Significant Risk Factors For Injury Research Articles

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

Poster 392: Analysis of Musculoskeletal Injuries Among Collegiate Varsity Esports Athletes

Objectives: Electronic sports (esports) have grown tremendously in the past decade with an estimated market value of $493 million in 2017 and an expected growth to $2.3 billion dollars by the end of 2022. Additionally, colleges are embracing this growing culture with over 200 varsity esports programs as of May 2022, up from 7 varsity programs just two years earlier. Despite its growing success, little has been studied on the injuries of these athletes. Prior studies have noted that injuries to professional esports players have forced them to miss significant time and in some instances, into an early retirement. Due to poor posture, a sedentary lifestyle, and repetitive hand motions, the most common injuries to esports athletes include injuries to the hand, wrist, back and neck. The purpose of this study is to investigate the prevalence of injuries sustained through collegiate esports players and explore the injuries’ impacts on their careers. The authors hypothesized that athletes who spend more time practicing and playing competitively in esports will report an increased history of musculoskeletal injury. Methods: A list of collegiate esports athletes was collected from publicly available sources. Athletes with available contact information were sent a self-reporting questionnaire. The questionnaire examined variables including length of time playing esports, hours/day playing esports, esports-related injury history, surgeries needed, and missed competition time. Demographic and workload data were then compared between injured and uninjured athletes. Results: Overall, 153 collegiate esports athletes (88% male, aged 18-42 years) were included, with 41 (26.8%) having experienced at least one injury from esports. As demonstrated in Table 1, of the 41 injured athletes, 3 (7.3%) required surgery, 17 (41.5%) had multiple injuries, and 7 (17.1%) missed competition time for an average of 3.0 ± 2.3 weeks. Athletes who have been on their respective college team longer (1.7 ± 0.9 vs. 2.0 ± 1.0 years, p=0.026) and who spent more hours per day practicing had a higher injury incidence (p=0.012). There was no difference in current age, sex, age at which athletes began competing in esports, and scholarship status between groups (all p>0.05). When analyzing the 41 athletes who experienced an injury, the most common injury was to the wrist with 25 total injuries. There were 11 neck, 10 back, 9 finger, 8 hand, 6 elbow, and 4 thumb injuries. Conclusions: Collegiate esports players who trained for more hours per day and played competitive collegiate esports for more years were more likely to have experienced an esports-related injury. Interestingly, while hours per day was a significant risk factor for injury, the number of days per week had was not a significant risk factor for injury, possibly indicating that injuries are sustained through continuous and excessive playing rather than intermittent playing over a longer period. The three most common injury locations were to the wrist, back, and neck, while shoulder and thumb injuries were the least common. Fortunately, only a small portion of athletes who experienced an injury were forced to miss competition time, and even fewer required surgery. With this being the largest investigation into collegiate esports-related injuries, future medical research can help collegiate and professional programs place a greater emphasis on the management and prevention of esports-related injuries. [Table: see text]

Injury Occurrence in Amateur Rugby: Prospective Analysis of Specific Predictors over One Half-Season.

Background and objectives: The incidence of injuries in rugby is extremely high, but studies have rarely examined the predictors of injury in amateur players. This study aimed to systematically analyse sports and injury factors as potential predictors of musculoskeletal injuries in senior-level amateur rugby players. Methods: The participants in this study were 101 senior-level rugby players from Croatia (average of 24.64 years old). At baseline, all participants were tested on sociodemographic and anthropometric parameters (age, body height and mass), consumption of dietary supplements, preseason injury status and training volume, and sport factors (position in game). Data on injury occurrence (dependent variable), prevalence of pain, training status, and characteristics of the played match were surveyed prospectively once a week during the three-month period (one half-season). Results: The logistic regression revealed a higher injury occurrence in forward players of the 1st row, 2nd row (OR = 5.07; 95% CI: 1.64-15.69), and center (OR = 4.72; 95% CI: 1.28-14.31), with reference to outside back players. When observed univariately, higher body mass, higher level of competition, more weekly training sessions, self-perceived pain, and playing with pain were significant injury risk factors. The multivariate logistic regression identified pre-season injury (OR = 1.30, 95% CI: 1.09-1.52), higher level of the game/match (OR = 1.44, 95% CI: 1.13-1.76), higher body mass (OR = 1.03, 95% CI: 1.01-1.05), and pain prevalence (OR = 5.71, 95% CI: 3.22-7.70) as multivariate predictors of injury occurrence over the season. Conclusion: The results of this study showed that among sport factors, the playing position, level of competition, and training exposure represent major injury risk factors. Therefore, in order to reduce the number of injuries, special emphasis should be placed on the specific tackling technique of forward players, which could both increase their situational efficiency and protect them from injuries. Additionally, perceived pain, injury history, and playing with injury were noted among injury factors as the ones that can be predictors of future injuries. In that manner, it is important that coaching and medical staff monitor players with previous injuries and with pain symptoms in order to act preventively against injury occurrence.

