Search

Methods: Fifty-four male athletes from two different teams were involved. Accidents and injuries were recorded immediately after the incident by a team physician present at every race. Exposure, location, type and cause of injury have been recorded. Incidence was calculated. Severity was measured as a cumulative severity score and burden depicted in a risk matrix., Results: Total time of exposure was 12537 hours over 3524 athlete days and 544002 kilometers of racing. 98 accidents were recorded, with 83 leading to injury. The total number of recorded injuries was 193. Injury incidence for all injuries was 54,8 (±SD 47,7-62,8) /1000 athlete days, 15,4 (±SD 13,4-17,7) /1000 athlete hours and 35,5 (±SD 30,8-40,8) /100.000 km raced. By far the most frequent types of injury were hematomas, contusions and bruising (n = 141, 73%) followed by lacerations (n = 22; 11,4%). Most injuries affected the arm and elbow (n = 34, 17,6%) followed by the shoulder and clavicle (n = 28, 14,5%) and occurred with contact (79%). Fractures pose a high injury burden due to long time loss, whereas hematomas, contusions and bruising showed the highest incidence numbers but comparably less time loss., Conclusion: Road cyclists' injuries have been underestimated in previous studies. Hematomas, contusions and bruising pose the highest number of injuries with a broad degree of severity and range of injury burden. Fractures are less common but show the highest injury burden. The upper extremities are involved the most.

Purpose: The purpose of this study was to provide a novel report on the head and neck injuries from the sport of wrestling and their characteristics in the USA., Materials and Methods: This is a 20-year retrospective cross-sectional study conducted using the National Electronic Injury Surveillance System (NEISS). Reports were included in the analysis if the injury stemmed from combat with another person. The predictor variables were obtained from both patient and injury characteristics. The principal outcome variable was admission rate, which was used to proxy the severity of the injury at hand. Bivariate analysis (i.e., chi-square and independent sample tests) was used to determine if an association existed between two variables of interest., Results: The final sample in our study consisted of 4485 cases of craniomaxillofacial injuries secondary to wrestling. The increase in injuries from the year 2000 to 2019 was significant (P < 0.05). The average age of patients was 15.73 (range: 3 to 59 years old). Virtually all of the injuries occurred in males (95.6%). The majority of patients was under the age of 18 (82.3%). With regard to race, white wrestlers (57.1%) comprised the majority of patients. Insight into race was not available for 1245 patients (27.8%). Most wrestling-related injuries took place during the winter season (60.6%). Concussion was the most common primary diagnosis (29.0%). The head (57.1%) was the most commonly injured craniomaxillofacial region. The most common setting in which the injury took place was a place of recreation/sports (49.9%). Among the mechanisms of injuries, the take-down (26.5%) was the most common. Patients who were thrown/taken down (5.04%) were significantly more likely to get admitted (P < 0.01) relative to patients who were injured otherwise (2.6%). Similarly, patients who fell/tripped (6.6%) were significantly more likely to get admitted (P < 0.05) relative to patients who were injured otherwise (3.1%). While cases of concussion (6.0%) were significantly more likely to get admitted (P < 0.01) relative to other cases, cases of contusions/abrasions (0.6%) were significantly less likely to get admitted (P < 0.01) relative to other cases. Similar to contusions/abrasions (0.2%), lacerations were significantly less likely to get admitted (P < 0.01) relative to other cases. Patients aged 12-18 (P < 0.01) were most likely to suffer concussions, whereas patients aged 19-34 (P < 0.01) were least likely to suffer concussions. In contrast to concussions, patients aged 12-18 (P < 0.01) were least likely to suffer lacerations, whereas patients aged 19-34 (P < 0.01) were most likely to suffer lacerations. Patients aged 6-11 (P < 0.01) were most likely to be thrown/taken-down whereas patients aged 19-34 (P < 0.01) were least likely to be thrown. Patients aged 19-34 (P < 0.01) were most likely to be collided against intentionally, while patients aged 6-11 (P < 0.01) were least likely to be collided against intentionally. Patients aged 34 years or older were most likely to fall/trip, while patients aged 12-18 (P < 0.01) were least likely to fall/trip., Conclusions: Certain types of injuries that occur during wrestling are more or less common depending on the age groups involved in the sport. Concussions were the most common injury incurred overall, and the head is the most commonly affected craniomaxillofacial area. Take-downs were the most likely mechanism of injury to lead to hospital admissions. The average number of wrestling injuries increased over 20 years being analyzed in this study. Future studies should investigate methods to lessen concussions in wrestling, decrease the number of illegal moves performed, and look into ways to mitigate harm from take-downs, given the increasing number of injuries acquired from this sport., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: The aim of this study was to investigate the incidence and characteristics of match and training injuries in elite-level national male beach soccer players., Method: The incidence, mechanism, location, type, severity, and burden of injuries of the Turkish national beach soccer team were recorded between 2017 and 2019., Results: A total of 136 injuries occurred during the study period. Total injury incidence was 238.9 injuries/1,000 match hours (MHs) and 37.7 injuries/1,000 training hours (THs) (p < 0.001). Twenty-seven injuries led to time-loss, and the incidences for match and training injuries were 36.7 and 7.9 per 1,000 hours, respectively. Of medical attention injuries (MAI) caused by trauma, 54.6% (n = 53) were due to another player and, 60.9% (n = 14) of time-loss injuries (TLI) caused by trauma were due to non-contact trauma (p < 0.001). While 82% (n = 91) of training injuries occurred in lower extremities, 29% (n = 9) of match injuries occurred in the head/neck region (p < 0.001). Head injury incidence was 45.9 per 1,000 match hours. Of MAI, 50% (n = 57) were contusion, and 32.1% (n = 9) of TLI were strain (p < 0.001). Also, the most common injury subtype was foot/toe contusion during match and training (19.4%; n = 6, 27.9%; n = 31, respectively). The majority of injuries 91.9% (n = 125) had slight severity., Conclusion: Head trauma, tendon injury, and foot/toe contusion are important for clinical practice in beach soccer. Protective measures (rule regulation, use of protective equipment, etc.) should be considered to prevent these injuries.

Background: Video analysis is one of the most commonly applied methods for analysing football injuries., Purpose: The objective of this study was to assess the accuracy of video analysis for recording head injuries in professional football from official matches in the four highest men's professional football leagues in Germany., Methods: In this cohort study, head injuries detected by means of video analysis of all official matches over one season (2017-18) were compared to head injuries registered with the German statutory accident insurance., Results: Our video analysis yielded 359 head injuries of 287 players. The comparison of head injuries found in our video analysis to those registered with the accident insurance only yielded a match in 23.1% (n = 83), which presents a rather low verification rate. The verification rates varied between the leagues (7.0-30.8%). All injuries documented in the accident insurance registry were found in the video analysis (100%). The types of head injury most often verified by the accident insurance registry (n = 83) were contusion (43.4%), bone fractures (19.3%) and skin lacerations (18.1%). Only 66 of the 359 head injuries (18.4%) resulted in absence from at least one training session and involved a mean time loss of 18.5 days (1-87 days)., Conclusion: The mismatch between the number of head injuries found in the video analysis and head injuries registered with the accident insurance is an important methodological issue in scientific research. The low verification rate seems to be due to the unclear correlation between injury severity and clinical consequences of head injuries detected by means of video analysis and the failure of football clubs to register minor head injuries with the accident insurance., Competing Interests: The authors have declared that no competing interests exist.

Objectives: Cricket is a popular sport enjoyed worldwide. Injuries in cricket are not well understood at community level but are important to understand for prevention to ensure the game continues to be enjoyed safely. This systematic review was designed to assess the quality of data collection and reporting, and to summarise the injury data, in studies of community cricket players., Design: Systematic review., Methods: Nine databases were searched to November 2018 using the terms "cricket*" and "injur*". A nine-item critical appraisal and three-item likelihood-of-bias evaluation was conducted on included studies. Data completeness was evaluated against recommendations in the international cricket consensus statement for recording/reporting injury and the Australian Sports Injury Data Dictionary (ASIDD). Descriptive injury data (n,%) are presented in tabular format for different subgroups (activity, position, population)., Results: Thirteen studies were included, of which eight were rated as unclear, one as high and three having a low likelihood-of-bias. The mean score for completeness of data against the consensus statement was 3.5/10 (95%C.I. 2.8-4.2). The mean score for completeness of data against the ASIDD was 4.4/6 (95%C.I. 3.9-5.0). Bruising and inflammation was the most common injury in junior cricket. Stress fractures were most common in studies of bowlers. Where studies included all activities, batting accounted for most injuries (7-49%)., Conclusions: The included studies inconsistently addressed recommended items for injury surveillance in community sport and cricket. Most studies focused on junior levels or adolescent bowlers, with bruising/inflammation and stress fractures being most common, respectively., (Copyright © 2020 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Objective: To analyze injury frequency, density, location, type, mechanism of injury (MOI), activity phase of injury, and injury risk in professional rodeo., Design: Retrospective epidemiological review., Setting: Professional Rodeo Cowboys Association sanctioned rodeos from 2011 to 2014., Participants: Professional Rodeo Cowboys Association competitors competing in bull riding, bareback riding, saddle bronc riding, team roping, tie-down roping, and steer wrestling., Main Outcome Measures: Injury reports were documented by sports medicine personnel. Variables assessed include event, frequency, density, location, type, MOI, activity phase of injury, and injury density., Results: A total of 2305 injuries from 139,098 competitor exposures (CEs) were reported, demonstrating overall injury density of 16.6 injuries per 1000 CEs (95% confidence interval, 0.016-0.017) and overall risk of injury of 1.69%. Rough stock riders accounted for 88.7% of all injuries. Bull riders, bareback riders, and saddle bronc riders demonstrated injury densities of 48.2, 41.1, and 23.2 injuries per 1000 CEs, respectively. Most injuries (62.9%) were sustained by collisions with the ground or animal, or being stomped on by the animal. Contusions, sprains, and concussions were the most frequent injury types (23.1%, 13.6%, and 11.6%, respectively). Neurological components, knees, and shoulders were the most injured body parts (13.4%, 11.1%, and 11.0%, respectively). Most injuries (36.8%) occurred during or immediately after the dismount., Conclusions: Rough stock events have the greatest risk of injury in professional rodeo, whereas steer wrestling has the greatest risk of injury for timed event athletes. Medical professionals should use these findings to implement prevention programming where possible.

