Athlete Exposures Research Articles

Head Impact Kinematics and Brain Tissue Strains in High School Lacrosse.

Male lacrosse and female lacrosse have differences in history, rules, and equipment. There is current debate regarding the need for enhanced protective headwear in female lacrosse like that worn by male lacrosse players. To inform this discussion, 17 high school lacrosse players (6 female and 11 male) wore the Stanford Instrumented Mouthguard during 26 competitive games over the 2021 season. Time-windowing and video review were used to remove false-positive recordings and verify head acceleration events (HAEs). The HAE rate in high school female lacrosse (0.21 per athlete exposure and 0.24 per player hour) was approximately 35% lower than the HAE rate in high school male lacrosse (0.33 per athlete exposure and 0.36 per player hour). Previously collected kinematics data from the 2019 high school male and female lacrosse season were combined with the newly collected 2021 kinematics data, which were used to drive a finite element head model and simulate 42 HAEs. Peak linear acceleration (PLA), peak angular velocity (PAV), and 95th percentile maximum principal strain (MPS95) of brain tissue were compared between HAEs in high school female and male lacrosse. Median values for peak kinematics and MPS95 of HAEs in high school female lacrosse (PLA, 22.3g; PAV, 10.4rad/s; MPS95, 0.05) were lower than for high school male lacrosse (PLA, 24.2g; PAV, 15.4rad/s; MPS95, 0.07), but the differences were not statistically significant. Quantifying a lower HAE rate in high school female lacrosse compared to high school male lacrosse, but similar HAE magnitudes, provides insight into the debate regarding helmets in female lacrosse. However, due to the small sample size, additional video-verified data from instrumented mouthguards are required.

Head Impact Exposure in Hawaiian High School Football: Influence of Adherence Rates on a Helmetless Tackling and Blocking Training Intervention.

High school football remains a popular, physically demanding sport despite the known risks for acute brain and neck injury. Impacts to the head also raise concerns about their cumulative effects and long-term health consequences. To examine the effectiveness of a helmetless tackling training program to reduce head impact exposure in football participants. A three-year, quasi-experimental, prospective cohort (clinicaltrials.gov #NCTXXX) study. Honolulu (XXX, XXX) area public and private secondary schools with varsity and junior varsity football. Football participants (n=496) ages 14 to 18 years old. Intervention(s) Participants wore new football helmets furnished with head impact sensor technology. Teams employed a season-long helmetless tackling and blocking intervention in Years 2 and 3 consisting of a 3-phase, systematic progression of 10 instructional drills. Head impact frequency per athlete exposure (ImpAE), location, and impact magnitude per participant intervention adherence levels (60% and 80%). An overall regression analysis revealed a significant negative association between ImpAE and adherence (p=0.003, beta=-1.21, SE=0.41). In year 3, a longitudinal data analysis of weekly ImpAE data resulted in an overall difference between the adherent and non-adherent groups (p=0.040 at 80%; p=0.004 at 60%), mainly due to decreases in top and side impacts. Mean cumulative impact burden for the adherent group (n=131: 2,105.84g ± 219.76,) was significantly (p=0.020) less than the non-adherent group (n=90: 3,158.25g ± 434.80) at the 60% adherence level. Participants adhering to the intervention on at least a 60% level experienced a 34% to 37% significant reduction in the number of head impacts (per exposure) through the season. These results provide additional evidence that a helmetless tackling and blocking training intervention (utilizing the HuTT® program) reduces head impact exposure in high school football players. Adherence to an intervention is crucial for achieving intended outcomes.

