Football-related Injuries Research Articles

Epidemiology of youth and high school American football-related injuries presenting to United States emergency departments: 2010-2019

ABSTRACT Objectives American football is one of the most popular sports in the United States (US) among youth and high school athletes; however, participation is decreasing due to concerns about safety. This has led to many new safety initiatives over the last decade, but few studies have sought to evaluate if these interventions have made football safer. The purpose of this study is to investigate national-level data on football-related injuries to compare the injury characteristics and specific injury risks of high school and youth athletes over the last decade. Methods This cross-sectional, retrospective study queried the National Electronic Injury Surveillance System (NEISS) database from 2010–2019 to compare national weighted estimates and injury characteristics of youth (ages 6–12) and high school (ages 14–18) athletes presenting to US emergency departments (EDs) with football-associated injuries. Results The overall injury risk of football-related injuries presenting to US EDs for high school athletes was 16.17 (C.I. 13.85–18.38) per 1,000 participants/year compared to 11.97 (C.I. 10.34–13.41) per 1,000 participants/year in youth athletes. From 2010 to 2019, the overall injury risk for youth athletes participating in football significantly (p < 0.0001) decreased from 13.31 (C.I. 11.23–15.38) per 1,000 participants to 9.93 (C.I. 7.24–12.62) per 1,000 participants. Additionally, the overall injury risk for high school athletes participating in football significantly (p < 0.0001) decreased from 2010 (N = 18.63 [C.I. 16.05–21.21] per 1,000 participants) to 2018 (N = 13.19 [C.I. 9.94–16.44] per 1,000 participants). High school athletes were almost twice as likely and 2.37 times more likely to present with knee and shoulder injuries compared to youth athletes per 1,000 participants/year. Conclusion Our study provides evidence that the overall injury risk for both youth and high school football players has significantly decreased since 2010. Furthermore, our study demonstrates that these athletes sustain unique injury characteristics.

Diagnosed Concussion and Undiagnosed Head Trauma Is Associated With Long-Term Concussion-Related Symptoms in Former College Football Players.

Head trauma experienced in contact football is a growing health concern, but limited research has been conducted to assess associations between head trauma exposure and long-term concussion-related symptoms among former college football players. We surveyed 275 former college football players who were at least 10 yrs after competition to determine the association between head trauma exposure and concussion-related symptoms later in life. Respondents provided data on their youth, high school and college playing experience, undiagnosed head injury, diagnosed concussions, and eight concussion-related symptoms. A Poisson regression was conducted to examine the association between playing experience and reported head trauma with reported symptom count, and significance was set at P ≤ 0.05. Few participants reported diagnosed concussions in college (17.5%), but a large number reported undiagnosed football-related head injuries (68.8%) that might have resulted in a concussion. A few participants (40.7%) reported concussion-related symptoms. After controlling for age, high school football participation, and nonfootball concussions (lifetime), diagnosed concussions in high school or college did not significantly predict concussion symptoms later in life. However, undiagnosed football head injury (range = 1-8 injuries) reported 350%-855% greater concussion-related symptoms later in life. Undiagnosed head injuries, which are less likely to be managed by a healthcare professional, were significantly associated with concussion-related symptoms later in life. These findings suggest that proper identification and management of concussions may prevent later symptoms, but more research is needed to test this conclusion.

An evaluation of the presentation and severity of Australian football injury in children

Introduction Child participation in sport is important for physical, cognitive and psychosocial wellbeing. Australian rules football has high participation, but also carries a high risk of injury due to the contact nature of the sport. This study aimed to evaluate changes in the presentation and hospital admission of paediatric Australian rules football-related injuries, and to compare the severity of these injuries with those from other team ball sports. Materials and methods At an Australian paediatric major trauma service, ED and hospital trauma registry data relating to Australian rules football injury between 2009 and 2015 were obtained. Data from other common team ball sports with a shared field of play were also identified. Results During the study period, there were 10,003 ED presentations, and 1110 admissions resulting from team ball sports. With 4751 ED presentations and 616 admissions, Australian rules football accounted for almost one-third of all sports-related presentations and admissions, and around half of the team ball sports cohort. Compared to other team ball sports patients, Australian rules football-related patients were 40% more likely to be admitted, and nearly twice as likely to be classified as severe injury. Australian rules football players presented with different injury patterns were compared to other team ball sports players; admitted players were significantly more likely to have sustained head or neck injuries, and were more than twice as likely to sustain truncal injury. Conclusions Australian rules football is a common cause of ED presentations and results in substantial morbidity, both overall and when compared with other team ball sports. Australian rules football should remain a focus for ongoing and active research into strategies which reduce injury risk.