Objective: To report the epidemiology of injuries in Olympic-style karate competitions., Design: Systematic review and meta-analysis. Pooled estimates of injury incidence rates per 1000 athlete-exposures (IIR AE ) and per 1000 min of exposure (IIR ME ) were obtained by fitting random-effects models., Data Sources: MEDLINE, Embase, AMED, SPORTDiscus and AusportMed databases were searched from inception to 21 August 2019., Eligibility Criteria: Prospective cohort studies published in peer-reviewed journals and reporting injury data (ie, incidence, severity, location, type, mechanism or risk factors) among athletes participating in Olympic-style karate competition., Results: Twenty-eight studies were included. The estimated IIR AE and IIR ME were 88.3 (95%CI 66.6 to 117.2) and 39.2 (95%CI 30.6 to 50.2), respectively. The most commonly injured body region was the head and neck (median: 57.9%; range: 33.3% to 96.8%), while contusion (median: 68.3%; range: 54.9% to 95.1%) and laceration (median: 18.6%; range: 0.0% to 29.3%) were the most frequently reported types of injury. Despite inconsistency in classifying injury severity, included studies reported that most injuries were in the least severe category. There was no significant difference in IIR ME between male and female karate athletes (rate ratio 1.09; 95%CI 0.88 to 1.36)., Conclusion: Karate athletes sustain, on average, 1 injury every 11 exposures (bouts) or approximately 25 min of competition. The large majority of these injuries were minor or mild in severity., Competing Interests: Competing interests: DC is a member of the Technical Commission of the European Karate Union and RA is the Chair of Medical Commission of the World Karate Federation; however, neither DC nor RA receive any remuneration from the European Karate Union or the World Karate Federation to conduct this study, and neither the European Karate Union nor the World Karate Federation have had any influence on this work., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Context: Most studies of injury trends associated with softball focus on injuries requiring at least 24 hours of missed participation time (time-loss [TL] injuries), with little focus on those that do not (non-time-loss [NTL] injuries). A better understanding of injury trends associated with softball will improve athlete care., Objective: To describe NTL and TL injuries experienced by secondary school girls' softball players., Design: Descriptive epidemiology study., Setting: Secondary school athletic training clinics., Patients or Other Participants: Secondary school girls' softball players., Main Outcome Measure(s): Aggregate data were collected from schools participating in the National Athletic Treatment, Injury, and Outcomes Network surveillance program during the 2011-2012 through 2013-2014 academic years. Frequencies and rates of injuries (NTL and TL) according to time of season, event type, body part injured, and diagnosis were analyzed., Results: In total, 1059 injuries were reported during 140 073 athlete-exposures (AEs): overall injury rate = 7.56/1000 AEs. Of these injuries, 885 (83.6%) were NTL (NTL rate = 6.32/1000 AEs) and 174 (16.4%) were TL (TL rate = 1.24/1000 AEs). Of the NTL and TL injuries, the largest numbers occurred during the regular season (NTL: n = 443 [50.1%]; TL: n = 131 [75.3%]). Injuries sustained during practices accounted for the majority of NTL and TL injuries (NTL: n = 631 [71.3%]; TL: n = 104 [59.8%]). The NTL injuries occurred most often at the shoulder (n = 134 [15.1%]) and hand/fingers (n = 109 [12.3%]) and were diagnosed as contusions (n = 316 [35.7%]), strains (n = 157 [17.7%]), and abrasions (n = 151 [17.1%]). The largest numbers of TL injuries were to the head/face (n = 71 [40.8%]) and diagnosed as concussions (n = 50 [28.7%]) and strains (n = 28 [16.1%])., Conclusions: Secondary school softball players sustained a larger proportion of NTL injuries than TL injuries. Although NTL injuries may be less severe, they are numerous. Efforts are needed to ensure that injury-prevention programs are incorporated into the care of softball athletes to promote health and reduce injury occurrence.

Context: Researchers analyzing data from the National Collegiate Athletic Association Injury Surveillance Program have not considered the differences in foot injuries across specific sports and between males and females., Objective: To describe the epidemiologic differences in rates of overall foot injuries and common injuries among sports and between sexes., Design: Descriptive epidemiology study., Setting: Online injury-surveillance data from 15 unique sports involving males and females that demonstrated 1967 injuries over 4 821 985 athlete-exposures., Patients or Other Participants: Male and female athletes competing in National Collegiate Athletic Association sports from the 2009-2010 through 2014-2015 seasons., Main Outcome Measure(s): Foot injury rates (per 10 000 athlete-exposures) and the proportion of foot injuries were calculated for each sport. The effect of sex was calculated using Poisson-derived confidence intervals for 8 paired sports. A risk analysis was performed using a 3 × 3 quantitative injury risk-assessment matrix based on both injury rate and mean days of time loss., Results: Foot injury rates differed between sports, with the highest rates in female gymnastics, male and female cross-country, and male and female soccer athletes. Cross-country and track and field had the highest proportions of foot injuries for both female and male sports. The 5 most common injuries were foot/toe contusions, midfoot injuries, plantar fascia injuries, turf toe, and metatarsal fractures. Only track and field athletes demonstrated a significant sex difference in injury rates, with female athletes having the higher rate. The quantitative injury risk-assessment matrix identified the 4 highest-risk injuries, considering both rate and severity, as metatarsal fractures, plantar fascia and midfoot injuries, and foot/toe contusions., Conclusions: Important differences were present among sports in terms of injury rates, the most common foot injuries, and the risk (combination of frequency and severity) of injury. These differences warrant further study to determine the mechanisms of injury and target intervention efforts.

Context: Hockey is a skillful contact sport with an elevated injury risk at higher levels of play. An understanding of injury incidence, type, mechanism, and severity at various levels of competition aids the clinician treating these athletes. The purpose of this clinical review is to discuss the epidemiology of hockey injuries at various levels of participation, including youth, high school, junior, college, and professional., Evidence Acquisition: A literature search was performed by a review of PubMed, Embase, and Cochrane databases and included articles published from 1988 to 2017. Studies were included in this review if determined to be of high quality and containing injury data relevant to the levels of competition. Pertinent data regarding ice hockey injury epidemiology and prevention at various levels of competition were analyzed., Study Design: Clinical review., Level of Evidence: Level 4., Results: Youth, high school, junior, college, and professional hockey players have unique injury patterns. Injuries occur much more often in a game compared with a practice, and injury risk increases with each level of competition. Preventative measures, such as mandatory facial protection and delayed body checking in games until age 13 years, are proven strategies to reduce the risk of facial injury and concussion., Conclusion: An understanding of common injury types and mechanisms according to age and level of play aids the clinician in diagnosis and management. This information can also guide preventative strategies in the areas of education, coaching, rule enforcement, rule modifications, equipment improvement, and sportsmanship.

