Oslo Sports Trauma Research Center Research Articles

Overuse injury and affects in competitive sport: Aprospective longitudinal study.

Overuse injuries, which have a high prevalence in sport, are suggested to result in different affective responses in comparison to traumatic injuries. Affects may also reciprocally act as risk factors for overuse injury. The aim of this study was to examine the associations between overuse injury and affects within a longitudinal follow-up design. Competitive athletes (N = 149) of various sports and levels of competition completed the Positive and Negative Affect Schedule (PANAS) and the Oslo Sports Trauma Research Centre Overuse injury questionnaire (OSTRC-O) once a week over 10 consecutive weeks. Bivariate unconditional latent curve model analyses with structured residuals were performed to evaluate the associations within and across weeks between OSTRC-O severity score and affects. Results indicated that OSTRC-O severity score and positive affects (PA) had a statistically significant negative within-week relation (r = -24.51, 95% CI = [-33.9, -15.1], p < 0.001). Higher scores of overuse injury were significantly related to lower levels of PA across weeks (ß = -0.02, 95% CI = [-0.04, -0.001], p = 0.044), while the reciprocal effect of PA on overuse injury was not significant (ß = -0.13, 95% CI = [-0.52, 0.26], p = 0.51). No statistically significant association was observed between OSTRC-O severity score and negative affects, neither within nor across weeks. Our findings suggest that overuse injury may have adverse psychological consequences on the long run through lessened PA and address the need for providing sustainable psychological support focusing upon such PA when working with athletes experiencing overuse injury.

Lower HAGOS subscale scores associated with a longer duration of groin problems in football players in the subsequent season

IntroductionGroin injuries represent a considerable problem in football. Although the Adductor Strengthening Programme reduced groin injury risk, players can still experience groin symptoms throughout the season. This study aimed to...

Study protocol for a prospective cohort study describing the injury characteristics in elite gymnasts in TeamGym: the Swedish TeamGym Injury Cohort – STIC

IntroductionGymnastics consists of several different disciplines, whereof TeamGym is one. TeamGym is a young discipline with sparse research. The aim of the study is to investigate the injury characteristics in...

Groin injuries in women's premier league football in Norway: A two-season prospective cohort study describing clinical and imaging characteristics.

To describe the prevalence, incidence, and burden of groin injuries in the Norwegian women's premier football league and to describe their clinical and imaging characteristics. During the 2020 and 2021 seasons, players in the Norwegian women's premier league reported groin injuries weekly, using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H2). We calculated weekly prevalence, incidence, and burden of groin injuries. The team physical therapists classified the player-reported injuries based on the Doha classification system. Injuries with more than 3 days' time loss or reported in 2 consecutive weeks were eligible for magnetic resonance imaging (MRI). On average, 3.9% (95% CI: 3.4-4.4) of players reported a groin injury at any time; of which 78% caused time loss. The incidence rate was 1.6 injuries/1000 h (95% CI: 1.3-2.0) and their burden was 11 days lost/1000 h. The physical therapists examined 67 of 124 player-reported groin injuries (53%). Adductor-related injury was most common (55%) followed by iliopsoas (15%) and rectus femoris-related (12%). Pubic-related injuries caused most time loss (median: 24 days, IQR: 5-133). In this study, 42 injuries were investigated with MRI; 8 (19%) showed no changes, 6 (14%) an acute musculotendinous lesion, and 32 (76%) a nonacute finding (e.g., central symphyseal disc protrusion, tendinopathies). The incidence rate and burden of groin injuries were high. Adductor-related injuries were most common, but pubic-related injuries caused most time loss. Most MRI examinations demonstrated nonacute findings.

