Traumatic upper limb injuries during the Men's Field Hockey Junior World Cup 2009

Humeral Torsion in Relation to Shoulder Range of Motion in Elite Field Hockey Players

CONTEXT

Sport-specific adaptations in shoulder rotation range of motion (ROM) and the relationship with humeral torsion have been described in overhead-throwing sports. However, information is lacking for other shoulder-loading sports such as field hockey. Therefore, this study's purpose was to evaluate humeral torsion in elite, male field hockey players and explore its association with shoulder ROM.

DESIGN

Cross-sectional study.

METHODS

Twenty-five male, elite field hockey players were included. Humeral torsion and shoulder external and internal rotation ROM were evaluated bilaterally by ultrasound and an inclinometer smartphone application, respectively.

RESULTS

Field hockey players showed a significantly increased humeral retroversion on the dominant compared with the nondominant side (P < .001; Cohen d = 1.75), along with a significantly increased external (P = .004; Cohen d = -0.64) and decreased internal rotation ROM (P = .003; Cohen d = 0.65). This finding illustrates a shift in total shoulder rotational ROM arc. Correlation analysis showed a significant moderate association between the increased humeral retroversion and decreased internal rotation ROM on the dominant side (r = .523).

CONCLUSIONS

Elite male field hockey athletes show sport-specific adaptations regarding humeral torsion and shoulder rotation ROM, similar to throwing athletes. These findings increase our insight into the field hockey athlete's shoulder, which is essential to optimize performance and assist in correctly interpreting shoulder rotational ROM measurements.

Field Hockey-Related Injuries Treated in US Emergency Departments, 2000 to 2020

OBJECTIVE

To describe the epidemiology of field hockey-related injuries of patients aged 6 to 24 years who were treated in US emergency departments from 2000 to 2020.

DESIGN

The researchers conducted a retrospective analysis using data from the National Electronic Injury Surveillance System (NEISS).

SETTING

The NEISS collects data on recreational activity-related and consumer product-related injuries treated in US Eds.

PATIENTS

Patients aged 6 to 24 years who were treated for field hockey-related injuries in Eds from 2000 to 2020.

INDEPENDENT VARIABLES

The researchers analyzed characteristics that included age, body part injured, injury diagnosis, disposition from the ED, injury locale, injury mechanism, contact, and equipment type.

MAIN OUTCOME MEASURES

All cases of field hockey-related injuries were identified using the NEISS product code for field hockey (1295).

RESULTS

There were an estimated 82 639 (95% CI = 45 536-119 742) field hockey-related injuries for patients aged 6 to 24 years treated in US emergency departments from 2000 to 2020. The rate of field hockey-related injuries per 100 000 population did not significantly change from 7.4 in 2000 to 7.4 in 2011 (slope = 0.048; P = 0.581) but significantly decreased from 7.4 in 2011 to 3.7 in 2019 (slope = -0.40; P = 0.018). As player age increased, the risk of injury due to contact with equipment increased ( 13 years: RR = 0.90; 95% CI = 0.82-0.98, 19-24 years: RR = 1.17; 95% CI = 1.06-1.29). Concussions or traumatic brain injuries accounted for 9.2% of injuries and were most associated with contact with the ball.

CONCLUSION

Although there was a decrease in the field hockey-related injuries, field hockey remains an important source of injuries for children and young adults.

The incidence of injury in male field hockey players: A systematic review and meta-analysis

OBJECTIVE

Few studies have investigated injury incidence in field hockey. The aim of this systematic review was to determine the incidence and characteristics of injury in male field hockey athletes.

DESIGN

Prognosis systematic review with meta-analysis.

LITERATURE SEARCH

MEDLINE via PubMed; EMBASE via Ovid; CINAHL via EBSCO; SPORTDiscus; and Web of Science were searched.

STUDY SELECTION CRITERIA

Prospective studies and retrospective studies employing video analysis, written in English and published in peer-reviewed journals, expressing the incidence of injury in male field hockey athletes were included. Studies must have been of a duration of a minimum one season or one tournament. Studies were screened by two authors, assessing the eligibility of each record. Following selection of the studies, data were extracted by the two authors.

DATA SYNTHESIS

Levels of heterogeneity were assessed in aggregate data using the I² statistic.

RESULTS

In total, 1722 records were identified. Twelve studies were included in the review. Injury incidence ranged from 4.5 to 57.9/1000h (I² = 98.5%). Nine studies were undertaken in tournament settings, with the remaining three conducted in club-based athletes in season-long settings. When a medical attention definition was used, there was a pooled incidence rate of 48.1/1000h, all in tournament studies. Contusions and muscle strains were the most frequently reported injury types, while the lower limb was the most common site of injury. Contact injuries were most common in tournament-based studies, while non-contact was more common in season-long studies.

