Search

Background There are 2.8 million youth competitive swimmers in the United States (US), and shoulder pain is the most common complaint among swimmers. Purpose To determine prevalence of shoulder pain, disability, and dissatisfaction in youth competitive swimmers. A secondary purpose was to determine influence of age, competitive swimming experience, and previous history of shoulder pain or injury on shoulder pain, disability, and dissatisfaction, and finally to determine if sex, geographic area, and participation in a second sport relate to shoulder pain, disability, and dissatisfaction. Study Design Multi-site cross-sectional design Methods Six-hundred and seventy-one swimmers aged 9--17 years from six states in the US completed surveys which included demographics, the Penn Shoulder Score (PSS), and the Disability of Arm Shoulder Hand (DASH) Sports. Independent t-tests were used to compare pain, disability, dissatisfaction, the influence of age, sex, participation in second sport, geographic region, and history of shoulder pain. Linear regression analyses were performed to determine the interaction of these variables with reported pain and disability. Results Forty-nine percent of swimmers had shoulder symptoms. Greater shoulder pain and disability were reported in 15 to 17-year-olds compared to 9 to 10-year-olds (pain and disability: p<0.001), in swimmers with greater versus less years of experience (pain and disability: p<0.001), and in swimmers from eastern versus western states (pain: p=0.001, disability: p=0.0014). Swimmers not participating in a second sport had higher shoulder dissatisfaction (p=0.002). History of prior shoulder pain/traumatic injury was the best indicator of increased pain, disability, and dissatisfaction (p<0.001). Conclusion Almost half of swimmers surveyed had shoulder pain, with a higher prevalence found in older age groups, those with greater experience, and in those with prior shoulder pain or traumatic injury. Further research should investigate shoulder pain prevention programs, and surveillance methods are recommended to identify symptomatic swimmers who may benefit from referral to prevent further pain and disability. Level of Evidence III [ABSTRACT FROM AUTHOR]

Context: The definition of an "overuse injury" had some ambiguity until recent publications . It is unknown whether the improved definition of "overuse injury" has been applied to epidemiology studies that examine high school-aged athletes. This population may be predisposed to overuse injuries due to several factors. Clinical Question : Is there more consistency in how the term "overuse injury" is being used, and has the rate of overuse injuries in high school-aged athletes epidemiology studies changed since Roos and Marshall's 2014 systematic review on overuse injury definitions? Clinical Bottom Line: Since Roos and Marshall's systematic review. more studies are recognizing "overuse injuries as needing a specific mechanism of injury: however, several studies failed to differentiate "overuse injuries" from "noncontact injuries." The rate of overuse injuries does not appear to have changed significantly. [ABSTRACT FROM AUTHOR]

Objective: Using data from a longitudinal national sports injury surveillance program, this study aimed to calculate injury rates and describe injury patterns across high school swimmers and divers. Design: Descriptive Epidemiological Study. Athletic trainers (ATs) from participating high schools reported injuries from swimming and diving programs for the High School Reporting Information Online system. Setting: Convenience sample of high school boys and girls' swimming and diving injuries during the 2008 to 2019 school years. Patients or other Participants: High school boy and girl swimmers and divers (aged ∼14-18 years). Independent Variables: Exposure data on gender, location of injury (practice vs competition), mechanism of injury, and sport (swimming vs diving). Main Outcome Measures: Injury rates, rate ratios (RRs) with 95% confidence intervals, and other descriptive statistics were performed. Results: 563 swimming and diving injuries occurred during 2 171 260 athlete exposures (0.26 per 1000 athlete exposures). Girls had higher injury rates than boys overall (RR 1.57, P < 0.05), in practice (RR 1.53, P < 0.05), and competition (RR 1.81, P < 0.05). In swimmers, most injuries were to the shoulder (48.6%), associated with the freestyle (67.3%), and classified as overuse/chronic (58.0%). Among divers, most injuries were to the head/face (36.6%) and from contact with the playing surface (68.3%). Conclusions: Girls had statistically significantly higher injury rates than boys. The shoulder and head/face were the most injured body parts in swimmers and divers, respectively. Swimming injuries were most frequently of an overuse etiology, whereas diving injuries were more likely traumatic. Coaches and ATs should be aware of these findings to develop targeted strategies for injury prevention. [ABSTRACT FROM AUTHOR]

