No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Incidence, Severity, Aetiology and Prevention of Sports Injuries: A Review of Concepts
Abstract
Notwithstanding the healthy influence of sporting activities on risk factors, in particular those of cardiovascular disease, it is becoming increasingly apparent that sports can present a danger to health in the form of sports injuries. The extent of the sports injury problem calls for preventative action based on the results of epidemiological research. For the interpretation of these facts uniform definitions are needed and limitations of research designs should be known. Measures to prevent sports injuries form part of what is called the ‘sequence of prevention’. Firstly the extent of the sports injury problem must be identified and described. Secondly the factors and mechanisms which play a part in the occurrence of sports injuries have to be identified. The third step is to introduce measures that are likely to reduce the future risk and/or severity of sports injuries. This measure should be based on the aetiological factors and the mechanism as identified in the second step. Finally the effect of the measures must be evaluated by repeating the first step.
In this review some aspects of the first and second step of the sequence of prevention are discussed.
The extent of the sports injury problem is often described by injury incidence and by indicators of the severity of sports injuries. Sports injury incidence should preferably be expressed as the number of sports injuries per exposure time (e.g. per 1000 hours of sports participation) in order to facilitate the comparability of research results. However, one should realise that the outcome of research applying this definition of sports injury incidence is highly dependent on the definitions of ‘sports injury’ and ‘sports participation’.
The outcome of such research also depends on the applied research design and research methodology. The incidence of sports injuries depends on: the method used to count injuries (e.g. prospective vs retrospective); the method used to establish the population at risk; and on the representativeness of the sample.
Severity of sports injuries can be described on the basis of 6 criteria: the nature of the sports injury; the duration and nature of treatment; sporting time lost; working time lost; permanent damage; and cost. Here also uniform definitions are important and necessary in order to enhance the comparability of research data. In the second step of the ‘sequence of prevention’ the aetiological factors that play a role in the occurrence of a sports injury have to be identified by epidemiological studies. Epidemiological research on the aetiology of sports injuries requires a conceptual model. The most commonly applied model is a stress/capacity model in which internal (personal) and external (environmental) aetiological factors are identified. In this model stress and capacity must be in balance and preventative measures must be designed to achieve or maintain this balance. However, merely to establish the aetiological factors is not enough; the mechanism by which sports injuries occur must also be identified. Athletes are in constant interaction with their environment and aetiological factors must be approached from this point of view. In a second, more dynamic, conceptual model on the aetiology of sports injuries, the importance of the determinants of sports behaviour, as well as the interaction between the various aetiological factors, is discussed. Whether or not a sports injury results from sports behaviour largely depends on the extent to which ‘prevention’ is incorporated in the determinants of sports behaviour. The drawback of both conceptual models is the fact that neither of them incorporate a time perspective. They can therefore not be applied to research on the aetiology of overuse injuries. In this perspective the application of a stress/strain/capacity model can be useful. This is a more dynamic and time-based 3-phase sequential model in which behaviour, amongst other aetiological factors, plays an important role. In this model an athlete is seen as an active manipulator of stress by whom the amount of strain evoked by sports participation can be altered, thereby influencing the capacity to perform in a certain sports situation, but also influencing the risk to sustain a sports injury, either acute or long term.
Finally, despite the importance of the model of choice in studying the aetiology of sports injuries one should realise that again the choice of research design influences the outcome of such research. Case series usually give no information on the underlying population at risk, so they are of no value in drawing valid conclusions on the risk factors of injuries. Only by relating the injuries to corresponding population denominators can one estimate injury rates and identify important risk factors and high risk sportspeople. As in research on sports injury incidence; research on risk factors should be undertaken on groups that are homogeneous with regard to age, sex, level of competition and type of sport.
... Young badminton players are predisposed to badminton-related injuries that may have long-term sequelae both emotionally and physically. A thorough understanding of specific injury incidence is the first step to enhance badminton injury preventive program 17 . Therefore, the objective of this study was to investigate the epidemiological characteristics of badminton-related injuries among Japanese national competitive level badminton players aged 7-22 years broken down by age and sex. ...
... The early, timely, and precise prevention of badminton-related injury among school-aged badminton players is necessary to lower and avoid the further injury occurrence. Epidemiological surveillance is the first step to enhance sports injury prevention 17 . Recent longitudinal studies of badminton injury among 133 Japanese badminton players reported that regardless of sex, university players showed the highest injury rate (male, 2.5; female, 5.1) per 1000-training hours, followed by high school players and junior high school players during badminton training 2 . ...
... In terms of anatomical regions, the knee was the most common injured site, followed by the ankle and the lower back among all the players in this study which is in consistent with several previous studies 6,17,26 . In contrast, some previous studies reported spine/lower back was the most common injured site, knee ranked the second followed by thigh, ankle, and shoulder 27 while other previous studies reported shoulder was the most common injured site, followed by knee, thigh, back, and ankle in elite players 9 . ...
Badminton-related injury is thought to happen with increasing incidence among badminton players. Literature shown injury incidence across age is scarce. The objective was to investigate the epidemiological characteristics of badminton-related injuries among badminton players broken down by age and sex. This epidemiology study is a retrospective design in 7–22-year-old badminton players at a national competitive tournament with a questionnaire from 2018 to 2023. An injury was defined as somatic complaint with time loss and/or medical care. Badminton-related injuries were normalized to rate per 1000 training-hours calculated by Poisson distribution in the collected data according to age and gender. Among all the 711 badminton players, 60.3% (429 players) suffered from at least one badminton-related injury. Regardless of gender, the most frequently injured anatomical site was knee (male: 18.8%, female: 18.6%), followed by ankle (male: 13.4%, female: 13.4%) and lower back (male: 12.3%, female: 10.0%). In male badminton players, the shoulder (7.6%) ranked fourth as the plantar (6.7%) ranked fourth in female badminton players. The rate per 1000 training-hours of badminton-related injuries showed that male players peaked at age 15–16 years and female players peaked at age 17–18 years, with 3.24 injuries and 3.52 injuries per 1000 training-hours, respectively. In 7–22-year-old badminton players, knee, lower back, and shoulder injuries frequently occurred and were significantly associated with the incidence of badminton-related injuries. The peak incidence of badminton-related injuries was in 15–16-year-old male badminton players while the peak incidence was in 17–18-year-old female badminton players. These data have the potential to help target the most at-risk anatomical sites and the most at-risk badminton players precisely for injury prevention programs.
... Beginning with the 2022/2023 season, the season our data stems from, body checking in the highest leagues for females is generally permitted all over the rink, except for body checking on open ice while skating in opposite directions (north-south checking) [20]. According to the conceptual model for injury prevention research by van Mechelen et al. [21] the frst step in the "sequence of prevention" is to identify the magnitude of the problem. We cannot transfer previous epidemiological results on elite male ice hockey players over to their female counterparts who play hockey under evolving rules. ...
... Te average weekly prevalence of health problems was 21% (95% CI: [19][20][21][22][23]. Fifteen percent of weekly health problems were injuries (95% CI: 14-17) and 7% (95% CI: 5-8) illnesses. ...
... Most existing studies in ice hockey have primarily focused on the frst two steps of the four steps in Van Mechelen's "sequence of prevention" model [21], namely, the extent, etiology, and mechanisms of injuries. A systematic review compiled studies evaluating interventions aimed at reducing aggression-related injuries in ice hockey, Translational Sports Medicine fnding that changes to mandatory rules were associated with reductions in such injuries [41]. ...
Introduction: Epidemiological studies on elite female ice hockey players are lacking but needed to tailor preventive efforts in this growing group of athletes. Therefore, the aim of this study was to describe the incidence, prevalence, and burden of health problems in elite female ice hockey players.
Methods: In this prospective cohort study, we asked all Swedish Women’s Hockey League (SWHL) players (N = 207) to report their health status on the OSTRC-H2 weekly throughout the 2022/2023 season (28 weeks). Reported problems were categorized as injuries (acute or overuse) or illnesses and presented as incidence per player season and mean weekly prevalence.
Results: A total of 129 players (62% of all SWHL players) provided 2286 health reports with a mean weekly response rate of 67%. Mean weekly prevalence of health problems was 21% (95% confidence interval [CI]: 19–23) (injuries: 15% [95% CI: 14–17] and illnesses: 6% [95% CI: 5–8]). Injury incidence was 2.1 (95% CI: 1.8–2.4) per player season (acute: 1.2 [95% CI: 1.0–1.5] and overuse: 0.8 [95% CI: 0.7–1.1]). Illness incidence was 1.3 per player season (95% CI: 1.1–1.6). Most reported health problems were acute injuries (59.4% of reported injuries). Most common among acute injuries where to the shoulder (15%), head (13%), and knee (11%). The hip/groin was the most reported (35%) and burdensome (49% of severity score) region among overuse injuries. Reported illnesses were mostly represented by respiratory infections (75%).
Conclusions: In average, one in five elite ice hockey players reported a health problem at any given time during the season. Results of this study highlight the need to develop and test primary prevention strategies for shoulder, head, and knee injuries and secondary prevention strategies for hip and groin problems.
... Therefore, optimizing technical and tactical strategies while ensuring a safe environment is crucial in sports like field hockey. In youth sports settings, understanding the extent and nature of injuries is essential for exploring potential approaches to injury prevention [9,10]. ...
... This study aligns with the initial phase of injury prevention frameworks, such as van Mechelen's model [10], which emphasize the identification of injury incidence and patterns as a foundational step. Accordingly, we aimed to provide a descriptive analysis of training-related injury characteristics among youth field hockey players. ...
This study aimed to analyze the incidence, affected areas, and types of injuries sustained during training among youth field hockey players to identify key characteristics. A survey was conducted with 374 youth field hockey players (236 males, 138 females) from middle and high school teams registered with the Korea Hockey Association in 2024. Data were collected on injury status, training hours, injury sites, and prevention methods. Chi-square tests, independent t-tests, and frequency analyses were performed to assess differences in injury incidence based on gender and school level. The analysis revealed no significant gender differences in training-related injury experiences, with 17.2% of male athletes and 10.2% of female athletes reporting injuries during training. Similarly, no significant difference was found between middle and high school athletes, although high school athletes had a significantly lower injury incidence than middle school athletes (1.54 vs. 2.28 per 1000 h, p < 0.05). The most common injury sites were the ankle and knee, with muscle injuries being the most frequent among males and ligament injuries among females. Additionally, male and high school athletes more frequently reported engaging in warm-up and cool-down exercises. There was no significant difference in injury rates between genders during training, but high school athletes tended to experience fewer injuries than middle school athletes. Ankle injuries were the most common, with muscle and ligament damage being the primary types of injuries. While warm-up exercises were commonly practiced, further research is needed to determine their actual effectiveness in injury prevention.
... 2,43,51 An understanding of injury epidemiology and etiology is crucial in designing injury risk mitigation programs. 41,50 A key aspect of injury etiology is establishing the contact mechanisms and context (situational patterns) in which injuries occur. 4 Video analysis is a frequently used and valid tool for investigating injury mechanisms, playing situations and gross biomechanics preceding and during actual injuries. ...
... Understanding injury mechanisms is considered important for prevention. 4,41,50 Our work-the findings from this study and our previous study on Italian soccer 15 -collectively suggests that many ACL injuries in elite professional soccer may be preventable, with \1 in 5 occurring because of direct contact. Indirect contact prevalence is similar or slightly greater than the prevalence of noncontact injuries in male players, which suggests mechanical perturbation as an important factor in ACL causation. ...
Background
Improving our understanding of the situations and biomechanics that result in anterior cruciate ligament (ACL) injury will support the design of effective injury risk mitigation programs. A few video analyses have been published in recent years, but not specifically involving English soccer.
Purpose
To describe the mechanisms, situational patterns, and biomechanics (kinematics) of ACL injuries of players involved in matches involving teams in the top 2 tiers of professional English soccer (the Premier League and the Championship).
Study Design
Case series; Level of evidence, 4.
Methods
We identified 148 consecutive ACL injuries across 11 seasons of professional English soccer. Overall, 124 (84%) injury videos were analyzed for mechanism and situational patterns, while biomechanical analysis was possible in 91 injuries. Three independent reviewers evaluated each video. ACL injury epidemiology (month, timing within the match, and location on the playing field at the time of injury) was also reported.
Results
More injuries occurred in defensive (n = 79; 64%) than offensive (n = 45; 36%) playing situations; 24 (19%) injuries were direct contact, 52 (42%) indirect contact, and 47 (38%) noncontact. Of the indirect and non-contact ACL injuries (n = 100), most (91%) occurred during 4 main situational patterns: (1) pressing/tackling (n = 50; 50%); (2) being tackled (n = 18; 18%), (3) landing from a jump (n = 13; 13%), and (4) regaining balance after kicking (n = 10; 10%). These injuries generally involved a knee flexion strategy (with minimal hip/trunk flexion and reduced plantarflexion) in the sagittal plane and appearance of knee valgus in most cases (70%; 96% of identifiable cases). More (n = 71; 57%) injuries occurred in the first half of matches than in the second half ( P < .01).
