Sports related injuries in Scottish adolescents aged 11-15

Injury patterns and treatment outcomes in sports-related knee and shoulder injuries in athletes from India's Olympic state, Haryana

Background

Our study aims to investigate injury patterns and treatment results in sports-related knee and shoulder injuries among athletes from Haryana, the most prominent state in the contribution of Olympic medals for India.

Material and methods

A cross-sectional prospective observational study was conducted in a tertiary referral centre. Over five years, from May 2018 to June 2023, 920 participants were included in our study.

Result

Most injuries (59.90 %) occurred between the ages of 16 and 20. Men (62.60 %) outnumbered women (37.40 %). On average, the individuals weighed 68.57 ± 13.65 kg, stood 1.57 ± 0.11 m tall, and had a BMI of 25.75 ± 4.81 kg/m2. Kabaddi players, most commonly injured athletes (42.60 %), followed by wrestling (31.30 %). Most athletes were professional, with 35.43 % competing at the national level, while 33.26 % competed at the state level. The average delay in presentation was 14.28 ± 8.12 months. Most injuries occurred during competitive matches (61.30 %), rest during practice. Contact injuries accounted for 31.41 % of cases, while non-contact injuries accounted for 54.02 % of all injuries. Only knee and shoulder injuries were considered, accounting for 77.28 % and 22.72 % of all injuries. Most observed injuries were ACL rupture (60.76 %), followed by meniscal tears (54.45 %) and collateral ligament injuries (26.96 %). 424 patients treated conservatively, whereas 53.9 % cases underwent arthroscopic/open surgical procedures. 74.13 % of athletes returned to competitive sports after their injury of which 38.71 % returned to the previous level of activity. The duration of time lost to injury ranged from 4 to 60 months (average 10.58 ± 4.74). Return to sports was significantly affected by the athletes' gender, BMI, level of competitiveness, and management modality (p-value <0.01 each).

Conclusion

Limiting the frequency, severity, and amount of time missed in sports while enabling athletes to return virtually to their pre-injury activity level should continue to be the primary goal of injury prevention.

Sever's Disease of the Pediatric Population: Clinical, Pathologic, and Therapeutic Considerations

Sever's disease is an underreported prevalent pediatric condition that causes heel pain in children worldwide. It is often described as an overuse injury that can present with either unilateral or bilateral heel pain. Even though the exact mechanism of injury is unknown, it is often thought it involves repetitive stress and pressure on the calcaneal growth plate. Diagnosing Sever's disease mainly relies on a thorough clinical investigation and physical examination, with a positive squeeze test usually sufficient to establish diagnosis. Nevertheless, radiographic imaging can help exclude other differential diagnoses. Therapeutic options of Sever's disease are mostly conservative, and these include rest, physical therapy, kinesiotherapy, and orthoses. Educating parents and coaches on the symptomatology and presentation of Sever's disease is pivotal for the establishment of efficient preventive interventions and earlier diagnoses. This study presents a case of a pediatric patient with Sever's disease and offers medical insight into the diagnostic, clinical, pathologic, and therapeutic characteristics of this condition, in light of the current existing literature.

Adolescent physical activity-related injuries in school physical education and leisure-time sports

Objective

The aims of this study were to investigate the prevalence of sports injuries in school physical education (PE) and leisure-time sports among 1011 15- to 16-year-old adolescents in relation to physical activity, and to examine goal orientation.

Methods

A survey was used with additional narrative descriptions.

Results

There was a higher prevalence of injuries in leisure time (645/993 = 65%) than in PE (519/998 = 52%). Two groups with high PE injury rates were identified: a) highly active (258/998 = 26%) in both school PE and leisure-time sports and b) highly inactive (180/998 = 18%) in both contexts. There were no differences between girls and boys. Task-oriented adolescents were more prone to injury.

Conclusions

The high prevalence of injuries in PE appears to have two mechanisms: renewed inadequately recovered leisure-time injuries among highly active adolescents, and injuries among fragile inactive adolescents unfamiliar with exercise. PE educators of these two groups with different injury patterns have a considerable didactic challenge. Knowledge of inadequately recovered injuries and consideration of the high volume and intensity of early sport-specific training in children and adolescents are important parameters in the design of lesson plans for PE.

