The South African Rugby Injury and Illness Surveillance and Prevention Project (SARIISPP): SARU Girls’ Youth Week Injury Surveillance Report 2019

As part of the South African Rugby Injury and Illness Surveillance and Prevention Project (SARIISPP), the annual SARU Youth Week tournaments’ injury data are recorded and investigated by SA Rugby. The BokSmart National Rugby Safety Programme has been collecting and analysing these data annually since 2011 for the SARU Boy’s Youth Week tournaments. In 2015, the SARU Girls’ Youth Week data collection began; this report being the first to analyse the Girls’ Youth Week data. The analysis shows injury patterns over time between tournaments, and collectively, for the girls’ u16 and u18 SARU Youth Weeks. Additionally, the analysis compares the profiles of injured players at each individual tournament. When investigating these patterns, areas of concern are identified, changes in the game, tournament structure or medical support services are considered or contested against the evidence, and injury specific interventions can be created and implemented, where the evidence indicates such a need. Each medical facility at the SARU Youth Week tournaments has a designated researcher onsite, who together with the tournament medical doctors, records the tournament injury data daily. Three injury cases were removed from the analysis. These data were recorded but did not appear to be accurate on follow-up and were therefore removed. Unfortunately, inaccuracy can occur during data collection and measures have been implemented to ensure that this is limited. This 2019 SARU Girls’ Youth Week report focuses on the Girls’ tournaments, comprising of the Girls u16 Week (Gu16W) and Girls u18 Week (Gu18W) held in 2019. The tournaments consisted of 32 teams and 48 matches. Comparisons are made between SARU Girls’ Youth Week tournaments and over time between 2015 and 2019. It must be noted that no Gu16W tournament was held in 2017. In 2019, the Gu16W recorded a higher Time-Loss injury incidence at 22 (11 - 33) [mean (95% confidence intervals)] injuries per 1000 player hours. Gu18W recorded slightly lower Time-Loss injury incidence at 19 (10 – 28) injuries per 1000 player hours. The collective tournament average was measured at 21 (13 to 28) injuries per 1000 player hours. When combining the injury incidence data collected over the five years, Gu18W had a lower Time-Loss injury incidence. In 2019, the Tackler and Open Play, followed by the Ball Carrier, were the most frequent injury-causing events in that order. Tackling front-on (regulation), Tackling LOW side-on, and Tackling LOW front-on, were the most frequent injury causing mechanisms involved in the Tackler phases of play. While Collision in Open Play was the most frequent injury causing mechanism in Open Play. The most common injury type was Central Nervous System injuries, where Gu18W recorded a higher incidence. Head and Neck were the most common injury locations in 2019, accounting for 69% of the injuries, with most of these injuries occurring in the Gu18W. Scrumhalves and flyhalves were the player positions with the highest normalised injury incidence per player per position across all tournaments. As expected, the injury incidence of ‘New’ injuries was higher than subsequent ‘Recurrent’ injuries. The majority of ‘New’ injuries were injuries to the joint, while most ‘Recurrent’ injuries were ligament and joint injuries. Fourteen concussions occurred across the two tournaments in 2019, which has dropped since the spike recorded in 2018. The Gu18W had the higher concussion incidence of the two tournaments. Furthermore, the act of Tackling contributed to 50% of the events causing concussions. The tackle contest is clearly an event that requires additional injury prevention focus for coaches on preparing their younger female players better for rugby, and requires more time spent on teaching them safer techniques and body positions in the tackle contest.