Reported Anterior Cruciate Ligament Injury Incidence in Adolescent Athletes Is Greatest in Female Soccer Players and Athletes Participating in Club Sports: A Systematic Review and Meta-analysis

To identify the risk of anterior cruciate ligament (ACL) injury in adolescent athletes based on sex, sport, and sport affiliation. A literature search was performed using 3 online databases (PubMed, Cochrane Library, andEMBASE) from database inception to November 2023 per the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies consisted of Level I or II studies reporting on ACL injury exposures in time (hours) or injuries per 1,000 athlete-exposures (AEs) (1 game or practice) in adolescent athletes. Exclusion criteria consisted of non-English studies, case reports, animal/cadaveric studies, and review articles. Methodological quality and bias assessment of the included studies was assessed using the Quality Assessment Tool for Observational Cohort andCross-Sectional Studies. ACL injuries were analyzed and pooled to calculate incidence rates (IRs), per-season risk, and relative risk (RR) based on sex, sport, and sport affiliation (club sport participation vs school sport participation). A total of 1,389 ACL injuries over 19,134,167 AEs were identified (IR, 0.075; 95% confidence interval [CI], 0.071-0.079). Of these, 670 ACL injuries were reported in female athletes over 7,549,892 AEs (IR, 0.089; 95% CI, 0.087-0.091) with 719 in males over 11,584,275 AEs (IR, 0.062; 95% CI, 0.058-0.067). The greatest RR for ACL injury in females was in soccer (RR, 3.12; 95% CI, 2.58-3.77) for AEs. The greatest per-season risk of ACL injuries reported in female athletes occurred in soccer (1.08%), basketball (1.03%), and gymnastics (1.01%). The greatest per-season risk of ACL injuries reported in male athletes occurred in football (0.82%), lacrosse (0.64%), and soccer (0.35%). Club sport participation, in both AEs (RR, 3.94; 95% CI, 3.19-4.87) and hours of exposure (RR, 1.57; 95% CI, 1.07-2.28), demonstrated an increased risk of ACL injury. The risk of ACL injuries was 1.56-fold greater in adolescent female athletes compared with male athletes. The highest-risk sport for females was soccer. Participation in club sports possessed higher rates of injury compared with school sports. Level II; meta-analysis of Level I and II studies.

When to Pull the Trigger: Conceptual Considerations for Approximating Head Acceleration Events Using Instrumented Mouthguards

Head acceleration events (HAEs) are acceleration responses of the head following external short-duration collisions. The potential risk of brain injury from a single high-magnitude HAE or repeated occurrences makes them a significant concern in sport. Instrumented mouthguards (iMGs) can approximate HAEs. The distinction between sensor acceleration events, the iMG datum for approximating HAEs and HAEs themselves, which have been defined as the in vivo event, is made to highlight limitations of approximating HAEs using iMGs. This article explores the technical limitations of iMGs that constrain the approximation of HAEs and discusses important conceptual considerations for stakeholders interpreting iMG data. The approximation of HAEs by sensor acceleration events is constrained by false positives and false negatives. False positives occur when a sensor acceleration event is recorded despite no (in vivo) HAE occurring, while false negatives occur when a sensor acceleration event is not recorded after an (in vivo) HAE has occurred. Various mechanisms contribute to false positives and false negatives. Video verification and post-processing algorithms offer effective means for eradicating most false positives, but mitigation for false negatives is less comprehensive. Consequently, current iMG research is likely to underestimate HAE exposures, especially at lower magnitudes. Future research should aim to mitigate false negatives, while current iMG datasets should be interpreted with consideration for false negatives when inferring athlete HAE exposure.

The Burden of Back and Neck Strains and Sprains in Professional Baseball Players.