Conclusion
Indirect contact rather than noncontact was the main ACL injury mechanism in male elite English soccer players. Four main situational patterns were described, with pressing/tackling and being tackled accounting for two-thirds of all indirect and noncontact injuries. Biomechanical analysis confirmed a multiplanar mechanism, with knee loading patterning in the sagittal plane accompanied with dynamic valgus. More injuries occurred in the first half of matches.
... To facilitate the comparison of research results, sports injury incidence should be reported as the number of sports injuries per exposure time [46]. Exposure time is frequently reported as athlete exposures, meaning one athlete participating in one sporting session or exposure hours, meaning one athlete being exposed to sustaining a sporting injury for 1 hour. ...
... The design used for injury surveillance (prospective or retrospective) influences the reliability of data collection [46]. With retrospective data collection longer recall periods underestimate injury rates. ...
Objectives
The aim of this umbrella review was to investigate the frequency of physical activity-related injuries (PARI) among adolescents. Our secondary objective was to describe the available reviews of injuries in three settings: organized sports, leisure time physical activity (PA), and school physical education (PE).
Methods
We conducted an overview of reviews consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines on the frequency of physical activity related injuries in adolescents.
Results
We identified 19 systematic reviews with at least moderate quality to include in the review. We were not able to pool data from reviews and conduct meta-analysis due to heterogeneity of injury definitions, exposure times, and sample demographics. All reviews included studies of injuries sustained in organized sports, and injury incidence was higher during matches than training. No systematic reviews were found focusing on leisure time or school-based PA injuries.
Conclusion
High-quality research is essential to understand the frequency of various types of physical activity related injuries among adolescents in organized sports, PE, and leisure time activities to develop more effective prevention strategies.
... Tabben and colleagues suggested that the successful implementation of IPS is influenced by contextual factors, including lifestyle habits (inadequate sleep, poor nutrition, smoking), the number of matches, pressure to win, team standings in competitions, and a lack of communication and cooperation among teammates [12]. Additionally, sports safety behavior plays a key role in the successful implementation of IPS [13], and the extent to which IPS influences sports behavior can determine the outcomes of sports injuries [14]. Thus, specific IPS and sporting behaviors (SB), such as training habits, technical skills, on-field behavior, and players' motivation, can have an impact on sports experience. ...
Background: Identifying how playing positions (PP) and playing years (PY) influence injury prevention strategies (IPS) and sporting behaviors (SB) of footballers may guide health professionals in developing targeted interventions to prevent sports injuries and enhance players' fitness. This study assessed the association of PP and PY with IPS and SB of male professional footballers. Methodology: A cross-sectional survey of 130 male footballers aged 18 to 35 years, from six professional teams in Calabar, Cross River, Nigeria. Data was collected on PP, PY, IPS, and SB using adapted questionnaires on IPS and SB. Data was summarised using frequencies and percentages. The Chi-square test was used to analyse the associations among variables at p < 0.05. Results: Respondents were 31.5% defenders, 32.3% midfielders, 31.5% forwards, and 4.6% goalkeepers. Among these respondents, 54.6% played for 1-5 years, 42.3% for 6-10 years, and 3.1% for 11-15 years. Injury prevention was important to 57.7%, 86.9% had used IPS, 26.9% had used FIFA 11+, and 23.8% had used general warm-up programmes. In SB, 40.0% of respondents looked forward to matches and training, and over 50% felt energetic, found sporting meaningful, behaved aggressively towards opponents, exhibited fair play, acted strong and rigorous, were oblivious of surroundings, felt inspired, and were happy when engrossed in sport. Significant associations (p<0.05) were found between SB and each of PP and PY. PP and PY were not significantly associated (p>0.05) with IPS. Conclusion: Although PP and PY influenced the SB of male professional footballers, they do not impact IPS. Usage of IPS was higher in FIFA 11+ than in other IPS. Defenders and forwards have a higher propensity of exhibiting aggressive behaviours towards opponents when liable to injury than midfielders, while the burden of a team having good results was highest among defenders and midfielders than in forwards and goalkeepers. Abstract Quick Response Code: Original Article Oghumu NS, et al. Injury prevention strategies and sporting behaviors of male footballers 622 Niger Med J 2025;66(2):621-636.
... However, they can also apply the techniques independently (Finch, 2006). Regular training programs involving medical personnel, coaches, and physiotherapists can enrich students' experience in dealing with injuries quickly and appropriately (Mears & Jago, 2016;Van Mechelen, Hlobil, & Kemper, 1992). ...
Background: Sports injuries are a risk often experienced by athletes, including special sports class students, so knowledge about proper injury management is needed, one of which is the PRICE method (Protection, Rest, Ice, Compression, Elevation). Objectives: This study aimed to assess the level of knowledge about first aid in sports injuries using the PRICE method among student-athletes. Methods: This study used a descriptive quantitative method with a survey technique. The research sample comprised 18 students selected through purposive sampling, using an instrument in the form of a questionnaire containing 48 items related to the PRICE method. Results: The results showed 33.3% of students had a high level of knowledge, 38.4% were moderate, 22.3% were low, and 5.5% were very low. Conclusions: The level of student knowledge of the PRICE method is mainly in the moderate to high category, but there are still some students with low understanding, especially in the Compression aspect, so further education is needed to improve the effectiveness of injury management. The compression component had the lowest understanding, indicating a need for further education and training.
... This study supports the claim of Van Mechelen et al. (2018), found that incorporating proper warmup routines and injury-prevention exercises significantly reduces the risk of muscle strains and ligament tears. Similarly, Faude et al. (2019), highlight that supervised training programs tailored to an athlete's specific needs enhance performance while reducing overuse injuries. ...
... Epidemiological surveillance during these events provides vital insights into injury and illness rates within the sporting domain (11,15,17). According to Van Mechelen et al. 's four-stage model of injury epidemiology, gathering descriptive data is the foundational step for developing effective prevention strategies (18,19). Therefore, understanding the characteristics of injuries and illnesses among elite athletes during major sporting events is crucial for mitigating and preventing the injuries and illnesses. ...
Objective
To provide insights and recommendations for athletes, medical personnel, and event organizers on optimize healthcare services and preventive measures for injuries and illnesses by describing the pattern of injuries and illnesses sustained during the 2021 Summer World University Games.
Methods
Medical records of athletes visiting Universiade Athletes’ Village Polyclinic from July 22 to August 10, 2023, were anonymously analyzed to describe the injuries and illnesses sustained.
Results
A total of 478 athletes visited the clinic, including 315 injuries and 163 illnesses. Translating to 9.5 injury visits and 3.1illness visits per 100 athletes. A total of 4.9% of athletes experienced at least one injury, and 2.5% experienced at least one illness. The injuries involved 540 sites, primarily affecting the thighs, shins, knees, lower back, and ankles. Illnesses predominantly involved the respiratory system and digestive system. Thirteen cases of COVID-19, and single cases of H1N1 influenza, malaria, dengue fever, candida intestinal infection, and infectious mononucleosis were detected.
Conclusion
Injuries and illnesses accounted for 7.4% of the participants. The injury incidence was lower compared to the Summer Olympics and slightly below similar Winter Universiade events, while the illness incidence was higher. Using the electronic medical record visit record data of the hospital information system in the athlete village to study athlete injuries is a method that can be adopted in future large-scale sports events. Taking appropriate infectious disease prevention and control measures can effectively prevent the prevalence of infectious diseases during international large-scale sports events. The athlete village of international large-scale sports events should be equipped with MRI to meet the diagnosis and treatment needs of athletes.
... The deficiency of vitamin D has been associated with impaired muscle function, evidenced by proximal muscle weakness and reduced diameter of type II muscle fibres (Ceglia, 2008). Given the strong correlation between muscle function and force-time characteristics (Suchomel et al., 2016), as well as injury incidence (Hootman et al., 2007;Van Mechelen et al., 1992), the impact of vitamin D on muscle | 2025 | ISSUE 3 | VOLUME 20 © 2025 ARD Asociación Española strength in athletes has attracted significant research interest. Despite the demonstrated effectiveness of vitamin D supplementation in improving vitamin D status (Farrokhyar et al., 2017), the evidence regarding its effects on maximal strength and power in athletes remains limited and currently inconsistent (Han et al., 2019;Zhang et al., 2019). ...
Vitamin D is essential for optimal athletic performance; however, the evidence for its effect on athletic performance remains inconclusive. This systematic review aimed to investigate the effect of vitamin D supplementation on athletic performance in athletes. A comprehensive and systematic search of six electronic databases was conducted in accordance with PRISMA reporting guidelines, using a combination of Boolean operators and MeSH keywords. A total of 13 studies were included in the review. The included studies demonstrated that vitamin D supplementation consistently elevates serum 25(OH)D levels in athletes. A subset of the included studies reported significant improvements in athletic performance following the administration of vitamin D supplements, particularly in those athletes with low vitamin D status initially. Another cluster of studies focused on the effects of vitamin D supplementation on parameters of haematological and muscle recovery, with mixed results. Additionally, there were observations of seasonal fluctuations in vitamin D levels, which highlight the importance of considering the timing of supplementation. Vitamin D supplementation has been linked to improved athletic performance, particularly in athletes with low initial vitamin D status. However, the impact of this intervention is influenced by individual characteristics, the type of exercise, and the specific dosage and duration of supplementation. To gain a more comprehensive understanding of the mechanisms and optimal protocols for vitamin D supplementation in athletes, further research is required.
... The results consistently demonstrate that NHE effectively decreases both the incidence of new injuries and the recurrence of previous ones, while also enhancing eccentric strength, which is a key factor in injury prevention. [44][45][46][47][48][49][50][51][52][53] The discussion here elaborates on the implications of these findings, compares them to existing literature, and highlights the limitations identified in the reviewed studies. The reduction in injury incidence reported across the reviewed studies is a pivotal finding. ...
Background
Hamstring strain injuries (HSIs) are among the most common injuries in football, causing significant time-loss and impacting player performance. Despite various preventive strategies, the incidence of HSIs remains high, necessitating evidence-based approaches to reduce injury rates.
Objective
This scoping review aims to evaluate the effectiveness of the Nordic Hamstring Exercise (NHE) in reducing the incidence and recurrence of HSIs in football players and to provide practical recommendations for its implementation.
Methods
A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, PEDro, and the Cochrane Library. Randomized controlled trials (RCTs) focusing on NHE interventions for football players were included. The primary outcomes were injury incidence, recurrence, and compliance with NHE programs.
Results
The review found that NHE significantly reduces the incidence of new hamstring injuries by up to 60% and recurrent injuries by up to 85%. Players performing NHE demonstrated a 35% increase in eccentric hamstring strength. Compliance with NHE programs was a critical factor in achieving these outcomes, with higher adherence rates leading to better preventive effects.
Conclusions
The Nordic Hamstring Exercise is an effective, evidence-based intervention for preventing hamstring injuries in football. Its integration into regular training programs, combined with education to improve compliance, can significantly reduce injury rates and enhance player performance. Future research should focus on standardizing protocols and exploring long-term outcomes.
... Several efforts have been made in the methodology of sports injury surveillance. [1][2][3] Detailed consensus statements on the recording and definition of injuries and illnesses have been issued for sports such as soccer, 4 rugby, 5 cycling, 6 artistic gymnastics, 7 and swimming, 8 while the International Olympic Committee (IOC) also developed a consensus statement regarding valid monitoring and analysis of sports injuries and illnesses. 9 Despite numerous monitoring systems being integrated into sports environments, many monitoring systems still focus on injuries causing time loss from training and competition. ...
Purpose
This study aimed to cross-culturally adapt the second version of the Oslo Sports Trauma Research Center Questionnaires on Overuse Injuries (OSTRC-O2) and Health Problems (OSTRC-H2) into Greek.
Materials and Methods
The questionnaires were translated using the back-translation method in accordance with international guidelines. The OSTRC-O2 was administered to 56 female volleyball players, focusing on shoulder injuries, while the OSTRC-H2 was delivered to 52 adolescent and young adult male and female volleyball and soccer players. Validity was assessed through content validity (Content Validity Index – CVI), face validity (using additional questions on comprehensibility, difficulty, relevance, and completeness), and concurrent validity (correlations between the OSTRC-O2 severity score and the numeric pain rating scale [NPRS], as well as between the OSTRC-H2 severity score with days of time loss [DL] and NPRS). Reliability was evaluated using internal consistency (Cronbach's α) and the test-retest method (intraclass correlation coefficient – ICC). The study was conducted for a two-week period and the test-retest was performed with a two-day interval.