Relationship between Lower Extremity Fitness Levels and Injury Risk among Recreational Alpine Skiers: A Prospective Cohort Study.

Background: Although the importance of physical fitness for injury prevention is recognized in sports medicine and rehabilitation, few studies have investigated this factor among recreational alpine skiers. Objective: To determine the effect of lower extremity fitness on the risk and severity of injury among recreational alpine skiers. Method: This prospective cohort study involved 117 recreational skiers at two alpine resorts during the 2021–2022 winter season. Anthropometric characteristics, skiing skills, and lower extremity agility (hexagon test), balance (Y-Balance Test), and endurance (60-s squat test) were assessed before the winter season. All of the participants were divided into an injured group and an uninjured group, based on whether an injury was recorded throughout the season. Results: In binary logistic regression, the hexagon test duration and composite Y-Balance Test score were significant injury risk factors (p < 0.05). Ordinal polytomous logistic regression revealed no significant factors for injury severity (p > 0.05). Conclusions: Recreational alpine skiers with inferior lower extremity agility or balance may have a higher injury risk and this must be considered when assessing individual risk. In the context of injury prevention, regular neuromuscular training and testing, including agility and balance aspects should be recommended to skiers.

Paper 10: Influence of Arm Path on Elbow Varus Torque in Professional Baseball Pitchers

Objectives:Arm path, or the distance the hand travels from the glove to ball release, has become an increasingly discussed topic within the baseball community. Arm path is a combination of elbow flexion, shoulder external rotation, shoulder abduction, forearm pronation, and wrist flexion movements. Traditionally, pitchers have been taught to throw with a longer arm path during the first part of the pitching motion, which includes extending the throwing arm away from the body and delaying shoulder external rotation. Advocates of the shorter arm path have recently made a push to get pitchers to shorten up as it is thought that it results in a more efficient motion and this in turn may decrease injury risk. By shortening the arm path, the throwing arm is closer to the body in a more loaded position theoretically creating less torque on the elbow. However, there is a lack of published data to support either claim of the benefits of a shorter or longer arm path. The purpose of this study was to determine if there was a relationship between arm path and elbow varus torque in professional pitchers.Methods:Data from 285 professional pitchers were included in this study (189.9±5.9 cm, 95.1±9.8 kg). Pitchers were tested pitching 8-12 fastballs at 480 Hz using a 3D motion capture system (Motion Analysis Corp., Santa Rosa, CA). The fastest pitch from each pitcher was used in the analysis. Arm path was measured as the total path the hand marker traveled during the entire pitch. Arm path was also normalized as a percentage of arm length (%AL). The pitch was broken down into four time points: maximum knee height (MKH), foot contact (FC), maximum external rotation (MER), ball release (BR). Linear regressions were calculated to evaluate the relationship between arm path and elbow varus torque at each time point. Significance was set at p<0.05.Results:There was no significant relationship between arm path and elbow varus torque (Figure 1). Arm path did not have a significant effect on elbow varus torque for MKH to BR (r2=.04, p<0.001), MKH to FC (r2=.05, p<0.001), and FC to BR (r2=0.00, p=0.207). Furthermore, there was no significant effect on elbow varus torque for MKH to BR, MKH to FC, and FC to BR when arm path was normalized by the pitcher’s arm length (r2=0.00 p=0.262; r2=0.02 p=0.018; r2=0.01 p=0.081 respectively).Conclusions:Recent anecdotal trends towards a shorter arm path in pitchers does not alter elbow varus torque as compared to both average and longer arm paths in a sample of professional pitchers. None of the studied time periods within the pitching motion revealed correlations between elbow varus torque and shorter arm paths. This suggests that total distance travelled by the arm during the pitching motion may not be a significant risk factor for injury in professional level pitchers. However, it is possible that components of arm path (i.e. elbow flexion, shoulder rotation, and shoulder horizontal abduction) play a larger role in the influence on elbow varus torque than simply arm path. Future studies should investigate the combined effects of arm path and arm path’s components on elbow varus torque.Figure 1.Correlations of arm path to elbow varus torque during a pitch. The left hand column measures arm path in centimeters and the right hand column uses arm path normalized to pitcher’s arm length. There were no correlations in arm path to elbow varus torque. Maximum knee height. MKII; FC. foot contact; BR. ball release.