A retrospective case series study. To analyze the epidemiology of diagnoses of back and neck strains and sprains among Major League (MLB) and Minor League (MiLB) Baseball players. Baseball players perform unique sets of repetitive movements that may predispose to neck and back strains and sprains. Data are lacking concerning the epidemiology of these diagnoses in this population. De-identified data on neck/back strains and sprains were collected from all MLB and MiLB teams from 2011 to 2016 using the MLB-commissioned Health and Injury Tracking System database. Diagnosis rates of conditions related to cervical, thoracic, and lumbar musculature and their impact on days missed due to injury, player participation, and season or career-ending status were assessed. Injury rates were reported as injuries per 1000 athlete exposures (AEs). There were 3447 cases of neck/back strains and sprains in professional baseball players from 2011 to 2016. Seven hundred twenty-one of these occurred in MLB versus 2726 in MiLB. Of injuries 136 were season-ending (26 in MLB, 110 in MiLB); 22 were career-ending (2 in MLB, 20 in MiLB). The total days missed were 39,118 (8838 from MLB and 30,280 from MiLB). Excluding season or career-ending injuries, the mean days missed were 11.8 (12.7 and 11.6 in MLB and MiLB, respectively). The median days missed were 4 (3 and 5 in MLB and MiLB, respectively). Combining MLB and MiLB, the pitcher injury rate was 1.893 per 1000 AEs versus 0.743 per 1000 Aes for other position players ( P < 0.0001). There was a high incidence of neck/back strains and sprains in MLB and MiLB players, with nearly 40,000 aggregate days missed in our 6-year study period. The median days missed were lower than the mean days missed, indicating rightward outliers. Pitchers had over double the rates of injuries compared with other position players. Level III.

Access to athletic trainers and sex as modifiers of time to reach clinical milestones after sport-related concussion in collegiate athletes

ABSTRACT Objective Investigate whether an athlete's biological sex and exposure to a dedicated athletic trainer (AT) were related to clinical milestones after a sports-related concussion (SRC). Design Retrospective chart review. Methods Medical charts of collegiate athletes (n = 196 [70.9% female]) diagnosed with SRC were reviewed to extract: biological sex, dedicated AT exposure for their sport (yes/no), and time (days) to reaching clinical milestones (diagnosis, symptom resolution, unrestricted return to sport [RTS]). Mann–Whitney U tests were used to determine whether time to clinical milestones differed by sex, AT exposure, or their interaction. Proportions of same-day diagnoses and times to diagnosis, symptom resolution, and unrestricted RTS were evaluated with chi-squared and spearman’s rank correlations, respectively. Results There were no significant differences in times to reaching any clinical milestone by sex, AT exposure, or their interaction (ps > 0.05). Forty-three percent of participants were diagnosed on the day of their SRC. This did not differ by sex or AT exposure (ps > 0.29). Longer times to SRC diagnosis were associated with more days to symptom resolution (ρ = 0.236, p = 0.001) and unrestricted RTS (ρ = 0.223, p < 0.001). Conclusions Athlete sex and AT exposure were not associated with times to reach any clinical milestone; however, delayed diagnosis was associated with longer times to reach clinical recovery.

Epidemiology of Concussive Injuries in Collegiate Recreational Athletes

Concussion rates are commonly reported in high school and National Collegiate Athletics Association (NCAA) sports. Given that participation in collegiate recreation is on the rise, institutions should examine concussion rates within their recreational programs. We, therefore, retrospectively examined a recreational department's injury reports establishing concussion rates across ( n = 16) club and ( n = 10) intramural sports at a public university in the southeastern United States from 2016 to 2019. One hundred and thirty-five concussions (club n = 56; intramural n = 79) were identified and constituted 12.4% of documented injuries ( n = 1,088). The intramural concussion rate was 0.57 per 1,000 athletic exposures (AEs) and AE was greatest in outdoor soccer (0.99 per 1,000 AE). Therefore, our data suggests an increased incidence of concussions in intramurals compared to published rates in NCAA and high school sports. Collegiate recreational departments should consider these concussion rates when formulating risk management strategies.

Epidemiological Study of Track-and-Field Meets On-Field Medical Care.