Results
Twenty-three athletes (41%) reported shoulder problems using the OSTRC-O2, while 28 injury events and 5 cases of illness were reported with the OSTRC-H2. Face and content validity were excellent (CVI = 0.925 and 0.975 for OSTRC-O2 and OSTRC-H2). A strong correlation was observed between the OSTRC-O2 severity score and the NPRS (ρ = 0.819, p < 0.001), while the OSTRC-H2 severity score demonstrated significant correlations with both the NPRS (ρ = 0.72, p < 0.001) and days of time loss (ρ = 0.625, p < 0.001). Both questionnaires demonstrated excellent reliability and internal consistency, with the OSTRC-O2 showing an ICC of 0.90 (95% CI: 0.82–0.94) and Cronbach's alpha of 0.84, and the OSTRC-H2 showing an ICC of 0.93 (95% CI: 0.89–0.97) and Cronbach's alpha of 0.93.
Conclusions
The Greek versions of the OSTRC questionnaires are valid and reliable tools for injury surveillance among Greek volleyball and soccer players.
... Indeed, epidemiological studies can help to develop suitable preventative measures by improving knowledge on health problems that occur. 6 In particular, observations over several events allow conclusions to be drawn regarding the most frequent and most severe injuries and illnesses, based on which risk reductions can be made. 7 Furthermore, national and local medical teams can also receive important information about specific medical needs and thus adapt and improve medical care. ...
Objective
To describe the incidence and characteristics of injuries and illnesses that occurred during the 54th Nordic World Ski Championships in Planica (Slovenia) 2023, including the disciplines of cross-country skiing, Nordic combined and ski jumping.
Methods
In this prospective cohort study, national medical teams and the medical team of the local organiser collected data on a daily basis on all new, exacerbated or recurrent injuries and illnesses of the registered athletes using the IOC consensus recommendations.
Results
There were 596 registered athletes (250 women, 346 men), all with access to medical services. The national medical teams covered 347 (58.2%) athletes with a response rate of 77.1%. A total of 24 injuries, corresponding to an incidence rate of 4.0 per 100 athletes (95% CI, 2.5 to 5.6), and 15 illnesses, corresponding to an incidence rate of 2.5 per 100 athletes (95% CI, 1.3 to 3.8), were reported. The lower extremities were the most common injury location (58.3%), and every second injury in this category was a knee injury. The predominant injury types were joint sprains/ligament tears (25.0%) and contusions/bruises (25.0%). A total of three concussions (12.5% of all injuries) were reported, all of them in ski jumping. Among the illnesses, infections (73.3%) were the most common aetiology, and the respiratory system (53.3%) was the most frequently affected organ system.
Conclusion
Special attention should be given to knee injuries in all disciplines and concussions in ski jumping. A high proportion of the recorded illnesses were of infectious origin. The reduction in hygiene regulations after the COVID-19 pandemic could have contributed to this.
... To promote healthy sports participation during adolescence, reliable and up-to-date surveillance data are crucial for understanding the prevalence and nature of health problems in this population [8]. The Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H2) has been developed to measure both injury and illness symptoms, proving particularly valuable in sports settings where gradual-onset injuries and illnesses pose a significant burden on health and performance [9]. ...
We aimed to assess the in‐season weekly average prevalence proportion, the incidence rate, and burden (the product of incidence rate and duration of injury in weeks) of health problems among Danish youth handball community players aged 11–17. In this 30‐week prospective cohort study, players self‐reported health problems, including all injuries and illnesses, regardless of time loss or medical attention, and handball exposure using weekly web‐based surveys (OSTRC‐H2). Sex differences were estimated using Poisson regression (incidence rates) and binomial regression (weekly average prevalence proportions) with clustered robust standard errors. We included 945 players (age: 14.5 ± 1.5 years; 55% female) from 20 clubs across Denmark. The response proportion to the weekly questionnaires was 63% (range: 42%–79%). The average prevalence proportion of health problems was 23% (95% CI 21%–25%), with 17% (95% CI 15%–19%) attributable to injuries and 6% (95% CI 5%–7%) to illnesses. The overall incidence rate was 14.9 (95% CI 13.9–15.9)/1000 h. Female players aged 13–15 showed a higher incidence rate (15.9 [95% CI 14.2–17.8]/1000 h) compared to age‐matched males (13.2 [95% CI 11.5–15.1]/1000 h), with an incidence rate ratio of 1.21 [95% CI 1.0–1.4], and had a higher weekly average prevalence proportion (23% [95% CI 19%–27%]) than age‐matched males (12% [95% CI 10%–15%]), corresponding to a difference of 10% points [95% CI 6%–15% points]. COVID‐19 infection accounted for 36% of reported illnesses. Our findings highlight the need for injury prevention initiatives to address both sudden‐onset and gradual‐onset injuries in youth handball players. Sex differences in injury measures and the potential link between illness and injury risk warrant further investigation.
... Muscular strength and power, including better muscle function, are critical elements for athletes. These abilities are not only the first step in maintaining excellent performance but are also essential for reducing the risk of sports injuries [33,34]. Additionally, the ability to rapidly change the speed and direction of the body's center of mass, known as agility, is a fundamental skill in most sports [35]. ...
In addition to various physiological parameters that affect athletes’ performance and outcomes, anthropometric variables are also related to athletic performance. In particular, the length of the lower limbs is closely associated with human mobility and stride length, making it a crucial factor in various movement-based sports. Furthermore, favorable body proportions may vary depending on the sport, and a better understanding of how body proportions affect physical performance across different levels of athletes is needed. Therefore, the purpose of this study is to investigate the relationship between leg length and physical performance by measuring body dimensions (tibia and femur length) for athletes categorized by sports characteristics and performance levels. The study involved 312 athletes from 23 sports, divided into three activity levels. Anthropometric measurements of tibia and femur length were taken, and physical performance tests, including strength, muscular endurance, cardiovascular endurance, agility, explosiveness, flexibility, and anaerobic power, were conducted in the laboratory. The relationships between variables (leg length × physical performance) were analyzed using Pearson’s correlation coefficients. Leg length via activity levels was verified through one-way analysis of variance (ANOVA) testing, including normality and homoscedasticity. Post hoc analysis (Tukey’s HSD test) was used to compare specific differences when significance was found. Statistical significance was accepted at the 0.05 level. As a result, an increase in lower limb length was found to have a relationship with physical performance components, including power (r = 0.302, p = 0.001), agility (r = −0.289, p = 0.001), endurance capacity (r = 0.168, p = 0.005), and anaerobic peak power (r = 0.265, p = 0.001). However, in the LD group, which consisted of athletes in static sports, no significant relationship was observed between lower limb length and physical performance components. However, in the LD group, which included static sports, no significant relationship was found between lower limb length and physical performance components. These findings may serve as foundational data for athlete talent identification and performance prediction.
... We did not find age to be a strong risk factor for ankle sprain. In contrast to our findings, Faude et al. [17], discovered that younger athletes suffered from more fractures, fewer strains and sprains [80,81]. However, similar to our results, Willems et al. [82] and Powers et al. [38] did not find a significant difference. ...
Background: Soccer is associated with substantial injury risk, with reported between 13 to 35 injuries per 1000 player-hours of competitive play. Notably, approximately 77% of soccer-related ankle injuries are attributed to ankle sprain injuries (ASIs). ASI can lead to chronic ankle instability, obesity, and post-traumatic osteoarthritis. This study focuses on identifying factors such as gender, age, body mass index (BMI), and a history of ASIs, which contribute to the development of ASI in soccer players. Methods: A systematic literature search was conducted in October 2023 across databases, including PubMed, Web of Science, Scopus, Cochrane Library, and ProQuest, without applying any filters. Keywords included ankle, ankle joint, sprain, risk factors, etc. Data extraction was performed on the included studies, with findings standardized and analyzed using Stata Statistical Software: Release 17 to determine a weighted treatment effect. Results: Our systematic review included 26 studies. The meta-analysis revealed that a history of ankle sprain is the most significant risk factor for future ASIs. BMI emerged as a risk factor in three out of seven studies, while age and height were significant in one out of six studies each. Gender and weight were not found to significantly affect ASI occurrence. Other factors identified but not subjected to a meta-analysis due to methodological heterogeneity or insufficient studies included playing surface, joint laxity, muscle weakness, match congestion, strength asymmetries, ground reaction forces, balance maintenance, skill level, and playing position. Conclusions: This research contributes valuable insights into the prevention of ASIs in soccer, highlighting the importance of previous ankle sprains and playing surface quality. These findings assist sports professionals in developing optimal conditions and strategies for effective ankle sprain prevention.
... 1 Establishing the extent of health problems allows for the investigation of risk factors and targeted preventative measures, but this requires robust and reliable surveillance systems. 2 These systems can access information from a variety of sources, with medical staff or athletes themselves often used as the primary recorders. Whilst recording by medical staff ensures valid diagnoses, many sport programmes do not have access to qualified personnel and the approach often fails to capture overuse problems or pain that does not lead to absence from training or competition. ...
... Various interventions, such as strength and neuromuscular training programs, have been shown to effectively prevent knee injuries in soccer athletes, with preliminary evidence suggesting their efficacy among NCAA athletes as well (Yoo et al. 2010;Herman et al. 2012;Myer et al. 2013;Sugimoto et al. 2016;Åman et al. 2018;Owoeye et al. 2020). However, to effectively tailor these programs to the needs of NCAA soccer athletes, it is crucial to determine the extent of the problem in this population (van Mechelen et al. 1992;. Accordingly, the purpose of this study was to describe the epidemiology of knee injuries in NCAA soccer athletes by: a) characterizing the overall incidence density and visually depicting the year-to-year incidence of knee injuries and ACL tears from 2009/10 to 2018/19, b) assessing sex-differences in injury incidence, c) categorizing these injuries by injury-specific and sport-specific characteristics, and d) analyzing post-injury recovery, to provide a comprehensive summary of knee injury incidence in NCAA men's and women's soccer athletes. ...
... Frameworks developed for sport injury, such as the 'the sequence of prevention model' (Fig. 1), address the complexity of injury prevention in sport, and now offer a more context-specific approach for addressing injury prevention [28,29]. However, as this model assumes equivalence between preventive measures (Step 3), scholars can potentially follow the same steps, yet reach different conclusions, depending on their interpretation of what constitutes primary, secondary or tertiary intervention. ...
Background
Formal statements articulating the meaning of primary, secondary and tertiary prevention concepts are commonly used in the musculoskeletal sports injuries literature, but appear to be employed inconsistently and incorrectly. Standard definitions, appropriate to athletic health and performance practice, are required to systematically develop the state-of-the-art. To accomplish this, we summarized prevention definitions with the aim of improving conceptual clarity across the musculoskeletal sports injuries literature.
Main body
We used a rapid literature review method, searching Scopus, PubMed/Medline, Cochrane Library reviews/trials, Web of Science, Sports Medicine and Education Index, SPORTDiscus and CINAHL databases for titles/abstracts for available literature, published in English from database-inception to November 2023. Our search terms were: sport/athlete, injury, primary prevention, secondary prevention, and/or tertiary prevention. Definitions were extracted to create categories illustrating overlap and variation. We extracted definitions from 144 included studies (n). Primary prevention appears focused on mitigating injury risk (n = 52) and preventing initial injuries (n = 42). Secondary prevention appears to address five distinct concepts: preventing recurrences (n = 42), preventing sequelae (n = 41), preventing index injury worsening (n = 27), mitigating injury risk (n = 15), and restoring function (n = 12). Tertiary prevention appears focused on preventing sequelae (n = 17) and restoring function (n = 9).
Conclusions
From a definition viewpoint, the aim of primary prevention is narrowly conceptualized and consistent in the musculoskeletal sports injury research literature. However, secondary prevention definitions vary substantially, with at least three distinct conceptual aims observable. Tertiary prevention definitions appear infrequently in the literature and when observed tend to overlap with secondary prevention. Currently, researchers are likely to struggle with the formulation of clearly-defined and transferrable research questions relating to the aims of secondary prevention.
... It is important to understand the current situation and analyze the causes of adverse events to prevent them during sports 7) . To date, reports on adverse events in community sports are limited. ...