Background: Drowning is a leading cause of unintentional injury-related death for toddlers within the USA. Keeping toddlers within arm's reach while swimming is recommended, yet many caregivers do not. Possibly, caregivers' attitudes are shaped by their expectations about whether they could quickly save a child. The aims of this study are to 1) explore caregivers' views of arm's reach pool supervision in various scenarios and 2) understand whether perceptions of arm's reach pool supervision are impacted by the caregiver's self-reported capability to swim the length of a standard pool. Results: Caregivers generally showed agreement with arm's reach pool supervision; however, arm's reach supervision was viewed as less necessary when a toddler was in shallow water, wearing a flotation device, or with an older child or teen. There was a significant effect of caregiver swimming capability on perceptions of arm's reach pool supervision, with non-swimmers and the strongest swimmers showing more positive perceptions of arm's reach pool supervision than caregivers reporting poor swimming capability. Female caregivers showed significantly more agreement with arm's reach pool supervision compared with male caregivers. Grandparents and parents showed significantly more agreement with arm's reach pool supervision than siblings. Conclusions: Caregivers' views about what constitutes appropriate supervision are impacted by gender, the relationship to the toddler, and the caregiver's swimming capability. Findings suggest that a caregiver's ability to offer close supervision or respond in an emergency may influence their attitudes about what constitutes appropriate supervision. Caregivers may view arm's reach pool supervision as less necessary when additional layers of protection are in place. [ABSTRACT FROM AUTHOR]

Antigravity treadmilk are being used in rehabilitation programs but have not been used consistently with posthip labral repair arthroscopy surgeries. The purpose of this study was to review the posthip labral protocol used by eight National Collegiate Athletic Association Division I collegiate athletes Call ages 18-21) from multiple sports that used the antigravity treadmill as a bridge between "no running" and 'on-ground running." The authors found that athletes who did this returned to play between 4.5 and 7 months. had a better overall functional status. and had no re-injuries. This is the first known study of its kind available in the literature. [ABSTRACT FROM AUTHOR]

Background Para swimming has experienced increased participation in recent years. Injury and injury prevention research on Para swimmers is lacking compared to swimmers without impairment. Purpose This study aimed to gather data in Para swimmers on typical injuries, injury prevention programs, and attitudes toward injury and injury prevention in this population. Study Design Cross-sectional, mixed-methods design evaluating injuries, injury management, and injury prevention in elite Para swimmers in United States (U.S.). Methods Para swimmers on the U.S. Paralympics Swimming National teams at multiple competition levels were invited to complete an online survey. Qualitative interviews with six U.S. Paralympics National team Para swimmers were conducted to provide detail on athlete experiences with injury and prevention. Results Twenty-one of 56 surveys were returned: 11 of 21 participants (52.4%) reported experiencing an injury that altered their weekly training. All (21/21) reported participating in strength training and 19 of 21 (90.5%) reported incorporating stretching into their training regimen, although strengthening/stretching regimens included routines that may not have been specifically targeted toward injury prevention. Six of 21 (28.6%) reported participation in an injury prevention program. Qualitative interview themes included the impact of swimmers' compensated body mechanics on injury risk, the value of individualized injury prevention programs, and the importance of knowledgeable coaching and rehabilitation staff. Conclusions Injury prevention programs are important components in Para swimming training although they are underutilized based on responses in this study. These programs should be individualized to address swimming biomechanics and athlete-specific impairments. Increasing coaching knowledge and access to individualized programs may reduce injury prevalence among this at-risk population. [ABSTRACT FROM AUTHOR]