Most epidemiological studies on track-and-field meets have been limited to the Olympics and world championships. These are meets inwhich only high-performance athletes participate at a certain time of the year. In contrast, epidemiological studies on athletes of various ages and across different seasons may provide health care providers with valuable insights into injury prevention and on-field medical care. The study aims to determine the trends and locations of injuries during track-and-field meets in athletes of various ages and seasons based on on-field medical care records. The number and incidence of injuries requiring on-field medical care during or after the event were obtained from 39 track-and-field meets. Injuries were defined as cases that required on-field medical care. The incidence was defined as the number of injuries per 1000 athlete exposures wherein 1 athlete exposure is the athlete's participation in one event. We also recorded the number of injuries at each location and whether transportation to a medical station was required. A total of 191 injuries were reported. This study identified a population with a high incidence of injury (middle- and long-distance events, combined events, and athletes over the age of 19), areas within the stadium where injuries were more likely to occur (finish line and first turn), and a high rate of transport to the medical station (approximately 70%); most of them were transported to wheelchairs. The results provide insights into the trends, locations, and transport of injured athletes during track-and-field meets. Professionals will better understand the injuries occurring during track-and-field meets and can improve the efficiency of on-field medical care activities. They will also assist organizers in track-and-field meets to improve the safety of their meet operations.

Epidemiology of injuries among Malaysian adolescent karate athletes: A cross-sectional study.

Despite the wide range of injuries sustained by adolescents during karate, limited studies have investigated the type and frequency of sports injuries among adolescent karate athletes. This study would be the first to examine the epidemiology of injuries among adolescent karate athletes. Its objective was to describe the incidence of injuries throughout the 2023 season and the pattern of injuries among Malaysian adolescent karate athletes. From 1 January to 31 December 2023, this cross-sectional study examined 119 Malaysian adolescent karate athletes aged 13-19 years. Data on demographic characteristics and patterns of injuries were collected using a standardised form and analysed using SPSS version 26. The incidence of injuries was 22.3 injuries per 1000 athlete exposures. Specifically, the incidence of injuries during training was 15.34 injuries per 1000 athlete exposures, while that during competition was 106.6 injuries per 1000 athlete exposures. The majority of the injuries were mild (n=113, 87.6%), while the minority were severe (n=6, 4.7%). The injuries most commonly occurred in the head and neck (n=31, 24%), followed by the ankle (n=13, 10.1%) and foot (n=14, 10.9%). There is a need to explore the extrinsic and intrinsic risk factors of injuries among adolescent karate athletes in Malaysia, as the incidence of injuries is high during competition. Additionally, it is important to educate athletes and supporting sports science members about injury prevention programmes.

Does Neuromuscular Training Reduce the Risk of Lower-Extremity Musculoskeletal Injury in High School Female Athletes With a History of Sport-Related Concussion?

There is a well-established increased risk of lower-extremity (LE) musculoskeletal (MSK) injury following a sport-related concussion (SRC). Neuromuscular training programs improve biomechanics associated with LE MSK injury and reduce LE MSK injury incidence, but their relative effectiveness in athletes with history of SRC is unknown. The purpose of this study was to evaluate LE MSK injury incidence in female adolescent athletes with history of SRC following a neuromuscular training intervention. Prospective case-control. Seventy-seven adolescent female athletes aged 12-18years who participated in soccer, volleyball, or basketball were recruited from a single institutional sports medicine research and performance center to complete a 6-week neuromuscular training program prior to competitive athletic season. Group (Control, History of SRC) comparisons of athlete exposure and relative LE MSK injury risk and rates during the competitive athletic season were assessed. Ten injuries were recorded by 9 athletes. Female athletes who reported history of SRC had increased injury risk (Risk Ratio 3.9, 95% CI, 1.1-13.8, P = .01) and increased injury rate (rate ratio 4.1, 95% CI, 1.1-15.8, P = .03) compared with female athletes without history of SRC. Female adolescent athletes with history of SRC showed a greater risk of LE MSK injury compared with athletes with no history of SRC. Future work is still needed to understand the underlying mechanisms associated with future LE MSK injury following SRC and interventions that ameliorate elevated injury risk.

Decreased Concussion Incidence Following the Implementation of the Targeting Rules: An Updated Epidemiology of National Football League Concussions From 2017 to 2022.