This study aimed to prospectively record the occurrence of adverse events and near-misses during sports in middle-aged and older adults who voluntarily engaged in sports in the community and to clarify the frequency and characteristics of such events. Participants were comprised of 14 groups (14 sports) of middle-aged and older adults who voluntarily played sports in Sakae Ward, Yokohama. The follow-up period was 14 months (November 1, 2022, to December 31, 2023). Representatives of the target groups reported once a month to Sakae Ward via postcards regarding the status of their activities and the occurrence of adverse events and near-misses. The survey items included the age of the main participants in each group, number of activities during the month, duration of each activity, number of participants per activity, adverse events, and near-misses during sports. During the 14-month observation, eight adverse events and two near-misses were reported in the 14 groups, mainly comprising middle-aged and older adults. Of the eight adverse events, four were falls, all occurring in those aged ≥70 years and triggered by environmental problems. In this study, there were only two near-misses compared to eight adverse events, suggesting that the participants may have been unaware of near-misses. Therefore, even for sports played by groups of residents, it is important to identify risks by assessing health conditions prior to exercise and to implement initiatives to foster safety awareness among participants, such as hazard prediction training.
... Conventionally, risk reduction interventions are assessed by monitoring injury frequency before and after the intervention. 22 A fall in incidence reflecting intervention success. However, reported concussion rates at community youth levels vary from 0.2 to 22/1000 hours 23 24 and concussion definitions have not been consistent. ...
Objective
This cross-sectional study describes the concussion knowledge and attitudes of male and female 14–18 year-old school rugby union players in England.
Methods
Data from 515 (male 421, female 94) players from 19 schools were collected via the specifically designed Rugby Union Concussion Knowledge and Attitude Survey (RUCKAS-YOUTH) between 2019 and 2022. Knowledge and attitude questions were grouped into themes and analysed against primary cohorts of sex, school status and age group and secondary cohorts of stated Rugby Football Union (RFU) education conduction, concussion history and rugby experience. Associations between knowledge and attitudes were then explored.
Results
No association between total concussion knowledge and attitude was found. Mean concussion knowledge was 79.3% (26.2/33±2.9). The mean concussion attitude safety score was 76% (129.3/170±14.8). RFU ‘Don’t Be a HEADCASE’ module completion was low (16.9%) and was not associated with concussion knowledge. Private school participants reported significantly safer attitudes towards concussion (77.8%, 132.2±14.0) than state school pupils (74.5%, 126.6±15.1), but not greater concussion knowledge. Male and female participants held similar knowledge and attitudes towards concussion, as did participants across the age spectrum. Concussion attitude safety was significantly greater in players with 7–15 years of playing experience than in the younger cohort (U=27 563.0 p=0.005).
Conclusion
The RUCKAS-YOUTH survey provides a detailed description of UK youth rugby concussion knowledge and attitudes. The survey results indicate that attitudes towards concussion, particularly those that influence symptom disclosure, should be a primary focus of concussion risk reduction interventions once key gaps in knowledge are addressed.
... 2 The second step in the sequence of injury prevention is to identify aetiological risk factors behind injuries. 9 In a separate study of perceived risk factors for hamstring muscle injuries in the ECIS, the teams' chief medical officers (CMOs) considered most risk factors associated with external factors connected to ...
Objectives
External risk factors connected to club, team and coaching are believed to be important in the causation of hamstring injuries, but little is known about the preventive measures used. The objective was to analyse the association between preventive factors and hamstring muscle injury burden.
Methods
14 teams participated in the Union of European Football Associations Champions/Europa Leagues from 2019/2020 to 2022/2023. An open question was sent out in January 2023 to the four teams with the lowest hamstring muscle injury burden, asking why their teams had successfully avoided hamstring muscle injuries and which preventive methods they had used. A questionnaire that investigated the use of these methods was sent to all 14 teams in February 2023. A multiple linear regression model was applied, using injury burden as an outcome variable and the questionnaire responses as possible explanatory variables possibly adjusted for team and season.
Results
The preventive methods included factors such as the level of communication between the coach, the medical staff and the performance staff. The adjusted multiple linear regression model indicated that communication between the medical staff and the performance staff was negatively associated with an increased hamstring muscle injury burden, where for every ‘higher’ grade of the communication variable, the average injury burden decreased by 4.1 (95% CI −8.2 to −0.04, p=0.048) days per 1000 hours.
Conclusions
Better communication between the medical and the performance staff and continuous involvement of the medical staff in load management was associated with a lower hamstring injury burden in male professional football teams.
... As in all aspects of sports medicine, knowledge of the epidemiology of injuries within a sports discipline (incidence, location, type, severity) allows establishing individualised guidelines and strategies, according to specific needs (4). Several articles have described that the most common injuries in artistic swimming occur due to overuse of the knee, shoulder, and lumbar spine, due to the nature of repetitive movements in training (2,5). ...
Introduction
Artistic swimming is a highly technical sport that requires a large volume of training and forced positions that generate a high risk of injury.
Objective
to compile scientific evidence on the incidence of injuries in artistic swimming. Literature study: PubMed, Web of Science, and SPORTDiscus databases were used to search for studies that analysed the epidemiology of injuries in artistic swimmers of any age and gender until June 2024. Methodology: the methodological quality of the studies was analysed with the Strengthening the Reporting Scale of Observational Studies in Epidemiology (STROBE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) were followed. Synthesis: eleven studies met the inclusion criteria showing a clear trend of joint-ligament or muscle-tendon injuries in the shoulders, back, and knees.
Conclusions
despite the publication of an injury surveillance document and a consensus on data collection and injury surveillance, there are methodological limitations that do not allow firm conclusions to be drawn. More epidemiological studies that follow data collection and injury surveillance guidelines are needed to establish differences by gender, age groups, and test.
... Classification of injuries as mild (1-7 days), moderate (8-28 days), or severe (>28 days), following the classification proposed by van Mechelen et al. 17 . ...
Injuries in professional basketball affect player performance and generate significant costs. This study analyzed the incidence and economic impact of 102 injuries in a team from the ACB League over four seasons, with an injury rate of 5.85 injuries per 1,000 hours, higher during games. Muscle injuries (42 %), mainly involving hamstrings and the Achilles tendon, were the most common. Although 68.6 % were minor (1-7 days), severe injuries (>28 days) accounted for the highest economic burden. Single-competition seasons exhibited a higher budgetary impact (6.5 %) compared to dual-competition seasons (4.5 %). The findings highlight the importance of preventive programs tailored to the competitive demands and player characteristics.
... Injury prevention is well outlined by Van Mechelen's injury prevention framework (11). ...
Objectives
To identify and critically appraise the available evidence on injury epidemiology and risk factors in figure skating.
Design
Systematic review.
Methods
Eight electronic databases were searched from inception to 01 November 2023. Studies were included if they reported injury epidemiology and/or injury risk factors in figure skating. Non-English publications were excluded. Risk of Bias of included studies was assessed using the QUIPS tool (quality in prognostic factor studies).
Results
This systematic review identified twenty-nine studies (n = 4202 figure skaters), with an injury prevalence of 2.1 %–34 %. An injury incidence of 1.37 injuries/1000 total training hours was reported in one study (n = 8). Three significant intrinsic risk factors (older age, previous history of stress fracture and a higher body mass) and eight significant extrinsic risk factors (training more than 12 sessions per week, skipping meals, RED-s indicators, hamstring and quadriceps immobility, training rather than competing, increased time on-ice time and boot-foot length difference) were identified from individual studies. Age, as the most studied risk factor, requires careful interpretation due to study design limitations.
Limitations
Existing data lacks quality of evidence and current reported injury risk factors in figure skating should be interpreted with caution.
Conclusions
High-quality research of injuries and injury risk factors in figure skating is scarce. The inconsistent reporting of injury data across the currently available literature due to variations in injury definition and data collection methods makes it difficult to compare and draw conclusions. A critical need exists for standardized research approaches to accurately determine the true burden of injury in this sport.
... (8) Sports related injuries can be described as kinds of injuries that most commonly occur during sports or outdoor game, but they are not limited to athletes. (9) This study shows percentage (prevalence) of self-reported non-specific musculoskeletal pain symptoms and sports related injuries among school going adolescents (13-18 age group) after playing sports. In this study, we found many adolescents were interested in sports, in which cricket, football and volleyball were highly popular. ...
Background: Musculoskeletal problems like pain, fatigue and weakness are usually a cause of concern among adolescents after playing sports. Changes can occur in the physical health of children because of injury after playing games or sports. The aim of the study was to find self-reported musculoskeletal problems after playing sports among adolescents. Method: A cross-sectional study was conducted on school going adolescents in the age group of 13-18 years. A self-administered questionnaire was generated to collect data, including questions related to sports, injury and musculoskeletal problems. Descriptive analysis was done. Result: Total 469 students completed the study- 232 males and 237 females with mean age 15.01 ± 1.22 years. All students were having 1 or more sports sessions in the school per week. 390 students (83.15%) were playing sports after their school hours. 366 students (78%) reported feeling tired after playing sports. 188 students (40%) reported having pain after playing sports of which 40 students had pain in shoulders and 30 students had pain in feet. 244 students (52%) had had some form of injury of which 113 (46%) reported injuries to their knees. Out of 227 girls, 128 (56.38%) had difficulty in playing sports during their periods. Conclusion: Playing sports is common in schools across Ahmedabad and even after school hours. About 40% adolescents have had pain mostly in the shoulder or lower limbs at some time and 52% have had some kind of injury after playing sports or games. Key words: musculoskeletal problems, school going adolescents, sports
Background
No previous study has analyzed the associations between Paralympic athletes’ sociocultural factors and injury risk.
Purpose/Hypothesis
The purpose of this study was to examine the associations of time to access the main training facility (TAF) and time to prepare before and after training (TPT) with the injury risk while controlling for sport, impairment type, and performance level. It was hypothesized that a longer TAF and TPT would be associated with an increased injury risk.
Study Design
Cross-sectional study; Level of evidence, 3.
Methods
A retrospective questionnaire was sent to 186 French athletes in 11 Paralympic sports who were identified by their sports federations as qualified to compete at the 2021 Tokyo Paralympic Games. The level of performance was determined according to past performance in international championships and the Paralympic Games. Impairment type was self-reported by athletes and then reclassified by a certified physician (limb deficiency, visual impairment, spinal cord–related disorder, central neurological disorder, short stature, peripheral neurological and muscular disorder). TAF and TPT were assessed by 2 self-reported questions. Injuries in the past 12 months were assessed using the latest consensus statement for the recording and reporting of self-reported epidemiological data on injuries in sports. Logistic regression analyses were performed to evaluate the relationship of TAF and TPT with the injury risk while controlling for sport, impairment type, and performance level.
Results
A total of 126 athletes (response rate: 67.7%) agreed to participate. The prevalence of injuries was 35.7% (95% CI, 33.3%-38.2%); it was lower among athletes with a high level of performance compared with those with a low level of performance. Athletes who reported a TAF ≥40 minutes were 5.5 times (95% CI, 1.2-30.5) more likely to have sustained an injury than those who reported <10 minutes. Athletes who reported a TPT ≥1 hour and 30 minutes were 6.3 times (95% CI, 1.1-44.4) more likely to have had an injury than those who reported 15 minutes.
Conclusion
Our study demonstrated that Paralympic athletes who reported a longer TAF and TPT had a higher risk of injuries. Future studies are needed to understand the exact mechanism that would explain these results and to assist in the prevention of injuries in this population of athletes.
Injury prevention and performance optimisation in sports are evolving from generic strategies to more personalised, timely and data-informed approaches. Traditional systems often rely on infrequent assessments and binary classifications of injury, which fail to reflect the complexity of athlete health. This perspective advocates for a refined approach to athlete screening and monitoring that captures historical and real-time data to support precise, context-driven decisions. We differentiate between screening as a point-in-time evaluation of underlying risk and monitoring as the continuous assessment of an athlete’s changing condition. The key principles of this approach include using valid, outcome-specific measures, timely data collection close to decision points and seamless integration into daily practice. By moving beyond simplistic metrics and incorporating advanced analytical techniques, this approach offers a more nuanced and proactive way to manage athlete health. It bridges the gap between research and real-world application, supporting better decision-making and long-term performance outcomes.
Injury prevention in sports remains a perpetual challenge, frequently hindered by linear approaches that fail to account for the complexity of real-world scenarios. We propose a paradigm shift in this perspective, framing injury prevention as a ‘wicked problem’ characterised by evolving, context-dependent factors and competing priorities. We suggest that while eliminating injuries entirely may not be feasible, their impact can be effectively reduced through tailored, adaptable solutions.
We illustrate the practical application of this framework through a case study of Cirque du Soleil. By adopting a revised ‘Sense-Think-Act’ paradigm, interventions were collaboratively developed with performers, medical personnel and organisational leaders. This resulted in a 15% reduction in injuries and substantial decreases in missed performances and overuse injuries over 4 years. The success of this approach can be attributed to context-sensitive strategies that effectively balance injury risk mitigation with performance objectives.