Context: Youth- through masters-level competitive swimmers incur significant shoulder pain. Risk factors associated with shoulder pain include high swimming yardage, a lack of cross-training, decreased shoulder strength and reduced core endurance, and limited posterior shoulder and pectoral length. Since training, swimming exposure, and physical-performance measures have all been associated with shoulder pain, the methods used to train swimmers may influence the development of shoulder pain, yet studies delineating training methods are lacking. Objectives: To identify in-water and dry-land practices among youth- through masters-level swimmers in the United States (US) and describe the potential effects of training practices on swimmers' shoulders. Design: A Web-based survey was developed to identify common training practices in 5 areas: quantification of swimming and dry-land training and in-water techniques such as kicking drills, upper-body stretching, shoulder and core strengthening, and cross-training. Participants: 156 swim-team coaches or captains of youth, high school, and college swim teams and 196 masters swimmers participated (N = 352). There was geographic representation from across the US. Results: Responses indicated diverse training practices. However, most respondents used kicking drills, which may provoke shoulder pain due to prolonged poor positioning. High yardage swum by high school and college teams increases their risk of shoulder tendinopathy. Stretching and strengthening exercises and dosages commonly used were inconsistent with current research recommendations and lacked specificity in terms of addressing typical mobility restrictions and muscle weaknesses described in the swimming literature. Core strengthening and cross-training are frequently performed. Conclusions: Several areas of in-water and dry-land practice were identified that may put swimmers' shoulders at risk for injury. Further research regarding the safety and efficacy of training programs is recommended to determine optimal methods of injury prevention and performance enhancement. [ABSTRACT FROM AUTHOR]

Introduction: Water-related recreational activities, including swimming and diving, are widespread. However, they carry a significant risk of craniofacial injuries. Despite the popularity of these activities, comprehensive data on injuries beyond drowning remain scant. This study addresses this gap by providing valuable epidemiological insight into the nature, prevalence, and demographic patterns of craniofacial injuries related to water sports activities., Methods: The authors queried the NEISS database for craniofacial injuries related to swimming, diving, and water sports from 2013 to 2022. Data were analyzed for demographics, anatomic locations of injuries, and the activities leading to these injuries., Results: Between 2013 and 2022, a total of 952,111 craniofacial injuries were associated with swimming and water sports. Of these, 510,706 (53.6%) were male patients, and 441,405 (46.4%) were female. This indicates that males were 1.16 times more likely to sustain such injuries. The age groups most affected were 0 to 9 and 10 to 19 years. Anatomic locations impacted were as follows: ears (58.1%), head (16.8%), face (13.9%), neck (4.8%), eyeballs (4.4%), and mouth (2%). Leading causes were identified as swimming and water sports activities (66.5%), swimming pools and equipment (28.2%), diving or diving boards (4.7%), and scuba diving (0.5%). Notably, 89.2% of patients with diving-related injuries and 99.1% with swimming-related injuries were not admitted to the hospital., Conclusions: This study offers critical epidemiological data to supplement targeted prevention strategies and resource allocation in managing craniofacial injuries associated with water activities. The findings highlight the urgent need for specialized care and serve as a foundation for future preventive initiatives., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

The article reports on the significance of a Model Aquatic Health Code (MAHC) in the U.S. It states that the code is intended to prevent disease and injuries while promoting healthy recreational water experiences by promoting a single national aquatic code. In addition, the code is being designed to create a uniform set of guidelines related to the planning, design and maintenance of all swimming pools and other public swimming areas to prevent recreational water illnesses.