The incidence of concussions in football, and the ensuing media attention, has garnered scientific investigation, prompted technological advances in protective gear, and altered the rules of the game, including the National Football League's (NFL) "Targeting" rule, which began in 2018, but the impact of these changes is unclear. This study aims to describe the epidemiology of concussions that occurred in five NFL seasons from the 2017-2018 season through the 2021-2022 season and characterize positional differences in rate and games missed. There was a significant decrease (p = 0.02) in total concussions between the 2017-2018 season (102 concussions) and the remaining four seasons (average of 73.80 concussions per year), accounting for a 38% decrease. Offensive and defensive units had decreased concussion rates and average games missed per concussion. Defensive backs (10.46 per 1,000 athlete exposures (AEs)) and tight ends (10.69 per 1,000 AEs) had the highest concussion rates, and the defensive line had the highest average games missed per concussion at 3.97. The introduction of the "Targeting" rule and other rule changes in the NFL in 2018 correlated with a decrease in total concussions per year, total games missed due to concussion, and average games missed per concussion. Offense and defense experienced similar reductions in concussion incidence and severity. Overall, the updated epidemiology of NFL concussions suggests that the incidence of concussions has decreased; however, players continue to experience concussions that require them to miss multiple games.

Injury Incidence, Outcomes, and Return to Competition Times after Sports-Related Concussions during One Professional Ice Hockey Season: A Prospective Cohort Study.

The objective of this study was to analyze the incidence and characteristics of sports-related concussions (SRCs) for a professional ice hockey team during one regular season in the International Central European Hockey League. Repeated concussions are a common cause of long periods of absence in team contact sports, with a wide range of potential short- and long-term consequences for the affected athlete. Questions mainly regarding early diagnosis and ideal follow-up treatment remain unanswered, especially regarding the timing of return to sports (RTS). A prospective data analysis for a professional ice hockey team during a regular season was conducted. Firstly, concussions per 1000 athlete exposure (AE) and average time loss due to SRC were calculated. Secondly, the data from ImPACT Applications were analyzed for those players who were diagnosed with an SRC. Five SRCs were evaluated during the regular season, which resulted in 1.35 concussions/1000 AEs, a maximum of 17 missed games, and a median of three games per SRC. The average symptom count was 9.6, with the most common symptoms being headache, sensitivity to light, and dizziness. SRCs sustained in professional ice hockey are a common in-competition injury, while practices play a subsidiary role. The duration of RTS is highly individual and can be associated with symptoms lasting days to months.

Injury incidence among adolescent and senior basketball players: a prospective study in 19 teams across an entire season

ABSTRACT Objective To quantify and compare injury incidence between national-level, adolescent and regional-level, senior, male basketball players competing in Serbia overall and according to injury mechanism (contact, non-contact, or overuse), exposure setting (training or games), and history (new or recurrent). Methods A total of 218 male basketball players from 19 teams (106 senior and 112 adolescent players) volunteered to participate in the study. Descriptive data regarding game and training injury incidence were gathered across all players and reported per 10,000 athlete-exposures (AE) with 95% confidence intervals. Results Overall, 26 injuries were reported across 52,509 AE. Ankle (n = 10, incidence rate [IR] = 1.90 [0.97, 3.40]) and knee injuries (n = 8, IR = 1.52 [0.71, 2.89]) accounted for 69% of all reported injuries, with only 1–2 injuries documented for other body regions. Ankle injuries were attributed to contact (60%, IR = 1.14 [0.46, 2.38]) or non-contact mechanisms (40%, IR = 0.76 [0.24, 1.84]). Most knee injuries occurred due to overuse (50%, IR = 0.76 [0.24, 1.84]) or non-contact mechanisms (38%, IR = 0.57 [0.15, 1.56]). Comparisons according to exposure setting revealed significantly higher knee (incidence rate ratio [IRR] = 9.95 [1.85, 53.41], p = 0.004) and ankle (IRR = 39.79 [7.94, 384.67], p < 0.001) injuries per 10,000 AE during games compared to training. Recurrent injuries were most prominent in the ankle (30% of all ankle injuries, p = 0.11). Total contact (p = 0.04), non-contact (p = 0.04), and recurrent IR (p = 0.005) were significantly higher in senior than adolescent players. Conclusion The players examined were most susceptible to ankle and knee injuries, particularly during games compared to training. Ankle injuries were mostly attributed to player contact, while knee injuries were mostly attributed to overuse and non-contact mechanisms. Senior players were at a greater risk of sustaining contact, non-contact and recurrent injuries than adolescent players.