Objectives: To explore the epidemiological patterns and musculoskeletal characteristics of lower limb injuries in Major League Baseball (MLB)., Design: Descriptive epidemiological study., Setting: The MLB was screened for injuries between 2010 and 2016, inclusive., Participants: Players that were placed on the Disabled List (DL) and had lower limb injuries., Main Outcome Measures: Our database entailed the player's position, injury location, injury cause, and time spent on the DL. Analysis of characteristics and mean incidence rates (MIR) were conducted, and P values<0.05 were considered significant (CI 95%)., Results: A total of 3546 injuries were recorded; 1053 injuries (29.7%) affected the lower limbs (n = 1053). On average, 150.4 players per season were placed on the DL for a mean of 45.7 days. Thighs were the most common site of injury, whereas hip injuries had the highest average days on DL (62 days). Fielders had a significantly higher MIR of lower leg injuries when compared to pitchers (P = 0.007) and catchers (P = 0.024), and a significantly higher MIR of foot injuries than that of pitchers (P = 0.035). April was the month with the highest number of injuries (224 injuries, 21.3%). Only 43(4%) injuries required surgical intervention., Conclusion: Lower limb injuries are increasing in the MLB. Understanding the neuromuscular patterns of injuries will help in extrapolating better prevention policies., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Although data exist on injuries in youth football leagues, there are limited recent data on injury incidence in middle school football. Updated injury incidence estimates can help drive the development of injury prevention strategies., Purpose: Describe the epidemiology of injuries in middle school football during school years 2015-2016 to 2017-2018., Study Design: Descriptive epidemiology study., Methods: Data originated from 9 public middle schools in Virginia during school years 2015-2016 to 2017-2018. Certified athletic trainers collected injury and athlete-exposure (AE) data from school-sanctioned games and practices in boys', football. Injury counts and rates per 1000 AEs were calculated. Injury rate ratios with 95% CIs compared rates between games and practices., Results: Overall, 664 middle school boys', football injuries were reported, leading to an overall injury rate of 20.54 per 1000 AEs (95% CI, 18.98-22.11). The time loss injury rate (inclusive of injuries with participation restriction time ≥24 hours) was 9.28 per 1000 AEs (95% CI, 8.23-10.33). The injury rate was higher in competition than practice (36.19 vs 17.97 per 1000 AEs; injury rate ratio, 2.01; 95% CI, 1.69-2.40). Most injuries were to the head/face (competition, 20.6%; practice, 15.8%) and hand/wrist (competition, 18.8%; practice, 16.4%) and were diagnosed as contusions (competition, 30.9%; practice, 25.9%) and sprains (competition, 19.4%; practice, 12.6%). Competitions also had a large proportion of concussions (10.3%). Overall, 80.0% and 66.9% of injuries were due to contact in competition and practice, respectively; of these contact-related injuries, 62.1% and 41.6% were specifically player contact., Conclusion: Injury distributions parallel those found in previous research from middle school and other sport settings. Injury rates in middle school football were higher than those reported in previous findings in high school and college. However, caution must be taken when interpreting findings in relation to other surveillance systems with varying methodologies. Still, the findings highlight the need for injury prevention strategies within middle school football, particularly as related to contact-related mechanisms.

Objectives: To identify all studies of gymnastics injuries and assess injury rates, types, locations, and causes., Methods: Seven electronic and two grey literature databases were searched. Two reviewers independently assessed titles/abstracts, abstracted data, and calculated average rates weighted by study size., Results: One study (n = 963) of three Olympic games (2008,2012,2016) provided injury rates for females of 86.4/1000gymnasts and males 79.9. For 29 databases one study of males (n = 64) provided a rate of 8.8 injuries/1000hours/AE (AE = athletic-exposure) and three of females varied rates (8.5, 9.4, and 91). Three studies for males (n = 153) provided a weighted average rate of 1.4 injuries/1000hours/training, and for females six studies (n = 476) 1.5 injuries. Four studies of males (n = 286) provided a weighted average of 678 injuries/1000gymnasts per year and eight studies of females (n = 1,764) a rate of 306. Of 19 surveys, eight provided rates for females (n = 1,463) of 596 injuries/gymnast per year and two for males (n = 40) a rate of 1,036. In the Olympics injuries were preponderately lower limb (63%) then trunk (23%) and upper limb (14%); injury type was sprains (35%) followed by tendinopathy/arthritis/impingements (17%), contusions (10%), and fractures (7%). Five database studies provided injury location data for 274 males: averages weighted by study size were upper extremity 42.8%, lower extremity 33.6%, torso/spine 11.8%, and head/neck 4.9% and 12 studies with 843 females provided average rates for lower extremity 51%, upper extremity 30.8%, torso/spine 13% and head/neck 0.8%. Official gymnastics organizations' websites provide no readily available data about injury rates or methods of prevention., Conclusions: Studies need to collect comprehensive data for injury rates by training/competitions, gender, age, injury location/type/cause. Studies could assess whether trainers and physiotherapists monitoring gymnasts closely for injury risk would reduce injuries. Studies including randomized controlled trials (RCTs) of interventions in training, videotaping and performance feedback to reduce injury rates would be helpful.

Context: Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided efforts to collect data on ice hockey injuries., Objective: To describe the epidemiology of injuries sustained in high school boy's ice hockey in the 2008-2009 through 2013-2014 academic years and collegiate men's and women's ice hockey in the 2004-2005 through 2013-2014 academic years using Web-based surveillance., Design: Descriptive epidemiology study., Setting: Online injury surveillance of ice hockey teams of high school boys (annual average = 34), collegiate men (annual average = 20), and collegiate women (annual average = 11)., Patients or Other Participants: Boys', men's, and women's ice hockey players who participated in practices and competitions during the 2008-2009 through 2013-2014 high school academic years or the 2004-2005 through 2013-2014 collegiate academic years., Main Outcome Measure(s): Athletic trainers collected time-loss (≥24 hours) injury and exposure data. We calculated injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis., Results: The High School Reporting Information Online system documented 831 boys' ice hockey time-loss injuries during 356 997 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2611 men's ice hockey time-loss injuries during 552 642 AEs and 752 women's ice hockey injuries during 232 051 AEs. Injury rates were higher in collegiate men than in high school boys during 2008-2009 through 2013-2014 (4.38 versus 2.33/1000 AEs; IRR = 1.88; 95% CI = 1.73, 2.05) and collegiate women during 2004-2005 through 2013-2014 (IRR = 1.46; 95% CI = 1.34, 1.58). Most injuries occurred during competitions (boys = 80.0%, men = 66.9%, women = 55.3%); injury rates were higher in competitions than in practices for boys (IRR = 8.14; 95% CI = 6.87, 9.65), men (IRR = 6.58; 95% CI = 6.06, 7.13), and women (IRR = 3.63; 95% CI = 3.14, 4.19). At all levels, most injuries occurred to the head/face and shoulder/clavicle and resulted in concussions, contusions, or ligament sprains., Conclusions: Injury rates varied across sports but were consistently higher in competitions than in practices. In competitions, concussions were common injuries, highlighting the need for continued development of injury-prevention strategies.

The physical and demanding style of play in soccer places these athletes at an elevated risk for hip and groin injuries. Several studies have examined hip and groin injuries in professional and youth soccer in European countries, but few have involved American counterparts. Hip injury data were analyzed retrospectively from the National Collegiate Athletic Association Injury Surveillance Program for the 2004 to 2014 academic years for collegiate men's soccer. This study found that hip and groin injuries among collegiate male soccer players were most often new injuries (87.8%; n=527) that were noncontact in nature (77.3%; n=464) and resulted in time loss of less than 7 days (67.5%; n=405). Hip injuries were significantly more likely during the pre-season (5.72 per 1000 athlete exposures) relative to in-season (injury proportion ratio, 1.64; 95% confidence interval, 1.39-1.94) and post-season (injury proportion ratio, 1.69; 95% confidence interval, 1.18-2.41). Further, they were more likely in competition relative to practice (injury proportion ratio, 2.33; 95% confidence interval, 1.98-2.74). The most common injuries were adductor strains (46.5%; n=279) followed by hip flexor strains (27.3%; n=164) and hip contusions (10.8%; n=65). Among these injuries, adductor (73.1%; n=204) and hip flexor (59.8%; n=98) strains were more commonly noncontact related and occurred in practice, whereas hip contusions were due to contact and during competition. The study of the complex and lingering nature of hip and groin injuries in soccer players is critical because these injuries not only are prevalent but also have multifactorial risks associated with coexisting pathologies that make them difficult to prevent and treat effectively. [Orthopedics. 2018; 41(6):e831-e836.]., (Copyright 2018, SLACK Incorporated.)

Context:: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of data for girls' and women's field hockey injuries., Objective:: To describe the epidemiology of injuries sustained in high school girls' field hockey in the 2008-2009 through 2013-2014 academic years and collegiate women's field hockey in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance., Design:: Descriptive epidemiology study., Setting:: Online injury surveillance from field hockey teams in high school girls (annual average = 61) and collegiate women (annual average = 14)., Patients or Other Participants:: Girls' and women's field hockey players who participated in practices and competitions during the 2008-2009 through 2013-2014 high school academic years and the 2004-2005 through 2013-2014 collegiate academic years., Main Outcome Measure(s):: Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated., Results:: The High School Reporting Information Online system documented 983 time-loss injuries during 569 551 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 996 time-loss injuries during 185 984 AEs. The injury rate from 2008-2009 through 2013-2014 was higher in college than in high school (3.25 versus 1.73/1000 AEs; IRR = 1.89; 95% CI = 1.63, 2.18). Most injuries occurred during practices in high school (52.0%) and college (60.7%). Injury rates were higher during competitions than practices in high school (IRR = 2.00; 95% CI = 1.76, 2.26) and college (IRR = 1.96; 95% CI = 1.73, 2.23). At both levels, injuries most commonly occurred to the lower extremity and head/face and resulted in muscle/tendon strains and contusions. However, injury patterns varied between practices and competitions., Conclusions:: Injury rates and patterns varied across age groups and between practices and competitions, highlighting the need for development of targeted injury-prevention strategies at both levels of play.