Injury Prevalence, Types and Mechanisms in Football: A Media-based Approach

The increase in demand for football players to perform at their best during training and competition results in the escalation of a varying number of football-related injuries. Media reports provide readily as well as timely information on injury-related issues that could assist the stakeholders in decision making before and after a competition. Although, many attempts have been made to quantify football-related injuries in many countries via media, however, little is known on its prevalence, types, and mechanisms as reported in Nigerian media. The present study employed a content analysis technique through which 94 football-related news articles from Nigerian newspapers were examined and the most frequently reported injuries are identified. It is demonstrated from the chi-square analysis that the occurrences of football-related injuries are distributed amongst players regardless of their positional role in the game [χ2(60) = 41.401; p>0.05]. Moreover, the prevalence in the mechanisms of injuries are disseminated across injury types [χ2(30) = 32.203; p>0.05]. A total of 94 different injuries are reported with knee, ankle, and thigh as the most affected locations. The findings further revealed that strikers have a higher rate of injury occurrences with a total of 52% as compared to midfielders 20%, defenders 14%, and goalkeepers 12% whilst 2% are unidentified. Many of the injuries reported are either fresh 48% or recurrent 50% with only 2% recovery. The present findings could be useful to stakeholders in projecting injury-related problems in football which could guide appropriate action.

Injury Prevalence, Types and Mechanisms in Football: A Media-based Approach

The increase in demand for football players to perform at their best during training and competition results in the escalation of a varying number of football-related injuries. Media reports provide readily as well as timely information on injury-related issues that could assist the stakeholders in decision making before and after a competition. Although, many attempts have been made to quantify football-related injuries in many countries via media, however, little is known on its prevalence, types and mechanisms as reported in Nigerian media. The present study employed a content analysis technique through which 94 football-related news articles from Nigerian newspapers were examined and the most frequently reported injuries are identified. It is demonstrated from the chi-square analysis that the occurrences of football-related injuries are distributed amongst players regardless of their positional role in the game [χ2(60) = 41.401; p>0.05]. Moreover, the prevalence in the mechanisms of injuries are disseminated across injury types [χ2(30) = 32.203; p>0.05]. A total of 94 different injuries are reported with knee, ankle, and thigh as the most affected locations. The findings further revealed that strikers have a higher rate of injury occurrences with a total of 52% as compared to midfielders 20%, defenders 14%, and goalkeepers 12% whilst 2% are unidentified. Many of the injuries reported are either fresh 48% or recurrent 50% with only 2% recovery. The present findings could be useful to stakeholders in projecting injury-related problems in football which could guide aappropriate action.

Proprioception is not associated with lower extremity injuries in U21 high-level football players

Football is a contact sport with a significant risk of injury. Although proprioception is well studied in rehabilitation, little is known about the association between proprioception and the occurrence of sport injuries. The purpose of this study was to look into the association between ankle and knee proprioception and lower extremity injuries in young football players. Seventy-three football players from the highest U-21 league in Iran volunteered to participate in this study. Before the start of the 2017–2018 competitive season, joint position sense was measured at 30°, 60° and 90° knee flexion and at 10° and 15° ankle dorsiflexion, and inversion using the Biodex Isokinetic pro 4 system. The teams’ medical staff recorded football-related lower extremity injuries. We used mixed effects Cox regression models to calculate hazard ratios (HRs) with 95% CIs, acknowledging the clustered data structure. Twenty-two players (30.1%) suffered one or more lower extremity injuries during the season. None of the proprioception measures examined was significantly associated with the risk of lower extremity injuries. Based on these results of our sample, joint position sense does not seem to be associated with lower extremity injuries in young male football players.

Athletes With Musculoskeletal Injuries Identified at the NFL Scouting Combine and Prediction of Outcomes in the NFL: A Systematic Review.