Obesity and Work-Related Injuries Among Farmers in Kentucky, Tennessee, and West Virginia

Background Obesity is a recognized risk factor for work-related injuries (WRI). Despite the inherent safety hazards associated with farm work, research on obesity among farmers is limited giving little guidance to occupational health providers on obesity as a risk factor in farm WRI. This study evaluated the association between obesity and farm WRI. Methods Cross-sectional data were collected from farmers ( n = 100) in Kentucky, Tennessee, and West Virginia. Data included a survey (demographic data, farm factors, health indicators, occurrences of work-related injuries consistent with the definition of Occupational Safety and Health Administration [OSHA] recordable injuries) and direct anthropometric measures (height, weight, and waist circumference). Logistic regression was used to model any work-related injury, injuries consistent with the definition of OSHA recordables (herein called OSHA-recordable injuries), and recurrent injuries occurring during farm work performance on body mass index (BMI) and waist circumference. Findings Twenty-five percent of the participants reported any injuries, and 18% reported OSHA-recordable injuries. Farmers with a BMI ≥30 kg/m2 had 3 times the risk for OSHA-recordable injuries and 5 times the risk for recurrent injuries. No significant relationship was identified between waist circumference and farm WRI. Conclusion This study provides evidence that increased BMI is a safety risk for farmers. Prospective studies with a larger sample are needed. Occupational health nurses and providers should educate farmers on the potential safety risk of obesity and implement weight management programs addressing obesity in farmers.

Methods Matter: Beware of collider stratification bias when analyzing recurrent injuries

A major objective of sport medicine research is to assess causes of injuries. Studying causes of subsequent injuries, including the effects of rehabilitation programs, presents unique challenges to provide appropriate guidance for treatment. In this commentary, we highlight the issue of “collider stratification bias”. Collider stratification bias is a major concern whenever we restrict populations based on variables that have multiple causes, which is common in surveillance programs studying subsequent injuries.

Sports Injury and Illness after Implementation of the Web-Based Surveillance System in World Taekwondo

ABSTRACT Context: There is a shortage of Taekwondo epidemiology studies since the rule changes introduced by World Taekwondo in 2017. Objective: To describe injury and illness patterns at the Muju 2017 World Taekwondo Championships (WTC) following the implementation of the web-based surveillance system by World Taekwondo. Design: Prospective cohort study. Setting: All injuries and illnesses were recorded during the 2017 WTC using a web-based system developed by the International Olympic Committee. Patients or Other Participants: 971 athletes who participated in the 2017 WTC. Main Outcome Measure(s): A profiles and mechanisms of injury and illness in the 2017 WTC. Results: We analyzed total 131 injuries and 26 illnesses, corresponding to an overall clinical incidence of 13.5 ((95% confidence interval (CI): 11.2–15.8)) injuries and 2.7 (95% CI: 1.6–3.7) illnesses per 100 athletes, and an overall incidence rate of 19.3 (95% CI: 16.0–22.6) injuries and 3.8 (95% CI: 2.4–5.3) illnesses per 1,000 athlete-days, respectively. Most injuries occurred in the lower extremities (46.6%, n=61), of which knee injuries were most frequent (19.8%, n=26). Among the head and trunk injuries (29.8%, n=39), face injuries (22.1%, n=29) were most frequent, whereas among upper extremity injuries (23.7%, n=31), finger injuries (6.1%, n=8) were most frequent. Contusions (33.6%, n=44) were the most frequent injury type, followed by fractures and ligament ruptures/sprains. The most common injury mechanism was in contact with another athlete (74.0%, n=97), whereas the least common was concussions (n=5). The major affected system was the respiratory system (30.8%, n=8), with major symptoms being pain (42.3%, n=11) and fever (26.9%, n=7). Environmental factors were the most common cause of illness (57.7%, n=15). Conclusion: The web-based surveillance system used at the 2017 WTC revealed that 13.5/100 athletes (77.8/1,000 athlete-exposures, 13.9/1000 minute-exposures) had new or recurrent injuries, whereas 2.7/100 athletes became ill.

