Time-loss Injuries Research Articles

Longitudinal study of six seasons of match injuries in elite female rugby union

ObjectiveTo establish match injury rates and patterns in elite female rugby union players in England.MethodWe conducted a six-season (2011/2012–2013/2014 and 2017/2018–2019/2020) prospective cohort study of time-loss match injuries in elite-level...

Gait asymmetry and running-related injury in female collegiate cross-country runners

BackgroundRunning biomechanics are commonly linked to injury. There is limited evidence on the effects of running speed on asymmetry and the prospective association of asymmetry and injury. The purposes of this study were to describe the degree in asymmetry in biomechanical variables commonly associated with injury, examine the effect of speed on asymmetry, and determine if there were any significant differences in pre-season measures of asymmetry between runners who went on to sustain an injury during the competitive season compared to those who remained healthy. MethodsThree-dimensional running biomechanics were obtained from twenty-two female collegiate cross-country runners at four different running speeds prior to their season. Asymmetry was quantified using the Symmetry Angle. Participants were followed over the twelve-week season and all time-loss injuries were identified. FindingsThere was no significant effect of velocity on asymmetry. Additionally, there were no significant differences in symmetry between runners who sustained an injury (n = 7) and those that remained injury-free (n = 15) during the cross-country season. InterpretationClinicians working with runners should expect a high degree of symmetry in running biomechanics when performing gait analyses across running speeds. In regards to injury, caution should be used when linking injury to asymmetry.

Injury characteristics in Norwegian male professional football: A comparison between a regular season and a season in the pandemic.

The Coronavirus Disease-19 (COVID-19) pandemic forced the Norwegian male premier league football season to reschedule, reducing the fixture calendar substantially. Previous research has shown that a congested match schedule can affect injury rates in professional football. Therefore, we aimed to investigate whether the Norwegian premier league teams suffered more injuries in the more match congested 2020 season than in the regular 2019-season. We invited all teams having participated in both seasons to export their injury data. Only teams that used the same medical staff to register injuries in both seasons were included, and to maximize data comparability between seasons, we applied a time-loss injury definition only. Seven of 13 teams agreed to participate and exported their injury data. Both seasons had 30 game weeks, but the 2020 season was 57 days shorter than the 2019 season. The match injury incidence did not differ significantly [incidence rate ratio 0.76 (0.48-1.20; p = 0.24) in the 2020 season compared to the 2019 season. Furthermore, we found no differences in the number of injuries, days lost to injury, matches missed to injury, or injury severity. We could not detect any differences between the two seasons, suggesting the congested match calendar combined with the safety measures in the 2020 season can be a safe alternative in future seasons.

The incidence and burden of injury in male adolescent community rugby union in Australia

ABSTRACT Objectives To describe the incidence, location, mechanism and burden of injury in community male adolescent rugby. Methods A prospective cohort injury surveillance study using sports trainers to record ‘any physical complaint’ over three seasons (2018/2019/2021) in 979 U13-U17 community male rugby union players. Results One hundred and fifty-two time-loss injuries (27.6/1000 hours) with an associated burden of 2313 days (419.7 days/1000 hours), 169 non-time loss medical attention (30.1/1000 hours) and 813 physical complaints (147.5/1000 hours) were recorded from 5511.7 exposure hours (matches 3932.5 hours, training 1579.2 hours). Time-loss injury incidence was highest in U16 (45/1000 hours) and lowest in U17 (16.6/1000 hours), with U17 significantly lower than U16 and U15 age-grades (p < 0.05). Injury burden was greatest in U13 (561.4 days/1000 hours), and significantly higher than U15 and U17 (p < 0.05). Collectively, injury incidence was greatest for the head/neck (11.8/1000 hours), bruise/contusions were most common (8.7/1000 hours) and concussion (4.5/1000 hours) accounted for the greatest injury burden (102 days/1000 hours). Being tackled was the most observed injury mechanism (10.0/1000 hours). Forwards had significantly higher incidence in mild injury (p < 0.01). The total burden (p < 0.001) associated with mild (p < 0.001) and moderate injuries (p < 0.001) was significantly higher in forwards, as was the burden of being tackled (p < 0.001), collisions (p < 0.001), trunk (p < 0.001) and lower limb (p < 0.01) injury locations. In contrast, ruck-related injury burden was greater in backs (p < 0.001). Conclusion This study showed age-grade and positional differences in incidence and burden of injury in community adolescent rugby union. The rate of non-time loss relative to time-loss injury and muscle strain injury in U13-U14s suggests further research into injury risk and maturation in rugby is needed.