Our proposed view challenges traditional definitions of success in injury prevention, that is, developing ‘optimal solutions’ instead of ‘ultimate solutions’. By rethinking injury prevention as a wicked problem, we nudge sports professionals to adopt flexible, sustainable practices that address the dynamic realities of their environments. Such a shift enhances injury prevention outcomes and aligns these efforts with the broader priorities of athletic communities.
Figure skating is a popular sport enjoyed by millions worldwide; however, research has largely overlooked the health challenges its participants face. Supported through an athlete’s maturation process from childhood to adulthood, participation in sports such as figure skating cultivates lifelong benefits for individuals and the sports community, improving long-term health and well-being.
However, athletes also face the risk of injuries and other health issues. This concern is particularly relevant for young athletes and female participants, often underrepresented in sports medicine research. Poor health can be devastating for the affected athlete and detrimental to the sports movement, which loses active participants.
Swedish figure skating has the world’s second-largest number of participants per capita, with over 51,000 participants, predominantly young girls. The sport continually evolves, increasing physical and mental demands on athletes. Despite its popularity, there is a notable gap worldwide in research on figure skaters' health. Media investigations and external reports often highlight injuries, violence, and unhealthy environments. Recent reports in Sweden have drawn attention to the exposure to violence in figure skating, including cases that violate children’s rights.
This dissertation explored the health of young Swedish figure skaters, identified risk factors for physical and mental health issues, and explored future ways to promote health and safety in figure skating.
Papers I and II were based on a cross-sectional study conducted via a questionnaire among a community population (N=400) of licensed competitive Swedish figure skaters of all levels. In total, 137 female skaters aged 12.9 years (SD 3.0) were included in the analysis.
Paper I investigated factors associated with sport injuries. It found that one-third of young skaters had sustained a severe injury episode in the past year, and one-fifth had an ongoing injury at the time of the study. Injury episodes primarily affected the lower extremities. Reported sport injury episodes were associated with being older and skipping more main meals per week.
Paper II examined mental health and associated factors. It showed that nearly half of the participants reported anxiety caseness, while one in ten reported depression caseness. Older participants exhibited poorer mental health, and anxiety caseness was associated with being older and with displaying a negative body image perception.
Papers III and IV employed reflexive thematic analysis of qualitative interviews with twenty Swedish licensed competitive figure skaters aged 12 to 25 (median age: 16).
Paper III focused on the athletes’ health-related experiences and how they balanced these with athletic performance. Young figure skaters held a positive view of their sports participation. They desired sustainability in their development and requested agency in decision-making. Young figure skaters sought accountability from adult stakeholders.
Paper IV explored young figure skaters' knowledge, experiences, and attitudes towards violence against children when participating in sports. Athletes struggled to recognise and report violence against children in sports, which was seen to perpetuate the normalisation and legitimisation of such behaviour.
In conclusion, very young athletes at the community level presented with a high degree of sport-related ill health that appeared to worsen with age, both physically and mentally. Repeated load, insufficient energy intake, negative body image perceptions and inadequate adult support contributed to adverse health consequences. This dissertation highlights the need for improved safety measures and consistent implementation of protection systems engaging collaborative resolutions across ecological levels within figure skating in Sweden and internationally.
This research emphasises the importance of addressing figure skaters' health needs, listening to young athletes’ experiences, and working towards creating safer and healthier environments for all sports participants.
Background: Sports injuries, particularly those affecting the lower extremities, are prevalent in volleyball. Neuromuscular asymmetry in the lower limbs may play a significant role in predicting injury risk. This study investigates the impact of limb asymmetry as a predictor of sports injuries in volleyball players. Objectives: The primary objective of this study was to examine the role of lower limb neuromuscular asymmetry as a predictor of injury risk in volleyball players. Additionally, the study aimed to assess the impact of limb asymmetry in functional tests, including the single-leg hop, 90-degree direction change, and dynamic Y-balance tests. Methods: This prospective cohort study began in June 2024 and will continue for nine months in Kermanshah. A sample of 101 male and female volleyball players was purposefully selected based on inclusion and exclusion criteria. Lower limb symmetry indices were assessed using functional tests (single-leg hop, 90-degree direction change, dynamic Y-balance) before the study. Injury registration and follow-up were conducted for nine months. Data were analyzed using SPSS version 27, employing independent t-tests to compare injured and non-injured groups and univariate logistic regression to explore the relationship between predictive variables and sports injuries. Results: Logistic regression analysis identified limb asymmetry in the single-leg hop for distance and Y-dynamic balance (anterior position) tests as significant predictors of sports injuries. The models explained 2.5% to 9.1% of injury variance for the single-leg hop and 1.4% to 7.4% for the Y-dynamic balance test, both of which were statistically significant (P = 0.02 and P = 0.04, respectively). Each 1% increase in limb asymmetry in the Y-dynamic balance (anterior position) test and each centimeter of limb difference in the single-leg hop for distance test increased the risk of injury by 18%. Conclusions: Limb asymmetry, as measured by the single-leg hop for distance and Y-dynamic balance (anterior position) tests, significantly predicts sports injuries in volleyball players. Even small increases in asymmetry raise the risk of injury by 18%. These findings emphasize the importance of incorporating these functional tests into injury risk assessments and prioritizing the reduction of asymmetries in injury prevention programs.
Background
Anterior cruciate ligament (ACL) injuries are common in female basketball players, who have a 2 to 3 times higher risk for an ACL injury than their male counterparts. Improving our understanding of the situations and biomechanics that result in an ACL injury in basketball players may support the design of more effective programs to mitigate the injury risk.
Purpose
To describe the injury mechanisms, situational patterns, and biomechanics of ACL injuries during matches in professional female basketball players.
Study Design
Case series; Level of evidence, 4.
Methods
A total of 105 ACL injuries in professional female European basketball leagues from the 2018 to 2023 seasons were identified. There were 41 (39%) injury videos analyzed for injury mechanisms and situational patterns, while biomechanical analysis was possible in 33 cases. There were 3 independent reviewers who rated each video. Data according to player position, phase of the match, and location on the court were also evaluated (n = 41). Analysis regarding neurocognitive perturbation was assessed in 41 cases (100%).
Results
Most injuries (n = 28 [68%]) occurred during offensive possession. Indirect contact injuries were more prevalent (n = 23 [56%]) than noncontact injuries (n = 18 [44%]). Overall, 3 main situational patterns constituted 95% of injuries: offensive cut (n = 20 [49%]), defensive cut (n = 12 [29%]), and landing from a jump (n = 7 [17%]). Injuries involving a knee-dominant pattern with valgus were identified in 64% of cases. Injuries were evenly distributed between the first (53%) and second (47%) halves of a game. Half (50%) occurred within the first 10 minutes of effective playing time, and the most frequent months of injury were October and November (44%; early season). Nearly half (46%) of the injuries occurred in small forwards, with 59% of injuries occurring in zone 5. Neurocognitive errors were seen in 56% of injuries, while 92% of defensive injuries showed signs of neurocognitive errors.
Conclusion
ACL injuries in professional female basketball players were caused by indirect contact or noncontact, involving offensive and defensive cuts as well as landing from a jump. Biomechanical analysis confirmed a multiplanar mechanism with a knee-dominant pattern and valgus. Most injuries occurred early in the season and within the first 20 effective minutes played (89%), making accumulated fatigue an unlikely risk factor for ACL injuries in basketball players.
Abstract
Objectives Brazilian Jiu-Jitsu (BJJ) is a rapidly growing combat sport characterised by ground fighting and submission techniques. There are limited data regarding BJJ injuries. This study described the incidence and characteristics of injuries in BJJ practitioners.
Methods This retrospective survey targeted BJJ practitioners globally who trained at least once per week. The survey was distributed online and via posters at multiple Dutch BJJ competitions. Data collection took place from 15 February 2024 to 17 March 2024. We collected training, competition and injury data from the past 12 months. Complaints that required medical attention caused time loss (≥1 week) or led to training modification (≥2 weeks) were defined as an injury.
Results Of 881 participants, 817 (90%) were male, and the average age was 30.8 years (SD 8.6). Injury information was provided on a total of 888 injuries. The injury incidence was 5.5 (95% CI 4.9 to 6.1) per 1000 hours in training and 55.9 (95% CI 38.8 to 73.0) injuries per 1000 matches, with a higher rate observed among participants with a lower belt level. Most injuries (n=789, 89%) occurred during training, mainly (n=620, 79%) during sparring. The knees (n=223, 25%) and shoulders (n=114, 13%) were the most affected body regions.
Conclusions This study found an injury incidence of 5.5 per 1000 hours of training and 55.9 per 1000 matches for BJJ practitioners. Future preventative practices should focus on the free sparring part of training to be most effective. Future studies should also monitor BJJ practitioners prospectively to understand injury aetiology better.
Adolescent elite athletes in Olympic sports often specialise at an early age, which increases the risk of overuse and traumatic injuries. The knowledge of injury patterns is a key aspect for prevention strategies. However, little is known about adolescent athlete’s injury patterns in most Olympic sports. This study aimed to analyse the incidence and pattern of traumatic and overuse injuries in adolescent elite athletes from three Olympic sports with various physical demands.
A retrospective data analysis was performed, including 348 initial orthopaedic consultations of adolescent elite athletes (m/f: 267/81, 15.9±1.7 years, 179±9 cm, 71±11 kg, 648±107 training hours/year). Athletes from handball (n=185), canoe sprint (n=112) and triathlon (n=51) presented at the local sports medicine centre. All consultations included a medical history obtained by a physician, an orthopaedic examination, and a documentation of anthropometric and training-related data. Injury patterns were classified for traumatic and overuse ratio, type, area, structure, and cause of injury. Incidence per 1000 hours (h) of exposure and injury ratio were analysed in the entire cohort and compared between sports.
The mean injury incidence was 3.3/1000 h, while overuse injuries occurred approximately twice as often as traumatic injuries (2.0 versus 1.2/1000 h). Sport-specific total injury incidence was lowest in canoe sprint (1.6/1000 h) and highest in handball (4.7/1000 h). The traumatic versus overuse injury ratio was lowest in canoe sprint (0.13) and highest in handball (0.54). Injury incidence increased with age and training hours from 1.0/1000 h in young athletes (12–13 years) to 5.1/1000 h in older athletes (16–17 years). Type, area, structure and cause of injuries differed significantly between athletes of the three sports. Handball players presented with various traumatic and overuse pathologies, mostly located in the lower extremity. Canoeists and triathletes mainly suffered from tendon overload and muscle injuries of the extremities and the lower back.
Both the total incidence and the ratio of traumatic versus overuse injuries differ between athletes participating in handball, canoe sprint, and triathlon. Overuse injuries occurred approximately twice as often as traumatic injuries in the present cohort. Further investigation is required to evaluate whether the variety of injuries seen in individual and team sports is to be taken into consideration in the development of prevention strategies.
Objective
This study describes the magnitude and burden of injuries and illnesses in elite Dutch female adolescent and young adult handball players.
Design
A retrospective open cohort study.
Methods
10 consecutive seasons were studied using a database including all injuries and illnesses needing medical attention. In total, 102 handball players, who participated in a full-time programme of the Dutch Handball Academy between August 2009 and July 2019, were included. Injuries were classified according to the consensus statement of the International Olympic Committee. Exposure hours were categorised into training and competition exposure. Training exposure included all handball and strength and conditioning sessions. Burden was defined as the injury duration in days divided by the total exposure hours.
Results
In total, 916 injuries in 101 players and 95 illnesses in 59 players were reported. The average seasonal prevalence was 83.2% for acute injuries and 78.7% for repetitive injuries. The overall incidence rate was 4.24/1000 exposure hours with an incidence of 23.06/1000 competition hours and 2.19/1000 practice hours. The highest average seasonal prevalence and burden were observed for repetitive injuries of the lumbosacral spine, knee and lower leg and acute injuries of the ankle and knee.
Conclusion
High injury prevalence proportions and competition incidence rates were observed. Repetitive injuries of the lumbosacral spine, knee and lower leg, as well as acute injuries of the knee and ankle, formed the largest problem. Future prevention programmes in elite Dutch adolescent and young adult female handball players should therefore focus on these injuries.
Soccer is a widely practiced and highly mediatic sport discipline. For this reason, the incidence of injuries associated with the game is an active area of research. High-impact actions occur during the game, affecting the knee joint and resulting in osteoarthritis. In this line, knee osteoarthritis results from mechanical and biological stress due to lesions that are not adequately repaired, resulting in an inflammatory process. This occurs because the degradation of extracellular matrix predominates over synthesis by chondrocytes. Therefore, in soccer players, knee osteoarthritis results from joint traumatic actions, displaying a degenerative evolution. Osteoarthritis occurs in up to 32% of male soccer players, 3 times more than in the male general population. On the other hand, female soccer players are a main target population to suffer from knee osteoarthritis, with a higher significant incidence observed compared to men. In this context, certain diet supplements have an instrumental potential in the prevention and/or treatment of knee osteoarthritis. Therefore, the aim of this narrative review is to present possible research lines to implement treatments for knee osteoarthritis in female soccer players.