Purpose: Beach handball is a relatively new type of sports, which was derived from team handball. Medical issues such as frequency and severity of injury are yet unknown. The purpose of this study was to investigate the injury pattern and injury rates of this new type of sports., Methods: This study investigated the injury incidence of 30 national teams (10 senior and 20 u-17 teams, 16 men's and 14 women's teams) participating in the 2017 European Beach Handball Championships. Reports on injuries sustained during the senior and u-17 youth tournaments were provided by the medical staff of each team. Injury incidence was differentiated between age and sex, and between the five field positions (goalkeeper, wing, central defender, pivot, and specialist)., Results: During the tournaments, 87 injuries were recorded yielding an overall injury incidence of 286.1 per 1000 match hours. Time-loss due to injury was 49.3 per 1000 match hours. Senior players had a higher overall injury incidence with 395.3 injuries than u-17 players with 205.7 injuries per 1000 h match hours (p < 0.01). Comparison of the injury incidence between the two sexes showed 330.23 injuries per 1000 h handball exposure for male players and 234.9 injuries for female players (n.s.). The most frequent injury type was sprains (21 injuries, 24.1%) followed by contusions (19 injuries, 21.8%) and skin abrasions with (15 injuries, 17.2%). Central defenders and specialists had the highest injury incidence. Thighs, ankles, as well as foot and toes (altogether 12 injuries, all 13.8%) were the three most frequently injured anatomic sites., Conclusions: Beach handball seems to have a lower incidence of time-loss injuries than that reported for indoor team handball. This study is an important basis for developing injury prevention strategies in this sports that should focus on thighs, ankles, feet and toes. Further research into this new type of sports is essential to identify risk factors and to develop adequate injury prevention measures., Level of Evidence: II.

Purpose: Examinations of injury among younger populations of lacrosse players that are beginning their development is limited. This study describes the epidemiology of youth boys' and girls' lacrosse injuries during the 2015 to 2016 seasons., Methods: Surveillance data originated from a convenience sample of 10 leagues in five states with 1090 boy lacrosse players and 408 girl lacrosse players from the U9-U15 divisions. Athletic trainers reported injury and exposure data at games and practices. Time loss (TL) injuries were defined as resulting in ≥24 h of participation restriction time. Injury counts and rates per 1000 athlete games/practices were calculated. Injury rate ratios (IRR) with 95% confidence intervals (CI) compared rates by sex and age division., Results: Overall, 241 and 59 injuries were reported in boys' and girls' youth lacrosse, respectively, of which 17.0% and 18.6% were TL. Compared with girls, boys had a higher overall injury rate (12.7 vs 8.7/1000 athlete games/practices; IRR, 1.5; 95% CI, 1.1-1.9). U13/U15 boys had a higher TL injury rate than U9/U11 boys (2.6 vs 1.0/1000 athlete game/practices; IRR, 2.6; 95% CI, 1.1-6.1). Most injuries were diagnosed as contusions (boys, 53.7%; girls, 47.2%) and resulted from stick contact (boys, 34.1%; girls, 30.6%) and ball contact (boys, 17.1%; girls, 25.0%). Among girls, ball contact contributed to 75.0% (n = 9) of all head/face injuries. Among the 14 concussions reported in boys, player contact was the most common injury mechanism (50.0%, n = 7), followed by stick contact (35.7%, n = 5)., Conclusions: Boys' lacrosse has a higher injury incidence than girls' lacrosse, reflecting the contact nature of the boys' game. The high incidence of stick- and ball-related injuries suggests the need for youth-specific rules to better protect youth players.

The aim was to compare the epidemiology of injuries between elite male and female football players from the same club. Injuries and individual exposure time in a male team and a female team, both playing in the Spanish first division, were prospectively recorded by the club's medical staff for five seasons (2010-2015) following the FIFA consensus statement. Total, training, and match exposure hours per player-season were 20% higher for men compared to women (P<.01). Total, training, and match injury incidence were 30%-40% higher in men (P≤.04) mainly due to a 4.82 (95% confidence interval [CI] 2.30-10.08) times higher incidence of contusions, as there were no differences in the incidence of muscle and joint/ligament injuries (P≥.44). The total number of absence days was 21% larger in women owing to a 5.36 (95% CI 1.11-25.79) times higher incidence of severe knee and ankle ligament injuries. Hamstring strains and pubalgia cases were 1.93 (95% CI 1.16-3.20) and 11.10 (95% CI 1.48-83.44) times more frequent in men, respectively; whereas quadriceps strains, anterior cruciate ligament ruptures, and ankle syndesmosis injuries were 2.25 (95% CI 1.22-4.17), 4.59 (95% CI 0.93-22.76), and 5.36 (95% CI 1.11-25.79) times more common in women, respectively. In conclusion, prevention strategies should be tailored to the needs of male and female football players, with men more predisposed to hamstring strains and hip/groin injuries, and women to quadriceps strains and severe knee and ankle ligament injuries., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Head injuries are considered harmful in children. We analyzed head and neck injuries in organized football in 7- to 12-year-old children. Data for this analysis were obtained from a prospective cohort study over two consecutive football seasons in two European countries, and a randomized intervention trial over one season in four European countries. Football exposure and injuries were documented through an online database. Detailed information regarding injury characteristics and medical follow-up was retrieved from coaches, children and parents by phone. Thirty-nine head injuries and one neck injury (5% of all 791 injuries) were documented during 9933 player-seasons (total football exposure 688 045 hours). The incidence was 0.25 [95%CI 0.15, 0.35] head/neck injuries per 1000 match hours (N=23 match injuries) and 0.03 [95%CI 0.02, 0.03] per 1000 training hours. Eleven concussions (27.5%), nine head contusions (22.5%), eight lacerations or abrasions (20%), two nose fractures (2.5%), and two dental injuries (2.5%) occurred. The remaining eight injuries were nose bleeding or other minor injuries. Thirty injuries (75%) resulted from contact with another player, and ten injuries were due to collision with an object, falling or a hit by the ball. Whereas 70% of all head injuries (N=28) were due to frontal impacts, 73% of concussions (N=8) resulted from an impact to the occiput. The incidence and severity of head injuries in children's football are low. Coaches and parents, however, should be sensitized regarding the potential of concussions, particularly after an impact to the occiput., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: To determine the injury incidence rate and injury pattern among youth karate athletes competing in national tournaments in Slovakia, and to identify risk factors for injury., Methods: Data were collected at nine national youth karate tournaments in Slovakia in 2015 and 2016. Injury incidence rates were calculated per 1000 athlete-exposures (IIR AE ) and per 1000 min of exposure (IIR ME ) with 95% CIs. Subgroups were compared by calculating their rate ratios (RR) with 95% CIs., Results: The overall IIR AE and IIR ME were 45.3 (95% CI 38.7 to 52.6) and 35.9 (95% CI 30.7 to 41.7), respectively. The most frequently injured anatomical region was the head/neck (57%), while the most common type of injury was contusion (85%). The risk of injury for the 12-17-year-old age group was almost twice that of the 6-12-year-old age group, after accounting for exposure time (RR ME 1.92 (95% CI 1.39 to 2.65)), and the difference was more pronounced for girls than boys (RR ME 2.47 (95% CI 1.52 to 4.00) vs RR ME 1.62 (95% CI 1.06 to 2.49), respectively)., Conclusions: Youth karate has a relatively large proportion of head injuries. Adolescent and female youth karate athletes are at higher risk of injury compared with their child and male counterparts., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Objective: The growth in participation in men's lacrosse has increased the likelihood of sport-specific injuries, yet there continues to be a need for specific epidemiological data concerning lacrosse injuries. The purpose of this literature review is to aggregate available published data on injuries that occur in the sport of men's lacrosse at the youth, high school, collegiate, and professional levels., Methods: A comprehensive literature search was performed in PubMed, High Wire Press, SPORTDiscus, Google Scholar, and Ovid, using the keywords Lacrosse Injuries, Epidemiology Lacrosse Injuries, Lacrosse Injury, Lacrosse AND Injury and limited to 1990-2016. All bibliographies were cross-referenced to identify any additional publications. Sources were categorized based on data provided and were aggregated into groups based on reported overall injury rates, rates by setting (competition vs. practice), nature of injury, location, type, severity, and player position., Results: The game and practice injury rates in college are greater than the rates in high school, similarly rates greater for high school players than in youth leagues. Rates of injury varied from 0.095-12.98 per 1000 athlete exposures. Game injury rates were higher across all studies. Injuries in men's lacrosse occur most often from player-to-player contact, which result in immediate injuries, such as concussions, contusions, and lacerations. Overall concussion incidence was reported to range from 0.11-0.84 per 1000 AE. The most common types of injuries were sprain, strain, concussion, and contusions and the most common area of injury was hand (23%), with a significant proportion of these (59.4%) being to the thumb. Limited evidence of different injuries among the player positions suggests there might be a pattern that midfield players had the most injuries, followed by offensive players and then defensive players., Conclusions: The potential for sports-related injury is of relative concern; especially considering rising participation and total number of injuries. Further development and proper enforcement of safety rules on player contact and protective equipment are recommended to decrease the rate of lacrosse-related injury. Additional longitudinal research is needed to better classify and to ultimately predict lacrosse injury factors and mechanisms across all levels of play.