Injury Patterns, Risk Factors, and Return to Sport in Brazilian Jiu Jitsu: A Cross-sectional Survey of 1140 Athletes.

Background:Brazilian jiu jitsu (BJJ) is a growing martial art that focuses on grappling techniques.Purpose:To quantify the 3-year incidence of BJJ-related injuries and detect common injury patterns as well as risk factors among those practicing BJJ. It was hypothesized that there would be a high incidence of injuries, they would be caused by submissions in sparring situations, and they would occur predominantly at the extremities.Study Design:Descriptive epidemiology study.Methods:Active BJJ athletes were invited to take an English-language online survey developed by orthopaedic surgeons together with BJJ athletes and a sports scientist. Data were recorded regarding athlete demographics, sporting activity level, injuries within the past 3 years that caused at least a 2-week time loss, injury mechanisms, and return to sport.Results:Overall, 1140 responses were received from 62 different countries; 88.9% of all athletes were male, and 63.9% were regular competitors. Within the investigated cohort, 1052 injuries were recorded in 784 athletes, for an injury incidence of 308 per 1000 athletes per year. The lower extremity (45.7%) and upper extremity (30.2%) were predominant sites of injury, with injuries to the knee (27.1%) being the most common. The most frequent knee injuries were meniscal injuries (n = 65), anterior cruciate ligament (ACL) tears (n = 36), and medial collateral ligament injuries (n = 36). ACL tears were especially associated with long time frames for return to sport. Most injuries occurred during sparring (77.6%) and were caused by submissions (29.7%) and takedowns (26.4%). Competing regularly (P = .003), older age (P < .001), and higher belt rank (P = .003) were significant risk factors for injury.Conclusion:Injury incidence was high among BJJ athletes surveyed, with 2 out of 3 athletes reporting at least 1 injury within a 3-year period that caused a 2-week absence from training. Most injuries occurred during sparring, and we believe that a high potential for injury reduction lies in drawing awareness to common injury patterns and sites in athletes.

Occupational Injuries among Latino/a Immigrant Cattle Feedyard Workers in the Central States Region of the United States.

Agriculture is a dangerous industry with high rates of occupational injuries. Immigrants comprise the majority of the hired agricultural workforce in the United States, and these workers may be at a higher risk for job-related injuries. This study addressed the frequency, characteristics, and risk factors of occupational injuries among Latino immigrant cattle feedyard workers. Data were collected through structured interviews with Latino immigrant cattle feedyard workers in Kansas and Nebraska (n = 243; 90.9% male). Descriptive statistics and logistic regression were used to identify risk factors for injury. Nearly three-fourths of participants (71.2%) reported having experienced one or more injuries in the past while working on a cattle feedyard. The most frequent types of reported injuries, including those not requiring medical care, were bruises/contusions (40%), cuts/lacerations (21%), and sprains/strains (12%). These injuries were mainly caused by animals/livestock (33%), chemicals (23%), falls (12%), and tools (9%). Significant risk factors for injury included male gender (OR 5.9), being over age 35 (OR 2.6), working on a large or an extra-large feedyard (OR 5.4), having 11 or more employees on the feedyard (OR 3.6), and working more than eight hours a day (OR 4.7). Having received safety training was also associated with greater risk of injury in a univariable model (OR 2.6). Cattle feedyard workers are at high risk for injury and require more effective preventive measures.

Machine Learning to Predict Lower Extremity Musculoskeletal Injury Risk in Student Athletes.