Background:Prior to the annual National Football League (NFL) Draft, the top college football prospects are evaluated by medical personnel from each team at the NFL Scouting Combine. On the basis of these evaluations, each athlete is assigned an orthopaedic grade from the medical staff of each club, which aims to predict the impact of an athlete’s injury history on his ability to participate in the NFL.Purpose:(1) To identify clinical predictors of signs, symptoms, and subsequent professional participation associated with football-related injuries identified at the NFL Combine and (2) to assess the methodological quality of the evidence currently published.Study Design:Systematic review; Level of evidence, 3.Methods:A systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We reviewed all studies that examined musculoskeletal injuries identified among athletes at the NFL Combine and associated outcomes. Data on signs, symptoms, and subsequent NFL participation were collected, and the methodological quality of the studies was assessed.Results:Overall, 32 studies, including 30 injury-specific studies, met the inclusion criteria. Twenty studies analyzed data collected at the NFL Combine from 2009 and later. When compared with matched controls, athletes with a history of a cervical or lumbar spine injury, rotator cuff repair, superior labrum anterior-posterior repair, anterior cruciate ligament reconstruction, full-thickness chondral lesions of the knee, or Lisfranc injury played in significantly fewer games early in their NFL careers. Additionally, athletes with a history of a cervical or lumbar spine injury, rotator cuff repair, and navicular injury had decreased career lengths versus controls. Defensive players and linemen were found to have decreased participation in the NFL for several injuries, including prior meniscectomy, anterior cruciate ligament reconstruction, and shoulder instability. Career length follow-up, measures of athletic participation, and matching criteria were highly variable among studies.Conclusion:For medical professionals caring for professional football athletes, this information can help guide orthopaedic grading of prospects at the NFL Combine and counseling of athletes on the potential impact of prior injuries on their professional careers. For future studies, improvements in study methodology will provide greater insight into the efficacy of current treatments and areas that require further understanding.

Football-Related Pediatric Extremity Fractures and Dislocations: Size Matters

Football remains a popular sport in the United States despite sometimes significant injuries, such as fractures and dislocations, occurring. The objective of this study was to evaluate pediatric extremity fractures and dislocations related to football. A retrospective review was conducted at a level 1 pediatric trauma center to identify patients who were treated specifically for American football-related injuries (International Classification of Diseases, Ninth Revision, code E007.0). All patients with football-related injuries presenting to the emergency department during a 6-year period (2007-2012) were reviewed for inclusion in the study. Patients with only fractures or dislocations involving the extremities were analyzed. Exclusion criteria included patients older than 18 years, non-football-related sports-related injuries, and patients presenting to non-emergency department health care facilities. Demographic information was collected in addition to type of injury, body mass index, and type of treatment. A total of 193 patients with 96 fractures and 7 dislocations were included. More than two-thirds of all fractures occurred in the lower extremities, with tibia (17.0%) and femoral shaft (14.2%) fractures being the most common. Thirty-five percent of the fractures and dislocations required operative treatment. No statistically significant correlations were identified pertaining to age, race, and timing of the injuries in the season. Regarding body mass index, underweight patients were associated with 3.6 times greater odds of sustaining a fracture when compared with patients who were not underweight (P=.006). Underweight patients may be at a higher risk for fractures or dislocations. Identifying at-risk children may result in improved patient and coach education, potentially leading to better preventive measures and fewer injuries. [Orthopedics. 2018; 41(4):216-221.].

The impact of tackle football injuries on the American healthcare system with a neurological focus.

BackgroundRecent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public.ObjectiveUsing the National Emergency Department Sample (NEDS) and the National Inpatient Sample (NIS), the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013.MethodsThe NEDS and NIS databases were queried to collect data on all patients presented to the emergency department (ED) and/or were admitted to hospitals with an ICD code for injuries related to American tackle football between the years 2010 and 2013. Subsequently those with football-related neurological injuries were abstracted using ICD codes for concussion, skull/face injury, intracranial injury, spine injury, and spinal cord injury (SCI). Patient demographics, length of hospital stay (LOS), cost and charge data, neurosurgical interventions, hospital type, and disposition were collected and analyzed.ResultsA total of 819,000 patients presented to EDs for evaluation of injuries secondary to American tackle football between 2010 and 2013, with 1.13% having injuries requiring inpatient admission (average length of stay 2.4 days). 80.4% of the ED visits were from the pediatric population. Of note, a statistically significant increase in the number of pediatric concussions over time was demonstrated (OR = 1.1, 95% CI 1.1 to 1.2). Patients were more likely to be admitted to trauma centers, teaching hospitals, the south or west regions, or with private insurance. There were 471 spinal cord injuries and 1,908 total spine injuries. Ten patients died during the study time period. The combined ED and inpatient charges were $1.35 billion.ConclusionInjuries related to tackle football are a frequent cause of emergency room visits, specifically in the pediatric population, but severe acute trauma requiring inpatient admission or operative interventions are rare. Continued investigation in the long-term health impact of football related concussion and other repetitive lower impact trauma is warranted.