CONCLUSION

Prospective, season-long epidemiological studies investigating injury incidence in field hockey are lacking.

Injury surveillance in elite field hockey: a pilot study of three different recording techniques

Objective

In field hockey, injuries are assessed by various recording techniques leading to a heterogenic collection of poorly comparable injury data.

Methods

Injury data were prospectively collected at the 2016 Men’s Hockey Junior World Cup using the match injury reports (MIRs), video injury clips provided by the Fédération Internationale de Hockey, and daily medical reports (DMRs). A pilot study comparing injury type, mechanism, location on the field, injured body part and overall injury incidence among the different injury recording techniques was performed.

Results

MIRs and video injury clips were completely available for analysis. DMRs were returned from 11 out of 16 teams (69%). In total, MIRs yielded 28, video analysis 36, and DMRs 56 injuries. Overall injury rate varied between 24.8 and 57.9 injuries per 1000 player match hours. The majority of injuries affected the lower limbs by all three methods (41.7–61.2%) and were mainly caused by having been hit by the ball (20.4–50%) or stick (11.1–28.6%). Reports of concussions during competition were incoherent between MIR (2 cases) and DMR (no cases). The DMR was the only method to record overuse injuries (16.1%), injuries in training (12.5%), and time-loss injuries of one or two days (12.5%) or of three or more days (14.3%).

Conclusion

Injury data vary substantially between the MIR, DMR and injury video recording technique. Each recording technique revealed specific strengths and limitations. To further advance injury research in field hockey, the strengths of each recording technique should be brought together for a synergistic injury assessment model.

Epidemiology of injuries in senior men's field hockey: A two-season prospective observational injury surveillance study

Determining the rate and severity of injuries incurred through sport is accepted as the primary step towards designing, implementing and evaluating injury prevention programmes. The aim of this study was to determine the injury incidence rate and characteristics of male field hockey athletes participating in the Irish Hockey League. Athletes from eight field hockey teams were assigned to an online reporting system, where they logged injuries as they were incurred. Injuries were defined as any physical complaint. Coaches and physiotherapists were contacted weekly to corroborateinjuries. Overall 323 injuries were reported across 34,449 exposure hours, giving rise to an incidence rate of 9.4/1000 h. On average, athletes sustained one injury over the course of two seasons. Muscle strains, pain and contusions were the most common types of injury, while the hamstring, knee and hip/groin were the most frequently reported locations. While 66.9% of injuries occurred through non-contact mechanisms, contact injuries were also common. Injury recurrences accounted for 16.1% of injuries. In conclusion, the incidence of injury in field hockey is high, occurring from a variety of mechanisms. Future injury prevention strategies should prioritise injuries to the hamstring, knee and ankle, and be specific to particular playing positions.

Quantifying acromiohumeral distance in elite male field hockey players compared to a non-athletic population

BACKGROUND

Shoulders of elite field hockey players are loaded continuously during play. Frequent high shoulder loading is known to influence certain shoulder variables, such as acromiohumeral distance. However, the influence of elite field hockey play on acromiohumeral distance is not examined yet.

OBJECTIVE

To examine the acromiohumeral distance in elite male field hockey players compared to a non-athletic control group.

DESIGN

Cross-sectional study.

METHODS

Fifty male participants were included; 25 elite field hockey players (age: 24.0±2.72 years; weight: 77.2±5.29kg; height; 180.5±5.37cm) and 25 age- and gender matched non-athletes (23.0±2.29 years; weight: 75.7±9.53kg; height: 181.8±5.52cm). A Telemed-Colormaster-128 EXT-IZ device was used to bilaterally obtain ultrasound acromiohumeral distance images at 3 different angles of shoulder abduction in the frontal plane.

RESULTS

Field hockey players showed a bilateral larger acromiohumeral distance at 45° (mean difference: 1.46mm [95% CI 0.46; 2.46]; p=0.005) and 60° (mean difference: 1.07mm [95% CI 0.21; 1.93]; p=0.016) compared to controls. In both groups, a significant but clinically less relevant, side difference was established for the acromiohumeral distance at 60° (mean difference: 0.79mm [95% CI 0.21; 1.34]; p=0.009).

CONCLUSION

With active shoulder abduction, elite field hockey players show a larger acromiohumeral distance in comparison to non-athletic participants. This may be a protective sport-specific adaptation, to better guard the shoulder from injury. Thus, acromiohumeral distance measurement may help physical therapists/coaches decide which athletes could benefit from specific, additional exercises aimed at enlarging the subacromial space.