Development and validation of an overuse injury questionnaire for youth athletes: The Youth Overuse Injury Questionnaire

ObjectiveTo develop and validate the Youth Overuse Injury Questionnaire (YOvIQ). DesignA cross-sectional study. SettingOnline platforms. ParticipantsTwo content experts (in sports injury epidemiology and in sports science and medicine) and seven end-users (youth volleyball athletes) provided feedback during development of the YOvIQ. 227 competitive youth athletes across 14 different sports assessed the psychometric properties of the YOvIQ. Main outcome measuresParticipants completed both YOvIQ and the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O2) for anatomical areas of the shoulder, elbow, lower back, knee, and ankle/foot. Validity was assessed via convergent validity. Reliability was assessed using internal consistency estimation and interclass correlation coefficient. ResultsFollowing feedback from content experts, examples and quantitative symbolization were added to the options in YOvIQ, with positive feedback from end-users. Convergent validity between YOvIQ and the OSTRC-O2 was demonstrated with non-significant differences (P ≥ .05) and significant correlations (P < 0.001) for prevalence and severity scores. YOvIQ demonstrated internal consistency for prevalence (Cronbach's alpha coefficient >0.70) and moderate-to-good reliability for severity scores (ICC: 0.51 to 0.88) for shoulder, lower back, and knee. ConclusionsThe YOvIQ is a valid and reliable instrument to identify overuse injuries to the shoulder, lower back, and knee in youth athletes.

Same game, different worlds? General conditions, perceived stress, and associations between stress and past season injuries in elite female and male ice hockey players.

Ice hockey is played by women and men but the arena they play in may differ substantially. Potential differences in general conditions to play the sport may be associated to perceived stress, which has shown to be related to athletic injury in other sports. Therefore, this study aimed to describe and compare general conditions for playing ice hockey, stress levels, and the association between perceived stress and injury occurrence among elite female and male players. Prior to the 2022-2023 season all female and male players from the top ice hockey leagues in Sweden were invited to an online survey. Players provided information about their general conditions for playing ice hockey and reported perceived stress during the previous season on the Perceived Stress Scale (PSS-10; sum score range 0-40) and current stress on the Single Item Stress Question (SISQ; scale range 1-5). Injuries during the previous season were self-reported on a modified version of the Oslo Sports Trauma Research Center - Overuse Injury Questionnaire. We received responses from 360 players (170 females and 190 males). Female players more frequently reported additional occupations besides ice hockey and less medical support during games and practices than male players (p < .001). General stress levels were significantly higher among female players (mean PSS score [SD]: 17.4 [5.6] vs 14.1 [5.6], p < 0.001; SISQ median [IQR]: 3 [2-3] vs 2 [1-3], p < 0.001). There was a statistically significant but weak correlation between past season injury and perceived stress (PSS score: rho 0.29; SISQ: rho 0.24). This correlation was stronger among males than females (PSS score: 0.38 vs 0.162; SISQ: 0.29 vs 0.16, p's < 0.05). Players with substantial injuries during previous season had higher previous and current stress levels than players without injury, a difference that was largest and statistically significant only among male players. General conditions for playing elite ice hockey are inequal for female and male athletes. Stress levels of elite ice hockey players were comparable to the general population. Experience of severe injuries during the previous season was associated to higher levels of perceived stress. This association is stronger among male players, which may be due to greater economic dependency.

Development and Feasibility of an Adolescent Dancer Screen.

Adolescent dancers are at high risk for injuries due to the physical demands of dance training and the physiological changes that occur during adolescence. Though studies report high injury rates, there are few standardized screening tools available for adolescent dancers. To develop and describe a standardized, feasible, evidence-based, and clinically relevant screen for adolescent dancers. Descriptive Epidemiology Study. Dancers at two suburban pre-professional dance studios, in two cohorts, participated in the Columbia Adolescent Dancer Screen (CADS) that includes dance injury history, health questionnaires (EAT-26, SF-36, DFOS), aerobic capacity, range of motion, strength, balance/orthopedic special tests, and dance technique. Participants were asked to complete a weekly injury surveillance questionnaire derived from the Dance-Specific Oslo Sports Trauma Research Centre Questionnaire on Health Problems for 14 weeks following the screening. Feasibility was assessed using process and content analysis in four areas: practicality, demand, implementation, and adaptation. Descriptive data were collected from 32 female dancers aged 11-17 with cohort one averaging 18.57 dance hours per week and cohort two averaging 10.6 dance hours per week. The screen was practical, able to screen seven to eight dancers per hour utilizing nine assessors and requiring a one-hour commitment from dancers. Cost and space requirements were considered and kept to a minimum while utilizing portable equipment. All screening slots were filled with all dancers agreeing to follow-up injury surveillance, indicating high demand. The screen was implemented with two cohorts with revisions to improve efficiency applied for the second cohort. The CADS is a feasible screening tool for adolescent dancers that overcomes barriers by being pragmatic, evidence-based, and efficient. Screening can be implemented to obtain baseline values, inform wellness recommendations, and establish relationships with medical professionals. Level 3b.