Kinesiophobia in Skiers with Knee Injuries

Introduction. Alpine skiing is one of the most dangerous winter sports that entails a high number of injuries, most commonly affecting the knee. Kinesiophobia is a condition in which an individual experiences fear of physical movement and activity as a result of feeling susceptible to injuries or recurrent injuries. The objective was to examine the level of kinesiophobia in skiers who have sustained knee injuries. Material and methods. The sample consisted of 22 female and 11 male professional skiers, with the average age of 24 ± 7.391 years. For the purpose of the assessment, the Tampa scale for kinesiophobia (TSK) was employed. Results. The number of knee injuries in skiers totals at least 1 and 11 at most, on average 2.45, most commonly involving the anterior cruciate ligament and meniscus. There were no significant differences between the left and the right knee or bilateral injuries. The average score in the TSK totals 36 points, which is close to the critical threshold of 37 points. 36% of the participants possess a high level of kinesiophobia. With respect to the general level of kinesiophobia, no significant differences were found in relation to gender, with regard to the number of surgeries or whether one or both knees were affected by injuries. Older skiers have also been found to have significantly lower fear of recurrent injuries. Conclusions. The number of knee injuries in skiing is high and aggravating, in such a way that almost one third of skiers that have sustained knee injuries experience a critical level of kinesiophobia, and that requires intervention. During rehabilitation, psychological support should also be provided to athletes in order to prevent or reduce kinesiophobia and thus prevent recurrent or new injuries.

Injury and Illness in World Taekwondo Junior Athletes: An Epidemiological Study

Taekwondo has been reported to be one of the most injurious sports in the summer Olympics, however, there is a dearth of data about injury profiles for junior athletes. Therefore, we aimed to identify the incidence and profiles of the injuries and illnesses that occurred during the 2018 World Taekwondo Junior Championships and recorded using an online system. Among the 889 athletes, 67 injuries and four illnesses were reported, corresponding to an overall clinical incidence of 7.5 injuries (95% confidence interval [CI]: 5.7–9.3) and 0.5 illnesses (0.1–0.9) per 100 athletes. The most frequent injuries were lower extremity injuries (n = 33, 3.71% of all athletes), mostly in the foot/toe (n = 11, 1.2% of athletes), followed by head and trunk injuries, mostly in the face (n = 14, 1.6% of athletes), and upper extremity injuries, mostly in the fingers (n = 6, 0.7% of athlete). Contusions (n = 37, 4.2% of athlete) were the most frequent injury type, followed by ligament ruptures/sprains and laceration. The most common injury mechanism was contact during an opponent attack (n = 51, 5.7% of athlete). Three mild concussions none resulted in time loss (none required hospital transfer or had prolonged recovery). The respiratory system was the most affected by illness, with pain and fever as symptoms. Environmental factors were the most common cause of illness. This study shows that 7.5 per 100 athletes (38.5/1000 athlete-exposures and 6.9/1000 min-exposures) had new or recurrent injuries, whereas 0.5 per 100 athletes experienced illness. In conclusion, the data shows male athletes reported more injuries than females and the most common cause of injury was due to contact between athletes. Contusions, ligament rupture/sprains, laceration and fractures to the lower extremities, head, and trunk were the most common injury. Knowing these injury profiles of junior taekwondo athletes can help taekwondo stakeholders, especially medical staff to prepare accordingly to ensure the safety of the athletes.

Patterns of Injuries and Illness Among Malaysian Contingents During the Kuala Lumpur South East Asia (KL SEA) Games 2017