Is the message getting through? Awareness and use of the 11+ injury prevention programme in amateur level football clubs.

A large body of evidence suggests that the 11+ warm-up programme is effective in preventing football-related musculoskeletal injuries. However, despite considerable efforts to promote and disseminate the programme, it is unclear as to whether team head coaches are familiar with the 11+ and how they rate its feasibility. The present study aimed to gather information on awareness and usage among German amateur level football coaches. A questionnaire was administered to 7893 individuals who were in charge of youth and adult non-professional teams. Descriptive and inferential statistics were used to analyse the obtained data. A total of 1223 coaches (16%) returned the questionnaire. There was no risk of a non-response bias (p>.05). At the time of the survey, nearly half of the participants (42.6%) knew the 11+. Among the coaches who were familiar with the programme, three of four reported applying it regularly (at least once per week). Holding a license (φ = .28, p < .0001), high competitive level (Cramer-V = .13, p = .007), and coaching a youth team (φ = .1, p = .001) were associated with usage of 11+. Feasibility and suitability of the 11+ were rated similarly by aware and unaware coaches. Although a substantial share of German amateur level coaches is familiar with the 11+, more than half of the surveyed participants did not know the programme. As the non-usage does not appear to stem from a lack of rated feasibility and suitability, existing communication strategies might need to be revised.

The incidence, prevalence, severity, mechanism and body region of injury in elite junior Australian football players: A prospective cohort study over one season

ObjectivesTo describe the incidence, prevalence, severity, mechanism and body region of injuries in elite junior Australian football (AF) players over one competitive season in order to help inform injury prevention interventions. DesignProspective cohort, data collected during the 2014 playing season. MethodsPlayer and staff-reported injuries sustained by 562 players from an under-18 state league were entered into an online sports injury surveillance system. An injury was recorded if it led to a missed training session or match. Injury incidence was calculated as the number of injuries per 1000h of training and competition. Injury severity was defined by the number of days players missed training or competition. Injury mechanism was identified as either contact, non-contact or overuse. ResultsThere were 1192 football-related injuries sustained during the season; the majority (n=1041, 87.3%) were new, occurred during competition (n=954, 86%) and led to 4–7 missed days in severity (n=429, 46%). Injury incidence was 37.2 injuries per 1000h of exposure. Over half of injuries were contact in mechanism (n=355, 51%). Most injuries were to the lower limb (n=720, 60%), with the thigh representing the highest proportion of these. ConclusionsThis study provides key information as to the aetiology of injury in this level of competition and provides a stronger foundation from which injury prevention studies could be carried out. Future research is well-placed to develop an understanding of the injury risk factors in the elite junior cohort, whilst also reducing injury risk once players transition to the AFL.

Characterization of American Football Injuries in Children and Adolescents.

As a collision sport, football carries a significant risk of injury, as indicated by the large number of pediatric football-related injuries seen in emergency departments. There is little information in the medical literature focusing on the age-related injury patterns of this sport. Our purpose was to evaluate the types of football-related injuries that occur in children and adolescents and assess which patient characteristics, if any, affect injury pattern. Retrospective chart review was performed of football-related injuries treated at a level 1 pediatric referral hospital emergency department and surrounding urgent care clinics between January 2010 and January 2014. Patients with e-codes for tackle football selected from the electronic medical record were divided into 4 age groups: younger than 8 years old, 8 to 11, 12 to 14, and 15 to 18 years. Data collected included diagnosis codes, procedure codes, and hospital admission status. Review identified 1494 patients with 1664 football-related injuries, including 596 appendicular skeleton fractures, 310 sprains, 335 contusions, 170 closed head injuries, 62 dislocations, 9 spinal cord injuries, and 14 solid organ injuries. There were 646 (43.2%) athletes with upper extremity injuries and 487 (32.6%) with injuries to the lower extremity. Hospital admissions were required in 109 (7.3%) patients. Fracture was the most common injury in all four patient age groups, but occurred at a lower rate in the 15 to 18 years old age group. The rate of soft tissue injury was higher in the 15 to 18 years old age group. The rate of closed head injury, which included concussions, was highest in the younger than 8 years old age group. Age does influence the rates of certain football-related injuries in children and adolescents. Fractures decrease with increasing age, while the rate of soft tissue trauma increases with increasing age. Younger patients (younger than 8 y old) trended toward higher rates of closed head injury compared with other age groups. Awareness of these variations in injury patterns based on age could result in age-specific changes in equipment, training, and safety rules. Level IV-case series.