Post-injury fear-avoidance and confidence in readiness to return to sport in Irish collegiate athletes

ABSTRACT Fear avoidance and low confidence in their ability to return to sport can impede athletes’ subsequent recovery and return to sport. This study aimed to identify fear avoidance and confidence in readiness to return to sport following injury in Irish collegiate athletes. Male (416) and female (256) athletes from 24 field-sport teams at one university were prospectively followed for one season. The Athlete Fear Avoidance Questionnaire (AFAQ) and pain on the Visual Analogue Scale was completed following a time-loss injury. Prior to return to sport, participants completed the AFAQ and the Injury Psychological Readiness to Return to Sport (I-PRRS). We recorded 179 injuries. Fear avoidance was evident post-injury (21.8 ± 6.7), and the mean total I-PRRS score was 48.4 ± 8.9. Those with severe injuries presented with higher fear avoidance and lower confidence. Higher pain was associated with greater fear avoidance following injury (r = 0.32, p < 0.0001), prior to return to sport (r = 0.38, p < 0.0001), and with lower confidence (r = −0.27, p < 0.0001). Low confidence and fear avoidance was identified, particularly in those with a severe injury or high pain levels. Identifying, and providing psychosocial support to athletes experiencing, these issues is recommended.

Impact of Sudden Rule Changes on Player Injuries and Performance: Insights from Australian Football.

This study investigated the effects of reduced quarter time due to COVID-19 pandemic rule changes, on running performance and injuries in Australian Football. Microsensor data for eight matches performed by the same 17 players were compared between the 2019 (standard) and 2020 (COVID-19) seasons using linear and generalised mixed models. Injury rates were assessed in 34 players across the full 2019 season, and 32 players across the full 2020 season. The total distance (ES = 1.28 [0.55 to 2.02]), high-speed (>18 km/h) (ES = 0.44 [-0.24 to 1.12]) and very highspeed (>24 km/h) (ES = 0.27 [-0.41 to 0.94]) distances, PlayerLoad™ (ES = 0.96 [0.25 to 1.67]), high-intensity efforts (ES = 0.48 [-0.20 to 1.16]), and accelerations (ES = 0.33 [-0.34 to 1.01]) were smaller (p ≤ 0.01) for the 2020 than the 2019 season. Expressed relative to playing time, distance (ES=-0.38 [-1.06 to 0.30]), PlayerLoad™ (ES = -0.27 [-0.94 to 0.41]), and acceleration efforts (ES = -0.50 [-1.18 to 0.18]) were greater (p < 0.05) for the 2020 than the 2019 season. No significant differences in maximum ball-in-play periods nor the difference between the 1st and 4th quarters were evident. Injury rates remained similar between 2019 (3.36 per game) and 2020 (3.55 per game). However, the proportion of injuries that led to lost time (missed games) was greater for the 2020 (38%) than 2019 season (24%). The changes in the rules had a profound impact on player performance and increased the likelihood of time loss injuries.

Return to performance following severe ankle, knee, and hip injuries in National Basketball Association players.