Mental health problems, sleep quality and overuse injuries in advanced Swedish rock-climbers – the CLIMB study

ObjectivesTo examine the prevalence of mental health problems (depression, anxiety, and stress), sleep quality, and disability due to overuse injuries in advanced and elite rock-climbers. The rock-climbers were compared to a group of non-climbing controls.MethodsA self-selected sample of advanced and elite Swedish rock-climbing athletes was recruited through the Swedish Rock-climbing Federation, local rock-climbing gyms and through social media. A control group, matched in size was recruited. Participants in the control group answered an online survey of validated questionnaires, examining symptoms of stress, anxiety, depression, sleep quality. The climbing participants answered the same survey as the non-climbing controls but with additional questions regarding musculoskeletal problems and disabilities related to these. Outcome measures used were the Depression Anxiety Stress Scale, Pittsburgh Sleep Quality Index and The Oslo Sports Trauma Research Center Overuse Injury Questionnaire.ResultsA total of 183 participants were included in the rock-climbing group, and 180 participants in the control group. In the rock-climbing group the mean age (SD) was 28.2 (8.3) years among women and 30.5 (9.6) years in men. The mean BMI of women was 21.2 (2.2) and 22.8 (2.1) in men. A total of 30.6% of the rock-climbing group (26.7% of men, 35.9% of women) reported at least moderate levels of symptoms of depression and 23.1% (17.2% men, 30.8% women) at least moderate levels of symptoms of anxiety. A total of 48.4% of rock-climbers (39.1% men, and 61.6% women) reported at least moderate levels of symptoms of stress. Among the rock-climbers, 45.0% reported having poor sleep quality. There were no statistical significant differences (p = 0.052–0.96) in mental health problems or sleeping problems between the rock-climbers and the controls. Among rock-climbers, reports of one-week prevalence of injury related problems was: Finger and hand (49.5%), Shoulder (35.2%), Knee (29.1%), Lumbar back (26.4%), Arm (25.3%), Thoracic back and neck (17.0%), and Foot and lower leg (12.1%).ConclusionThe overall results indicate high levels of symptoms of mental health problems and poor sleep quality in both rock-climbers and controls. Although no significant differences between the climbing group and the control group was displayed, symptoms that warrant clinical attention is high. Overuse injuries were commonly reported among the rock-climbers in all examined injury locations. Previous studies reporting mental health problems to be more prevalent among athletes were contradicted in this study. The results display the need for a broader perspective regarding climbers general health and the need to provide structured care and adequate support in order to come to terms with these concerns.

Musculoskeletal Injuries in Police Enforcement Trainees in the Pre-service Training Course of Iran

Purpose: Intensive military training courses are among the programs and specialties of the police force. Musculoskeletal disorders in the military are one of the vital factors that keep people away from courses and shorten their service life. This research aims to measure the prevalence of musculoskeletal injuries in newly arrived students in the pre-service training course of the police force using the Oslo Sports Trauma Research Center (OSTRC) questionnaire. Methods: For this purpose, 124 soldiers with a mean age of 20.7 years, a mean height of 178.5 cm, a mean weight of 72.9 kg, and a mean activity per week for 3 hours and 19 minutes in one of the training barracks affiliated to the Tehran Police Force and were selected and completed the OSTRC questionnaire every month for 6 months. The research design of this study is epidemiology and the results are presented descriptively. Results: The results of the research related to prevalence measurement on a monthly mean showed that ankles at 2.8%, knees at 2.2%, and waist at 1.8% respectively have the highest prevalence rates among soldiers. Also, among the harmful factors, the parade had the largest share with 22.5% and during 6 months, the second month had the highest number of injuries, and the sixth month had the lowest number of injuries. In terms of participation in exercises, 86.6% of soldiers participated in practical classes without any physical injuries during the six months. A total of 9.1% of the soldiers could not perform optimally and properly despite their full attendance in the practical classes due to physical injuries and finally, 3.8% of the participants, despite attending the practical classes, had to leave the class halfway due to the severity of the injury. Conclusion: What is clear is that the most affected areas are the central area and the lower limbs, and the spine of the back, head, neck, and upper limbs were not among the most damaged areas. Finally, it seems that the prevalence rate among the soldiers in training courses is acceptable and close to the average of global statistics. However, it is required to take preventive measures as well as plan to add classes and specialized exercises to strengthen physical fitness and specialized exercises related to improving the conditions of damaged areas.