Elite male field hockey players have symmetric isokinetic glenohumeral strength profiles, but show asymmetry in scapular muscle strength

Shoulders of elite field hockey players are loaded continuously during play. However, shoulder girdle muscle performance in this population has never been examined yet. This study aimed to compare isokinetic shoulder girdle performance in elite male field hockey players to matched controls, with respect to strength, endurance and muscle balance. The complete male national field hockey team of Belgium (n = 25) was included and matched to a gender- and age-matched control group of healthy participants (n = 25). A Biodex system-4 dynamometer was used to measure glenohumeral and scapular muscle strength at 2 velocities in a concentric/concentric mode. With the main outcome measures being isokinetic strength values, peak force (protraction-retraction), peak torque (rotations), fatigue index and agonist/antagonist ratio's. Measurement results showed that elite male field hockey players were stronger than their matched controls, for both the rotational and the protraction-retraction movement. Concerning rotational strength, symmetrical findings were established, contrary to scapular strength, where side differences were noted. At low velocity, retraction peak force was higher on the dominant side. Protraction peak force was higher on the non-dominant side when measured at high velocity. In conclusion, elite field hockey players have a symmetrical rotational strength profile, in contrast to their scapular strength profile.

Injury data of major international field hockey tournaments

BACKGROUND

Detailed injury data are not available for international tournaments in field hockey. We investigated the epidemiology of field hockey injuries during major International Hockey Federation (Fédération Internationale de Hockey, FIH) tournaments in 2013.

MATERIALS AND METHODS

FIH injury reports were used for data collection. All major FIH tournaments for women (n=5) and men (n=11) in 2013 were included. The main focus of this study was to assess the pattern, time, site on the pitch, body site and mechanism of each of the injuries. We calculated the average number of injuries per match and the number of injuries per 1000 player match hours.

RESULTS

The average number of injuries was 0.7 (95% CI 0.5 to 1.0) per match in women's tournaments and 1.2 (95% CI 0.8 to 1.7) per match in men's tournaments. The number of injuries per 1000 player match hours ranged from 23.4 to 44.2 (average 29.1; 95% CI 18.6 to 39.7) in women and 20.8 to 90.9 (average 48.3; 95% CI 30.9 to 65.8) in men. Most injuries occurred in the circle (n=25, 50%, in women, n=95, 51%, in men). The rate of injuries increased after the first quarter. Injuries to the head and face (n=20, 40%) were most common in women. The head/face (n=51, 27%) and the thigh/knee (n=52, 28%) were equally affected in men. The ball caused the most injuries, followed by the stick, collisions and tripping/falling. There were no deaths or injuries that required hospital treatment in the entire cohort.

SUMMARY

Field hockey has a low incidence of acute injuries during competition.

Epidemiology of injuries in hurling: a prospective study 2007-2011

OBJECTIVES

Hurling is a stick handling game which, although native to Ireland, has international reach and presence. The aim of this study was to report incidence and type of injuries incurred by elite male hurling players over five consecutive playing seasons.

DESIGN

Prospective cohort study.

SETTING

Male intercounty elite sports teams participating in the National GAA Injury Database, 2007-2011.

PARTICIPANTS

A total of 856 players in 25 county teams were enrolled.

PRIMARY AND SECONDARY OUTCOMES

Incidence, nature and mechanism of injury were recorded by team physicians or physiotherapists to a secure online data collection portal. Time-loss injury rates per 1000 training and match play hours were calculated and injury proportions were expressed.

RESULTS

In total 1030 injuries were registered, giving a rate of 1.2 injuries per player. These were sustained by 71% (n=608) of players. Injury incidence rate was 2.99 (95% CI 2.68 to 3.30) per 1000 training hours and 61.75 (56.75 to 66.75) per 1000 match hours. Direct player-to-player contact was recorded in 38.6% injuries, with sprinting (24.5%) and landing (13.7%) the next most commonly reported injury mechanisms. Median duration of time absent from training or games, where the player was able to return in the same season, was 12 days (range 2-127 days). The majority (68.3%) of injuries occurred in the lower limbs, with 18.6% in the upper limbs. The trunk and head/neck regions accounted for 8.6% and 4.1% injuries, respectively. The distribution of injury type was significantly different (p<0.001) between upper and lower extremities: fractures (upper 36.1%, lower 1.5%), muscle strain (upper 5.2%, lower 45.8%).

CONCLUSIONS

These data provide stable, multiannual data on injury patterns in hurling, identifying the most common injury problems. This is the first step in applying a systematic, theory-driven injury prevention model in the sport.