The purpose of this study was to compare basketball performance markers 1 y prior to initial severe lower extremity injury, including ankle, knee, and hip injuries, to 1 and 2 y following injury during the regular National Basketball Association (NBA) season. Publicly available data were extracted through a reproducible extraction computed programmed process. Eligible participants were NBA players with at least three seasons played between 2008 and 2019, with a time-loss injury reported during the study period. Basketball performance was evaluated for season minutes, points, and rebounds. Prevalence of return to performance and linear regressions were calculated. A total of 285 athletes sustained a severe lower extremity injury. A total of 196 (69%) played for 1 y and 130 (45%) played for 2 y following the injury. A total of 58 (30%) players participated in a similar number of games and 57 (29%) scored similar points 1 y following injury. A total of 48 (37%) participated in a similar number of games and 55 (42%) scored a similar number of points 2 y following injury. Fewer than half of basketball players who suffered a severe lower extremity injury were participating at the NBA level 2 y following injury, with similar findings for groin/hip/thigh, knee, and ankle injuries. Fewer than half of players were performing at previous preinjury levels 2 y following injury. Suffering a severe lower extremity injury may be a prognostic factor that can assist sports medicine professionals to educate and set performance expectations for NBA players.

The pattern of non-contact injuries in a South African professional football team.

The incidence, pattern and severity of non-contact injuries in European football has been researched extensively. In South African football only two studies have been conducted to date and with disparate outcomes. Further research into injury rates in South African football is therefore warranted. To determine the incidence and pattern of non-contact injuries in a South African professional football team during the course of a single season (2016-2017) in relation to competition exposure, training load and playing position. Thirty-four male professional football players belonging to a single team competing in the Premier Soccer League (PSL) in South Africa were studied. Non-contact time-loss injuries (total training and match injuries) were recorded. Injury incidence, location, severity, type, and playing position (defender, midfielder, attackers, goalkeepers) during either match play or training were recorded. The non-contact incidence was 52 injuries with an injury rate of 3.74 per 1 000 exposures (training and competition). Competitions resulted in an incidence of 26.4 injuries per 1 000 exposure and training incidence 2.08 injuries per 1 000 exposures. Hamstring, groin and quadriceps injuries were the most frequently injured locations and muscle-tendon injuries accounted for the majority of injuries. The majority of injuries (52%) occurred during match play while 48% occurred during training. The greatest absolute number of injuries were sustained by midfielders (50%), followed by defenders (33%) and attackers (17%). However, relative to player numbers, the greatest number of injuries during match play were for defenders (44%), attackers (32%) and midfielders (24%). During training attackers sustained the most injuries (39%), followed by defenders (31%) and midfielders (30%). Goalkeepers did not sustain any non-contact injuries during the duration of the study. The non-contact injury incidence in South African professional football players is similar to European football players. Hamstrings and groin injuries are predominant and were sustained throughout the competitive season. Defenders sustained the most non-contact injuries within the team relative to exposure time compared to attackers and midfielders. To our knowledge, injuries relative to player position have not been reported previously.

The epidemiology of back injuries in elite Gaelic football athletes: An 8-year prospective study

ObjectivesTo describe the epidemiology of back injury in elite male Gaelic football athletes between 2008 and 2016. DesignProspective cohort study. SettingInjury data from the National GAA Injury Surveillance Database. ParticipantsElite male Gaelic football athletes. Main outcome measuresIncidence of injury as a rate per 1000 h of exposure. Results38 datasets were analysed. Out of a total of 1606 time-loss injuries, 76 were back injuries (4.73%, 95% CI 3.80%–5.88%). The incidence of back injuries in match play was 1.72 (CI 95% 1.21 to 2.45) and in training was 0.2 (CI 95% 0.14 to 0.28) injuries per 1000 h of exposure. The majority of back injuries (63.16%, CI 95% 51.93–73.12) were new, as opposed to recurrent (35.53% CI 95% 25.7–46.74). Most back injuries were acute (51.32%, CI 95% 40.29–62.22), compared to chronic (31.58%, CI 95% 22.23–42.7) or overuse (11.84%, CI 95% 6.36–21.00). The majority of back injuries occurred during non-contact player activities (n = 60, 78.94% CI 95% 68.50–86.60). ConclusionsBack injury rates in Gaelic football are similar to soccer and Australian football but less than rugby union. Further research is needed to understand the factors leading to the onset and recurrence of back injury in Gaelic football athletes.

Non-Time-Loss and Time-Loss Injuries in Secondary School Girls' Volleyball Athletes: A Report From the National Athletic Treatment, Injury, and Outcomes Network Surveillance Program.