We determined whether the incidence of injuries would increase with advancing age and whether the participation in cross-training would be related to a decreased rate of injuries and healthcare costs in Masters swimmers. A total of 499 swimmers (55 ± 14 years of age) belonging to US Masters Swimming completed a comprehensive questionnaire that included questions regarding their medical history as well as their training history. In average, swimmers had been training for 13 ± 12 years, and 35, 40, and 47 % participated in running, cycling, and dryland resistance training, respectively. According to the logistic regression, prevalence of injuries increased significantly but modestly with advancing age (p < 0.05). Linear regression analysis showed that for every 1 month increase in the length of injury, healthcare costs increased by 7.4 % (p < 0.05). Linear regression and logistic regression analyses determined that overall volume of swimming training was not related to age or incidence of injuries, respectively. Multinomial logistic regression analyses using age and sex as predictors demonstrated that the odds of reporting a swim-related injury were significantly lower for individuals who participated in any number of cross-training activities compared with those who do not cross-train (p < 0.05). Regular participation in any cross-training modality was inversely related to age (p < 0.05). We concluded that the diversification of the overall training program by incorporating cross-training may be an important strategy to reduce sport-specific injuries among Masters athletes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The goal of this study was to describe the epidemiology of pediatric submersion events occurring in portable pools in the United States. METHODS: A retrospective analysis of fatal and nonfatal submersion events involving children younger than 12 years in portable pools was conducted using injury and fatality data compiled by the US Consumer Product Safety Commission from 2001 through 2009. RESULTS: There were 209 fatal and 35 nonfatal submersion cases reported to the commission from 2001 through 2009. The majority (94%) involved children younger than 5 years, 56% involved boys, 73% occurred in the child's own yard, and 81% occurred during the summer months. The number of submersion events increased rapidly from 2001 to 2005 and then leveled off from 2005 to 2009. CONCLUSIONS: The use of portable pools in residential settings poses a significant risk of submersion-related morbidity and mortality to children, especially in the <5-year-old age group. No single strategy will prevent all submersion deaths and injuries; therefore, layers of protection are recommended. Industry is advised to engage in development of protective devices that are effective and affordable for portable pools, including isolation fencing, pool alarms, and safety covers. A strong and pervasive consumer education campaign is needed to make consumers aware of the dangers of portable pools, because these small, inexpensive, consumer-installed pools may not generate the same sense of risk as an in-ground pool. [ABSTRACT FROM AUTHOR]

Background: In the last 25 years, it is estimated that over 42,000 male and female swimmers have competed at the National Collegiate Athletic Association (NCAA) Division I-A level. Despite the magnitude of these numbers, little is known about the epidemiology of collegiate swimming injuries. Purpose: To describe the pattern of injuries incurred for one NCAA Division I collegiate men's and women's swimming team over 5 seasons. Study Design: Descriptive epidemiology study. Methods: Musculoskeletal and head injuries reported in the Sports Injury Management System for a Division I swimming team from 2002-2007 were identified. Gender, body part, year of eligibility, position, stroke specialty, scholarship status, and team activity during which the injury occurred and lost time were recorded. Risk of injury was assessed relative to gender, stroke specialty, and year of eligibility. Results: From 2002-2007, 44 male and 50 female athletes competed for the University of Iowa swimming and diving team. The overall injury rates were estimated as 4.00 injuries per 1000 exposures for men and 3.78 injuries per 1000 exposures for women. Thirty-seven percent of injuries resulted in missed time. The shoulder/upper arm was the most frequently injured body part followed by the neck/back. Freshman swimmers suffered the most injuries as well as the highest mean number of injuries per swimmer. A significant pattern of fewer injuries in later years of eligibility was also demonstrated. The relative risk (RR) for injury was higher among nonfreestyle stroke specialties (RR, 1.33 [1.00-1.77]). Injury most often occurred as a result of, or during, practice for all swimmers. However, 38% of injuries were the result of team activities outside of practice or competition, such as strength training. No significant relationship was found between occurrence of injury and gender or scholarship status. There was no significant relationship between body part injured and stroke specialty. An increased number of total injuries and an increased risk of injuries in freshman collegiate swimmers were found. Conclusion: Particular attention should be given to swimmers making the transition into collegiate level swimming. These data also suggest that injury surveillance and potential prevention strategies should focus on the shoulder for in-pool activities and the axial spine for cross-training activities. [ABSTRACT FROM AUTHOR]

Conducts a questionnaire survey on 1,262 United States swimmers: 993 age group, 198 senior development, and 71 national team athletes, in order to evaluate the prevalence of shoulder pain. Materials and methods; Results; Discussion.