Factors associated with injuries in adolescents, from the National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE

To estimate the prevalence of injuries among teenagers and to examine the associated risk factors, such as sociodemographic characteristics, risk behaviors, family ties and other factors.

METHOD

The prevalence of the outcome (injury) was estimated with a 95%confidence interval. In order to verify factors associated with the injury, a bivariate analysis was made with estimated odds ratio (OR) and its respective confidence intervals. Then, a multivariate analysis was carried out, only with variables whose descriptive level was equal to or lower than 5% (p < 0.05) remaining in the model.

RESULTS

The study of injury in adolescents, based on the data from the National Adolescent School-based Health Survey (PeNSE), pointed out that 10.3% of the teenagers suffered severe injuries in the past 12 months, such as cuts or perforations, broken bones or dislocated joints. The following variables remained independently associated with "suffering severe injuries": being a male teenager; black, mulatto or indigenous race/color and working. Factors related to family ties are significant when the relations are fragile amongst members: adolescents that are injured the most are the ones who suffer most aggressions at home, who skip classes without notifying their parents, those who do not live with their parents and have low family control. The most relevant aspects of mental health are insomnia and loneliness. The factors associated to the exposure to situations of violence that remained in the model were: insecurity in school and in the route home-school; getting a ride with someone inebriated; drinking and driving motorized vehicles; not wearing the seatbelt; not wearing a helmet and being bullied. Among the factors of individual behavior, the following can be emphasized: use of alcohol, cigarettes, trying illicit drugs and early sexual intercourse.

CONCLUSION

The analysis of the determinants for suffering injuries in childhood and adolescence shows the complex relationship between associated factors, which points to the need for action towards several aspects to reduce social inequalities, strengthen family ties and prevent violent contexts and individual risk factors.

Trend in injury-related mortality and morbidity among adolescents across 30 countries from 2002 to 2010

BACKGROUND

The aim was to examine temporal trends in injury mortality and morbidity across 30 countries in Europe and North America, and the impact of regional geography and adolescent risk behaviours (including substance use and physical fighting) on such trends.

METHOD

s: Data were obtained for 30 countries in 2002, 2006 and 2010. Mortality data were obtained from the World Health Organization's (WHO) Health for all database. Trends over time were described by WHO Regions using standardized rates comparisons and Poisson regression analyses.

RESULTS

Injury-related mortality, but not morbidity, declined over time across all countries (from 10 to 8 deaths per 100 000 between 2001 and 2010), with notable differences observed by Regions (e.g. from 48 to 39 deaths in Russia). Risk behaviours included in the models were consistently and significantly associated with injury morbidity, with substance increasing the risk for injury by 1.15 to 1.36 among girls, and physical fighting increasing the risk by 1.21 to 1.31 among boys across WHO Regions. Risk behaviours did not explain the observed temporal trends.

CONCLUSIONS

Injury mortality and morbidity represent different health phenomena. Efforts that have been made to make societies safer for children have seemed to be successful in reducing injury morbidity.

Risk factors for acute and overuse sport injuries in Swedish children 11 to 15 years old: What about resistance training with weights?

To determine the 1-year self-reported incidence of overuse and traumatic sport injuries and risk factors for injuries in children participating in a summer sports camp representing seven different sports. 4363 children, 11 to 15 years old participating in a summer camp in seven different sports answered a questionnaire. Injury in this cross-sectional study was defined as a sport-related trauma or overload leading to pain and dysfunction preventing the person from participation in training or competition for at least 1 week. A number of risk factors for injury were investigated such as sex, age, number of hours spent on training in general, and on resistance training with weights. Nearly half [49%, 95% confidence interval (CI) 48-51%] of the participants had been injured as a result of participation in a sport during the preceding year, significantly more boys than girls (53%, 95% CI 50-55% vs 46%, 95% CI 43-48%; P < 0.001). Three factors contributed to increased incidence of sport injuries: age, sex, and resistance training with weights. Time spent on resistance training with weights was significantly associated with sport injuries in a logistic regression analysis. In children age 11 to 15 years, the risk of having a sport-related injury increased with age and occurred more often in boys than in girls. Weight training was the only modifiable risk factor that contributed to a significant increase in the incidence of sport injuries.