Volleyball is a popular sport with a risk of injury to the entire body. Insight into non-time-loss (NTL) and time-loss (TL) injuries is needed to inform seasonal injury trends that may lead to appropriate prevention and management strategies. This study provides a descriptive analysis of volleyball injuries among secondary school athletes. Descriptive epidemiology study. Data were collected from 72 secondary schools, representing 135 team seasons of data from the National Athletic Treatment, Injury, and Outcomes Network Surveillance Program (2014-2015 to 2018-2019 academic years). Injury counts, injury rates (IR) per 1000 athlete exposures (AEs), and incidence rate ratios (IRR) were reported with 95% confidence intervals (CIs). In total, 529 injuries over 193,858 AEs for girls' volleyball were captured, producing an IR of 2.73/1000AEs (95% CI = 2.50-2.96). The overall IR was highest during the preseason compared with regular season (IRR = 1.31, 95% CI = 1.09-1.59). Overall IRs were higher in competition (IR: 3.56, 95% CI = 3.07-4.05) compared with practice (IR: 2.38, 95% CI = 2.12-2.64; IRR = 1.49, 95% CI = 1.25-1.79). Common body locations injured were ankle (n = 141, 26.7%; NTL: n = 56, 21.7%; TL: n = 85, 31.7%), knee (n = 61, 11.5%; NTL: n = 33, 12.8%, TL: n = 28, 10.5%), hand/wrist (n = 59, 11.2%; NTL: n = 32, 12.4%, TL: n = 27, 10.1%), and head/face (n = 62, 11.7%; NTL: n = 14, 5.4%; TL: n = 47, 17.5%). Volleyball IRs were highest in preseason and during competition. Most injuries affected the lower-extremity which is notable considering the high upper-extremity load in volleyball. Consideration of strategies to reduce injuries prior to the start of the formal sports season may be needed to help reduce the incidence of preseason injuries.

Incidence, burden, and pattern of injuries in Spanish male youth soccer players: A prospective cohort study

ObjectivesTo explore the incidence, burden, and pattern of injuries in Spanish male youth soccer players during a 9-month competitive season (from September to May–June). DesignProspective cohort study. Participants314 young (10–19 years) soccer players. Main outcome measuresIncidence, burden, location, type, severity, mechanism, and circumstance of injuries, as well as potential differences by tactical position, month of the year, age group, and maturity status. ResultsA total of 146 time-loss injuries were sustained by 101 different players. This resulted in an overall injury incidence of 3.1 injuries per 1000 h, a training injury incidence of 1.8 injuries per 1000 h, and a match injury incidence of 11.2 injuries per 1000 h. The probability of injury over the season was 34%. Most of the injuries affected the lower extremity and were classified as muscle/tendon injuries, with hamstring muscle injuries representing the most burdensome diagnosis. The incidence of injuries increased with age and maturation, but a heightened risk of overuse injuries during periods around peak height velocity was also identified. ConclusionsThese findings suggest a need for implementing specific injury prevention measures. Due to the high burden shown, these measures should mainly focus on reducing the number and severity of hamstring muscle injuries.

Forecasting football injuries by combining screening, monitoring and machine learning

Identifying players or circumstances associated with an increased risk of injury is fundamental for successful risk management in football. So far, time-constant and volatile risk factors are generally considered separately in either a screening (constant) or a monitoring (volatile) approach each resulting in a restricted set of explanatory variables. Consequently, improvements in predictive accuracy may be expected when screening and monitoring data are combined, especially when analysed with current machine learning (ML) techniques. This trial was designed as a prospective observational cohort study aiming to forecast non-contact time-loss injuries in male professional football (soccer). Injuries were registered according to the Fuller consensus. Gradient boosting with ROSE upsampling within a leave-one-out cross-validation was used for data analysis. The hierarchical data structure was considered throughout. Different splits of the original dataset were used to probe the robustness of results. Data of 88 players from 4 teams and 51 injuries could be analysed. The cross-validated performance of the gradient boosted model (ROC area under the curve 0.61) was promising and higher compared to models without integration of screening data. Importantly, holdout test set performance was similar (ROC area under the curve 0.62) indicating prospect of generalizability to new cases. However, the variation of predictive accuracy and feature importance with different splits of the original dataset reflects the relatively low number of events. It is concluded that ML-based injury forecasting based on the integration of screening and monitoring data is promising. However, external prospective verification and continued model development are required.