Changes in the incidence of stress reactions and fractures among intercollegiate athletes after the COVID-19 pandemic

PurposeThe purpose of this study was to characterize the impact of detraining due to the COVID-19 pandemic on incidence of bony injuries and stress fractures in collegiate athletes.MethodsA comprehensive collegiate athletic conference injury database was queried for all in-season, sport-related bony injuries (defined as all stress reactions and fractures) that occurred across all sports from January 2016 to June 2021. The bony injury rate per 1000 athlete exposure hours (AEH) was calculated and compared between the immediate post-hiatus season and historic rates from pre-hiatus seasons (2016–2019). Injury characteristics were also compared between the pre- and post-hiatus time periods.ResultsA total of 868 bony injuries across 23 sports were identified. The sports with highest overall baseline bony injury rates in historic seasons were women’s cross country (0.57 injuries per 1000 AEH) and men’s cross country (0.32). Compared to historic pre-hiatus rates, female cross-country runners demonstrated a significantly lower bony injury incidence rate in the post-hiatus season (0.24 vs. 0.57, p = 0.016) while male swimming athletes demonstrated a statistically significant increase in bony injury rate (0.09 vs. 0.01, p = 0.015). The proportion of bony injuries attributed to repetitive trauma increased; while, the proportion of injuries attributed to running decreased between the pre- and post-hiatus seasons.ConclusionAcross all sports, there was no consistent trend toward increased rates of bony injury in the immediate post-hiatus season. However, female cross-country runners demonstrated lower rates of bony injury in the post-hiatus season while male swimmers demonstrated higher rates. Furthermore, bony injuries in the post-hiatus season were more likely to be the result of repetitive trauma and less likely to be from running.Level of Evidence: Level III, retrospective, cross sectional study.

Investigating the multifactorial etiology of supraspinatus tendon tears.

The purpose of this study was to develop a multivariable model to determine the extent to which a combination of etiological factors is associated with supraspinatus tendon tears. Fifty-four asymptomatic individuals (55 ± 4 years) underwent testing of their dominant shoulder. Diagnostic ultrasound was used to assess for a supraspinatus tendon tear. The etiological factors investigated includeddemographics (age and sex), tendon impingement during shoulder motion (via biplane videoradiography), glenohumeral morphology (via computed tomography imaging), family history of a tear (via self-report), occupational shoulder exposure (via shoulder job exposure matrix), and athletic exposure (via self-report). Univariate relationships between etiological predictors and supraspinatus tears were assessed using logistic regression and odds ratios (ORs), while multivariable relationships were assessed using classification and regression tree analysis. Thirteen participants (24.1%) had evidence of a supraspinatus tear. Individuals with a tear had a higher critical shoulder angle (OR 1.2, p = 0.028) and acromial index (OR 1.2, p = 0.016) than individuals without a tear. The multivariable model suggested that a tear in this cohort can be explained with acceptable accuracy (AUROC = 0.731) by the interaction between acromial index and shoulder occupational exposure: a tear is more likely in individuals with a high acromial index (p < 0.001), and in individuals with a low acromial index and high occupational exposure (p < 0.001). The combination of an individual's glenohumeral morphology (acromial index) and occupational shoulder exposure may be important in the development of supraspinatus tears.