Background: Rock climbing first evolved as a sport in the late 18th century. With its growing popularity, the number of rock climbing-related injuries has potential to increase, spurring a rise in the number of articles associated with it. Despite the available literature, there remains a paucity of information about upper extremity injuries sustained by rock climbers, and no studies to date have focused on gender-specific injuries., Methods: A 24-question online survey was distributed to rock climbers about upper extremity injuries sustained during rock climbing. Statistical analysis was used to study association between participants' demographics and injuries., Results: A total of 397 participants responded to the survey. Mean age was 32.5 years with males comprising 85%. No significant differences in demographics or climbing behaviors were found between males and females. Ninety percent of participants reported sustaining an upper extremity injury. Fingers were the most common injury followed by shoulder/arm and elbow/forearm. Our study found females to be more likely to report a rock climbing-related injury, and more likely to undergo surgery for it., Conclusion: Female rock climbers were significantly more likely to report a shoulder/upper arm injury and were also more likely to report undergoing surgery compared with males, where these differences were not due to age or climbing behaviors. Further investigation is warranted into the association between shoulder injuries and female athletes to determine how the gender differences relate to extent of injury as well as health service utilization behaviors.

It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]., (Copyright 2016, SLACK Incorporated.)

Introduction: Freestyle Motocross (FMX) is an emerging extreme sport in which motocross riders perform risky jumps and tricks, which are graded by judges for their degree of difficulty, originality, and style. To this date, injury, patterns and causes in Freestyle Motocross have not been determined., Methods: Over the time period from January 2006 to December 2012, 19 professional FMX riders of an internationally active FMX team were retrospectively surveyed by means of a questionnaire and questionnaire-based interviews regarding injuries sustained during training, shows, or competition. The questionnaire collected information regarding injury type, circumstances, causes, and treatment. In addition, general information was obtained on body dimensions, experience, training, and equipment used., Results: A total of 54 accidents resulting in 78 severe injuries were registered. The most common types of injuries were fractures (66.6 %), ligament ruptures (7.7 %), and contusions (6.4 %). Most frequently affected body regions were foot/ankle (20.5 %), shoulder (12.8 %), and back (10.3 %). The Backflip was the trick during which most of the injuries occurred (35.2 %). Incorrect execution of jumps (25.9 %) was the leading cause of accidents., Conclusion: Based on our data, FMX is a high-risk sport. To avoid injuries, ramps, motorcycles, and equipment should be in the best possible shape and the athletes themselves in good physical and mental condition. Attendance of medical staff during FMX activity is advised at all time., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: American football and rugby players are at substantial risk of injury because of the full-contact nature of these sports. Methodological differences between previous epidemiological studies hamper an accurate comparison of injury rates between American football and rugby., Purpose: To directly compare injury rates in American collegiate football and rugby, specified by location, type, mechanism, and severity of injury, as reported by licensed medical professionals., Study Design: Cohort study; Level of evidence, 2., Methods: Licensed medical professionals (athletic trainer or physician) associated with the football and rugby teams of a National Collegiate Athletic Association Division I university reported attendance and injury details over 3 autumn seasons. Injuries were categorized by the location, type, mechanism, and severity of injury, and the injury rate was calculated per 1000 athlete-exposures (AEs). Injury rate ratios (IRRs) were calculated to compare overall, game, and practice injury rates within and between sports., Results: The overall injury rate was 4.9/1000 AEs in football versus 15.2/1000 AEs in rugby: IRR = 3.1 (95% CI, 2.3-4.2). Game injury rates were higher than practice injury rates: IRR = 6.5 (95% CI, 4.5-9.3) in football and IRR = 5.1 (95% CI, 3.0-8.6) in rugby. Injury rates for the shoulder, wrist/hand, and lower leg and for sprains, fractures, and contusions in rugby were >4 times as high as those in football (all P ≤ 0.006). Concussion rates were 1.0/1000 AEs in football versus 2.5/1000 AEs in rugby. Most injuries occurred via direct player contact, especially during games. The rate of season-ending injuries (>3 months of time loss) was 0.8/1000 AEs in football versus 1.0/1000 AEs in rugby: IRR = 1.3 (95% CI, 0.4-3.4)., Conclusion: Overall injury rates were substantially higher in collegiate rugby compared with football. Similarities between sports were observed in the most common injury types (sprains and concussions), locations (lower extremity and head), and mechanisms (direct player contact). Upper extremity injuries were more common in rugby, and the rate of season-ending injuries was similar between sports., (© 2016 The Author(s).)

Background: As part of a risk-management approach, sound epidemiological data are needed to develop prevention programs. A recent review on soccer injuries of players younger than 19 years concluded that prospective data concerning children are lacking., Purpose: To analyze the incidence and characteristics of soccer injuries in children aged 7 to 12 years., Study Design: Descriptive epidemiological study., Methods: The present survey was a prospective descriptive epidemiological study on soccer injuries over 2 seasons in the Czech Republic and Switzerland. Exposure of players during training and match play (in hours) and injury data were reported by coaches via an Internet-based registration system. Location, type, and severity of injuries were classified according to an established consensus. Injury characteristics are presented as absolute numbers and injury incidence rates (injuries per 1000 hours of soccer exposure). An injury was defined as any physical complaint sustained during a scheduled training session or match play resulting in at least 1 of the following: (1) inability to complete the current match or training session, (2) absence from subsequent training sessions or matches, and (3) injury requiring medical attention., Results: In total, 6038 player-seasons with 395,295 hours of soccer exposure were recorded. The mean (±SD) age of the players was 9.5 ± 2.0 years, and 3.9% of the participants were girls. A total of 417 injuries were reported. Most (76.3%) injuries were located in the lower limbs, with 15.6% located in the upper limbs. Joint and ligament injuries comprised 30.5%, contusions 22.5%, muscle and tendon injuries 18.5%, and fractures and bone injuries 15.4% of all injuries; 23.7% of injuries led to more than 28 days of absence from sport participation. The overall injury incidence was 0.61 (95% CI, 0.53-0.69) injuries per 1000 hours of soccer exposure during training sessions and 4.57 (95% CI, 4.00-5.23) during match play. Injury incidence rates increased with increasing age., Conclusion: The observed injury incidences were lower compared with studies in youth players. Children showed a relatively high proportion of fractures and bone stress and of injuries to the upper limbs., Clinical Relevance: The study provides an evidence base for injury incidence rates and injury characteristics in children's soccer. These data are the basis to develop an age-specific injury-prevention program., (© 2015 The Author(s).)

Background: Prospective studies on injuries in martial arts competition are scarce, especially those involving young practitioners, but the upsurge of children and adolescents taking part in organized training and competition in these sports requires clarification of the injury risk that they represent for youths., Hypothesis: Top-level karate competition for young adolescents (cadets, or 14- to 15-year-olds) has a low injury rate and can be safely promoted., Study Design: Descriptive epidemiological study., Methods: Prospective recording of the injuries resulting from all bouts in 3 consecutive World Karate Championships (2009, 2011, and 2013) for cadets was performed. Data were collected prospectively in situ with checklists that described competitor sex, bout category, and weight as well as injured area, diagnosis, mechanism of injury, severity, and treatment., Results: A total of 1020 bouts were reviewed, 671 in the male category and 349 in the female category. A total of 61 injuries were recorded. Of those, only 3 were time-loss injuries. During the 2009 and 2011 championships, there was 1 injury per 25.6 fights, while during the 2013 championship the number of injuries increased, with 1 injury per 10 fights (P = .003). There was no statistical difference in the total injury rate between the male and female categories (P = .71), with an odds ratio of 1.16 (95% CI, 0.52-2.55)., Conclusion: The injury rate for cadet top-level karate competition found in this prospective study is much lower than the rates previously published for karate or other martial arts competitions, but there seems to be a marked increase as more championships are held, which is a matter of concern., (© 2015 The Author(s).)