Injury incidence, severity, and burden in elite youth soccer players – A 3-year prospective study

ObjectivesThis study aimed to investigate age-related injury incidence, severity, and burden over a 3-year period in U14 to U19 elite male soccer players in a German youth academy. DesignDescriptive epidemiology study. MethodsTime-loss injuries of 166 unique players were prospectively documented and injury incidence, severity, and burden were calculated for each age group, body part, and type of injuries. ResultsA total of 562 time-loss injuries were recorded. Across all age groups (U14 to U19), injury incidence was 42.2 per squad season (ranging from 30.5 in the U19 to 67.7 in the U15), severity was 11.0 days lost (ranging from 8.0 in the U15 to 17.0 in the U17), and burden was 464.1 days lost per squad season (ranging from 304.9 in the U19 to 756.7 in the U14). The thigh, knee and ankle were the body parts with the highest injury incidence (9.2; 5.9; 5.9), severity (11.0; 16.0; 13.0), and burden (101.6; 94.9; 76.1). Cruciate ligament injuries had both the highest burden (164.4) and severity (137.0), and muscle injuries the highest incidence (11.0) of all types of injuries. U15 had the highest injury incidence (67.7) of all age groups. U14 and U17 had both the highest injury severity (15.0; 17.0) and burden (756.7; 618.8) of all age groups. Age-related patterns were observed for selected types of injuries such as muscle injuries, tendinopathy, bone-stress injury, and fractures. ConclusionsInjury incidence, severity, and burden substantially differed descriptively between age groups and clear age-related patterns for selected types of injuries were evident.

Anterior ankle impingment syndrome is less frequent, but associated with a longer absence and higher re-injury rate compared to posterior syndrome: a prospective cohort study of 6754 male professional soccer players

PurposeTo study the epidemiology and return to play characteristics of anterior and posterior ankle impingement syndromes (AAIS and PAIS) over 18 consecutive seasons in male professional soccer players.MethodsBetween the 2001–2002 and 2018–2019 seasons, 120 European soccer teams were followed prospectively for various seasons. Time loss injuries and player exposures were recorded individually in 6754 unique players. Injury incidence and burden were reported as the number of injuries and days absence per 1000 h with 95% confidence intervals (CIs). Injury severity was reported as median absence in days with the interquartile range (IQR).ResultsOut of 25,462 reported injuries, 93 (0.4%) were diagnosed as AAIS (38%) or PAIS (62%) in 77 players. AAIS and PAIS were similar regarding injury characteristics except for a greater proportion of AAIS having a gradual onset (69% vs.47%; P = 0.03) and being re-injuries (31% vs. 9%; P = 0.01). Impingement syndromes resulted in an overall incidence of 0.03 injuries (95% CI 0.02–0.03) per 1000 h and an injury burden of 0.4 absence days per 1000 h. PAIS incidence was significantly higher than that for AAIS [0.02 (95% CI 0.002–0.03) vs. 0.01 (95% CI 0.005–0.01) injuries per 1000 h (RR = 1.7). The absence was significantly longer in AAIS than in PAIS [10 (22) vs. 6 (11) days; P = 0.023]. Impingement syndromes that presented with a gradual onset had longer absences in comparison to impingement with an acute onset [8 (22) vs. 5 (11) days; P = 0.014]. Match play was associated with a higher incidence and greater injury burden than training: 0.08 vs. 0.02 injuries per 1000 h (RR 4.7), respectively, and 0.9 vs. 0.3 days absence per 1000 h (RR 2.5).ConclusionAnkle injuries are frequent in men’s professional soccer and ankle impingement is increasingly recognized as a common source of pain, limited range of motion, and potential time loss. In our study, ankle impingement was the cause of time loss in less than 0.5% of all injuries. PAIS was more frequently reported than AAIS, but AAIS was associated with more absence days and a higher re-injury rate than PAIS. The findings in this study can assist the physician in best practice management on ankle impingment syndromes in professional football.Level of evidenceII.