Introduction: Malaysia has participated in many international multi-sport events, but there is limited data on the injury and illness prevalence of the Malaysian contingent.Objective: The purpose of this study was to investigate the pattern of injuries and illnesses among the athletes and officials in the Malaysian contingent during the KL SEA Games 2017.Materials and methods: The medical records of the Malaysian contingent who received medical attention from the Malaysian medical team contingent during the centralised camp and the Games, were retrieved. The Malaysian medical team used a standardised injury and illness reporting form to record clinical and socio-demographic information of the athletes and officials in the Malaysian contingent.Results and Discussion: The total number of medical consultations received were 509 and 85.4% were with athletes. Two-hundred two injuries and 238 illnesses were diagnosed among the athletes. The most common injury among the athletes was muscle tears and strains, followed by ligamentous injuries, tendon injuries, bruises, and contusions. Majority of the injuries were mild and occurred during training. Recurrent injuries and increase in athlete’s age were significant predictors of injury severity. Comparable to earlier reports, the most common illness among athletes, was the respiratory system, followed by gastroenterology and dermatology. A total of 11 injuries and 58 illnesses were reported among the Malaysian contingent officials. Compared to athletes, the injury rate among the officials was much lower. The illness rate among the officials was half of the athletes’ illness rate, even though there was a higher prevalence of underlying chronic diseases among the officials.Conclusion: The rate of injuries and illness among Malaysian athletes in the KL Sea Games 2017 was comparable to previous reports. However, the rate of injuries and illness of the officials in the Malaysian contingent was lower compared to athletes.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 347-354

Pattern of Injuries in Indian Wrestlers

Objectives: Wrestling is a popular sport the world over. As one of the sports played during the Olympic games, it sees high player participation at both school and scholastic levels. However, player to player contact and its arduous nature leads to a high incidence of injuries. In spite of this, it has received little attention, especially with respect to injury rate in the Indian wrestlers. Hence, our aim was to study their pattern in these wrestlers. Material and Methods: We performed an observational study involving 190 wrestlers who were followed up over a period of 2 years. Their injuries were studied by means of a structured questionnaire, which they filled up with assistance from their athletic trainers. Results: A total of 184 injuries occurred in 190 wrestlers (≥16 years) with an injury rate of 5.08/1000 athlete exposure (A-E). There were 47.83% new injuries, while 52.1% were recurrent. Injuries that occurred during practice sessions were more than those during competitions. Most injuries occurred to the knee joint, followed by the shoulder joint. Ligament sprains and muscular strains were the most frequent injuries. Wrestlers practicing Freestyle (FS): Greeco-roman (GR) was 5.3:1. Statistically significant injuries to the trunk occurred in those practicing FS style. Ten wrestlers were operated for knee injuries. Conclusion: Indian wrestlers are at risk of higher injury rates, with the majority being recurrent and occurring mostly in practice sessions. The knee joint is most commonly involved, followed by the shoulder. FS is the preferred style and more commonly associated with trunk injuries. The goal of our study was to study the pattern of injuries in the Indian wrestler and to minimize the risk of injury by understanding the factors responsible.

Recurrent and Subsequent Injuries in Professional and Elite Sport: a Systematic Review

Background Injury surveillance in professional sport categorises injuries as either “new” or “recurrent”. In an attempt to make categorisation more specific, subsequent injury categorisation models have been developed, but it is not known how often these models are used. The aim was to assess how recurrent and subsequent injuries are reported within professional and elite sport. Methods Online databases were searched using a search strategy. Studies needed to prospectively report injury rates within professional or elite sports that have published consensus statements for injury surveillance. Results A total of 1322 titles and abstract were identified and screened. One hundred and ninety-nine studies were screened at full text resulting in 81 eligible studies. Thirty studies did not report recurrent injuries and were excluded from data extraction. Within the studies that reported recurrent injuries, 21 reported the number and percentage; 13 reported only the proportion within all injuries; three reported only the number; five reported the number, percentage and incidence; and two only reported the incidence. Seven studies used subsequent injury terminology, with three reporting subsequent injury following concussion, one using an amended subsequent injury model and three using specific subsequent injury categorisation models. The majority of subsequent injuries (ranging from 51 to 80%) were categorised as different and unrelated to the index injury. The proportion of recurrent injuries (exact same body area and nature related to index injury) ranged from 5 to 21%. Conclusions Reporting recurrent or subsequent injuries remains inconsistent, and few studies have utilised subsequent injury models. There is limited understanding of subsequent injury risk, which may affect the development of injury prevention strategies. Trial Registration CRD42019119264