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Epidemiology of Sporting Injuries
Abstract
There is an increasing awareness of the importance of both recreational and professional sporting endeavors as most societies are well aware of the health benefits of exercise. This interest has spawned multiple industries for the production of sporting goods, entertainment, and an entire medical specialty devoted to specific injury resulting from sport. Intrinsic to the system which deals with these injuries is an awareness of the risk and cost involved in time lost due to injury. The epidemiology of these injuries has therefore become critical as strategies are implemented to minimize these risks.
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Context:
The incidence of injury for elite youth and professional adult soccer players is an important concern, but the risk factors for these groups are different.
Objective:
To summarize and compare the injury incidences and injury characteristics of male professional adult and elite youth soccer players.
Data sources:
We searched MEDLINE and Web of Science using the search terms elite, international, European, soccer, football, injury, injuries, epidemiology, incidence, prevalence, not female, not American football, and not rugby. We also used the search terms professional for studies on professional adult soccer players and high-level, soccer academy, youth, adolescent, and young for studies on elite youth soccer players.
Study selection:
Eligible studies were published in English, had a prospective cohort design, and had a minimum study period of 6 months. To ensure that injury data were assessed in relationship to the athlete's individual exposure, we included only studies that reported on injuries and documented exposure volume.
Data extraction:
Two independent reviewers applied the selection criteria and assessed the quality of the studies.
Data synthesis:
A total of 676 studies were retrieved from the literature search. Eighteen articles met the inclusion criteria: 6 for elite youth and 12 for professional adult soccer players.
Conclusions:
Injury rates were higher for matches than for training for both youth and adult players. Youth players had a higher incidence of training injuries than professionals. Efforts must be made to reduce the overall injury rate in matches. Therefore, preventive interventions, such as adequately enforcing rules and focusing on fair play, must be analyzed and developed to reduce match-related injury incidences. Reducing training injuries should be a particular focus for youth soccer players.
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Background:
The risk of all-cause injury and concussion associated with football is significant. The National Football League (NFL) has implemented changes to increase player safety warranting investigation into the incidence and patterns of injury.
Purpose:
To document the incidence and patterns of all-cause injury and concussions in the NFL.
Study design:
Descriptive epidemiology study.
Methods:
Injury data were collected prospectively from official NFL injury reports over 2 regular seasons from 2012 to 2014, with identification of injury incidence rates and patterns. Concussion rate ratios were calculated using previously reported NFL rates.
Results:
A total of 4284 injuries were identified, including 301 concussions. The all-cause injury rate was 395.8 per 1000 athletes at risk (AAR) and concussion incidence was 27.8 per 1000 AAR. Only 2.3% of team games were injury free. Wide receivers, tight ends, and defensive backs had the highest incidence of injury and concussion. Concussion incidence was 1.61-fold higher in 2012 to 2014 compared with 2002 to 2007. The knee was injured most frequently, followed by the ankle, hamstring, shoulder, and head.
Conclusion:
The incidence of all-cause injury and concussion in the NFL is significant. Concussion injury rates are higher than previous reports, potentially reflecting an improvement in recognition and awareness. Injury prevention efforts should continue to reduce the prevalence of injury associated with football.
To study the injury characteristics in professional football and to follow the variation of injury incidence during a match, during a season and over consecutive seasons.
Prospective cohort study where teams were followed for seven consecutive seasons. Team medical staff recorded individual player exposure and time-loss injuries from 2001 to 2008.
European professional men's football.
The first team squads of 23 teams selected by the Union of European Football Associations as belonging to the 50 best European teams.
Injury incidence.
4483 injuries occurred during 566 000 h of exposure, giving an injury incidence of 8.0 injuries/1000 h. The injury incidence during matches was higher than in training (27.5 vs 4.1, p<0.0001). A player sustained on average 2.0 injuries per season, and a team with typically 25 players can thus expect about 50 injuries each season. The single most common injury subtype was thigh strain, representing 17% of all injuries. Re-injuries constituted 12% of all injuries, and they caused longer absences than non re-injuries (24 vs 18 days, p<0.0001). The incidence of match injuries showed an increasing injury tendency over time in both the first and second halves (p<0.0001). Traumatic injuries and hamstring strains were more frequent during the competitive season, while overuse injuries were common during the preseason. Training and match injury incidences were stable over the period with no significant differences between seasons.
The training and match injury incidences were stable over seven seasons. The risk of injury increased with time in each half of matches.
Increasing injury incidences prove the
importance of injury prevention in football.
The aim of this review was to summarise
the recent evidence on the epidemiology
and inciting events of acute injuries within
subgroups (performance level, age and
sex). A systematic literature search was
conducted in the databases PubMed, CINAHL,
Embase, Cochrane, PEDro, and SPORTDiscus
for articles published from 1 January 2014
until 15 October 2017. The search yielded
4690 results. After the initial screening of
titles and abstracts, 182 studies underwent
detailed full-text screening according to
the inclusion and exclusion criteria. Finally,
53 studies were included. Of these, 46 papers
contained epidemiological data, with a total
of approximately 41,212 observed player
seasons and 11 further tournaments, including
7122.5 observedmatches with approximately
126,748.5 player hours. A total of 30,844
injuries were identified. The overall injury
incidence ranged from 0.6 to 20.3 injuries per
1000 h of exposure. The locations at highest
risk of injury were the lower limbs, particularly
the thighs, knees and ankles. Injuryinciting
events were reported in 12 studies,
involving a total of 8035 injuries. Of these
12 studies, 5 considered all body locations,
3 concentrated on anterior cruciate ligament
injuries, 1 reported on general head injuries,
2 reported on concussions, and 1 reported
on midfacial trauma only. One of the main
findings of this review was that playing
football does not necessarily imply a high risk
of injury. Promising preventive approaches
are being used to revise implementation
strategies of evident training programmes
and management of individual workloads.