Self-Reported Injury History and Health-Related Quality of Life in Competitive, Collegiate Baton Twirlers.

Injury epidemiology and health-related quality of life (HRQOL) have not been researched in baton twirlers. This cross-sectional study described time-loss injuries sustained by competitive collegiate baton twirlers, identified the relationship between training volume and injuries, and established injury impact on HRQOL. An online survey was used to collect activity volume, number and characteristics of time-loss injuries experienced within a 12-month window, and HRQOL via the Short Form-36. Current injury status was addressed to place participants into categories: no injury history (No Injury), history of injury but no symptoms (Injury Hx, No Sx), and currently injured (Current Injury). One hundred forty-two participants met the inclusion criteria. One hundred twenty-eight (90%) participants experienced a time-loss injury with 295 total reported injuries (2.1±1.4; range 1-9 injuries). Sixty-two percent of all reported injuries were still producing symptoms. There was a high average reported injury severity score (6.3±2.3). The most commonly affected area was the hip/thigh (30%), followed by the knee (15%) and ankle (14%). The Current Injury group had worse SF-36 bodily pain (p=0.003), vitality domains (p=0.001), and physical composite score (p=0.015) compared to the No Injury group. Both the No Injury and Injury Hx, No Sx groups performed better than the Current Injury group on physical function (p=0.007 and 0.02, respectively). Competitive collegiate baton twirlers experience the majority of injuries in the lower extremity which cause prolonged physical and non-physical symptoms.

Injury and Illness Incidence in 2017 Super Rugby Tournament: A Surveillance Study on a Single South African Team.

BackgroundProfessional rugby presents significant injury and illness risks to players, which need to be regularly assessed to monitor the effects of interventions and competition rules changes.Hypothesis/PurposeThe purpose of this study was to determine the incidence and nature of time-loss injuries and illness during the pre-season and competition period of the 2017 Super Rugby tournament in a single South African team.Study DesignDescriptive Epidemiology StudyMethodsForty-five adult players were recruited from one 2017 Super Rugby South African team, with 39 included in the final data set. Daily injury and illness data were routinely collected during the season by support staff over a 28-week period (January to July 2017), based on standardized injury and illness definitions. Retrospective analyses of the data were performed.ResultsThe incidence of match injuries (241.0 per 1000 player hours) was significantly higher than training injuries (3.3 per 1000 player hours). Twenty one percent of all injuries occurred during the tackle; 37.5% of all injuries were of a “moderate” severity. The proportion of players who sustained a time-loss injury was 76.9% (n=30). The overall incidence of illness was 1.8 per 1000 player days. Acute respiratory tract infection (28.6%) was the most common diagnosis, and the majority of illnesses (64.3%) did not result in time-loss.ConclusionThis study presented a longer study period than previous research by including the pre-season training, but represented only one single team. The incidence of match injuries was significantly higher than previously reported in Super Rugby tournaments, whereas illness rates were significantly lower. Support staff in professional rugby need to be trained on the standardized Orchard System of Classifications to ensure good quality data that can be compared to other teams within the same or other sporting codes.Level of evidenceLevel 3

Observed Injury Rates Did Not Follow Theoretically Predicted Injury Risk Patterns in Professional Human Circus Artists.