Cricket related maxillofacial fractures

BACKGROUND

Cricket is a popular sport in New Zealand, enjoyed both at social and competitive level. Although it is a non-contact sport and there is in place good facial protection, injury to the head and neck region is still frequently seen in the emergency department.

METHODS

Data were collected from departmental records between 1996 and 2006. Variables examined included incidence, demographics, site of fracture and treatment method.

RESULTS

Of the 561 patients with sports-related maxillofacial fractures during the study period, 40 were cricket-related. Male to female ratio was 36:1. 45% of patients were in the 16-30 year age group. 55% of injuries were due to impact from cricket ball. 70% of injuries occurred at midface level, while 30% at the mandible. 38% of patients required surgery and hospitalization.

CONCLUSION

Maxillofacial fracture from cricket playing is a frequent injury in patients presenting with sports-related injuries. Cricket players need to be educated on the safety measures in playing the sport, including facial protection devices.

Sports injuries among adolescents: incidence, causes and consequences

AIM

The purpose of this study was to evaluate the 1-year incidence, location, type, mechanism and severity of sports injuries for adolescents in Germany.

METHODS

Data were from the 'German Health Interview and Examination Survey for Children and Adolescents', a nationwide study of n = 17 641 children and adolescents. Analyses were based on a weighted total sample size of n(w) = 7451 adolescents between 11 and 17 years of age, 51% of them boys.

RESULTS

A total of 577 adolescents (8%) reported having experienced a sports injury during the past year. Collisions and falls were reported as being the most important causes. The most frequent diagnoses were contusions, dislocations, strains and sprains (60%), followed by fractures (26%). Most injuries (88%) were treated on an outpatient basis with only 12% resulting in hospitalisation. Gender-specific analyses showed that 9% of the boys and 7% of the girls suffered from a sports injury during the past year. After adjusting for the level of physical activity, these gender differences disappeared (OR(girls) 0.94; 95% confidence intervals: 0.74-1.18). Excluding injuries incurred from falls while horse riding, there were no gender differences in the mechanism of injury. Among boys, 30% of all injuries were fractures, among girls 20% (P < 0.05). Apart from fractures, no further differences between the sexes in the range of diagnoses were identified.

CONCLUSIONS

Although these results suggest that the risk of sports injuries does not differ significantly based on adolescents' gender, the incidence rate of adolescent sports injuries within Germany is relatively high.

Injury and social correlates among in-school adolescents in four Southeast Asian countries

The aim of this study was to determine estimates of the prevalence and social correlates of injury among adolescents in four Southeast Asian countries. Cross-sectional national data from the Global School-based Health Survey (GSHS) included 9,333 students at the ages from 13 to 15 years inclusive from Indonesia, Myanmar, Sri Lanka and Thailand is chosen by a two-stage cluster sample design to represent all students in grades 6, 7, 8, 9, and 10 in each country. The percentage of adolescents reporting one or more serious injuries within the past 12 months was 42.2% for all countries, ranging from 27.0% in Myanmar to 46.8% in Thailand. By major activity, “fall” (14.6%) was the leading external cause of injury, followed by playing or training for a sport (9.9%) and vehicle accident (6.1%). In multivariate regression analysis Thailand and Indonesia, being male, substance use (smoking and drinking alcohol) and psychological distress were associated with annual injury prevalence. Risk factors of substance use and psychological distress should be considered in an integrated approach to injury etiology in planning injury prevention and safety promotion activities among school children.

