 years of age was significantly associated with lower odds of injuries in the shoulder and wrist ( P = 0.013 and 0.018, respectively), after adjusting for select covariates. Age of specialization was not significantly associated with injuries in any body part ( P > 0.05), after adjusting for covariates. Greater years of diving experience was significantly associated with diving injuries in all 11 body parts ( P < 0.05).

CONCLUSIONS

This study indicates that early sports specialization is associated with decreased injury rates in elite youth divers who specialized before age 13 years, particularly for head/neck, shoulder, and wrist injuries. Moreover, we observed a positive correlation between experience and injury rate. Further investigation should focus on distinguishing between acute and overuse injuries.

Artistic Swimming Injuries in Young Elite Athletes: An 11-year Follow-Up

OBJECTIVE

Artistic swimming is a highly challenging discipline, requiring physical skills and creativity. There are almost no published data on trauma. We aimed to assess the incidence and the nature of injuries in artistic swimmers.

DESIGN

An 11-year retrospective single-center cohort study.

SETTING

Department of Sport Medicine of a University Hospital.

PATIENTS

One hundred and twenty-four elite female artistic swimmers aged 12.9 ± 1.6 years.

INTERVENTIONS

The cohort was divided into 3 groups according to the competition categories (from 9 to 12 years old called "future", 12-15 years old called "youth", 15-19 years old called "junior").

MAIN OUTCOME MEASURES

Injury rate per season and per athlete was assessed.

RESULTS

The injury rate was 0.95 injuries/season/athlete and 1.05 injuries/1000 hours of practice. The most frequent injuries were rotator cuff tendinopathy (13.6%), acute low back pain (13.6%), and patellofemoral syndrome (11.9%). Swimmers in the youth and junior categories had significantly more injuries than those in the future category (P = 0.009), possibly because of more training hours (P < 0.001). Twelve major injuries occurred, all in the same group of youth swimmers.

CONCLUSION

This is the first study investigating trauma during artistic swimming practice. A better knowledge of the main injuries is necessary for the physician to provide optimal care for athletes and to develop prevention. Attention should be particularly paid to the swimmers' shoulders and knees.

The design and evaluation of an integrated training load and injury/illness surveillance system in competitive swimming

OBJECTIVE

To design and evaluate an integrated training load monitoring and injury/illness surveillance system in a competitive swimming environment.

DESIGN

Descriptive/mixed methods.

SETTING

Swim Ireland National Training Centres.

PARTICIPANTS

Fourteen competitive athletes and seven coaches/medical data collectors participated in the evaluation process.

OUTCOME MEASURES

System satisfaction, usefulness and burden were evaluated. Barriers to the implementation and effectiveness of the system were explored.

RESULTS

Most athletes were 'extremely' or 'very' satisfied with the overall data collection process and also found it to be 'extremely' or 'very' useful in the training centre environment. All practitioners were 'extremely satisfied with the system and found it to be either 'extremely' or 'very' useful in their role. Process constraints and data access and control were significant themes related to the athletes, while practitioners highlighted communication and cooperation amongst stakeholders, layering context to the data, maintaining data integrity and the coach's influence in the monitoring process as being important to the monitoring/surveillance process.

CONCLUSIONS

Training load monitoring and injury/illness surveillance are necessary to elevate the standard of prospective injury/illness prevention research. Integrated systems should be designed in line with key consensus statements, while also being implemented in a way that counteracts the challenges within the real-world training environment.

Intrinsic Risk Factors for Noncontact Musculoskeletal Injury in Collegiate Swimmers: A Prospective Cohort Study

CONTEXT

Shoulder pain is pervasive in swimmers of all ages. However, given the limited number of prospective studies, injury risk factors in swimmers remain uncertain.

OBJECTIVE

To determine the extent to which the risk factors of previous injury, poor movement competency, erroneous freestyle swimming technique, and low perceived susceptibility to sport injury were associated with noncontact musculoskeletal injury in collegiate swimmers.

DESIGN

Prospective cohort study.

SETTING

College natatorium.

PATIENTS OR OTHER PARTICIPANTS

Thirty-seven National College Athletic Association Division III swimmers (21 females, 16 males; median age = 19 years [interquartile range = 3 years], height = 175 ± 10 cm; mass = 70.0 ± 10.9 kg).