Injury rates in student athletes are high and often unpredictable. Injury risk factors are not agreed upon and often not validated. Here, we present a random-forest machine learning methodology for identifying the most significant injury risk factors and develop a model of lower extremity musculoskeletal injury risk in student athletes with physical performance metrics spanning joint strength measured with force transducers, postural stability measured using a force plate, and flexibility, measured with a goniometer, combined with previous injury metrics and athlete demographics. We tested our model in a population of 122 student athletes with performance metrics for the lower extremity musculoskeletal system and achieved an injury risk accuracy of 79% and identified significant injury risk factors, that could be used to increase accuracy of injury risk assessments, implement timely interventions, and decrease the number of career-ending or chronic injuries among student athletes.

A Review of Workload-Monitoring Considerations for Baseball Pitchers.

Because of the unique demands of a pitch, baseball players have the greatest percentage of injuries resulting in surgery among high school athletes, with a majority of these injuries affecting the shoulder and elbow due to overuse from throwing. These injuries are believed to occur because of repeated microtrauma to soft tissues caused by the repetitive mechanical strain of throwing. Researchers and practitioners have suggested that baseball pitchers' workloads are a significant risk factor for injury in adolescent players, resulting in lost time and slowing of performance development. The purpose of our review was to investigate the current research relative to monitoring workload in baseball throwers and discuss techniques for managing and regulating cumulative stress on the arm, with a focus on preventing injury and optimizing performance in adolescent baseball pitchers.

Training load characteristics and injury and illness risk identification in elite youth ski racing: A prospective study

PurposeThe study aimed to investigate the role of training load characteristics and injury and illness risk in youth ski racing. MethodsThe training load characteristics as well as traumatic injuries, overuse injuries, and illnesses of 91 elite youth ski racers (age = 12.1 ± 1.3 years, mean ± SD) were prospectively recorded over a period of 1 season by using a sport-specific online database. Multiple linear regression analyses were performed to monitor the influence of training load on injuries and illnesses. Differences in mean training load characteristics between preseason, in-season, and post-season were calculated using multivariate analyses of variance. ResultsDifferences were discovered in the number of weekly training sessions (p = 0.005) between pre-season (4.97 ± 1.57) and post-season (3.24 ± 0.71), in the mean training volume (p = 0.022) between in-season (865.8 ± 197.8 min) and post-season (497.0 ± 225.5 min) and in the mean weekly training intensity (Index) (p = 0.012) between in-season (11.7 ± 1.8) and post-season (8.9 ± 1.7). A total of 185 medical problems were reported (41 traumatic injuries, 12 overuse injuries, and 132 illnesses). The weekly training volume and training intensity was not a significant risk factor for injuries (p > 0.05). Training intensity was found to be a significant risk factor for illnesses in the same week (β = 0.348; p = 0.044; R² = 0.121) and training volume represents a risk factor for illnesses in the following week (β = 0.397; p = 0.027; R² = 0.157). ConclusionA higher training intensity and volume were associated with increased illnesses, but not with a higher risk of injury. Monitoring training and ensuring appropriate progression of training load between weeks may decrease incidents of illness in-season.

Relationship of Changes in Physical Fitness and Anthropometric Characteristics over One Season, Biological Maturity Status and Injury Risk in Elite Youth Ski Racers: A Prospective Study.

Alpine ski racing is a sport with a high risk of injuries. In order to contribute to the longitudinal career development of young athletes, prevention measures should be elaborated. Therefore, the aim of the present study was to investigate prospectively the role of biological maturity status, and changes in anthropometric characteristics and physical fitness parameters over one season in elite youth ski racers younger than 15 years. Eighty-nine elite youth ski racers (39 females, 50 males), aged 10–14 years (mean age: 12.1 ± 1.3), were investigated. Anthropometric characteristics and physical fitness parameters were assessed prior and after the winter season; traumatic and overuse injuries were recorded over the 32 weeks. Binary logistic regression analyses (R² = 0.202–0.188) revealed that the biological maturity (Wald = 4.818; p = 0.028), and changes over the season in the jump agility test (Wald = 4.692; p = 0.03), in body height (Wald = 6.229; p = 0.013), and in leg length (Wald = 4.321; p = 0.038) represented significant injury risk factors. Athletes who could improve their jump agility performance more, had smaller changes in the anthropometric characteristics and who were closer to their peak height velocity were at a lower injury risk. In the context of injury prevention, regular neuromuscular training should be incorporated, and phases of rapid growth have to be considered.