Context: The number of women's swimming and diving teams sponsored by the National Collegiate Athletic Association has increased over the last 5 years., Background: Routine examinations of women's swimming and diving injuries are important for identifying emerging temporal patterns., Methods: Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 through 2018-2019 athletic seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates., Results: The overall injury rate was 1.78 per 1000 athlete-exposures in swimmers and 2.49 per 1000 AEs in divers. Shoulder (33.0%) injuries accounted for the largest proportion of all swimming injuries; most injuries were classified as overuse (51.3%). Head or face (29.4%) and trunk (20.2%) injuries accounted for the largest proportions of all diving injuries., Summary: Findings indicated that shoulder and trunk injuries, as well as injuries resulting from overuse mechanisms, warrant further attention in swimming. Given the low in the National Collegiate Athletic Association Injury Surveillance Program observed across the study period, the need for greater participation in sports injury surveillance is also apparent., (© by the National Athletic Trainers' Association, Inc.)

Context: The National Collegiate Athletic Association (NCAA) has sponsored men's swimming and diving since 1937., Background: Routine examinations of men's swimming and diving injuries are important for identifying emerging injury-related patterns., Methods: Exposure and injury data collected in the NCAA Injury Surveillance Program during the 2014-2015 through 2018-2019 academic years were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates., Results: The overall injury rate was 1.56 per 1000 athlete-exposures (AEs) for swimmers and 1.52 per 1000 AEs for divers. Shoulder (27.0%) injuries accounted for the largest proportion of all swimming injuries, and most injuries were attributed to overuse mechanisms (42.6%). Shoulder (23.3%) and trunk (23.3%) injuries accounted for the largest proportion of all diving injuries, and most injuries resulted from surface contact (32.6%)., Conclusions: Findings were consistent with existing literature on swimming and diving. The need for continued surveillance, coupled with more robust participation by swimming and diving programs was also highlighted., (© by the National Athletic Trainers' Association, Inc.)

Background: Recent injury data for collegiate-level swimming and diving are limited. This study describes the epidemiology of men's and women's swimming and diving injuries reported by the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) during the 2009/2010 to 2013/2014 academic years., Methods: Injuries and athlete-exposure (AE) data reported within 9 men's and 13 women's swimming and diving programmes were analysed. Injury rates, injury rate ratios (IRR), and injury proportions by body site, diagnosis and mechanism were reported with 95% CIs., Results: The ISP captured 149 and 208 injuries for men's and women's swimming and diving, respectively, leading to injury rates of 1.54/1000 and 1.71/1000 AEs. Among females, divers had a higher injury rate (2.49/1000 AEs) than swimmers (1.63/1000 AEs; IRR=1.53; 95% CI 1.07 to 2.19). Injury rates for male divers (1.94/1000 AEs) and swimmers (1.48/1000 AEs) did not differ (IRR=1.33; 95% CI 0.85 to 2.31). Most injuries occurred to the shoulder, resulted in strains and were classified as overuse or non-contact. Female swimmers had a higher overuse injury rate (1.04/1000 AEs) than male swimmers (0.66/1000 AEs; IRR=1.58; 95% CI 1.14 to 2.19). Overuse injury rates for female divers (0.54/1000 AEs) and male divers (0.46/1000 AEs) did not differ (IRR=1.16; 95% CI 0.40 to 3.34). Injury rates in 2012/2013-2013/2014 were lower than those in 2009/2010-2011/2012 for women's swimming (IRR=0.70; 95% CI 0.52 to 0.95) and diving (IRR=0.56; 95% CI 0.30 to 1.08), respectively. No time trends existed for men's swimmers or divers., Conclusions: Shoulder, strain and overuse injuries were common in collegiate men's and women's swimming and diving. Female swimmers were more likely to suffer an overuse injury than male swimmers. In addition, divers may have higher injury rates than swimmers, although small reported numbers warrant additional research., (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.)