Measuring children's self-reported sport participation, risk perception and injury history: development and validation of a survey instrument

Despite the health benefits associated with children's sport participation, the occurrence of injury in this context is common. The extent to which sport injuries impact children's ongoing involvement in sport is largely unknown. Surveys have been shown to be useful for collecting children's injury and sport participation data; however, there are currently no published instruments which investigate the impact of injury on children's sport participation. This study describes the processes undertaken to assess the validity of two survey instruments for collecting self-reported information about child cricket and netball related participation, injury history and injury risk perceptions, as well as the reliability of the cricket-specific version. Face and content validity were assessed through expert feedback from primary and secondary level teachers and from representatives of peak sporting bodies for cricket and netball. Test-retest reliability was measured using a sample of 59 child cricketers who completed the survey on two occasions, 3-4 weeks apart. Based on expert feedback relating to face and content validity, modification and/or deletion of some survey items was undertaken. Survey items with low test-retest reliability (κ≤0.40) were modified or deleted, items with moderate reliability (κ=0.41-0.60) were modified slightly and items with higher reliability (κ≥0.61) were retained, with some undergoing minor modifications. This is the first survey of its kind which has been successfully administered to cricketers aged 10-16 years to collect information about injury risk perceptions and intentions for continued sport participation. Implications for its generalisation to other child sport participants are discussed.

Risk groups for sports injuries among adolescents--representative German national data

BACKGROUND

Physical activity during childhood and adolescence is of major importance with regard to an individual's engagement with sports in later life. Apart from the physical trauma, sports injuries often have negative effects on the motivation to remain physically active. This study evaluates data to gain detailed knowledge on 1-year incidence and risk groups with the aim of providing information for the development of preventive measures.

METHODS

Our data analysis is based on a net sample from a national study in Germany including 7697 children and adolescents aged 11 to 17 years. Within the statistical analyses, we developed weighting factors and calculated group differences as well as regression models for sports injury incidence.

RESULTS

A total of 7.7% of the children and adolescents reported a sport injury during the last 12 months. Bivariate analyses showed significant associations between sports injuries and several social and lifestyle-related covariates. After adjustment for participation in leisure time physical activity, age, non-migrant status and residence in a large city remained positively associated with the incidence of sports injuries.

CONCLUSIONS

In comparison with other results for developed countries, the incidence seems rather high. It remains to be clarified whether this is because of our use of more accurate population-based data. The results suggest that while developing preventive measures, the interaction between preferences for high-risk sports and physical as well as psychological development has to be considered.

The nature and characteristics of abdominal injuries sustained during children's sports

OBJECTIVE

To increase the evidence base by characterizing various features of pediatric sports-related abdominal injuries.

DESIGN

A review of the trauma database at The Children's Hospital at Westmead was undertaken for all abdominal injuries presenting to the emergency department between 2001 and 2006.

SETTING

The Children's Hospital at Westmead is a tertiary-level pediatric trauma center servicing Sydney's west. It sees approximately 50,000 patients a year.

PARTICIPANTS

Only those injuries occurring during an organized sport were included for analysis. Thirty-three of the original 513 patients were eligible for inclusion.

MAIN OUTCOME MEASURES

The data collected included basic demographics, mechanism of injury, sport injury, time to presentation, length of stay, diagnoses, treatment, and complications. Injury severity scores were assigned retrospectively.

RESULTS

Males sustained more injuries than females. Collisions and falls were the most common modes of injury. Rugby was the most common sport for injury. Most patients presented within 12 hours, and most presented with musculoskeletal injuries. Injury severity was usually mild; treatment, conservative; length of stay, short; and complications, uncommon. When characteristics were compared by sex, males had mostly collision injuries in high-impact/contact sports, with females having more falls in other sports. When characteristics were compared by age, the only statistically significant difference was in the organ injured: older children had more single solid organ injuries, and younger children had more multiple and hollow viscus injuries.

CONCLUSIONS

Sports-related abdominal injuries in children are mostly minor and not as common as other injury mechanisms. Despite this, they can be serious, with early diagnosis often delayed because of their subtle nature. Sports-related abdominal injuries in children require a high index of suspicion in the part of the clinician if they are to be recognized early and managed effectively.

Gender differences in adolescent injury characteristics: A population-based study of hospital A&E data

OBJECTIVES

To investigate patterns of adolescent home/leisure injury serious enough to require hospital attendance.

STUDY DESIGN

Population-based analysis of data collected by the Home and Leisure Accident Surveillance System (HASS/LASS).