Background: The IOC encourages international federations to establish systematic athlete injury and illness surveillance programmes., Objective: To describe pattern of injuries and illnesses during the 24th Men's Handball World Championship 2015 by implementing the IOC injury and illness surveillance protocol., Methods: The medical staff of participating teams (n=24) were requested to report all new injuries and illnesses during matches and/or training on a daily basis throughout the event (15 January to 1 February, 2015). Exposure (number of player-hours) during all matches was calculated for all players (n=384) and for each of the 4 player positions (wing, back, line and goalkeeper)., Results: Medical staff of all teams submitted 96.7% (n=325) of the daily report forms. In total, 27.1% of the players were injured, and of the 132 injuries reported, 40% were time-loss injuries. The total incidence of injuries was 104.5 per 1000 player-hours. The highest risk of injury was found among line players, and more injuries occurred during the first half of the matches. The most frequent injury location was the ankle, followed by the thigh, knee and head/face. The majority of injuries were contusion, sprain or strain. In total, 10.9% of the players were affected by an illness during the event. Of the 42 cases recorded, 31 (73.8%) were reported as respiratory tract infection., Conclusions: The risk of injury in handball is high among Olympic sports. Preventive measures should focus on contusions, ankle sprains, and thigh muscle strains, as well as measures aimed to reduce upper respiratory tract infections., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

The purpose of this study was to examine the incidence and mechanisms of acute injuries in the sport of fistball. No scientific studies on injury characteristics have yet been conducted in this traditional sport game. The study was conducted prospectively over the course of 12 months. During a total of 40.308 h of sport-specific exposure, 240 players reported 492 injuries, representing an overall injury rate of 12.2 injuries/1000 h of exposure. Most injuries were classified as bagatelle injuries (67.8%). The majority of the injuries were located in the knee (23.5%) followed by the elbow (11.9%) and the hip (11.5%). Ankle injuries resulted in the longest impairment from sports participation. The most common types of injury were abrasions (38.2%), contusions (21.1%), distortions (7.5%) and muscle strains (6.9%). Wrong or insufficient equipment (15.0%) was the most commonly mentioned causes of injury. The data indicate that the injury risk in fistball is rather high; however, the sport should not be considered a high-risk sport because most of the injuries are slight and do not prevent the players from training or competition. Injury prevention strategies should include the development of fistball-specific protective equipment with focus on the knee and elbow joint., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The practice of combat sports creates a potential for training- and sports-related injuries among military members. During the 4-year surveillance period, there were 12,108 cases of injuries associated with combat sports among active component service members; the overall incidence rate was 21.0 per 10,000 person-years (p-yrs). The rates were higher among service members who were male, Hispanic, in the youngest age groups, in the Army, junior enlisted, and in combat-specific occupations. The rate among recruit/ trainees (779.4 per 10,000 p-yrs) was more than 165 times the rate among all other active component service members (non-recruits) (4.7 per 10,000 p-yrs). Sprains, strains, and contusions accounted for more than one-half of the primary (first-listed) diagnoses associated with combat sports cases. More serious conditions such as concussions/head injuries and skull/face fractures/intracranial injuries were reported among 3.9% and 2.1% of all cases and were more common among boxing-related cases. Hand/wrist fractures were also common among boxing cases. Wrestling had comparatively greater proportions of dislocations and open wounds. Although the combat sport training provides many physical and mental benefits to the individual, safety practices should be enforced to reduce the most frequent and serious injuries.

Background: Bone bruising is commonly observed on magnetic resonance imaging (MRI) after non-contact anterior cruciate ligament (ACL) injury., Objectives: The primary objective of this study was to determine if the location and prevalence of tibial and femoral bone bruises after ACL injury can be explained by specific injury mechanism(s). The secondary objective was to determine whether the bone-bruise literature supports sex-specific injury mechanism(s). We hypothesized that most studies would report bone bruising in the lateral femoral condyle (LFC) and on the posterior lateral tibial plateau (LTP)., Methods: MEDLINE, PubMed, and SCOPUS were searched for studies that reported bone bruise prevalence and location in ACL-injured subjects. Sex differences in bone-bruise patterns were assessed. Time from injury to imaging was assessed to account for confounding effects on bone-bruise size and location., Results: Thirty-eight studies met the inclusion/exclusion criteria. Anterior-posterior location of bone bruises within the tibiofemoral compartment was assessed in 11 studies. Only five of these studies reported bone-bruise locations on both the tibia and the femur. The most common bone-bruise combination in all five studies was on the LFC and the posterior LTP. Sex differences were only assessed in three studies, and only one reported significantly greater prevalence of LTP bruising in females., Conclusion: Bone-bruise patterns in the current literature support a valgus-driven ACL injury mechanism; however, more studies should report the specific locations of tibial and femoral bone bruises. There is insufficient evidence in the literature to determine whether there are sex-specific bone-bruise patterns in ACL-injured subjects.

Context: Previous research on American football injuries in Japan has focused on incidence proportion in terms of the number of injuries divided by the number of players. This is the first study to examine injury rates over several seasons., Objective: To conduct a prospective study of injuries in a Japanese Division I collegiate American football team over the 2007 through 2009 seasons., Design: Cohort study., Setting: Collegiate football team at Doshisha University, Kyoto, Japan., Patients or Other Participants: All 289 athletes who played on the collegiate Division I football team during the 2007 through 2009 seasons., Main Outcome Measure(s): A certified athletic trainer kept a daily record of all practice and game injuries. Injury rates were calculated according to season, injury type, body part, severity, and mechanism. Injuries were also analyzed according to position of player, school year, and playing experience., Results: The game injury rate (GIR; 32.7 injuries/1000 athlete-exposures) was higher than the practice injury rate (PIR; 10.9 injuries/1000 athlete-exposures) over the 3 seasons (P < .05). The PIR was higher among Japanese players than the comparable United States collegiate football injury rates (5.8-7.0 injuries/1000 athlete-exposures). Ankle and foot injuries occurred more frequently during games, whereas thigh and gluteal injuries occurred more frequently during practices., Conclusions: Our data show differences between games and practices in terms of injury rates, body parts injured, and positions of players injured. The high PIR in Japan may be due to the increased contact during practices and length of practices compared with the United States. Further research involving multiple teams is recommended to validate the trends noted in this study. The expanded data set could assist in the development of safety regulations and preventive interventions for Japanese football.

Introduction: Parkour sport is the playfully breaching of obstacles originally not created to get from A to B in the fastest manner. There have been only few publications on injuries in this young and trendy sport mainly performed in urban areas. The aim of this study is to analyse parkour-related acute injuries and their factors., Methods: For the retrospective cross-sectional study, a total of n = 266 traceurs (m: n = 255, w: n = 11) completed anonymized online questionnaires., Results: On average, each traceur sustained 1.9 injuries per sport career/year, or 5.5 injuries/1000 h training, respectively. The upper extremity was the most affected body region (58 %), followed by the lower extremity (27 %), head and the back. An increase of injuries from proximal to distal was observed in the upper extremity. However, for the lower extremity it was the opposite. Of all injuries, the most common were skin abrasions (70.3 %). Muscle injuries were observed in 13.1 % of the traceurs, followed by dislocations (6.1 %), and soft tissue (e. g., ligaments, tendons) injuries (5.3 %). Passive precautionary measures were abandoned by the majority of the traceurs (88 %). Landing belonged to the movement elements resulting in most of the injuries (61 %), followed by supportive and static efforts of the arms (10.7 %). Overestimation (23 %) as well as misjudging the situation (20 %) were the most common causes., Conclusion: Other than expected, parkour is an urban movement style with most of the injuries being neither severe nor common despite the lack of precautionary measures. Localisation and type of injuries reflect the characteristic movement elements. There is a need for further investigations to allow a more differentiated analysis in order to develop injury prevention concepts., (© Georg Thieme Verlag KG Stuttgart · New York.)

The term, hip pointer, is applied in the setting of a blunt trauma injury to the iliac crest. It typically occurs in contact and collision sports and can cause significant pain and loss of practice or game time. A direct blow results in subperiosteal edema with hematoma formation within surrounding muscle or soft tissue and bone contusion of the iliac crest. Conservative management with compression, ice, antiinflammatories, and rehabilitation exercises are successful in treating hip pointers. Injection therapy with the use of local anesthetic can be helpful in minimizing pain and increasing function to allow more rapid return to play., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objectives: To describe the epidemiology of competition and training-based surf sport-related injury in Australia in the years 2003-2011., Design: A retrospective epidemiological review., Methods: Information on surf sport-related injuries was obtained from Surf Life Saving Australia's SurfGuard Incident Reporting Database during 1 January 2003 to 20 August 2011., Results: There were 2645 surf sport-related competition or training-related incidents. Males and females experienced similar proportions of injury by activity type, with older individuals experiencing a higher proportion of injuries during training than younger individuals. Minor first aid was required for 54.5% of the competition and 43.7% of the training-related incidents, with major first aid required in just over 10% of both incident types. Overall, inflatable rescue boats, beach flags, and surf boats were the most common activities performed at the time of the incident, with returning to shore and negotiating the break the most common possible contributing factors to surf boat incidents. Bruises/contusions, strains, inflammation/swelling, and sprains were the most common types of injuries that occurred during both competition and training. RICE--Rest-Ice-Compression-Elevation--was the most common form of initial treatment for the injury during both competition and training., Conclusions: Participation in surf sports is not without risk of injury. Information from this study will inform injury prevention efforts for surf sport and act as a guide for future research in this area, and towards improved injury surveillance for surf sport-related injuries., (Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

This study was a prospective epidemiological investigation of upper limb injuries during the Men's Field Hockey Junior World Cup 2009. Three hundred twenty-four players were observed in 58 matches of the tournament. Twenty-eight upper limb-related injuries were documented. The injury incidence was 0.48 per match and 19 per 1,000 match hours. Most injuries were due to contact with the ball, and the left hand was the most commonly injured part. Contusion was the most common type of injury. The odds ratio for hand and wrist injuries in players not wearing gloves was 4.01 (95% CI, 0.52-30.62), and the relative risk of hand and wrist injuries in players wearing gloves was 0.26 (95% CI, 0.03-1.92). Male youth hockey players are at a high risk of upper limb, especially hand and wrist, injuries during major international tournaments and that use of protective gloves can provide significant protection against hand and wrist injuries in the sport.