Reducing the Price of Naïveté in return‐to‐play from sports‐related concussion

Patient‐reported outcomes (PROs) play an increasingly important role in medical decision making. Yet, patients whose objectives differ from their physician's may strategically report symptoms to alter treatment decisions. For example, athletes may underreport symptoms to expedite return‐to‐play (RTP) from sports‐related concussion (SRC). Thus, clinicians must implement treatment policies that mitigate the Price of Naïveté, that is, the reduction in health outcomes due to naïvely believing strategically reported symptoms. In this study, we analyze dynamic treatment cessation decisions with strategic patients. Specifically, we formulate the Behavior‐Aware Partially Observable Markov Decision Process (BA‐POMDP), which optimizes the timing of treatment cessation decisions while accounting for known symptom‐reporting behaviors. We then analytically characterize the BA‐POMDP's optimal policy, leading to several practical insights. Next, we formulate the Behavior‐Learning Partially Observable Markov Decision Process (BL‐POMDP), which extends the BA‐POMDP by learning a patient's symptom‐reporting behavior over time. We show that the BL‐POMDP is decomposable into several BA‐POMDPs, allowing us to leverage the BA‐POMDP's structural properties for solving the BL‐POMDP. Then, we apply the BL‐POMDP to RTP from SRC using data from 29 institutions across the United States. We estimate the Price of Naïveté by comparing the BL‐POMDP to naïve benchmark policies. Accordingly, the BL‐POMDP reduces premature RTP by over 44% and provides up to 3.63 additional health‐adjusted athletic exposures per athlete compared to current practice. Overall, changing the interpretation of reported symptoms can better reduce the Price of Naïveté over adjusting treatment cessation thresholds. Therefore, to improve patients' health outcomes, clinicians must understand how strategic behavior manifests in PROs.

Epidemiology of Anterior Cruciate Ligament Tears in National Collegiate Athletic Association Athletes: 2014/15 - 2018/19.

To describe the epidemiology of ACL tears in NCAA men's and women's sports. Injury and exposure data collected within the NCAA Injury Surveillance Program from 2014/15-2018/19 were analyzed. ACL tear frequencies, rates (IRs) and proportions were used to describe injury incidence by sport, event type, injury mechanism, and injury history. Injury rate ratios (IRRs) were utilized to examine differential injury rates, and injury proportion ratios (IPRs) were used to examine differential distributions. A total of 729 ACL tears were reported from 8,474,401 recorded athlete exposures (AEs) during the study period (IR = 0.86 per 10,000 AEs), and the competition-related ACL tear rate was higher than the practice-related rate (IRR = 5.52, 95% CI: [4.75, 6.39]). Among men's sports, the highest overall ACL tear rate was observed in men's football (IR = 1.44 per 10,000 AEs), while among women's sports, the highest overall rate was observed in women's soccer (IR = 2.60 per 10,000 AEs). Among sex-comparable sports, ACL tear rates were higher in women's basketball, softball, and soccer, as compared with their men's counterparts. ACL tears were more prevalently attributed to player-contact mechanisms in men's sports than women's sports (IPR = 1.73, 95% CI: [1.37, 2.19]), while more prevalently attributed to non-contact mechanisms in women's sports than men's sports (IPR = 1.17, 95% CI: [1.01, 1.35]). ACL tear risk in women's sports continues to warrant attention and prevention efforts. Given the differential rates by event type, future research efforts may also evaluate initiatives to reduce competition-related injury burden in NCAA sports.

Injury Rates at an NCAA Division I Institution After the COVID-19 Lockdown: A Descriptive Epidemiological Study.