METHODS

Study subjects were 0-17 year old residents of Airdrie and Coatbridge, Lanarkshire, Scotland, who attended Monklands Hospital Accident and Emergency (A&E) Department with a home/leisure injury during calendar years 1996-1999. Male to female relative risk ratios (M:F RRRs) for A&E attendance, fracture and hospital admission, stratified into sports and non-sports injuries, were calculated. Sports injuries were further analysed by specific sports and by whether the sports activity was organized or informal. Data were analysed in age groups corresponding to children's stage of schooling.

RESULTS

The M:F RRR for non-sports A&E attendances remained constant throughout childhood (1.35, 95% CI 1.30-1.39 in 0-17 year olds), whilst that for sports attendances increased sharply with age (2.50, 95% CI 0.89-7.02 in 0-4 year olds, increasing to 8.11, 95% CI 6.27-10.51 in 16-17 year olds). Of sports injury attendances, 50.3% were football-related. Football was overwhelmingly the main cause of boys' sports injury in both the organized and informal sports injury categories. When football injuries were excluded from the analysis, the widening teenage gender gap in injury risk disappeared. There was no significant gender difference in teenagers' rates of A&E attendance for injuries sustained during compulsory school physical education (PE), suggesting a dose-response relationship between sports participation and injury risk.

CONCLUSIONS

This study found significant gender inequalities in adolescent injury risk, which were largely attributable to boys' football injuries. Focusing prevention efforts on making football safer would, then, be a sensible strategy for reducing the overall burden of adolescent injury and for reducing sex inequalities in injury risk; however further research is needed to understand how the risks differ between organized and informal football. These findings are also interesting because of what they suggest about teenage girls' lack of participation in sport and habitual physical activity. This is clearly of public health concern because of the links between physical inactivity and a range of health problems.

Quantifying the association between physical activity and injury in primary school-aged children

BACKGROUND

Regular physical activity is strongly advocated in children, with recommendations suggesting up to several hours of daily participation. However, an unintended consequence of physical activity is exposure to the risk of injury. To date, these risks have not been quantified in primary school-aged children despite injury being a leading cause for hospitalization and death in this population.

OBJECT

Our goal was to quantify the risk of injury associated with childhood physical activity both in and out of the school setting and calculate injury rates per exposure time for organized and non-organized activity outside of school.

METHODS

The Childhood Injury Prevention Study prospectively followed a cohort of randomly selected Australian primary school-and preschool-aged children (4 to 12 years). Over 12 months, each injury that required first aid attention was registered with the study. Exposure to physical activity outside school hours was measured by using a parent-completed 7-day diary. The age and gender distribution of injury rates per 10 000 hours of exposure were calculated for all activity and for organized and non-organized activity occurring outside school hours. In addition, child-based injury rates were calculated for physical activity-related injuries both in and out of the school setting.

RESULTS

Complete diary and injury data were available for 744 children. There were 504 injuries recorded over the study period, 396 (88.6%) of which were directly related to physical activity. Thirty-four percent of physical activity-related injuries required professional medical treatment. Analysis of injuries occurring outside of school revealed an overall injury rate of 5.7 injuries per 10000 hours of exposure to physical activity and a medically treated injury rate of 1.7 per 10000 hours.

CONCLUSION

Injury rates per hours of exposure to physical activity were low in this cohort of primary school-aged children, with <2 injuries requiring medical treatment occurring for every 10000 hours of activity participation outside of school.

Sports injuries: population based representative data on incidence, diagnosis, sequelae, and high risk groups

OBJECTIVE

To generate national representative data on the incidence, diagnosis, severity, and nature of medically treated sports injuries and to identify high risk groups.

METHODS

The first national health survey for the Federal Republic of Germany, conducted in the format of a standardised, written, cross sectional survey in the period October 1997 to March 1999, gathered data on the incidence of accident and injury and information on social demographics, injury related disability/time off work, and injury location/setting. The net sample comprised 7124 people aged 18-79.