Upper Extremity and Hip Range of Motion Changes Throughout a Season in Professional Baseball Players

Background: Loss of upper and lower extremity range of motion (ROM) is a significant risk factor for injuries in professional baseball players. Purpose/Hypothesis: The purpose was to determine changes in ROM in professional baseball players over the course of a single season and their careers. We hypothesized that pitchers and position players would lose ROM, specifically total shoulder motion (total ROM [TROM]) and hip internal rotation (IR), over the course of a season and their careers. Study Design: Case series; Level of evidence, 4. Methods: Upper and lower extremity ROM measurements were recorded during pre-, mid-, and postseason on all professional baseball players for a single organization between 2011 and 2018. ROM measurements were compared for pitchers and position players over the course of the season and their careers. Also, ROM measurements over the pre-, mid-, and postseason were compared between pitchers and position players. Results: A total of 166 professional baseball players (98 pitchers, 68 position players) were included. Pitcher hip external rotation (ER; P < .001), IR (P = .010), and TROM (P < .001) for lead and trail legs decreased over the course of the season. Pitcher shoulder ER (P = .005), TROM (P = .042), and horizontal adduction (P < .001) significantly increased over the course of the season. Position player shoulder flexion (P = .046), hip ER (P < .001, lead leg; P < .001, trail leg), and hip TROM (P = .001; P = .002) decreased over the course of the season. Position player shoulder ER (P = .031) and humeral adduction (P < .001) significantly increased over the course of the season. Over the course of pitchers’ careers, there was decreased shoulder IR (P = .014), increased shoulder horizontal adduction (P < .001), and hip IR (P = .042) and hip TROM (P = .027) for the lead leg. Position players experienced loss of hip TROM (P = .010, lead leg; P = .018, trail leg) over the course of their careers. Pitchers started with and maintained more shoulder ER and gained more shoulder TROM over a season as compared with position players. Conclusion: Pitchers and position players saw overall decreases in hip ROM but increases in shoulder ROM over the course of the season and career.

Venous Thromboembolism in Prader-Willi Syndrome: A Questionnaire Survey.

Prader–Willi Syndrome Association (USA) monitors the ongoing health and welfare of individuals with Prader–Willi syndrome (PWS) through active communication with members by membership surveys and data registries. Thromboembolism and blood clots have emerged in clinical studies as significant risk factors for injury and death in PWS. A 66-item questionnaire was developed by a panel of PWS medical and scientific experts, with input from Prader–Willi Syndrome Association (USA) leadership, so as to probe their membership on the frequency, risk, and protective factors for venous thromboembolism, pulmonary embolism, and related findings. The characteristics of those with and without a reported history of blood clots and related health factors were tabulated and analyzed. Responses were obtained for 1067 individuals with PWS (554 females and 513 males), and 38 (23 females and 15 males) had a history of blood clots. The individuals with clots did not differ by gender, but were significantly older 32.8 ± 15 years vs 20.4 ± 13 years, and were more likely to have a reported history of obesity (76%), edema (59%), hypertension (24%), vasculitis (33%), and family history of blood clots (33%) than those without clots. Growth hormone treatment was more common in individuals without clots. The risk factors for thromboembolism in PWS overlap those commonly observed for the general population.

Epidemiology of Competition Injuries in Elite European Judo Athletes: A Prospective Cohort Study.

To determine the injury incidence rate (IIR) and injury pattern, and to identify risk factors for injury, among elite adult European judo athletes. Prospective cohort study. The 2015 Under 23 European Judo Championships, Bratislava, Slovakia. All registered athletes (N = 295). Sex, weight division, and fight outcome. Injury incidence rates were calculated per 1000 athlete-exposures (IIRAE) and per 1000 minutes of exposure (IIRME) with 95% confidence intervals (CI). Subgroups were compared by calculating the injury incidence rate ratio (RR) with a 95% CI. The overall IIRAE and IIRME were 35.6 (95% CI, 22.8-53.0) and 10.9 (95% CI, 7.0-16.2), respectively. The most frequently injured anatomical region was the head/neck (41%), whereas the most common type of injury was contusion (33%). The risk of injury was almost 4 times greater for defeated athletes compared with winners [RRME 3.80 (95% CI, 1.47-9.82)]. Athletes in middleweight divisions had a greater risk of injury compared with their lightweight [RRME 3.58 (95% CI, 1.24-10.35)] and heavyweight [RRME 2.34 (95% CI, 0.93-5.89)] counterparts. The risk of injury for women was not significantly different from their male counterparts [RRME 1.33 (95% CI, 0.61-2.90)]. Weight division (middle) and fight outcome (losing) are significant risk factors for injury. The IIR in elite adult judo competition is lower than that in taekwondo and karate. Future research is encouraged to investigate the actual severity of judo injuries, and to investigate potentially modifiable risk factors to mitigate the risk of injury in judo.