Identifying which types of athletes have increased injury risk (ie, predictive risk factors) should help develop cost-effective selective injury prevention strategies. Our objective was to compare a theoretical injury risk classification system developed by coaches and rehabilitation therapists, with observed injury rates in human circus acts across dimensions of physical stressors, acrobatic complexity, qualifications, and residual risks. Descriptive epidemiological study. professional circus company. Human circus artists performing in routine roles between 2007 and 2017. Characteristics of circus acts categorized according to 4 different dimensions. Medical attention injury rates (injury requiring a visit to the therapist), time-loss injury rates (TL-1; injury resulting in at least one missed performance), and time-loss 15 injury rates (TL-15; injury resulting in at least 15 missed performances). Among 962 artists with 1 373 572 performances, 89.4% (860/962) incurred at least one medical attention injury, 74.2% (714/962) incurred at least one TL-1 injury, and 50.8% (489/962) incurred at least one TL-15 injury. There were important inconsistencies between theoretical and observed injury risk patterns in each of the 4 dimensions for all injury definitions (medical attention, TL-1, and TL-15). Although theoretical classifications are the only option when no data are available, observed risk patterns based on injury surveillance programs can help identify artists who have a high (or low) theoretical risk but are nonetheless actually at low (or high) risk of injury, given their current roles. This will help develop more cost-effective selective injury prevention programs.

Influence of the COVID-19 Lockdown and Restart on the Injury Incidence and Injury Burden in Men’s Professional Football Leagues in 2020: The UEFA Elite Club Injury Study

BackgroundStudies on football and the coronavirus disease 2019 (COVID-19) have mainly focused on the lockdown consequences for player fitness, the resumption of football training, and how to safely restart the league play, but injury data are scarce.ObjectiveTo describe the injury incidence and injury burden in men’s professional football teams during the pandemic year of 2020.MethodsNineteen teams in 12 countries prospectively registered data on player-exposure and time-loss injuries throughout 2020. All major football leagues were paused as a direct response to the pandemic in March 2020 and were thereafter completely cancelled or restarted after a lockdown interval of at least two months. Historical data from 43 teams in the same cohort during the five preceding years (2015–2019) were used as reference. Between-season and within-season comparisons were made for injury incidence (number of injuries per 1000 h) and injury burden (number of absence days per 1000 h) with 95% confidence intervals and interquartile ranges.ResultsThere was no increased match injury incidence or injury burden following the restart in 2020 compared with other time periods of 2020 and the corresponding periods 2015–2019. There was an increased training injury incidence and injury burden immediately during the lockdown in 2020, and they remained elevated also following the restart, being higher in 2020 compared with 2015–2019, respectively. The injury characteristics during the first months of the new 2020/21 season (August/September–December) were similar between the five teams that cancelled their 2019/20 season in March 2020 and the 14 teams that restarted their season in May/June 2020.ConclusionsThere was no increased match injury incidence or injury burden following the COVID-19 lockdown and restart of the football season in 2020, but training injury incidence and injury burden were elevated and higher than in 2015–2019.

Relationships Between Performance and Injury Occurrence in Athletics (Track and Field): A Pilot Study on 8 National-Level Athletes From Sprints, Jumps and Combined Events Followed During at Least Five Consecutive Seasons.

BackgroundPerformance success or failure in athletics (Track and Field) and the capacity to succeed are driven at the adult level, like in other sports, by many factors, injury being one of them. More information regarding the potential relationships between performance and injuries in athletics is needed.ObjectiveTo analyse the potential association between performance and occurrence of injuries in national-level athletics athletes from sprints, jumps and combined events through several seasons.MethodsWe performed a retrospective analysis of performance and injury data collected prospectively in 8 national-level athletics athletes followed during at least five consecutive seasons from 2009 to 2019. For each athlete, injuries data [total injuries (injuries) and time-loss injuries (TLI)] were collected by the same sports medicine physician throughout the study period using a medical attention injury definition. Performances during official competitions were collected on the French Federation of Athletics website, and included (i) any participation in national championships, (ii) any participation in an international competition (i.e., being national team member for an international competition), (iii) any podium at the national championships, (iv) any podium at an international competition, and (v) performance metrics normalised to the world record (WR) of the respective athletics speciality (%WR). For each athlete, we performed a descriptive analysis of the performances and injuries. We also performed four binomial logistic regressions with (1) national championships participation (yes/no) or (2) international competition participation (yes/no) as dependent variables, and injuries (yes/no) or TLI (yes/no) as independent variables, adjusted for individual athlete and number of seasons, and in models on participation in international competitions, was also adjusted for national championship participation (yes/no), with Odd Ratios (OR) with 95% confidence intervals (95%CI).ResultsAmong the 8 national-level athletics athletes included in the present study, cumulated 155 injuries, including 52 TLI (33.5%). There was an average of 2.7 ± 1.7 injuries and 0.9 ± 0.6 TLI per athlete per season over the study period. The occurrence of injuries was significantly associated with higher odds of national championships participation (OR = 4.85 [95% CI 3.10 to 3050.5], p = 0.021). The occurrence of TLI was significantly associated with higher odds of national championships participation (OR = 133.6 [95% CI 4.92 to 14251.5], p = 0.013). The occurrence of injuries or TLI were associated with insignificantly lower odds of international championships participation.ConclusionsOur present pilot study confirms that injuries are part of an athletes' life. The occurrence of at least one injury was associated with higher odds of participation in a national championship, whereas the absence of at least one injury was associated with higher odds of participation in an international championship. We hypothesised that the length of the season can play a role in the risk of injury occurrence, but if the athlete wants to reach his/her highest level, decreasing the risk of injuries seems to be of importance. Despite the caution that should be taken in the interpretation of our results, our present study confirms the interest and relevance of injury risk reduction approach in athletics.