Objective: Swimming is one of the most popular recreational activities in the United States. The objective of this study was to investigate the epidemiology of the complete spectrum of injuries associated with swimming and swimming pools treated in US hospital emergency departments., Methods: Data from the National Electronic Injury Surveillance System from 1990 to 2008 were analyzed. Injury rates were calculated using US census swimming participation data., Results: An estimated 1688924 swimming injuries occurred during the 19-year study, averaging 1 injury every 6 minutes. During the study period, the number of injuries and rate of injury among individuals 7 years or older significantly increased. Within this trend, injuries peaked in 1999 and significantly decreased during the last 10 years but still showed an overall increase of 18.6% in number and 29.3% in rate from 1900 to 2008. Patients 17 years or younger accounted for 60.5% of injuries, and patients 7 to 17 years of age had a greater mean annual swimming injury rate (18.78 per 10000 participants) than patients older than 17 years (9.15). Most injuries occurred in or around a swimming pool (87.0%), and most were soft tissue injuries (54.7%), followed by strains/sprains (16.4%), fractures/dislocations (11.3%), and submersion (4.9%). Injuries to patients younger than 7 years, submersion injuries, and injuries occurring at home were more likely to result in hospital admission or fatality., Conclusions: The observed increase in injuries among individuals older than 7 years underscores the need for increased prevention efforts, including education about safe swimming practices, supervision, and environmental modifications., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: To describe the current use of dry-land training in swimmers by age category., Design: Randomized sampling questionnaire., Setting: Web-based survey., Participants: Ninety-seven coaches from swim clubs throughout the United States., Main Outcome Measures: Dry-land training use, frequency, duration, mode of exercise, and exercise by body region in the following groups: ≤10 years, 11-14 years, 15-18 years, collegiate, and masters swimmers (≥18 years, noncollegiate)., Results: Among the surveyed coaches (n = 97), dry-land training use varied by swimmers' age (≤10 years [54%], 11-14 years [83%], 15-18 years [93%], collegiate [86%], and masters [26%]) and type of training modality (age ≤18 years [body weight exercises, stretching]; collegiate [free weight/machine weights and body weight exercises]; and masters [weight and cardiovascular training]). The most common body region exercised for all categories except masters was the spine/core, followed by the proximal leg, and then the shoulder. Masters swimmers focused on the shoulder region, followed by the spine. The primary reason for participation in dry-land training was injury prevention for all categories except masters. Limited practice time was the most common reason for not using dry-land training., Conclusions: A total of 50%-93% of swim coaches surveyed for all groups except masters incorporated some form of dry-land training; they used body weight exercises in younger swimmers. The focus of dry-land training among swimmers ≤18 years and collegiate swimmers was the spine/core. These findings may be used to develop future studies on how dry-land training contributes to performance or injuries, especially in the younger swimmer., (Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)

Body surfing accidents (BSA) can cause cervical spinal cord injuries (CSCIs) that are associated with near-drowning (ND). The submersion injury from a ND can result in aspiration and predispose to pulmonary complications. We predicted a worse outcome (particularly the development of pneumonia) in patients with CSCIs associated with ND. A retrospective review was performed of patients who were treated at Eastern Virginia Medical School for a CSCI resulting from a blunt mechanism. Data collected included basic demographic data, data regarding injury and in-hospital outcomes, and discharge data, including discharge disposition. Statistics were performed using χ(2) and Student t test. In 2003 to 2008, 141 patients were treated for CSCIs with inclusion criteria. Thirty patients (21%) had an associated ND (BSA) and 111 patients (79%) did not (BLT). The cohorts were similar in mean age (BSA, 45 years; BLT, 50 years; P = 0.16) and male gender distribution (BSA, 93%; BLT, 79%; P = 0.13). The cohorts were similar in injury severity using Injury Severity Score (BSA, 22; BLT, 24; P = 0.65). The cohorts were similar in rates of developing pneumonia (BSA, 3%; BLT, 12%; P = 0.31). The rate of infection was significantly higher in the cohort without an associated near-drowning (BSA, 10%; BLT, 32%; P = 0.033). The mean intensive care unit stay (BSA, 3.5 days; BLT, 11.3 days; P = 0.057) and the rate of mortality were similar (BSA, 10%; BLT, 10% P = 0.99). Those patients with an associated ND had a shorter hospital stay (BSA, 5.7 days; BLT, 22.2 days; P = 0.007) and a better chance of being discharged home (BSA, 57%; BLT, 27%; P = 0.004). CSCIs after a BSA do better than their counterparts without an associated ND. CSCIs associated with ND appear to be isolated injuries with minimal pulmonary involvement despite submersion injuries.