Context: Epidemiologic information on the incidence of youth soccer injuries in southern Europe is limited., Objective: To compare the incidence, type, location, and severity of injuries sustained by male subelite youth soccer players over the 2008-2009 season., Design: Descriptive epidemiology study., Setting: Twenty-eight Portuguese male youth soccer teams., Patients or Other Participants: A total of 674 youth male subelite soccer players in 4 age groups: 179 U-13 (age range, 11-12 years), 169 U-15 (age range, 13-14 years), 165 U-17 (age range, 15-16 years), and 161 U-19 (age range, 17-18 years)., Main Outcome Measure(s): Injuries that led to participation time missed from training and match play prospectively reported by medical or coaching staff of the clubs., Results: In total, 199 injuries reported in 191 players accounted for 14.6 ± 13.0 days of absence from practice. The incidence was 1.2 injuries per 1000 hours of exposure to soccer (95% confidence interval [CI] = 0.8, 1.6), with a 4.2-fold higher incidence during match play (4.7 injuries per 1000 hours of exposure; 95% CI = 3.0, 6.5) than during training (0.9 injuries per 1000 hours of exposure; 95% CI = 0.6, 1.3) (F₁,₆₇₃ = 17.592, P < .001). The overall incidence of injury did not increase with age (F₁,₆₇₃ = 1.299,P = .30), and the incidence of injury during matches (F₁,₆₇₃ = 2.037, P = .14) and training (F₁,₆₇₃ = 0.927, P = .44) did not differ among age groups. Collisions accounted for 57% (n = 113) of all injuries, but participation time missed due to traumatic injury did not differ among age groups (F₃,₁₁₀ = 1.044, P = .38). Most injuries (86%, n = 172) involved the lower extremity. The thigh was the most affected region (30%, n = 60) in all age groups. Muscle strains were the most common injuries among the U-19 (34%, n = 26), U-17 (30%, n = 17), and U-15 (34%, n = 14) age groups, whereas contusions and tendon injuries were the most common injuries in U-13 players (both 32%, n = 8). The relative risk of injury slightly increased with the age of the competitors., Conclusions: The higher incidence of injury during matches than training highlights the need for education and prevention programs in youth soccer. These programs should focus on coach education aimed at improving skills, techniques, and fair play during competitions with the goal of reducing injuries.

Background: Bone bruises on magnetic resonance imaging (MRI) are common in patients with acute knee ligament injuries and have been well described for injuries involving the anterior and posterior cruciate ligaments and the medial collateral ligament. These have not yet been described in detail for posterolateral corner injuries., Hypothesis: Acute grade III posterolateral corner (PLC) injuries are often accompanied by bone bruises located in the medial compartment., Study Design: Case series; Level of evidence, 4., Methods: One hundred two patients with acute grade III PLC knee injuries and MRI scans within 6 weeks of injury were prospectively identified. Images were reviewed for the location of bone bruises, which were defined as areas with high signal intensity adjacent to the joint surface on fat-suppressed, T2-weighted sequences., Results: Overall, 83 patients had at least 1 bone bruise and 56 patients had a bone bruise of the anteromedial femoral condyle. Tibial plateau fractures were found in 19 knees, with 12 in the anteromedial quadrant. Isolated PLC injuries were found in 28 patients; of this group, 18 had at least 1 bone bruise with 17 located in the anteromedial femoral condyle. Seventy-four patients sustained a combined ligamentous injury; 65 of these had at least 1 bone bruise on MRI and 39 had a bone bruise on the anteromedial femoral condyle. In patients with a combined injury to the PLC and anterior cruciate ligament (38), anteromedial femoral condyle bruises were seen in 19 patients and posteromedial tibial plateau bruises in 11., Conclusion: Medial compartment bone bruises, most commonly of the anteromedial femoral condyle, were frequently found in patients with both acute isolated and combined PLC injuries. Thus, the presence of an anteromedial femoral condyle bone bruise should increase the level of suspicion of a concurrent PLC knee injury. In addition, we believe that the presence of a posteromedial tibial plateau bone bruise may be a secondary sign of a potential combined PLC injury in the setting of anterior cruciate ligament tear.

Aims: The aims of this pilot study were to determine the prevalence of head, face and dental injuries sustained by schoolboys while playing cricket and to compare the prevalence of those injuries in England and Australia., Methods: A questionnaire that determined distribution and prevalence of orofacial injuries sustained when playing cricket was distributed to all players (n=411) who played cricket in four private schools in England and four private schools in Australia. There was a 100% response rate., Results: Fifty subjects (24.1%) from English schools and 52 subjects (25.5%) from Australian schools reported injury/injuries to the head, face and teeth. Australian cricketers reported more injuries per player. The distribution of injuries between the two countries was similar. Sixteen players had sustained loosened or broken teeth. Two players reported avulsed teeth., Conclusion: It was concluded that there was a high prevalence of head and orofacial injuries among the schoolboy cricketers but relatively few dental injuries. The distribution of types of head, face and dental injury in England and Australia were similar.

Context: Estimates suggest that more than 5.5 million youths play football annually, and 28% of youth football players (age range = 5 to 14 years) are injured each year, resulting in more than 187 000 emergency room visits., Objective: To analyze time-loss (TL) and non-time-loss (NTL) injury patterns across age groups in youth football players., Design: Two-year observational cohort., Setting: Two midwestern communities, including players from the fourth through eighth grades and between the ages of 9 and 14 years., Patients or Other Participants: A total of 779 players participated, including 296 in grades 4 and 5; 203 in grade 6; 188 in grade 7; and 92 in grade 8. (Players in the fourth and fifth grades participated on the same teams, so we considered them as a single group.), Main Outcome Measure(s): Injury frequencies and exposures were collected by certified athletic trainers present at each practice and game and used to calculate injury rates with 95% confidence intervals (CIs) for both TL and NTL injuries across age groups., Results: A total of 474 injuries and 26 565 exposures were identified. Injuries were reported by 36.5% of the players, with 14.4% reporting more than 1 injury in a season. The overall injury rate per 1000 athlete-exposures (A-Es) was 17.8 (95% CI = 16.3, 19.5). The injury rate increased with each succeeding grade from 14.3 per 1000 A-Es (95% CI = 12.1, 16.9) in grades 4 and 5 to 21.7 per 1000 A-Es (95% CI = 17.2, 27.3) in grade 8. A total of 58.6% of all injuries were NTL. Non-time-loss injuries accounted for 70.1% of the injuries reported by fourth and fifth graders, 55.1% by sixth graders, 64.0% by seventh graders, and 33.8% by eighth graders. The cumulative NTL injury rate was 10.5 per 1000 A-Es (95% CI = 9.3, 11.8), and the TL injury rate was 7.4 per 1000 A-Es (95% CI = 6.4, 8.5)., Conclusions: Youth football players sustained more NTL injuries than TL injuries. We recommend that a first-aid-certified coach or league official be present at all games and practices.

Introduction: Rehabilitation in ambulatory heart groups has become well established in comprehensive cardiac care. The prevention of injuries is critical to the safety and efficiency of the program., Methods: Questionnaires were mailed to the ambulatory heart groups in the state of Hessen, Germany and answered by 1935/13 000 (15 %) patients (65.9 +/- 7.6 years, 1504/1935 (77.7 %) men covering approximately 674,000 patient exercise hours., Results: Seventy-eight of the 106 (73.6 %) injuries reported occurred during games encompassing 28/106 (26.4 %) strains, 24/106 (22.6 %) bruises, 17/106 (16.0 %) sprains, 11/106 (10.4 %) bone fractures, 6/106 (5.7 %) ruptured tendons, 8/106 (7.5 %) ruptured muscles, 3/106 (2.8 %) ruptured ligaments, and 9/106 (8.5 %) miscellaneous. The injury risk was neither related to the cardiovascular diagnosis, the prevalence of diabetes, body mass index, previous sport experience, duration of participation in rehabilitation programs, nor to the participant's age. Patients on anticoagulants or after cardiovascular surgery had no excess risk. Gender was the only independent predictor of injuries. In men the overall incidence of injuries was higher (97/1504 [6.4 %]) than in women (9/431 [2.1 %]), p < 0.0005) while the severity was higher in women (6/9 = 66.7 % vs. 22/97 = 22.7 % p < 0.001). The injuries were treated by elastic bandages or band-aids in 69/106 (65.1 %), by splinting in 4/106 (3.8 %), by local injections in 4/106 (3.8 %), by massages in 3/106 (2.8 %), and by others in 26/106 (24.5 %). Five of the 106 (4.7 %) injuries required hospitalization., Conclusion: The traumatologic risk in the rehabilitation of cardiovascular outpatients is associated with a low incidence of injuries.