The primary aim is to assess the impact of a multidomain intervention that integrates education, exercise, psychological techniques and machine learning feedback on the duration athletes remain free from injury complaints leading to participation restriction (ICPR) during a 20-week summer competitive athletics season. The secondary aims are to assess the intervention’s effect on reducing (i) the incidence, (ii) the burden, (iii) the period prevalence and (iv) the weekly prevalence of ICPR during the same timeframe. We will perform a two-arm randomised controlled trial. This study will involve an intervention group and a control group of competitive athletes licensed with the French Federation of Athletics, aged between 18 and 45, over an outdoor athletics competitive season lasting 20 weeks (March to July 2025). Data will be collected before the start (demographic, training and injury history) and one time per day (training and competition volume/intensity, perceived physical and psychological state, and illness and injury incidents) for both groups. The intervention group will be required to (i) view a series of 12 educational videos on injury prevention, (ii) engage in discipline-specific exercise programmes, (iii) implement stress and anxiety management techniques and (iv) view daily the injury prognostic feedback generated by the athlete’s collected data based on machine learning. Outcomes will be analysed over the final 14 weeks of follow-up to allow time for the intervention to establish any potential efficacy. The primary outcome will be the time-to-event for each ICPR. Secondary outcomes will include (i) incidence, (ii) burden, (iii) period prevalence and (iv) weekly prevalence of ICPR. The primary outcome will be analysed using a Prentice–Williams–Peterson gap-time model. In contrast, the secondary outcomes will employ Poisson (i, ii), logistic (iii) and generalised estimating equations (iv) regression models, respectively.
Background: Dance is a popular activity worldwide that comes with inherently high injury rates. Despite the call for implementation and evaluation of injury prevention strategies, the utility and efficacy of injury prevention practices in dance are unknown. Objective: The primary objective of this systematic review was to describe dance-specific injury prevention strategies in any dance population. The secondary objective was to evaluate the effectiveness of these strategies in the reduction of injury prevalence or incidence rates. Methods: Six electronic databases were searched to March 2024 (Medline, EMBASE, SportDiscus, CINAHL, SCOPUS, Cochrane). Selected studies met a priori inclusion criteria that required original data describing an injury prevention strategy for any genre of dance. Studies were excluded if; no injury outcomes were reported, no injury prevention strategy was utilized, or if dance was used as a therapeutic intervention/fitness. Two reviewers independently assessed abstracts and full texts for inclusion. Study quality was evaluated using the Joanna Briggs Institute Level of Evidence tool. Results: From 2209 potentially relevant records, 8 studies met criteria for inclusion. Injury prevention strategies were diverse across conditioning and exercise programs, neuromuscular training warm-up, psychological coping skills training, and educational programs, with a range of duration and adherence measures. Due to inconsistent injury surveillance methodology, efficacy of these programs could not be determined. Quality of included studies was moderate to high, with moderate to low risk of bias. Conclusions: Efficacy and adherence to dance-specific injury prevention strategies are understudied in the dance science literature. Conditioning and exercise programs are currently the most common injury prevention strategies, with initial evidence suggesting they may be efficacious in reducing injury rates. Further research using valid injury surveillance methodologies and standardized injury definitions to examine the efficacy of these strategies in reducing dance-related injury is needed. Level of evidence: I.
The increasing discussions regarding the research-to-practice gap in sport injury prevention have led to a growing focus on the significance of context in injury prevention programs. A context-driven injury prevention program is advantageous to address and enhance injury prevention efforts in specific populations. Considering the prevalent concern for overuse injuries among overhead youth athletes, and the developmental and contextual factors unique to this population, this review introduces the OverHead Youth Athlete (OH-YA) overuse injury prevention process. Tailored to address the challenges of working with overhead youth athletes, the context-specific four-step framework includes the following: (1) development of a context-specific instrument with strong sample representation, (2) determination of the context-specific injury burden magnitude and associated factors, (3) development of a context-specific intervention with end-users, and (4) evaluation of the context-specific intervention. This framework would likely help maximize the use of typically limited resources in youth sports. Using shoulder overuse injuries among overhead youth athletes as a case study, the OH-YA overuse injury prevention process provides an enhanced approach to context-driven overuse injury prevention while illustrating the importance and integration of context to minimize the “research-to-practice” gap.
Background
Research on catastrophic injuries and medical conditions among majority girls’ and women’s sports are underrepresented. In this study, we describe the incidence, characteristics, and mechanisms of severe softball injuries/medical conditions between 2014 and 2021.
Hypothesis
Catastrophic injury and illness patterns will be observed with a higher incidence rate at the collegiate level.
Study Design
Descriptive epidemiologic study.
Level of Evidence
Level 3.
Methods
Events from the National Center for Catastrophic Sport Injury Research (NCCSIR) and National Electronic Injury Surveillance System (NEISS) were included. NCCSIR included catastrophic injuries during participation in high school (HS) or college sponsored girls’/women’s softball resulting in death, temporary or permanent disability, or life-threatening injury. NEISS included severe girls’/women’s softball injuries (product code 5034) among 13- to 17- and 18- to 24-year-olds among severe dispositions. National estimates were derived using a weighted sample for NEISS. Counts (%) and incidence rates (IR) per 100,000 participants overall and by age level, injury/medical event, and outcome were reported.
Results
NCCSIR captured 0.3 events per 100,000 participants (95% confidence interval, 0.1-0.5), and incidence was higher in college (IR, 2.5; 0.9-6.6) compared with HS (IR, 0.1; 0.1-0.4). Sudden cardiac arrest was the most common event (5, 63%), and 2 (25%) fatalities were reported. NEISS captured 10.2 events per 100,000 participants (9.7-10.8). Incidence was higher in 18- to 24-year-olds (IR, 8.9; 8.3-9.6) compared with 13- to 17-year-olds (IR, 4.2; 3.8-4.6), and no fatalities were captured.
Conclusion
Collegiate and 18- to 24-year-old athletes demonstrated a higher incidence of severe injuries than HS and 13- to 17-year-old athletes across both surveillance systems. NEISS captured a higher incidence of catastrophic events than NCCSIR. NCCSIR observed more cardiac events, whereas NEISS observed more head/face injuries.
Clinical Relevance
Continued monitoring of severe injuries and medical events in softball is necessary to support response and prevention measures.
This study investigates the longitudinal patterns of musculoskeletal injuries in an NCAA field hockey team, emphasizing the predictive value of index injuries on subsequent injury rates. Analyzing a dataset from a women’s collegiate field hockey team, this research monitored 810 injuries across 124 athletes from 2008 to 2024. The study categorized injuries as local, nonlocal, and recurrent, employing a negative binomial regression to assess the impact of index injuries on the total number of career injuries. Results indicated that ankle sprains, hamstring strains, and back strains significantly predicted the total number of career injuries. Furthermore, the analysis revealed that the majority of subsequent injuries occurred within 69 days of the index injury, suggesting a critical window for targeted interventions. The findings underscore the need for robust longitudinal data and standardized reporting to enhance injury prevention strategies in field hockey.
Topical nonsteroidal anti‐inflammatory drugs (NSAIDs) are commonly used to treat sports injuries, but evidence‐based medical guidance for their standardized and rational use is lacking. This guideline working group identified clinically important issues, obtained the full opinions of patients and clinical staff, and discussed them with the expert group. Based on evidence from the literature, the “clinical practice guidelines for topical NSAIDs in the treatment of sports injuries” were formulated following the methods and principles of international guidelines. According to these guidelines, 7 clinical concerns were ultimately selected, and 22 recommendations were formed. These included the status, indications, contraindications, efficacy, combined application, use in special populations, adverse reactions, and countermeasures of topical NSAIDs in the treatment of sports injuries. The purpose of these guidelines is to provide evidence‐based recommendations for practitioners in the fields of orthopedics, sports medicine, rehabilitation medicine, and sports science, as well as other fields, in the treatment of sports injuries to promote more standardized and rational use of topical NSAIDs.
A Badminton Injury Questionnaire (BIQ) was developed to survey the type and frequency of injuries that are likely to occur from playing competitive badminton. Two hundred and thirty-one players, ranging from club players to international champions, completed the survey which indicated an injury incidence rate of .09 and .14 injuries per person per year for male and female badminton players respectively. Badminton participation resulted in relatively few injuries, most of which were cramps, blisters, strains and sprains of the lower extremities and a surprisingly low incidence of tennis elbow.
The planning of health education aimed at preventing sports injuries is often incomplete and not stated explicitly. In most instances, the evaluation is incomplete or nonexistent. We present a theoretical framework for planning and evaluating health education, illustrating the main points by using as an example the health education for downhill skiers. Systematic planning consists of analyzing the magnitude of the problem and the behavioral risk factors, studying behavior determinants, designing an optimal intervention, and implementing the intervention. The evaluation phase deals with the effects on these five levels (implementation, intervention, determinants, behavior, and incidence of injury). Some common pitfalls are mentioned and special attention is given to the study of determinants of behavior and to the design of the intervention. The importance of pretesting health education material and the community approach in educating sports participants is underlined. Health education, together with regulations and facilities, constitutes the health promotion strategy in the prevention of sports injuries. For most sports, there seems to be a strong need for further research on the etiology and determinants of behavior before effective prevention can be realized.
A prospective study of injuries encountered during participation in a summer soccer camp for youths aged 6 through 17 years revealed an injury incidence of 10.6 per 1000 hours for girls (107 injuries in 458 girls) and 7.3 per 1000 hours for boys (109 injuries in 681 boys). For both sexes, the incidence of injury increased at age 14 years. One certified athletic trainer (W.D.C.) assessed and documented all injuries during the course of the study. Seventy percent of injuries involved the lower extremities. Contusions represented 35.2%, strains 27.8%, sprains 19.4%, and fractures and dislocations 2% of all reported injuries. The ankle was the most frequent site of injury in both sexes. Quadriceps strain was a common injury in boys. The boys with the highest incidence of injury were tall (greater than 165 cm) and had a weak grip (less than 25 kg), suggesting that skeletally mature but muscularly weak boys may be more susceptible to injury while playing soccer with peers of the same chronological age.
From the summer of 1978 to May 1981 there were 154 eye injuries from squash and 91 from racquetball reported to the eye surgeons of Canada. The ball caused 90% of the most serious racquetball injuries and 67% of those in squash. Fifty-two players reported eye injuries that occurred while wearing open eye guards. Only two injuries occurred involving protectors with plastic in front of the eye. Players who wear prescription lenses are particularly at risk during play, because the glasses cannot withstand balls and rackets traveling at speeds of up to 127 mph.
A Canadian survey of 450 amateur athletes with injuries found that nearly half waited five days or longer before seeing a physician.
A comparison of injury between boys and girls in eight similar sports showed that there was no difference in overall or individual injury rates. The girls had a significantly greater number of knee injuries and significantly more loss of time because of ankle injury. Although these differences existed, the girls did not show any general increase in joint injury or any increase in severity of knee or other joint injury.
Using a survey questionnaire design, we investigated the incidence, site, and nature of jogging injuries among all participants of a popular 16 km race. The response rate was 83.6%. Of 4,358 male joggers, 45.8% had sustained jogging injuries during the 1 year study period, 14.2% had required medical care, and 2.3% had missed work because of jogging injuries. Occur rence of jogging injuries was independently associated with higher weekly mileage (P < 0.001), history of previous running injuries (P < 0.001), and competitive training motivation (P = 0.03). Higher mileage was also associated with more frequent medical consultations due entirely to jogging-related injuries. In 33 to 44 year olds (N = 1,757), the number of years of running was inversely related to incidence of injuries (P = 0.02). Injuries were not significantly related to race running speed, training surface, characteristics of running shoes, or relative weight. Achillodynia and calf muscle symptoms were the two most common overuse injuries and occurred significantly more often among older run ners with increased weekly mileage. We conclude that jogging injuries are frequent, that the number of firmly established etiologic factors is low, and that, in recom mending jogging, moderation should be the watchword.
In den letzten drei Skisaisons haben wir in unserer Klinik insgesamt 105 Kinder stationär wegen Schädel-Hirnverletzungen nach Skiunfällen betreut.