Profiling of Injuries Sustained During 2018 Football Tournament: An Observational Study

Objective: This study aims at documenting the incidences, nature and severity of injuries on the Kingdom of Swaziland football players. In addition, we investigate the association between injury incidence rates (IRs), players’ age and playing positions. Methods: Anthropometric characteristics, field-playing positions, match exposure injury occurrences were monitored in 24 teams (432 players). The teams were drawn from four main structures: Premier Soccer League (PSL), first division, super league and regional leagues (promotional league). The type, severity and duration of football-related injuries were documented following FIFA recommendations. Descriptive data was computed to characterize the injury profile using SPSS v23.0. Results: There were no significant differences on age (p=0.234, body mass (p=0.898 and height (p=0.451) among all players. IR of 29.8 (CI: 27.4, 32.2) injuries per 1000 exposure hours were observed. A sum of 92 injuries were observed and recorded. Of these injuries, 3 out of 4 were classified as either minimal (31.5%) or mild (35.9%), while merely 1 out of 10 injuries (5.4%) necessitated absence from play of more than 28 days. Overuse and traumatic injuries accounted for 27.3% and 78.3% respectively. Conclusions: The study reflected that the quantity and severity of injuries were not only associated with player’s age but also different playing positions. The injury profile of this nature can also enhance the knowledge of injuries, identification of risk factors for the most prevalent differential diagnoses in Swaziland soccer. Therefore, assisting sport medical teams and physicians to plan and develop any injury intervention programs.

A Multinational Cluster Randomised Controlled Trial to Assess the Efficacy of \u201811+ Kids\u2019: A Warm-Up Programme to Prevent Injuries in Children\u2019s Football

ObjectiveThe objective of this study was to assess the efficacy of a newly developed warm-up programme (‘11+ Kids’) regarding its potential to reduce injuries in children’s football.MethodsChildren’s football teams (under 9 years, under 11 years, and under 13 years age groups) from Switzerland, Germany, the Czech Republic and the Netherlands were invited. Clubs were randomised to an intervention group and a control group, and followed for one season. The intervention group replaced their usual warm-up by ‘11+ Kids’, while the control group warmed up as usual. The primary outcome was the overall risk of football-related injuries. Secondary outcomes were the risks of severe and lower extremity injuries. We calculated hazard ratios using extended Cox models, and performed a compliance analysis.ResultsIn total, 292,749 h of football exposure of 3895 players were recorded. The mean age of players was 10.8 (standard deviation 1.4) years. During the study period, 374 (intervention group = 139; control group = 235) injuries occurred. The overall injury rate in the intervention group was reduced by 48% compared with the control group (hazard ratio 0.52; 95% confidence interval 0.32–0.86). Severe (74% reduction, hazard ratio 0.26; 95% confidence interval 0.10–0.64) and lower extremity injuries (55% reduction, hazard ratio 0.45; 95% confidence interval 0.24–0.84) were also reduced. Injury incidence decreased with increasing compliance.Conclusion‘11+ Kids’ is efficacious in reducing injuries in children’s football. We observed considerable effects for overall, severe and lower extremity injuries. The programme should be performed at least once per week to profit from an injury preventive effect. However, two sessions per week can be recommended to further increase the protective benefit.Trial RegistrationClinicalTrials.gov identifier: NCT02222025.

THE EPIDEMIOLOGY OF US HIGH SCHOOL FOOTBALL (SOCCER) INJURIES, 2005–06 THROUGH 2013–14

BackgroundDespite the worldwide popularity of football, research on epidemiology of high school injury is sparse.ObjectiveTo describe high school football injury rates and patterns by type of athletic exposure and gender.DesignThis...