Objective: About 5 % of the pupils suffer from an injury in school sports every year. In addition to the kind of injury, the localization and the type of sport, the corresponding reasons for the injuries should be investigated to provide insights for physical education., Methods: In a prospective study 213 accident cases with 234 injuries during physical education classes were examined. At primary presentation in our clinic, an empirical questionnaire was used to document the grade of class, the exact time point of the injury, the question of guilt, out-of-school sports activity as well as the mechanisms of injuries and the type of sport. Clinicians who worked in our out-patient clinic completed the questionnaire after physical examination documenting diagnosis, therapy and the duration of restriction of sports practice. All patients were followed until returning to physical education at school. The data were statistically analyzed using the chi (2)-test to examine gender-specific differences., Results: Gender-specific differences were seen in the type (p = 0.018) and mechanisms (p = 0.028) of injuries. The most common injuries were sprains (female pupils 36.8 % male pupils 24.5 %], contusions (female pupils 27.4 % male pupils 27.9 %) and fractures (female pupils 14.7 % male pupils 18.6 %). Frequent mechanisms of injuries were errors in basic motion training like running, jumping and catching (female pupils 35.8 % male pupils 28.8 %). No gender-specific differences could be shown for the localization of injuries or for the type of sport. The upper extremity with 55 % was more frequently involved than the lower extremity with 37 %. Playing soccer (21.2 %) and basketball (19.8 %) were the most frequent reasons for sports injuries. The highest prevalence of school sports injuries occurred at the onset of and during puberty., Conclusion: For the girls it is necessary to improve the basic motor skills, while the boys need to learn considerate behavior and how to read the game. Basic skill levels in ball games must be improved before practice in competition form is initiated.

Background: To date, the pattern and rate of kitesurfing injuries are largely unclear., Hypothesis: The pattern and rate of kitesurfing injuries are comparable to that of contact sports such as football and soccer., Study Design: Prospective study., Methods: The study was conducted over a 6-month period of 1 season and included 235 kitesurfers., Results: The number of self-reported injuries was 124, for an overall self-reported injury rate of 7 per 1000 hours of practice. One fatal accident (polytrauma) and 11 severe injuries occurred during the study period (2 knee ligament injuries and 9 fractures at various sites). The most commonly injured sites were the foot and ankle (28%), skull (14%), chest (13%), and knee (13%). Fifty-six percent of the injuries were attributed to the inability to detach the kite from the harness in a situation involving loss of control over the kite. There was a tendency for athletes using a quick-release system to sustain fewer injuries than athletes without such a release system., Conclusion: Kitesurfing can be considered a high-risk sport., Clinical Relevance: The use of a quick-release system that enables the surfers to detach the kite in case of an accident might aid in the prevention of injuries.

Background/purpose: Since 2000, a substantial increase in injuries related to nonmotorized scooters (kickboards) has been observed among children. The authors conducted a population-based prospective study to characterize these injuries in comparison with skateboard-related injuries during the same period., Methods: All children (age <16 years) presenting with a scooter-related injury between July and October 2000 in Graz (Austria) and all children presenting with a scooter- or skateboard-related injury between June and September 2001 in Helsinki, Finland were interviewed at the time of seeking medical attention., Results: One hundred thirteen patients with scooter injuries and 72 patients with skateboard injuries were recorded. The 4-month calculated incidence in children less than 16 years of age was 0.72 per 1,000 for scooter injuries and 0.68 per 1,000 for skateboard injuries. The scooter injuries accounted for 1.9% and the skateboard injuries for 2.6% of all pediatric traumas within the respective catchment areas. The majority of the patients in both groups were boys. The patients with scooter injuries were younger than the patients with skateboard injuries (mean age 10.2 +/- 2.7 v 12.5 +/- 2.4 years; P <.001). Most of the scooter-related accidents were claimed to be caused by the wheels of the scooter getting caught by uneven ground, whereas most skateboard accidents occurred during attempted trick maneuvers. Protective gear was seldom used. More than half of the scooter-related injuries were minor bruises, wounds, or contusions. One third of the patients sustained a fracture, usually involving the upper extremity distal to the elbow. The only life-threatening injury was a ruptured spleen in a skateboarder. The injury pattern of scooter and skateboard injuries was similar., Conclusions: Public awareness of the potential dangers related to scooter riding should be increased and the use of protective gear encouraged.

Background: Little is known about the pattern of injury in short track speed skating., Purpose: To investigate the incidence and characteristics of injuries in short track speed skating., Study Design: Retrospective study., Methods: Ninety-five of 150 elite-level skaters (63.3%) were surveyed to collect information on training and competition load as well as on injuries sustained during the 1999-2000 competitive season. Injuries were characterized in terms of anatomic location, type of injury, time loss from training and competition, and circumstance of injury (acute onset during competition, on-ice practice, off-ice training, or insidious onset)., Results: Sixty-one of the 95 skaters (64.2%) reported sustaining at least one injury. The knee, ankle, spine, leg, and groin were the most commonly reported sites of injury. Skaters were also asked to list previous on-ice injuries. The two most common injuries occurring on-ice before the 1999-2000 season were lacerations from the knee down (11.1%) and ankle fractures (10.2%)., Conclusion: The results of this study suggest that there is a high incidence of injury in competitive short track speed skating.

Background: Although player-to-player contact is a risk factor in the majority of soccer injuries, the mechanisms leading to these injuries have not been analyzed., Purpose: To assess the relationships between foot/ankle injuries and foul play and tackle type, and to identify the position of the foot and ankle at the time of injury., Study Design: Prospective cohort study., Methods: Team physicians prospectively recorded each injury in four world soccer competitions, and the videotaped incident leading to the injury was retrospectively analyzed., Results: Of 76 foot and ankle injuries (52 contusions, 20 sprains, 4 fractures), direct contact occurred between players in 72. Significantly more injuries involved a tackle from the side and a lateral or medial tackle force. The injured limb was weightbearing in 41 and nonweightbearing in 35 of the incidents. Significantly more injuries resulted in time lost from soccer when the limb was weightbearing. The most common foot and ankle positions at the time of injury were pronated/neutral in the sagittal plane for weightbearing limbs, and plantar flexed/neutral in the coronal plane for nonweightbearing limbs. The most common foot and ankle rotations at the time of injury were external (23) and eversion (28)., Conclusions: The majority of injuries were caused by tackles involving lateral or medial forces that created a corresponding eversion or inversion rotation of the foot or ankle. The weightbearing status of the injured limb was a significant risk factor.

A prospective study of soccer injuries, involving 287 male youth players, from the ages of 12-15 was conducted in 24 Greek soccer clubs, during the course of one year. A total of 193 players sustained 209 injuries. The incidence of injuries was 4.0 injuries per 1000 h of soccer time per player, and the most common types of injuries were sprains and strains. Surprisingly, it was found that an increase of injury incidences occurred during practice. Fifty-eight injuries required medical assistance. The majority of injuries (80%) were located in the lower extremities. Collision with other players was the most common activity at the time of injury, accounting for 40% of all injuries. The conclusion of this study and the evidence from other studies suggests that youth soccer is a relatively low risk sport. However, a substantial amount of injuries could be prevented. It is necessary to identify the risk factors, which are associated with these types of injuries.

Triathlon is an individual sport consisting of three disciplines - swimming, cycling and running. Triathlon has changed from a novel appearance to a very popular Olympic sport within the last fifteen years. Nevertheless, there is not sufficient data about injuries in triathlon. The aim of this retrospective survey was to investigate the incidence of injuries according to class of injuries, anatomical sites and disciplines. Relations to age, sex, performance level, training habits and medical care were analysed. Questionnaires were sent to all German speaking participants of the Ironman Europe 2000. With a response rate of 35 %, 656 questionnaires met the inclusion criteria. At least one injury was experienced by 74.8 % (95 %-CI: 71.3-78.1) of all respondents during their active time in triathlon. 51.1 % (95 %-CI: 47.2-55.0) suffered one or more contusion/skin-abrasions, 33.1 % (95 %-CI: 29.5-36.8) muscle-/tendon-injuries, 29.0 % (95 %-CI: 25.5-32.6) ligament-/capsule-injuries and 11.9 % (95 %-CI: 9.5-14.6) fractures. Most of the injuries happened during cycling (54.8 % [95 %-CI: 51.9-57.8]) within training sessions. 18.7 % (95 %-CI: 16.4-21.2) of all injuries occurred while the athletes were competing. Considering the low number of competition hours per year, the incidence of injuries during competition was higher than during training session. Significant relations were found considering the age, performance level and weekly training hours of the triathletes. Older athletes sustained more fractures (p = 0.024), high performance athletes suffered more contusions/abrasions (p = 0.003) and muscle-tendon-injuries (p = 0.001) and athletes with a large number of weekly training hours suffered more muscle-tendon-injuries (p = 0.014). To summarize, injuries in triathlon seem to be related to age, performance level and weekly training hours, but not to sex, presence of training coach and medical care.