25 Fälle (25,2%) davon wurden operiert, dies zumeist wegen einer Impressionsfraktur (92%) mit oder ohne Hirnläsion/-Blutung, welche sich die Kinder durch Kollision mit verschiedenen Hindernissen zugezogen hatten. Unkontrollierte überhöhte Geschwindigkeit und unvorsichtige Fahrweise sind zumeist Ursache dieser Verletzungen. Die Verantwortung jedoch für die zunehmende Zahl von skisportbedingten Schädel-Hirnverletzungen liegt nicht bei diesen Kindern selbst, sondern bei uns Erwachsenen, d. h. bei Eltern, Lehrern und Ärzten, solange wir nicht energisch gezielte indirekte und direkte Verhütungsmaßnahmen dagegen propagieren und auch durchsetzen.
Nach einer Analyse der typischen Verletzungsarten und ihrer vielfältigen Ursachen kommen wir zum Schluß, daß neben den üblichen Vorsichtsmaßnahmen nur eine einfache, sinnvolle und wirksame Prophylaxe der Schädel-Hirntraumata denkbar ist, der ,,Schutzhelm". Ähnlich dem Helmobligatorium für Motorradfahrer und gleich wie fur Skirennfahrer, denen sich die Kinder zunehmend in Fahrweise und Geschwindigkeit angleichen, dringen wir ernsthaft auf ein allgemeines Obligatorium des Schutzhelmes bei kindlichen Skifahrern bis 17 Jahre.
This overview of the epidemiology of running injuries, which focuses on running injuries in adult recreational and competitive athletes, analyzes the benchmark "numerator studies," those rich in clinical detail but lacking control groups, as well as the salient "denominator studies," those employing control groups of non injured runners. It concludes that most running injuries seem to stem from a complex interplay that may include: (1) training errors, (2) anatomic factors, (3) shoes and surfaces, (4) prior injuries, (5) hormonal milieu, and (6) psychologic makeup.
A consecutive series of 65 fractures, dislocations, and ligament tears produced by roller skating accidents treated by the Orthopaedic Department of the Mt. Sinai Services at City Hospital Center of Elmhurst, New York, is reviewed. It was learned that the injuries resulting from collisions occurring in a skating rink were more serious than those resulting from street accidents. Data indicated that lack of expertise is a prominent factor in the production of serious injury. However, the sport has inherent risk which is not eliminated by expertise.
It was concluded that roller skating can and does produce disabling injuries. In order to reduce the number of injuries it will be required to reduce crowding in rinks, designate separate beginners' areas, use training wheels or clampon-type of skates when learning, encourage lessons, and separate beginners in the rinks.
(C) Williams & Wilkins 1984. All Rights Reserved.
Seit zehn Jahren werden die alpinen Skiunflle der Region Davos-Klosters statistisch verfolgt und auf mgliche Unfallprophylaxe analysiert. Das Unfallrisiko ist vor allem fr immobilisierende Verletzungen der unteren Extremitt drastisch zurckgegangen. Es zeigt sich jedoch gleichzeitig eine Verlagerung des Verletzungsmusters zur oberen Extremitt. Die Entwicklung des Schweregrades ist aufgrund verschiedener Kriterien eindeutig rcklufig. Zur weiteren Unfallverhtung mssen in Zukunft vor allem eine Verminderung der Sturzhufigkeit und der Sturzintensitt angestrebt werden.The alpine ski accidents have been studied for the last ten years in the Region of Davos-Klosters, Switzerland. Possibilities of prevention were analyzed. The accident risk has drastically decreased for immobilizing injuries of the lower extremities. Simultaneously, however, the pattern of injuries moved to the upper extremities. The accidents became, according to several criteria, less severe. Future preventive measures should be aimed primarily at reducing fall frequency and intensity.Depuis dix ans nous examinons et analysons les accidents de ski alpin de la rgion Davos-Klosters en vue d'une diminution des accidents. Les risques de blessures des extrmits infrieures sont en nette diminution; en mme temps, les blessures se situent plus vers le haut. L'intensit relve de plusieurs critres. Afin d'viter l'avenir des accidents plus graves, c'est vers une diminution des chutes (frquence et intensit) que doivent se porter nos recherches.
In North America, estimates of recreational runners have grown from two million in 1970 to 30 million in 1979. In Canada increased interest in running has been sparked by Participaction. Habituation to running is attributed to a sense of wellbeing and increased energy levels, as well as the possibility of reducing the threat of cardiovascular disease. Musculoskeletal injury is common to runners and can be prevented by carefully planned training programs, proper selection of training surface, regular stretching and strength drills, the use of protective footwear and balancing of vulnerable biomechanical alignments with functional orthotics in shoes.
A statistical collection of squash injuries in 8000 players from 30 squash centers in the Federal Republic of Germany over a 12 months period is presented and evaluated. The comparison with other types of sport shows squash to be sooner likely to cause injuries than tennis, but to entail essentially less injuries than e.g. football or handball. With a view to prevention, certain demands must be made on the player as regards his manner of playing and equipment, but also as regards the ground conditions of squash halls.
The National Football Head and Neck Injury Registry has documented 1,129 injuries since 1971 that involved hospitalization for more than 72 hours, surgical intervention, fracture-dislocation, permanent paralysis, or death. Of this group of injuries, 550 were fracture-dislocations of the cervical spine, of which 176 were associated with permanent quadriplegia. It appears that during the last two decades, there has been a decrease in the incidence of direct fatalities, head injuries associated with intracranial hemorrhage, and injuries associated with death. Conversely, cervical spine injuries with fracture-dislocation and with permanent quadriplegia have increased. We believe that these observations are the result of the development of a protective helmet-face mask system that has effectively protected the head, and by so doing has allowed it to be used as a battering ram in tackling and blocking techniques, thus placing the cervical spine at risk of injury.
Full textFull text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (429K), or click on a page image below to browse page by page.
173
174
175
A prospective study of orthopaedic injuries to children (ages 6 to 17) was conducted for a calendar year in the controlled environment of a military post. Data were collected on the number of participants, the hours of participation, and the number of injuries for six supervised sports (football, soccer, basketball, baseball, swimming, and gymnastics). An injury index factor was derived by a formula: (number of injuries x 10(4)) divided by [(number of participants) x (average number of hours of participation) x (number of weeks in the season of the sport)]. When the injury index factors were compared, the risk a participant has for sustaining an injury in football was twice as high (1.72) as its nearest competitors, basketball (0.88) and gymnastics (0.85). Soccer had an index factor of 0.29; baseball, 0.14; and swimming had a factor of zero. Eighty percent of all sports-related orthopaedic injuries involved the upper extremities. Lower extremity orthopaedic injuries occurred only in football and gymnastics. The evidence suggests that those persons concerned with reducing the number of injuries to the growing athlete in supervised sports should focus their attention on reducing the risk of injury to the upper extremities.
A one year prospective study of equestrian injuries was carried out in an area where horse riding is a popular pursuit. 115 persons suffered injury--eighty females and thirty-five males of whom sixty were under fifteen years of age. No fatalities were recorded and there were 0.2 injuries per 100 rides. Most injuries were minor and to the musculo-skeletal system. Visceral and cerebral injuries were not common but the former were life threatening in all cases. It is concluded that young riders should be supervised.
When players are engaged in the sport of tennis, injuries may occur to the eyes, in the neck, to the shoulder and back, arm and elbow, wrist and hand, and feet. The key to prevention and treatment of these injuries is good coaching and a formal stretching and strengthening program.
The drooped "tennis shoulder" of professionals and senior tennis players is a natural response to heavy use. Shoulder elevating exercises are useful when soreness is associated. The treatment of tennis elbow includes wrist extensor stretching, isometrics, and light weightlifting. When a player follows this program, injections or counterforce braces are rarely needed. It is important for the player to bring his racket to the exami nation so that his stroke mechanics and grip can be checked. Wrist soreness in a tennis player may denote a hamate hook fracture. Special radiographic views are needed to discern the fracture and it is treated with a short arm cast and little finger extension splint. Nonunion of a hamate hook requires excision. The calf pain prodrome of "tennis leg" requires rest and then a stretching program. Tennis shoes should have rolled heels and large toe boxes with reinforced toe bumpers. The physician may have to fashion soft inserts for the tennis shoes; arch supports may be insufficient.
When a person dies of cardiovascular causes during recreational running, the public frequently assumes the exercise caused the death. For a statistical perspective, the number of cardiovascular deaths while running that occurs by chance alone is estimated. If white male runners resemble marathoners, being nonsmokers and at lowest lean weight, four deaths from cardiovascular disease would occur per year while running 20 minutes, three times per week and 30 deaths per year if the two hours after running are considered as a running-associated period. However, if runners resemble the white male population, then 15 deaths would occur from cardiovascular disease per year while running and 104 during the associated period. Thus, four to 104 cardiovascular deaths per year are predicted on a purely temporal basis in white men while running.
The multifaceted problem of what caused athletic injuries has only rarely been studied from a psychological point of view. Studies critiqued in this paper reveal grave methodological errors which detract from the significance of the data generated. Little attempt has been made to control environmental and physical variables which surely play a significant role in the incurring of athletic injuries. The psychological makeup of an athlete is only one of ten significant facrots listed in this article which combine to cause an athletic injury. Most studies dealing with the psychological factors involved in an injury pay scnat attention to such factors as environmental conditions, exposure time to hazard, physical condition of the victim, and so on. This paper examines previous literature dealing with psychosocial factors involved in athletic injuries and proposes a unique research design which tries to avoid the pitfalls involved in previous injury research. Beginning with a group of same aged, similarly conditioned college athletes, a highly controlled study is proposed which follows the athletes from their first involvement with a college sports team through the inevitable injuries which some members of each team seem in incur at rates higher than those of their teammates. If appropriate psychological measures are obtained of data collection, a well-controlled prospective study can be carried out and statistically significant data can be obtained.
Studies on the incidence of sports injuries are an integral part of sports medicine. A survey of three sports medicine journals showed a paucity of information in this area. In view of the need for well designed studies, a series of guidelines for studies is presented.
Recreational sports injuries are expensive to society. Prevention of such injuries must be a major public health goal.
In a previous retrospective study, base sliding was found to be responsible for 71 % of recreational softball injuries. Because most injuries occurred during rapid deceleration against stationary bases, quick-release (break-away) bases were evaluated as a means to modify this mechanism of injury. In a prospective study, 633 softball games were played on break-away base fields and 627 games were played on stationary base fields. Forty-five sliding injuries occurred on the station ary base diamonds (1 injury for every 13.9 games) and only two sliding injuries occurred on the break-away fields (1 injury for every 316.5 games). The medical costs for injuries on the stationary base fields was 79 times greater than that on the break-away fields. In a 1035 game follow-up study performed on all fields equipped with break-away bases, two sliding injuries occurred (1 injury for every 517.5 games).
Installing break-away bases in fields used by recrea tional leagues would achieve a significant reduction of serious softball injuries (98%) and, therefore, should be mandatory.
Based on our findings, the Centers for Disease Con trol has estimated 1.7 million injuries would be pre vented nationally per year, saving $2.0 billion per year nationally in acute medical care costs.
Epidemiological reports of sports injury confirm a high incidence of injuries occurring at all levels of sport participation, ranging in severity from cuts and bruises to spinal cord injury. The psychosocial dynamics accompanying sport injury should be known to ensure psychological recovery, an important aspect in rehabilitating the injured athlete. Earlier studies demonstrating psychological differences between athletes and nonathletes indicated the need for actual research on the athlete's postinjury response in lieu of accepting the hypothesis that the emotional responses of athletes to injury parallels existing (i.e. terminally ill) 'loss of health models'. Recent research has shown that injured athletes experience simultaneous mood disturbance and lowered self-esteem. Due to a paucity of research on the coping methods of injured athletes, studies involving the coping methods of several nonathletic patient populations were reviewed. These patients benefitted primarily from a concrete, problem-focused, behaviourally orientated programme which minimises uncertainty. This approach is theoretically ideal for injured athletes, congruent with the goal setting and performance outcome emphasis common to exercise and sport training programmes but to date the effectiveness of these strategies for injured athletes have not been fully examined. Therefore, until such research is available, these coping strategies (also used for performance enhancement) are provided as therapeutic guidelines for dealing with the emotional distress experienced by injured athletes. Individual responses of injured athletes varied from those who took injury in stride to those who required psychiatric intervention. This marked individual variation in response underscores the importance of neither assuming mood disturbance nor overlooking a serious emotional response in the injured athlete. Awareness of the emotional responses of athletes to injury and employment of appropriate coping strategies should facilitate optimal rehabilitation and return to sport.
Injuries sustained during competitive sport activities are accepted as an inherent part of the game. While it may be true that the associated risk of participating in certain sports increases the chance of becoming hurt, it is safe to assume many injuries can be avoided if preventive medicine is practiced. Conditioning and strength training go a long way in protecting the athlete from possible harm, but in some cases this is not enough. The accumulated effect of psychological stressors (in and outside the athletic world) may cloud the mental functioning of the athlete and override physical conditioning enough to precipitate injury or prolong it. After extensive reviews of literature, it has been determined that a collective researched list of psychological risk factors can be recognized which may predispose an athlete (especially in a contact sport) to injury (real or imagined).