The coronavirus 2019 (COVID-19) pandemic led to frequent schedule changes, abbreviated seasons, and disrupted training at all levels of organized sports. The purpose of this study was to investigate the epidemiology of sports-related injuries at a single National Collegiate Athletic Association (NCAA) Division I institution during the 2020 COVID lockdown season when compared with pre-COVID seasons. It was hypothesized that there would be an increase in the overall injury rate and an increase in the number of days missed because of injury during the 2020 season when compared with the previous seasons. Descriptive epidemiology study. The injury surveillance database at a single NCAA Division I institution was queried for injuries that resulted in time loss (missed game or practice) for a student-athlete or for injuries that persisted >3 days. Injuries were categorized by anatomic area. Days unavailable because of injury were recorded as total days that a student-athlete was listed as "out of activity." Injury incidence and days unavailable, per 1000 athlete-exposures (AEs), were calculated for 3 pre-COVID seasons (2017-2019) and the 2020 season. The authors calculated the injury rate ratio (IRR) and its associated 95% CI of the 2020 season in comparison with those for the pre-COVID seasons. Compared with the pre-COVID seasons, the total injury incidence increased by 10.5% in the 2020 season (68.45 vs 75.65 injuries/1000 AEs; IRR, 1.11 [95% CI, 1.08-1.13]). Total days unavailable decreased by 20.7% in the 2020 season (1374 vs 1089 days/1000 AEs; IRR, 0.79 [95% CI, 0.77-2.26]). Compared with women's teams, men's teams had a larger increase in total injury incidence (16.4% vs 6.5%) and larger decrease in days unavailable (23.7% vs 10.75%). There were no clear trends to changes in anatomic distribution of injuries, either by sport or between the sexes. Compared with the pre-COVID seasons, the injury incidence was higher and the number of days missed because of injury lower among collegiate student-athletes at a single NCAA Division I school in the season immediately after the COVID-19 lockdown.

축구에서 두부 손상의 발생률, 종류와 기전

Acute traumatic head injury associated with football usually occurs in heading. Especially sports-related concussion (SRC) occurs frequently. SRC in football have recently earned increased attention due to world-wide popularity. The SRC incidence rate was 0.3 ~ 9 / 1000 hours athlete exposures (AE). But it is under reported. The most frequent injury mechanism was head to head contact in heading duels. SRC rates are higher during competition and in female players. More research is needed to better detect and understand the mechanism of SRC.

Association of Injury Rates Among Players in the National Football League With Playoff Qualification, Travel Distance, Game Timing, and the Addition of Another Game: Data From the 2017 to 2022 Seasons.

Injury incidence is higher in the National Football League (NFL) than in other collision sports. Although previous research has identified that scheduling variations, including overseas games and bye week timing, does not affect concussion risk, data are currently lacking regarding the effects of scheduling variation on season-long musculoskeletal injury incidence. To determine whether higher cumulative travel distance, overseas play, an early season bye week, and an expansion of the regular season is associated with higher injury rates in the NFL. Descriptive epidemiology study. All 1275 injuries across 5 NFL seasons from 2017 to 2018 through 2021 to 2022 were reviewed retrospectively. Injury data and travel distances were extracted from publicly available sources, which were cross-referenced for validation. Injury rates were calculated per 1000 athletic-exposures (AEs). Cumulative team travel distances were compared statistically using a linear regression. Single factor analysis of variance was used to compare categorical variables. Travel distance did not significantly predict injury rates (P = .47), and there was no difference in injury rates between teams that played a game overseas versus teams that did not (19.3 injuries per 1000 AEs for both; P = .96). In addition, no difference was found in injury rates (F[109,2100[ = 0.704; P = .73) or players placed on the injured reserve list (F[99,778] = 1.70; P = .077) between various bye weeks (P = .73). Injury rates did not differ between the new 17-game regular season (18.4 per 1000 AEs) versus the previous four 16-game regular seasons (19.7 per 1000 AEs; P = .12). However, teams that did not qualify for the playoffs had a significantly higher injury rate (19.9 per 1000 AEs) as well as players on injured reserve (8.0 per 1000 AEs) than playoff-qualifying teams (18.4 and 6.8 per 1000 AEs, respectively; P < .05 for both). Over 5 NFL seasons, cumulative travel distance, overseas play, bye week timing, and adding 1 regular season game were not associated with increased injury rates in NFL players. However, a lack of regular season success was associated with higher injury rates and more players on injured reserve.