Objective: To review injuries associated with falls from river tree rope swings (RTRS) and identify points of action for prevention., Methods: This study was a retrospective analysis of injury reports directly related to falls from RTRS. Case reports for 2002-06 were extracted from the National Electronic Injury Surveillance System (NEISS), US legal literature, and news reports. Direct observation of river tree rope swings was performed with kayak and camera to identify potential hazards. A laboratory study was performed on samples of rope used in RTRS to assess entanglement risk., Results: NEISS detailed 73 injuries directly related to falls from RTRS in ages 5-25 years. Finger fractures were the most commonly reported injury. Based on NEISS data, an estimated 700 injuries may occur related to RTRS each year. RTRS share risk of severe injuries with traditional rope swings such as lower extremity fractures, concussions, and spinal cord injuries. Drowning, finger avulsion and genital lacerations appear more common with river tree rope swings., Conclusions: RTRS are dangerous and are associated with a variety of serious injuries from falls and entanglement. The most hazardous risk factors of RTRS are use by a non-swimmer, shallow water, extreme fall distance, and presence of a small diameter retrieval line. RTRS injuries occurring in remote locations are challenges to rural physicians and EMS providers. Prevention of recreational injuries, including injuries sustained from RTRS, remains a daunting task.

Methods: The authors conducted a survey of 296 competitive swimmers to assess the incidence and importance of interfering groin pain in breaststroke swimmers., Results: Breaststroke swimmers were more likely to have current groin pain (6.92%) than individual medley swimmers who did not compete in pure breaststroke events (0, P = 0.015). Breaststroke swimmers (42.7%) were also more likely than individual medley swimmers (21.5%, P = 0.000622) or nonbreaststroke, nonindividual medley swimmers (5.8%, P = 0.00000311) to have been unable to train breaststroke in practice during the past year due to groin injury., Conclusion: Results indicate that breaststroke swimmers are at significant risk of groin injury, groin injury is positively correlated with increased magnitude of breaststroke training, and groin injury may prevent participation in practices and competitions.

Background: Soccer reportedly places participants at risk for neuropsychological impairment, although it is unknown if the risk is associated primarily with concussion, subconcussive blows from heading the ball, or some combination thereof. Moreover, the extent to which younger versus older athletes are at risk for soccer-related cognitive impairment is unclear. We hypothesized that soccer athletes, especially older ones, would show poorer neuropsychological test performance than comparable swimmers., Methods: Thirty-two soccer (26 college and 6 professional) and 29 swimmers (22 college and 7 masters level), all involved for at least 4 years in their sport at collegiate or national levels, participated. In a 2 X 2 (sport X age category) factorial design, all participants underwent 4 neuropsychological tests with 11 outcome measures assessing motor speed, attention, concentration, reaction time, and conceptual thinking., Results: Soccer athletes performed worse than swimmers on measures of conceptual thinking. The older soccer group in particular performed poorly on measures of conceptual thinking, reaction time, and concentration. Among non-goaltender soccer athletes, estimates of career exposure to brain trauma (based on length of career and level of play) predicted significantly poorer test performance on 6 of 11 measures, even after statistically controlling for age., Conclusions: Results provide additional evidence that participation in soccer may be associated with poorer neuropsychological performance, although the observed pattern of findings does not specifically implicate heading as the cause. Although deficits were most apparent among older soccer players, serial neuropsychological testing for early detection of impairment is recommended for younger players as well.

Competitive swimming is commonly thought to be an injury-free sport. Traumatic and overuse injuries do occur, especially if one includes accidents occurring to both athletes and spectators, and accidents resulting from some of the newer diving and starting techniques. United States Swimming, Incorporated, the national governing body for competitive swimming, and provider of insurance coverage for most of the swimming clubs in the United States, keeps track of reported injuries to club members, and requires specific safety accreditation for member coaches. These data provide an informative view on injuries to competitive swimmers.

Competitive swimming has a low incidence of back pain and spine injury. Catastrophic cervical injury can occur from diving into a shallow pool; and injuries frequently result from diving from any height. Functional lower and middle back pain usually are due to musculoskeletal causes and are treated conservatively. In a sport that rewards flexibility, it is vital that coaches, trainers, and treating physicians stay current with the physical effects resulting from evolving competitive techniques and rules.