アメリカンフットボールにおけるHeads Up Tackling (HUT) 指導プログラムがタックルの安全性およびパフォーマンスに与える影響

The purpose of this study was to verify the effectiveness of the Heads Up Tackling program for defensive players and its influence on safety and performance. Head impacts in football players are directly associated with brain and spine injury, and have been proposed to be associated with injuries such as chronic traumatic encephalopathy (CTE). Therefore, improvement of safety has been a challenge in American football, from the perspective of injury prevention. In 2012, USA Football, the national governing body for amateur American football in the USA developed the Heads Up Football (HUF) program which included “Heads Up Tackling” (HUT), a set of new guidelines for tackling. HUT has been attracting attention in the context of safe tackling through a new coaching methodology. Although in Japan so far, there have been no reports of football-related chronic injuries caused by head impacts, many concussions occur in football games. Therefore, it seem necessary to identify a methodology for teaching tackling techniques in order to reduce the risks of head and neck injury. A number of studies have focused on coaching intervention in relation to safety, and for reducing head impact exposure and injury. However, no reports have focused on the impact of these efforts on athletic performance during a game. If it could be confirmed that HUT reduces the risk of injury in football games without decreasing athlete performances, it would be a useful resource for instruction on tackling skills. Here, 4 matches in the Japan top league (X-league) 2014 and 2015 season were analyzed, before and after HUT intervention was executed in the preseason of 2015. A total of 166 coded tackles were compared in terms of “tackling characteristics”, “amount of injuries”, “effectiveness of tackling”, and “loss of yards” to examine the effect of HUT techniques on “safety” and “effectiveness”. The results revealed that (1) the frequency of “head down” tackling was significantly lower after HUT intervention, (2) the “amount of injuries” was reduced after HUT intervention, (3) there was no effect on the “effectiveness of tackling” in games, (4) “loss of yards” was reduced after HUT intervention, and (5) HUT appeared to reduce the risks of injury in football games, without decreasing tackling performance.

Epidemiology of Sports-Related Eye Injuries in the United States

ImportanceOcular trauma can lead to lifelong sequelae, and sports-related ocular injuries have been shown to disproportionately affect the young. Studies quantifying and characterizing the incidence and type of injuries seen with sports-related ocular trauma may be useful for resource utilization, training, and prevention efforts.ObjectiveTo examine the emergency department (ED) burden of sports-related ocular trauma in the United States.Design, Setting, and ParticipantsThis retrospective, cross-sectional study examined the Nationwide Emergency Department Sample, containing data from approximately 30 million ED visits annually at more than 900 hospitals nationwide, from January 1, 2010, to December 31, 2013, to determine factors associated with sports-related ocular trauma.Main Outcomes and MeasuresAnnual incidence of sports-related ocular trauma, broken down by age, sex, mechanism of injury, and related activity, as well as factors associated with short-term impaired vision. ResultsDuring the study period, 120 847 individuals (mean age, 22.3 years [95% CI, 21.9-22.7]; 96 872 males, 23 963 females, and 12 with missing data) presented with sports-related ocular trauma, which was the primary diagnosis in 85 961 patients. Injuries occurred most commonly among males (69 849 [81.3%]; 95% CI, 80.6%-81.9%) and occurred most frequently as a result of playing basketball (22.6%; 95% CI, 21.7%-23.6%), playing baseball or softball (14.3%; 95% CI, 13.7%-14.9%), and shooting an air gun (11.8%; 95% CI, 10.8%-12.8%). Odds of presentation to the ED with impaired vision were greatest for paintball and air gun injuries relative to football-related injuries (odds ratio, 4.75; 95% CI, 2.21-10.19 and 3.71; 95% CI, 2.34-5.88, respectively; P < .001).Conclusions and RelevanceIn our study, approximately 30 000 individuals presented annually to EDs in the United States with sports-related eye injuries; in more than 70% of these cases, eye injuries were the primary diagnosis. Activities involving projectiles pose the greatest risk for visual impairment in the short term, although long-term outcomes were unavailable.

Injuries in professional male football players in Kosovo: a descriptive epidemiological study.