This investigation determined the accuracy of self-reports of physical activity compared to observations obtained surreptitiously. Subjects were 44 adults engaged in 1 h of their preferred physical activity while actual activity levels were surreptitiously obtained and compared to immediate self-reported estimates of physical activity. Results indicated that subjects were moderately accurate in recalling their physical activity levels (R = 0.62) but underestimated sedentary activities and overestimated aerobic activities by over 300%. Males overestimated their activity relative to females, and obese subjects underestimated their activity levels compared to normal-weight subjects. Finally, a number of two-way interactions that moderated the accuracy of those subjects engaging in high chronic levels of physical activity were observed.
A prospective study of acute injuries from sports and physical exercise was carried out during 1 year in a total population of a municipality with 31,620 inhabitants. The medical treatment and the services required for the injuries have been calculated and related to the total consumption of medical care in the municipality.
A total of 571 injuries (17% of all injuries) occurred in 28 different sports: 65% of the injured were males. Sports injuries accounted for 3% of all acute visits and there were altogethter 1,083 outpatient visits, which yields a mean of 1.9 visits per injury. Related to the total consumption of outpatient visits to the five clinics in the municipality sports injuries also accounted for 3%. Forty-four patients were hospitalized; the proportion of inpatient care due to sports injuries was 0.7% and the mean length of stay in hospital 3.9 days.
The total amount of sickleave compensated for sports injuries (3,477 days) was 1.2% of all days compensated in 1984.
The overall mean cost per injury was US$ 335. Individual sports (motorcycling, downhill skiing and equine sport) were by far the most costly in the Falköping survey, the dearest of the team sports ranking only fifth (handball followed by soccer).
• National estimates of the mortality, morbidity, and cost of childhood injuries are presented by specific causes. Motor vehicle–related inuries, homicide, and suicide are the leading causes of childhood injury deaths. Falls and sports-related injuries are the leading causes of hospitalizations and emergency department visits. We estimate that unintentional childhood injuries cost the nation $7.5 billion in 1982. The highest direct costs per year for unintentional injuries are attributable to falls, sports, and motor vehicle occupant injuries, while the highest indirect costs are related to motor vehicle occupant injuries, pedestrian injuries, and drowning. Injury accounts for 78% of the total fatalities among late adolescents (age 15 to 19 years), the pediatric age group at highest risk for injury mortality. A stronger federal and state commitment is needed to prevent childhood injury.
(AJDC. 1990;144:649-652)
Much of the research on the economic impact of fitness and sport programmes has been initiated with a view to cost containment, or the justification of specific exercise initiatives. Care must be taken when evaluating such reports to consider any resultant biasing of conclusions. Analyses should conform to sound scientific and economic principles, with cost-effectiveness measures generally being more appropriate than cost-benefit analyses. Critical issues of measurement include opportunity costs, marginal and intangible costs, discount and inflation rates, and programme participation rates. At the worksite, costs vary greatly with the scale of facilities and the level of programme supervision that are offered. Beyond a certain ceiling, further expenditures do not seem to enhance programme effectiveness. Likely benefits to a company include an improvement of corporate image, a recruitment of premium employees, gains in the quality and the quantity of production, a decrease of absenteeism and turnover, lower medical costs, an improvement of personal lifestyle (with a potential for future health savings), and a reduced incidence of industrial injuries. Community exercise programmes have the advantage of reaching certain target groups not serviced at the worksite, for instance the unemployed, women with young children and the elderly. Possible benefits of exercise participation arising in such groups included a reduced demand for medical services, an extended lifespan, and a reduction of disability in the final years of life. While current evidence has many limitations, it does suggest that exercise (particularly in the context of more general health promotion) is both cost-effective and cost-beneficial; the immediate return may be as much as 5 per dollar invested.
In general, children and youth sports are safe. The great majority of injuries which are sustained are minor and self-limiting. Fortunately, catastrophic acute injuries such as paraplegia, quadriplegia and major limb insults are rare. The 2 mechanisms of injuries at these age groups are acute traumatic insults and unresolved sequelae of repetitive microtrauma. The latter usually results from inappropriate training and coaching techniques.
In the United States, adolescents and children are becoming involved in sport at earlier ages and with higher levels of intensity and competition. Factors which lead to injury include the athlete and his/her own psychobiology, inappropriate equipment, the sports environment (playing surfaces, temperature), training and coaching errors, and parental influences. Preparticipation assessment usually reveals extremely healthy children with rare factors which contribute to non-sports participation. Preventative efforts must be made to provide these children with the appropriate equipment and coaching to limit the number of overuse injuries. Management of acute sports problems and rehabilitation of significant injuries are as important in childhood and youth sports as in those of their older sibs in order to prevent lifelong sequelae of musculoskeletal injury. The appropriate goal of children and youth sports must remain one of enjoyment with acquisition of sport-specific skills.
The review of the effects of artificial turf and natural grass on surface-related traumatic injuries in soccer suggests that surfaces with artificial turf produce more abrasion injuries than surfaces with natural grass. Most authors report no significant difference in injury frequencies for the number of traumatic injuries. However, some authors report fewer traumatic injuries on artificial turf especially after a period of adaptation on the artificial turf A difference in injury pattern and injury mechanism when playing on different types of surfaces has been suggested, as well as an increased injury risk for frequent alternating between different playing surfaces.
The relationship between knee and ankle injuries and the fixation of the foot to the ground is not yet evaluated in soccer. In American football, the severity and incidence of knee and ankle injuries were reported to be significantly lower when using shoes with lower friction properties. However, in American football severe injuries typically occur in collision situations often independent of the surface. Soccer is characterised by sprinting, stopping, cutting and pivoting situations, where shoe-surface relations are essential and frictional resistance must be within an optimal range. Future research should address this compromise between performance and protection.
A prospective study of injuries affecting 50 highly competitive young female gymnasts was conducted over a period of 1 year. Many of the findings of this investigation were consistent with previous studies and suggest particular injury trends in women's gymnastics. These results included injury location, injury severity, nature of onset, event, and activity at the time of injury. Some of the descriptive results, however, provided information that was heretofore unreported or inconsistent with previous investigations. These findings involved injury rate, reinjury rate, time loss, injury type, hours of practice, and incidence of physician-seen injuries. Some of these findings were disturbing and echo concerns registered in the professional literature. In particular, the reinjury rate is alarming and points to the need for complete rehabilitation before return to full participation. The results of the analytic component of the study alluded to the potential role of competitive level and maturation rate in the profile of the injury-prone gymnast. Specifically, rapid periods of growth and advanced levels of training and competition appeared to be related to injury proneness. Pursuant to the descriptive and analytic results of the investigation, recommendations for injury prevention and continued research are made.
This prospective study of 583 habitual runners used baseline information to examine the relationship of several suspected risk factors to the occurrence of running-related injuries of the lower extremities that were severe enough to affect running habits, cause a visit to a health professional, or require use of medication. During the 12-month follow-up period, 252 men (52%) and 48 women (49%) reported at least one such injury. The multiple logistic regression results identified that running 64.0 km (40 miles) or more per week was the most important predictor of injury for men during the follow-up period (odds ratio = 2.9). Risk also was associated with having had a previous injury in the past year (odds ratio = 2.7) and with having been a runner for less than 3 years (odds ratio = 2.2). These results suggest that the incidence of lower-extremity injuries is high for habitual runners, and that for those new to running or those who have been previously injured, reducing weekly distance is a reasonable preventive behavior.
A cohort of 1680 runners was enrolled through two community road race events and monitored during a 12-month follow-up period for the occurrence of musculoskeletal injuries. Forty-eight percent of the runners experienced at least one injury, and 54% of these injuries were new; the remainder were recurrences of previous injuries. The risk of injury was associated with increased running mileage but was relatively unassociated with other aspects of training, such as usual pace, usual running surface, hill running, or intense training. Injury rates were equal for all age-sex groups and were independent of years of running experience. Runners injured in the previous year had approximately a 50% higher risk for a new injury during follow-up.
We report the attempt to set up a mini sports medicine clinic in a health centre resourced by a Department of Community Medicine. The type of problems seen are similar to those reported by other clinics. On the results of this pilot project, we believe it would be possible to establish similar clinics in health centres elsewhere in the United Kingdom. The National Health Service resources required are minimal, but the benefits to local communities are considerable.
A prospective study of acute injuries from sports and physical exercise was carried out during 1 year in a total population of a municipality with 31,620 inhabitants. Data on exposure were collected : the number of participants in each sport, the hours of participation, and number of weeks in the season per year. The number of injuries was used as numerator and the exposure data as denominator in a formula modified from Chambers for the calculation of population at risk in sports.
A total of 571 injuries occurred in 28 different sports: 65% of the injured were males. The majority of the injuries were from soccer: 50% of the males and 27% of the females. Incidence rates in 17 sports are presented. The ranking order differs, when calculating not only the number, but also the exposure. Ice hockey and handball were then found to have the highest risk followed by soccer. Team and contact sports on the whole had the highest rates in both genders. As a group, intercompany players had the highest rate, especially in soccer. The lowest rates were found in individual sports such as downhill skiing, horseback riding, racket sports, and running. Gymnastics, except in school physical education, had no injuries at all.
Sprains and strains were diagnosed in nearly half of the cases and the foot and ankle were the most frequent sites. Preventive measures are proposed.
From 1981 to 1985 193,611 jumps were made by sport parachutists in the Netherlands. Of these 267 (0.14%) resulted in injuries including 4 fatalities. In this report the different types of injuries and their causes are discussed and comments are given in relation to training, selection, precautions and equipment, as well as upon accident registration and possible modifications.
Most studies reporting on sports injuries have been investigations of specific types and locations in specific sports events and levels. This study aims at outlining the features of sports injuries in general regardless of type, severity, or treatment during 1 year among the adult population of the Greater Helsinki area (pop. 600,000). This study was carried out in cooperation with the Central Statistical Office, which in 1980 performed a nationwide survey aimed at outlining the incidence and features of accidents occurring in Finland. The actual data from this study concerning sports injuries in the Greater Helsinki area was broken down and further analyzed. During the actual time period under investigation, an estimated 40,380 acute sports injuries occurred in the area. Based on this estimate, the calculated occurrence of sports injuries was found to be 670 +/- 121/10,000 inhabitants. Sports injuries were found mainly among young people in their productive working years, though surprisingly low was the occurrence of injuries among women of 20-24 years of age. The majority of the injuries were of mild character, though 9% were classified as severe, and it was estimated on the basis of the data obtained from this study that some 4000 patients attended a casualty department in the area because of an injury sustained in sports, thus placing a considerable burden on these agencies. Distorsions formed with 65% the most common type of injury, and the application of an adhesive bandage was the commonest form of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Using a survey questionnaire design, we investigated the incidence, site, and nature of jogging injuries among all participants of a popular 16 km race. The response rate was 83.6%. Of 4,358 male joggers, 45.8% had sustained jogging injuries during the 1 year study period, 14.2% had required medical care, and 2.3% had missed work because of jogging injuries. Occurrence of jogging injuries was independently associated with higher weekly mileage (P less than 0.001), history of previous running injuries (P less than 0.001), and competitive training motivation (P = 0.03). Higher mileage was also associated with more frequent medical consultations due entirely to jogging-related injuries. In 33 to 44 year olds (N = 1,757), the number of years of running was inversely related to incidence of injuries (P = 0.02). Injuries were not significantly related to race running speed, training surface, characteristics of running shoes, or relative weight. Achillodynia and calf muscle symptoms were the two most common overuse injuries and occurred significantly more often among older runners with increased weekly mileage. We conclude that jogging injuries are frequent, that the number of firmly established etiologic factors is low, and that, in recommending jogging, moderation should be the watchword.
Sixty runners belonging to two clubs were followed for 1 year with regard to training and injury. There were 55 injuries in 39 athletes. The injury rate per 1,000 hours of training was 2.5 in long-distance/marathon runners and 5.6 to 5.8 in sprinters and middle-distance runners. There were significant differences in the injury rate in different periods of the 12 month study, the highest rates occurring in spring and summer. In marathon runners there was a significant correlation between the injury rate during any 1 month and the distance covered during the preceding month (r = 0.59). In a retrospective analysis of the cause of injury, a training error alone or in combination with other factors was the most common injury-provoking factor (72%). The injury pattern varied among the three groups of runners: hamstring strain and tendinitis were most common in sprinters, backache and hip problems were most common in middle-distance runners, and foot problems were most common in marathon runners.