MAIN OUTCOME MEASURE(S)

Participants completed preseason questionnaires on their previous injuries and perceived susceptibility to sport injury. At the beginning of the season, they completed the Movement System Screening Tool and the Freestyle Swimming Technique Assessment. Logistic regression was used to calculate odds ratios (ORs) with 95% CIs for the association between each risk factor and injury.

RESULTS

Eleven of the 37 participants (29.7%) sustained an injury. Univariate analyses identified 2 risk factors: previous injury (OR = 8.89 [95% CI = 1.78, 44.48]) and crossover hand positions during the freestyle entry phase (OR = 8.50 [95% CI = 1.50, 48.05]). After adjusting for previous injury, we found that a higher perceived percentage chance of injury (1 item from the Perceived Susceptibility to Sport Injury) decreased the injury odds (adjusted OR = 0.11 [95% CI = 0.02, 0.82]). Poor movement competency was not associated with injury (P > .05).

CONCLUSIONS

Previous injury, a crossover hand-entry position in freestyle, and a low perceived percentage chance of injury were associated with increased injury odds. Ascertaining injury histories and assessing for crossover positions may help identify swimmers with an elevated injury risk and inform injury-prevention strategies.

Descriptive Epidemiology of High School Swimming and Diving Injuries

OBJECTIVE

Using data from a longitudinal national sports injury surveillance program, this study aimed to calculate injury rates and describe injury patterns across high school swimmers and divers.

DESIGN

Descriptive Epidemiological Study. Athletic trainers (ATs) from participating high schools reported injuries from swimming and diving programs for the High School Reporting Information Online system.

SETTING

Convenience sample of high school boys and girls' swimming and diving injuries during the 2008 to 2019 school years.

PATIENTS OR OTHER PARTICIPANTS

High school boy and girl swimmers and divers (aged ∼14-18 years).

INDEPENDENT VARIABLES

Exposure data on gender, location of injury (practice vs competition), mechanism of injury, and sport (swimming vs diving).

MAIN OUTCOME MEASURES

Injury rates, rate ratios (RRs) with 95% confidence intervals, and other descriptive statistics were performed.

RESULTS

563 swimming and diving injuries occurred during 2 171 260 athlete exposures (0.26 per 1000 athlete exposures). Girls had higher injury rates than boys overall (RR 1.57, P < 0.05), in practice (RR 1.53, P < 0.05), and competition (RR 1.81, P < 0.05). In swimmers, most injuries were to the shoulder (48.6%), associated with the freestyle (67.3%), and classified as overuse/chronic (58.0%). Among divers, most injuries were to the head/face (36.6%) and from contact with the playing surface (68.3%).

CONCLUSIONS

Girls had statistically significantly higher injury rates than boys. The shoulder and head/face were the most injured body parts in swimmers and divers, respectively. Swimming injuries were most frequently of an overuse etiology, whereas diving injuries were more likely traumatic. Coaches and ATs should be aware of these findings to develop targeted strategies for injury prevention.

International survey of injury surveillance practices in competitive swimming

OBJECTIVE

The purpose of this study was to identify the injury surveillance practices being used in competitive swimming environments. It explored the nature of the data collected, the injury definitions used and the perceived effectiveness of injury surveillance. Finally, this study also examined barriers to injury surveillance.

DESIGN

Online cross-sectional.

PARTICIPANTS

Twenty-two responders working in competitive swimming.

OUTCOME MEASURES

Injury surveillance methods, data collected, perceived level of effectiveness and barriers associated with injury surveillance.

RESULTS

Fifteen responders participated in injury surveillance, with 13 responders using a recognised definition for injury. Ten responders did not use any sports injury classification system. Ten responders found injury surveillance to be very effective at identifying injury trends, while previous injury history and training load data were perceived to be most influential in preventing injury. Limited time, funding and compliance were common obstacles, while poor staff communication and engagement were barriers to the effective implementation of injury surveillance.

CONCLUSIONS

The implementation of injury surveillance is related to the system objectives, competitive level of those under surveillance and the resources available. This implementation requires the balance of adhering to the principles outlined in prominent consensus statements and overcoming the barriers associated with implementing a system effectively.