Are internal load measures associated with injuries in male adolescent Gaelic football players?

This study aimed to examine internal loads in male adolescent Gaelic footballers and their association with musculoskeletal injury. Written training diaries were completed by 97 male adolescent Gaelic footballers weekly and injuries, defined as any injury sustained during training or competition causing restricted performance or time lost from play, were assessed by a Certified Athletic Therapist. Daily load was determined for each player (session rating of perceived exertion by session duration) and summed to give weekly load. Univariate and multiple logistic regressions were conducted to determine the association with injury. Twenty-two injuries were recorded with match injuries significantly more common than training injuries. Periodic variations in weekly load and injuries were evident throughout the season. Univariate analysis identified weekly load (OR = 2.75; 95%CI = 1.00–7.59), monotony (OR = 4.17; 95%CI = 1.48–11.72) and absolute change in load (OR = 3.27; 95%CI = 1.15–9.32) greater than the team average were significant injury risk factors. Multiple logistic regression with 2-weekly and 3-weekly cumulative loads, absolute change, monotony, strain, ACWR and age as independent variables identified internal load measures (monotony, strain and absolute change) were associated with injury with high specificity (96.0%) but low sensitivity (25.0%). The findings highlight the need to monitor team and individual loads to avoid sudden week-to-week changes or excessive weekly loads. Open communication between players, parents, coaches and sports medicine clinicians enables effective load monitoring that can reduce injury risk and may subsequently minimise dropout, improve team success and overall sport enjoyment and promote life-long sports participation.

A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS)

Background: The National Center for Injury Prevention and Control, noting flaws in previous running injury research, called for more rigorous prospective designs and comprehensive analyses to define the origin of running injuries. Purpose: To determine the risk factors that differentiate recreational runners who remain uninjured from those diagnosed with an overuse running injury during a 2-year observational period. Study Design: Cohort study; Level of evidence, 2. Methods: Inclusion criteria were running a minimum of 5 miles per week and being injury free for at least the past 6 months. Data were collected at baseline on training, medical and injury histories, demographics, anthropometrics, strength, gait biomechanics, and psychosocial variables. Injuries occurring over the 2-year observation period were diagnosed by an orthopaedic surgeon on the basis of predetermined definitions. Results: Of the 300 runners who entered the study, 199 (66%) sustained at least 1 injury, including 73% of women and 62% of men. Of the injured runners, 111 (56%) sustained injuries more than once. In bivariate analyses, significant (P ≤ .05) factors at baseline that predicted injury were as follows: Short Form Health Survey–12 mental component score (lower mental health–related quality of life), Positive and Negative Affect Scale negative affect score (more negative emotions), sex (higher percentage of women were injured), and knee stiffness (greater stiffness was associated with injury); subsequently, knee stiffness was the lone significant predictor of injury (odds ratio = 1.18) in a multivariable analysis. Flexibility, quadriceps angle, arch height, rearfoot motion, strength, footwear, and previous injury were not significant risk factors for injury. Conclusion: The results of this study indicate the following: (1) among recreational runners, women sustain injuries at a higher rate than men; (2) greater knee stiffness, more common in runners with higher body weights (≥80 kg), significantly increases the odds of sustaining an overuse running injury; and (3) contrary to several long-held beliefs, flexibility, arch height, quadriceps angle, rearfoot motion, lower extremity strength, weekly mileage, footwear, and previous injury are not significant etiologic factors across all overuse running injuries.

The Emerging Workforce of International University Student Workers: Injury Experience in an Australian University.