Knee, Low Back, and Shoulder Problems Among University and Professional Volleyball Players: Playing With Pain.

The knee, low back, and shoulder account for most overuse injuries in volleyball. Previous researchers have used methodology that did not examine the extent of injury burden and effect on performance. To develop a more accurate and complete understanding regarding the weekly prevalence and burden of knee, low back, and shoulder problems within the highest levels of men's volleyball, including the role that preseason complaints, match participation, player position, team, and age have on complaints. Descriptive epidemiology study. Professional volleyball clubs and the National Collegiate Athletic Association Division I program. A total of 75 male volleyball players, representing 4 teams playing in their country's respective premier league (Japan, Qatar, Turkey, and the United States), participated over a 3-season period. Players completed a weekly questionnaire (Oslo Sports Trauma Research Centre Overuse Injury Questionnaire) reporting pain related to their sport and the extent to which knee, low back, and shoulder problems affected participation, training volume, and performance. Problems leading to moderate or severe reductions in training volume or performance or the inability to participate were considered substantial problems. The mean weekly prevalence of knee, low back, and shoulder problems based on 102 player-seasons was 31% (95% CI = 28%, 34%), 21% (95% CI = 18%, 23%), and 19% (95% CI = 18%, 21%), respectively. Most players (93%, 95/102 player-seasons) reported some level of knee (79%, n = 81/102 player-seasons), low back (71%, n = 72/102 player-seasons), or shoulder (67%, n = 68/102 player-seasons) complaints during the season. Most players (58%, n = 59/102 player-seasons) experienced at least 1 episode of substantial problems affecting the knee (33%, n = 34/102 player-seasons), low back (27%, n = 28/102 player-seasons), or shoulder (27%, n = 28/102 player-seasons). Players with preseason complaints had more in-season complaints than teammates without preseason problems (mean weekly prevalence: knee, 42% versus 8%, t49 = -18.726, P < .001; low back, 34% versus 6%, t32 = -12.025, P < .001; shoulder, 38% versus 8%, t30 = -10.650, P < .001). Nearly all included elite male volleyball players experienced knee, low back, or shoulder problems, and most had at least 1 bout that substantially reduced training participation or sport performance. These findings suggest that knee, low back, and shoulder problems result in greater injury burden than previously reported.

Injury patterns in Swedish elite female and male ice hockey – A cross-sectional comparison of past-season's injuries

ObjectivesTo describe and compare seasonal prevalence, anatomical location, severity, and onset of injuries between female and male elite ice hockey players. DesignCross-sectional survey study. SettingElite ice hockey. ParticipantsSwedish elite ice hockey players (170 females & 190 males). Main outcome measuresPast season injuries reported on a modified version of the Oslo Sports Trauma Research Center overuse injury questionnaire. Proportions of players who experienced any and substantial problems, as well as respective injury severity scores were presented and compared between sexes. ResultsHighest seasonal prevalence was reported for hip/groin [31.1% (n = 112)], lower back [24.2% (n = 87)], and shoulder injuries [23.6% (n = 85)]. Prevalence of injuries was approximately similar between sexes. Substantial injuries were most prevalent in the hip/groin (13.3% [n = 48]) and knee (18.6% [n = 67]) region. Females reported a higher proportion of substantial hip/groin injuries. Most reported injuries were acute except for hip/groin and lower back injuries (74.4% and 81.8% due to overuse). ConclusionSeasonal prevalence of injuries in elite ice hockey players were comparable between sexes. Acute injuries were most common but hip/groin as well as lower back injuries were predominantly due to overuse. The highest reported prevalence was found for hip and groin-, lower back-, and shoulder injuries.