RESULTS

3.1% of adult Germans said they sustained a sports injury during the previous year, corresponding to an annual injury rate of 5.6% among those engaging in regular recreational physical activity and ranking sports injuries as the second most common type of accident. About 62% of all sports injuries result in time taken off work. The period of occupational disability is 14 days or less in around two thirds of these cases. The occupational disability rate after occupational and traffic accidents is much higher by comparison. Dislocations, distortions, and/or torn ligaments make up 60% of all sports injuries, followed by fractures (18%), contusions, surface wounds, or open wounds (12%). Three out of four sports injury casualties are male. The incidence declines noticeably in higher age groups.

CONCLUSIONS

Future injury prevention measures should focus on the high risk group of young male recreational athletes. The data indicate that the fear of damage to health and injury, believed to be significant internal psychological barriers to participation in sports, is largely unwarranted for the female population and/or older age groups. Sporting injuries are a marginal phenomenon among the female population and mobile seniors actively engaged in sports.

Socioeconomic status and non-fatal injuries among Canadian adolescents: variations across SES and injury measures

Background

While research to date has consistently demonstrated that socioeconomic status (SES) is inversely associated with injury mortality in both children and adults, findings have been less consistent for non-fatal injuries. The literature addressing SES and injury morbidity among adolescents has been particularly inconclusive. To explore potential explanations for these discrepant research findings, this study uniquely compared the relationship across different measures of SES and different causes of injury (recreation versus non-recreation injuries) within a sample of Canadian adolescents.

Methods

The sample included adolescent participants (aged 12 to 19 years) in the Canadian 1996–1997 cross-sectional National Population Health Survey (n = 6967). Five SES measures (household income, two neighbourhood-level proxy measures, two parental indicators) were examined in relation to three injury outcomes (total, recreation, and non-recreation injuries) using multivariable logistic regression.

Results

Among males, a clear relationship with injury was observed only for a parental SES index, which was positively associated with total and recreation injuries (odds ratios for the highest versus lowest SES category of 1.9 for total and 2.5 for recreation injuries). Among females, there was some evidence of a positive relationship between SES and injuries, particularly for a neighbourhood-level education measure with total and recreation injuries (odds ratios of 1.7 for total and 2.0 for recreation injuries).

Conclusion

The results suggest that differences related to the measures of SES chosen and the causes of injury under study may both contribute to discrepancies in past research on SES and non-fatal injuries among adolescents. To clarify the potential SES-injury relationship among youth, the findings emphasize a need for a greater understanding of the meaning and relevance of different SES measures for adolescents, and for an exploration of the pathways through which SES may be related to injury risk.

Injuries during physical activity in school children

During the spring of 2001, 1975 children, from grades 3, 6 and 9 participated in a nationwide, multidisciplinary collaboration study. The students came from randomly selected classes throughout Sweden, representing different geographical and socio-economic areas. The aim of this study was to collect and evaluate self-reported injuries and associated factors during various physical activities as recalled retrospectively for 3 months by the students. Every sixth student (n=299 or 16%) reported 306 injuries. Twice as many girls than boys were injured during physical education class. Ninth-grade students reported relatively more injuries during organized sports than during physical education class and leisure activities. There were no age or gender differences in incidence rate during leisure activities. Most injuries were minor, as 70% were back in physical activity within a week. Half of the students (50%) reported that they previously had injured the same body part. Primary care of the injured student was, with the exception of a family member, most often carried out by the physical education teacher or coach, which accentuates the importance of continuous sports medicine first aid education for this group.

Perception of Nigerian athletes of the use of mouth guards to prevent the stresses of sports injury

OBJECTIVE

The perception of Nigerian athletes of the use of mouth guards to prevent the stresses of sports injuries was examined using psychological, sociological, and physical stress variables.

METHODS

The descriptive survey research design was used in this study. Participants (n = 333) were selected using the purposive random sampling technique and data were collected using the 4 point Likert type instrument. The coefficient alpha was used to determine the reliability of the instrument with r = 0.79 for psychological, r = 0.66 for physical, and r = 0.74 for sociological stress.

RESULTS

The result reveals that female athletes perceived the use of mouth guards as being more important to prevent the stresses of sports injuries than male athletes, while athletes who had used mouth guards for longer periods also perceived them as being more important to prevent the stresses of sports injuries compared to those who had used them less. The result also revealed a significant difference (p<0.05) among the various sport groups as independent variables on the psychological and physical stress variables. Scheffe post hoc analysis was used to identify the group where significant difference was found.