BackgroundThe incidence and severity of football-related injuries has been found to differ strongly between professional leagues from different countries. The aims of this study were to record the incidence, type and severity of injuries in Kosovarian football players and investigate the relationship between injury incidence rates (IRs), players’ age and playing positions.MethodsPlayers’ age, anthropometric characteristics and playing positions, training and match exposure as well as injury occurrences were monitored in 11 teams (143 players) of Kosovo’s top division during the 2013/14 season. The exact type, severity and duration of football-related injuries were documented following International Federation of Football Associations (FIFA) recommendations.ResultsA total of 272 injuries were observed, with traumatic injuries accounting for 71 %. The overall injury IR was 7.38 (CI: 7.14, 7.63) injuries per 1,000 exposure hours and ~11x lower during training as opposed to matches. Strains and ruptures of thigh muscles, ligamentous injuries of the knee as well as meniscus or other cartilage tears represented the most frequent differential diagnoses. While no statistical differences were found between players engaged in different playing positions, injury IR was found to be higher by 10–13 % in younger (IR = 7.63; CI: 7.39, 7.87) as compared to middle-aged (IR = 6.95; CI: 6.41, 7.54) and older players (IR = 6.76; CI: 5.71, 8.00).ConclusionsThe total injury IR in elite football in Kosovo is slightly lower than the international average, which may be related to lesser match exposure. Typical injury patterns agree well with previously reported data. Our finding that injury IR was greater in younger players is related to a higher rate of traumatic injuries and may indicate a more aggressive and risky style of play in this age group.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1202-9) contains supplementary material, which is available to authorized users.

Stress fractures in football

Football (soccer) is one of the most popular sports in the world with high-reported injury rates; many injuries are potentially career ending. Stress fractures represent the inability of a normal or weakened bone to withstand repeated stresses and are reported to account for 0.5% of all football-related injuries. The pathophysiology of stress factors is multifactorial and involves a complex interplay of several extrinsic and intrinsic factors. A high degree of suspicion and adequate imaging is necessary to diagnose these injuries, as plain radiographs may miss the diagnosis in many cases. Once the diagnosis of a stress fracture has been confirmed, treatment consists of activity modification and relative or complete rest, depending on the site and nature of the stress fracture. Surgical intervention may be necessary in the ‘high-risk’ stress fractures, which are prone to displacement, delayed union and non-union. This review looks at the epidemiology, aetiopathogenesis, classification, diagnosis and treatment of stress fractures in football.

Tackling causes and costs of ED presentation for American football injuries: a population-level study

BackgroundAmerican tackle football is the most popular high-energy impact sport in the United States, with approximately 9 million participants competing annually. Previous epidemiologic studies of football-related injuries have generally focused on specific geographic areas or pediatric age groups. Our study sought to examine patient characteristics and outcomes, including hospital charges, among athletes presenting for emergency department (ED) treatment of football-related injury across all age groups in a large nationally representative data set. MethodsPatients presenting for ED treatment of injuries sustained playing American tackle football (identified using International Classification of Diseases, Ninth Revision, Clinical Modification code E007.0) from 2010 to 2011 were studied in the Nationwide Emergency Department Sample. Patient-specific injuries were identified using the primary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code and categorized by type and anatomical region. Standard descriptive methods examined patient demographics, diagnosis categories, and ED and inpatient outcomes and charges. ResultsDuring the study period 397363 football players presented for ED treatment, 95.8% of whom were male. Sprains/strains (25.6%), limb fractures (20.7%), and head injuries (including traumatic brain injury; 17.5%) represented the most presenting injuries. Overall, 97.9% of patients underwent routine ED discharge with 1.1% admitted directly and fewer than 11 patients in the 2-year study period dying prior to discharge. The proportion of admitted patients who required surgical interventions was 15.7%, of which 89.9% were orthopedic, 4.7% neurologic, and 2.6% abdominal. Among individuals admitted to inpatient care, mean hospital length of stay was 2.4days (95% confidence interval, 2.2-2.6) and 95.6% underwent routine discharge home. The mean total charge for all patients was $1941 (95% confidence interval, $1890-$1992) with substantial injury type–specific variability. Overall, at the US population, estimated total charges of $771299862 were incurred over the 2-year period. ConclusionIn this nationally representative sample, most ED-treated injuries associated with football were not acutely life threatening and very few required major therapeutic intervention. This study provides a cross-sectional overview of ED presentation for acute football-related injury across age groups at the population level in recent years. Longitudinal studies may be warranted to examine associations between the patterns of injury observed in this study and long-term outcomes among American tackle football players.