An 8-Week Neuromuscular Training Program After Concussion Reduces One-Year Subsequent Injury Risk: A Randomized Clinical Trial

Background:Existing data suggest that after returning to sports post-concussion, athletes are at an increased risk of sustaining a subsequent injury. Exploring methods that may reduce injury risk following successful post-concussion return-to-play may lead to new treatment approaches.Hypothesis/Purpose:Our purpose was to examine the efficacy of a neuromuscular training (NMT) intervention on acute, time-loss sport-related injury over the subsequent year relative to standard-of-care among adolescent athletes, using a prospective randomized clinical trial design. We hypothesized the hazard of injury over the year after concussion RTP would be greater for those randomized to standard-of-care relative to those randomized to the NMT intervention.Methods:Twenty-seven youth athletes were assessed initially post-concussion (median=7; interquartile range [IQR]=5-10 days post-concussion) and following return-to-play clearance (median=40, IQR=15-52 days post-concussion). After return-to-play clearance, they were randomly assigned to NMT intervention (n=11, mean=14.7±1.7 years; 36% female; Table 1) or standard-of-care (n=16, mean=15.3±1.8 years; 44% female; Table 1) groups. The intervention (duration=8 weeks; frequency=2x/week) included guided strength, landing, and stability exercises with landing stabilization focus. Standard-of-care received no recommendations. Randomization strata included age and sex. For the subsequent year, athletes prospectively completed a monthly log documenting sport-related injuries and the number/hours of organized sport competitions. Clinical Trial Registration Number: NCT03917290.Results:During the first year after post-concussion return-to-play clearance, time-loss sport-related injuries were more common among standard-of-care relative to neuromuscular training intervention (75% vs. 36%). After adjusting for the randomization strata (age and sex), the hazard of subsequent injury in the standard-of-care group was 3.56 [95% CI=1.11, 11.49, p=0.0334] times the hazard of subsequent injury in the neuromuscular training intervention group. Sport participation was similar between neuromuscular training intervention and standard-of-care groups during the year-long monitoring period (median=12 [IQR=2.6, 32.1] vs. 15.6 [IQR=3.5, 105.9] hours of organized sports/month; p=0.55). The incidence of injuries was 10.2 per 1,000 competitive exposures [95% CI: 3.7 to 28.4] in the standard-of-care group compared to 3.4 per 1,000 competitive exposures [95% CI: 0.9 to 13.4] in the NMT intervention group.Conclusion:A NMT intervention initiated after post-concussion return-to-play clearance provided significant efficacy in reducing time-loss sport-related injuries over the subsequent year. NMT interventions may be feasibly applied by sports medicine clinicians as a part of return-to-play protocols after concussion to minimize injury risk. Given the relatively small sample size, the findings should be considered preliminary until further definitive trials can be conducted within different geographical locations and/or age groups.Table 1.Comparison of NMT intervention and standard-of-care participant characteristics.Figure 2.Injury free survival in the standard-of-care and NMT intervention groups.