Background There are limited data on hamstring injury rates over time in football.
Aim To analyse time trends in hamstring injury rates in male professional footballers over 13 consecutive seasons and to distinguish the relative contribution of training and match injuries.
Methods 36 clubs from 12 European countries were followed between 2001 and 2014. Team medical staff recorded individual player exposure and time-loss injuries. Injuries per 1000 h were compared as a rate ratio (RR) with 95% CI. Injury burden was the number of lay off days per 1000 h. Seasonal trend for injury was analysed using linear regression.
Results A total of 1614 hamstring injuries were recorded; 22% of players sustained at least one hamstring injury during a season. The overall hamstring injury rate over the 13-year period was 1.20 injuries per 1000 h; the match injury rate (4.77) being 9 times higher than the training injury rate (0.51; RR 9.4; 95% CI 8.5 to 10.4). The time-trend analysis showed an annual average 2.3% year on year increase in the total hamstring injury rate over the 13-year period (R2=0.431, b=0.023, 95% CI 0.006 to 0.041, p=0.015). This increase over time was most pronounced for training injuries—these increased by 4.0% per year (R2=0.450, b=0.040, 95% CI 0.011 to 0.070, p=0.012). The average hamstring injury burden was 19.7 days per 1000 h (annual average increase 4.1%) (R2=0.437, b=0.041, 95% CI 0.010 to 0.072, p=0.014).
Conclusions Training-related hamstring injury rates have increased substantially since 2001 but match-related injury rates have remained stable. The challenge is for clubs to reduce training-related hamstring injury rates without impairing match performance.
To describe the trends in recreational sports injury in Perth, Western Australia.
A prospective cohort study of sports injuries during the 1997 winter season (May to September).
Sample of Australian football, field hockey, basketball, and netball players from the Perth metropolitan area, Western Australia.
A cohort of sports participants was followed over the five month winter sports season. Before the season, participants completed a baseline questionnaire and during the season were interviewed every four weeks by telephone.
Overall, 92% of participants (n = 1391) who completed a baseline questionnaire completed at least one follow up telephone interview. About half (51%) of the cohort sustained one or more injuries during the winter season accounting for a total of 1034 injuries. Most injuries were of moderate (58%, n = 598) or minor (40%, n = 412) severity, with only 3% (n = 24) requiring emergency department treatment or a hospital stay. The injury incidence rate was greatest for football (20.3/1000 hours of participation), similar for field hockey and basketball (15.2/1000 hours and 15.1/1000 hours respectively), and lowest for netball (12.1/1000 hours). The incidence of injury was greatest in the first four weeks of the season, and participants aged between 26 and 30 years had about a 55% greater risk of injury than those aged less than 18 years.
This is one of the first studies to show that recreational sports are safe. Although the likelihood of injury was greatest in the first month of the season, few injuries required admission to hospital or emergency department treatment. A greater emphasis on prevention in the early part of the season should help to reduce the elevated incidence of injury found at this time.
To provide a critical review of the available literature on the descriptive epidemiology of pediatric sport-related injuries.
MEDLINE (1966 to 2006) and SPORTDiscus (1975 to 2006) were searched to identify potentially relevant articles. A combination of medical subject headings and text words was used (epidemiology, children, adolescents, athletic injuries, sports, injury, and injuries). Additional references from the bibliographies of retrieved articles were also reviewed.
Published research reports on the incidence and distribution of injury in children's and youth sports. Specific emphasis was placed on reviewing original studies, which report incidence rates (rate of injuries per unit athlete time). Forty-nine studies were selected for this review.
Data summarized include incidence of injury relative to who is affected by injury (sport, participation level, gender, and player position), where injury occurs (anatomical and environmental location), when injury occurs (injury onset and chronometry), and injury outcome (injury type, time loss, clinical outcome, and economic cost).
There is little epidemiological data on injuries for some pediatric sports. Many of the studies retrieved were characterized by methodological short-comings and study differences that limit interpretation and comparison of findings across studies. Notwithstanding, the studies reviewed are encouraging and injury patterns that should be studied further with more rigorous study designs to confirm original findings and to probe causes of injury and the effectiveness of preventive measures.
Incidence and severity of injury are high in some child and youth sports. This review will assist in targeting the relevant groups and in designing future research on the epidemiology of pediatric sports injuries. Well-designed descriptive and analytical studies are needed to identify the public health impact of pediatric sport injury.
Epidemiology of sports injuries and illnesses
- D Palmer-Green
- G Whyte
- M Loosemore
- C Williams