Injury and illness among Norwegian Olympic athletes during preparation for five consecutive Summer and Winter Games

ObjectiveTo describe the patterns of health problems among Norwegian Olympic candidates during their preparations for five consecutive Olympic Games (London 2012, Sochi 2014, Rio de Janeiro 2016, PyeongChang 2018 and...

Italian Cross-Cultural Adaptation and Validation of the Improved Report of Oslo Sports Trauma Research Centre Questionnaires on Overuse Injuries and Health Problems

Italian Cross-Cultural Adaptation and Validation of the Improved Report of Oslo Sports Trauma Research Centre Questionnaires on Overuse Injuries and Health Problems

#ReadyToPlay: health problems in women’s football–a two-season prospective cohort study in the Norwegian premier league

ObjectivesTo describe the prevalence, incidence and burden of all health problems in the Norwegian women’s premier league.MethodsDuring the 2020 and 2021 seasons, players in the Norwegian women’s premier league reported...

Does injury risk increase when youth athletes start to study at a sports high school?

Background/aimThe injury risk is high in adolescent elite athletes. However, little is known about how the injury risk changes when young talented athletes start studying at a sports high school....

PREVALENCE OF MUSCULOSKELETAL OVERUSE INJURIES AMONG MALAYSIAN ELITE ATHLETES DURING THE PREPARATION PHASE FOR INTERNATIONAL SPORT COMPETITION

Intensive training with a high volume of training in preparation for the tournament may predispose athletes to overuse injuries. Therefore, this study aims to determine the prevalence of musculoskeletal overuse injuries among Malaysian athletes during the pre-competition phase. A 13-week prospective cohort study was conducted, including 100 elite athletes representing Malaysia at Commonwealth Games, Asian Games and World Championships. Data on overuse injuries were collected every second week using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. The average weekly prevalence of overuse injuries was calculated using the questionnaire results. A total of 119 cases of substantial overuse condition were reported, which were in the back (35 cases), knee (31 cases), ankle (28 cases), and shoulder (25 cases), affecting 100 athletes (100% of the cohort). About 42.5 % of the participants classified themselves as having substantial overuse problems, leading to a moderate (71%) or severe (29%) reduction in sports participation or performance or inability to participate in high-performance activities. The average weekly severity score for the back was 16, 12 cases for the shoulder, and the same score of 14 cases for the knee and ankle. Overuse injuries occurred among elite Malaysian athletes during the preparation and training phase for international competition due to the rapid intensity of the training. This study suggests that a guideline is needed for injury prevention strategies for the benefit of Malaysian athletes to prevent injuries.

Health problems occurring in national-level female soccer players are different between leagues and throughout the season: a 6-month prospective cohort study

ObjectivesThis study investigated the prevalence and severity of health problems in national-level female soccer players with respect to league and seasonality.MethodsIn a prospective cohort study, 46 female soccer players aged...

Higher age and present injury at the start of the season are risk factors for in-season injury in amateur male and female football players—a prospective cohort study

PurposeTo describe the injury prevalence, injury pattern, and potential baseline risk factors for injuries in male and female adolescent and adult amateur football players.MethodsThis prospective study followed adolescent and adult amateur football players over one season March–October 2020. The study was completed by 462 players (130 men, age 20.0 ± 5.7, 14–46 years) who answered a baseline survey and a weekly web survey during the season. A total of 1456 weekly surveys were registered from males and 5041 from females. Injuries were recorded with the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O2). Potential baseline risk factors (age, performance of strength/conditioning training, participation in other sports, perceived importance of sporting success, self-rated training and match load, perceived balance between training/match load and recovery, previous/present injury at start of season, and injury beliefs) and their association with injury were analysed with Poisson regressions within each sex.ResultsMales reported 95 injuries (262 injury weeks, weekly prevalence 18.0% (95% CI 16.1–20.1)) and females 350 injuries (1206 injury weeks, weekly prevalence 23.9% (95% CI 22.8–25.1)). Gradual-onset injuries accounted for 57% of the injuries in males and 66% in females. For males, substantial injuries were most common in the hip/groin (weekly prevalence 3.8%), ankle (2.1%), posterior thigh (2.0%), and knee (2.0%); and for females, in the knee (4.3%), ankle (2.5%), and lower leg/Achilles tendon (2.0%). Significant risk factors for injury were higher age (rate ratio males 1.05 per year increase (95% CI 1.02–1.08), females 1.03 (95% CI 1.01–1.05)), and present injury at baseline (males 1.92 (95% CI 1.27–2.89), females 1.58 (95% CI 1.19–2.09)).ConclusionAt any given week, almost one in five male and one in four female amateur football players reported new or ongoing injuries. Hip/groin injuries were more frequent in males, while female players had a higher prevalence of knee injuries. Older players and those with an existing injury at the start of the season were more prone to new injury during the season. Rehabilitation of pre-season injury and complaints are key to reduce the injury burden in amateur football.Level of evidenceLevel II.Trial registration number NCT04272047, Clinical trials