International university students are a growing section of the workforce and are thought to be at greater risk of injury. Qualitative studies have highlighted vulnerabilities, but there is a shortage of quantitative research exploring the injury experience and associated risk factors of this emerging issue. In this study, a total of 466 university student workers across a range of study programs in a single Australian university completed an online survey, with questions relating to their background, working experience, training and injury experience. Risk factors for injury were explored in a multivariate statistical model. More than half had not received any safety training before they started work, and 10% reported having had a work injury. About half of these injuries occurred after training. Statistically significant risk factors for injury included working more than 20 h per week (adjusted odds ratio 2.20 (95% CI 1.03–4.71) and lack of confidence in discussing safety issues (AOR 2.17; 95% CI 1.13–4.16). The findings suggest the need for a more engaging and effective approach to safety education and a limit on working hours. This situation is a moral challenge for universities, in that they are effectively sponsoring young workers in the community. It is recommended that longitudinal studies of international student workers be conducted.

Physical and Performance Characteristics Related to Unintentional Musculoskeletal Injury in Special Forces Operators: A Prospective Analysis.

Seventy-seven percent of musculoskeletal injuries sustained by United States Army Special Forces Operators are preventable. Identification of predictive characteristics will promote the development of screening methods to augment injury-prevention programs. To determine physical and performance characteristics that predict musculoskeletal injuries. Clinical laboratory. A total of 95 Operators (age = 32.7 ± 5.1 years, height = 179.8 ± 6.9 cm, mass = 89.9 ± 12.7 kg). Laboratory testing consisted of body composition, aerobic and anaerobic capacity, upper and lower body strength and flexibility, balance, and biomechanical evaluation. Injury data were captured for 12 months after laboratory testing. Injury frequencies, cross-tabulations, and relative risks (RRs) were calculated to evaluate the relationships between physical characteristics and injury proportions. Between-groups differences (injured versus uninjured) were assessed using appropriate t tests or Mann-Whitney U tests. Less shoulder-retraction strength (RR = 1.741 [95% confidence interval = 1.003, 3.021]), knee-extension strength (RR = 2.029 [95% confidence interval = 1.011, 4.075]), and a smaller trunk extension : flexion ratio (RR = 0.533 [95% confidence interval = 0.341, 0.831]) were significant risk factors for injury. Group comparisons showed less trunk strength (extension: P = .036, flexion: P = .048) and smaller right vertical ground reaction forces during landing ( P = .025) in injured Operators. Knee strength, aerobic capacity, and body mass index were less in the subgroup of spine-injured versus uninjured Operators ( P values = .013-.036). Knee-extension and shoulder-retraction strength were risk factors for musculoskeletal injury in Operators. Less trunk-flexion and -extension strength, higher body mass index, lower aerobic capacity, and increased ground reaction forces during landing were characteristics that may also contribute to musculoskeletal injury. Having 2 or more risk factors resulted in a greater injury proportion (χ2 = 13.512, P = .015); however, more research is needed. Athletic trainers working in the military or similar high-demand settings can use these data to augment screening and injury-prevention protocols.

A SYSTEMATIC REVIEW OF THE ASSOCIATION BETWEEN ADIPOSITY AND SPORT INJURY RISK IN YOUTH

BackgroundObesity, defined as an accumulation of excessive fat mass that impairs health, is associated with lower levels of neuromuscular control including balance and coordination, which may place youth with higher...

Miners' return to work following injuries in coal mines.

The occupational injuries in mines are common and result in severe socio-economical consequences. Earlier studies have revealed the role of multiple factors such as demographic factors, behavioral factors, health-related factors, working environment, and working conditions for mine injuries. However, there is a dearth of information about the role of some of these factors in delayed return to work (RTW) following a miner's injury. These factors may likely include personal characteristics of injured persons and his or her family, the injured person's social and economic status, and job characteristics. This study was conducted to assess the role of some of these factors for the return to work following coal miners' injuries. A study was conducted for 109 injured workers from an underground coal mine in the years 2000-2009. A questionnaire, which was completed by the personnel interviews, included among others age, height, weight, seniority, alcohol consumption, sleeping duration, presence of diseases, job stress, job satisfaction, and injury type. The data was analyzed using the Kaplan-Meier estimates and the Cox proportional hazard model. According to Kaplan-Meier estimate it was revealed that a lower number of dependents, longer sleep duration, no job stress, no disease, no alcohol addiction, and higher monthly income have a great impact on early return to work after injury. The Cox regression analysis revealed that the significant risk factors which influenced miners' return to work included presence of disease, job satisfaction and injury type. The mine management should pay attention to significant risk factors for injuries in order to develop effective preventive measures. Med Pr 2016;67(6):729-742.