Epidemiology of Acute and Overuse Injuries in Underwater Rugby.

Underwater rugby (UWR) is a team sport. Athletes require a high degree of strength, endurance, speed, and coordination involving intense physical contact. Currently, a paucity of literature exists regarding injury occurrence in UWR. To examine the nature and prevalence of acute and overuse injuries in UWR. Descriptive epidemiology study. Between November 2020 and March 2021, a total of 720 German UWR athletes were invited to take an online survey developed by orthopaedic specialists with UWR athletes. Data were recorded regarding general and health-related information, training habits, acute injuries that necessitated an interruption in training and/or doctor consultation, as well as overuse injuries. Overuse injuries were evaluated using the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire. Statistical analyses included t tests or rank sum tests depending on normality of distribution. A nonparametric Kruskal-Wallis 1-way analysis of variance on ranks was used for nonnormally distributed data among several groups. This study included 161 active athletes (mean ± SD, 36.1 ± 11.9 years old; 75.3% male) for analysis, of whom 90.1% were competing regularly. The performance-level distribution was as follows: first German national league (n = 73), second German national league (n = 46), state league (n = 17), district league (n = 1), and no league (n = 24). The mean ± SD sport-specific training workload was 5.6 ± 3.0 h/wk, including UWR training, additional swimming (n = 71; 44.1%), strength (n = 70; 43.5%), and/or endurance training (n = 102; 63.4%). Acute injuries were recorded in 78.9% of all athletes. The most typical locations for acute injuries were hand/finger (42.4%), head/face (concussion, ruptured eardrum; 18.1%), wrist (5.5%), or spine (5.0%). Overuse injuries were reported by 42.9% of the participants. The predominant locations for overuse injuries were hand/finger (18.8%), shoulder/clavicle (14.1%), spine and wrist (10.7% each), head/face (8.7%), and ankle joint and knee (6.7% each). In the current study, 3 of 4 athletes reported at least 1 acute injury, and 2 of 5 athletes reported at least 1 overuse injury. Leading injury regions were the hand/finger, head/ear, wrist, and spine.

Prevalence and incidence of health problems and their characteristics in Brazilian para athletes: A one-season single-center prospective pilot study

BackgroundPara athletes experience high prevalence and incidence of health problems related to sport. Despite this, there are few longitudinal studies. ObjectiveTo describe the characteristics, prevalence, incidence, and severity of health problems in para athletes from one of the Brazilian Paralympic Reference Centers during a sports season and to compare the prevalence of health problems between para athletics, para powerlifting, and para swimming. MethodsThis prospective pilot study was conducted from October 2019 to March 2020. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used to record injuries and illnesses every week for 24 weeks. The characteristics, prevalence, incidence, and severity of health problems were described for each modality. The prevalence of health problems was compared among the three sport modalities. ResultsThirty-five para athletes participated. Most of the injuries occurred in the shoulder, and most illnesses caused respiratory and gastrointestinal symptoms. The average weekly prevalence and the incidence rate of health problems were 40.6% (95% CI 17.0–64.4) and 12.7 (95% CI 9.6–15.9) per 1000 athlete hours, respectively. Para powerlifting had the highest prevalence of all and substantial health problems; para swimming had the lowest prevalence of injuries; and para athletics had the lowest prevalence of illnesses. ConclusionsThis group of Brazilian para athletes showed a high prevalence and incidence of health problems throughout the season. Para athletics, para powerlifting, and para swimming each had a different prevalence of injuries and illnesses.