CONCLUSIONS

The study concluded that since the impact of injury is perceived to affect the cognitive function of athletes, athletes should be educated on the use of mouth guards in order to reduce the incidence of oral and dental injuries to the barest minimum.

Nigerian dentists' knowledge and attitudes towards mouthguard protection

The objective of this study was to assess the knowledge and attitudes of Nigerian dentists towards mouthguard protection. A pre-tested 15-item, one-page questionnaire was distributed to 185 dentists practising in different parts of the country with government hospitals or private establishments, by 'hand-delivery' system. Filled and returned forms were 170 (response rate of 92%). The period of the survey was between April and August 2003. Dental graduates from the different dental schools in the country responded to this survey. About 49% of the respondents indicated having only classroom lectures on mouthguards during their undergraduate trainings, 11% said they had some laboratory sessions in addition while no form of education on mouthguards was received by 40%. About 82% had never recommended mouthguard protection for athletic patients, and the major reason was no formal training in the subject. Only 58.5% were familiar with the different types of mouthguards, 75.9% would not be able to supervise or fabricate mouthguards and 50.6% would prefer custom-made mouthguard for their athletic patients. About 84% felt the current training on mouthguards in Nigerian dental schools is inadequate. Over 98% agreed that mouthguard usage in contact sports should be encouraged with the involvement of the dentists. The knowledge and attitudes of the respondents towards mouthguard protection did not vary significantly across years of postqualification from dental schools as well as the professional status of the dentists (P > 0.05). Although Nigerian dentists support mouthguard protection in contact sports and want to be involved in the provision of mouthguards for athletes, their knowledge of the protective device is inadequate. There is need for attention to be given to this subject in the undergraduate curricula of our dental schools.

Secondary school athletes: a study of mouthguards

The purpose of this study was to determine the extent of mouthguard awareness and use, as well as the amount and type of oro-facial trauma associated with and without mouthguard wear in adolescent Nigerian athletes. A 13-item self-completion questionnaire was completed and returned by 1,127 secondary school athletes (completion rate of 93.9%) comprising 683 (60.6%) males and 444 (39.4%) females ranging in age from 12- to 19 years (mean age 15.18+/-2.97 SD). The athletes were randomly drawn from 23 secondary schools located in different parts of Ibadan city in Nigeria. Sixty-five-and-a-third percent of the athletes professed awareness of the need for mouthguards for sports, but only 19.6% claimed usage of the device. Thirty-four-and-a-half percent of the athletes reported having sustained one form of oro-facial injury or the other previously. The prevalence of oro-facial injuries was significantly lower while wearing a mouthguard (p<0.05), and most of the injuries occurred during contact sports. The study supports the need for the enforcement of mandatory mouthguard use in contact sports.

Knowledge and attitudes of coaches of secondary school athletes in Ibadan, Nigeria regarding oro-facial injuries and mouthguard use by the athletes

- The objective of this study was to assess the perceptions of secondary school sports' coaches about oro-facial injuries and mouth protector usage in sports by the adolescent athletes. A 10-item, self-completion questionnaire was distributed to 42 coaches from 23 secondary schools randomly selected from different parts of Ibadan city in Nigeria between May and June, 2002. The questionnaire sought information on why a mouth protector (mouthguard) is used, when it is required; the types of mouth protector used, the major reasons for choosing a specific mouth protector, and personal feeling as to whether mouthguards prevent oral injury. Descriptive statistics were used for the data while the chi-square statistic was employed to test the significance of association between variables. All the coaches, 25 (59.5%) males and 17 (40.5%) females with age range of 19-51 years and mean age of 38.07 +/- 8.97 years (mean +/- SD), completed and returned the forms (100% completion rate). 95.2% of the coaches believed that mouthguards prevent oral injuries and 95.2% of them also would like more information on different types of mouthguard, while 4.8% each felt otherwise. The main factor determining the choice of the type of mouthguard for athletes by the coaches was the quality of oral protection (57.1%), and the next was the cost (23.8%). Acceptance of mouthguard was scored as positive by 88.1% of the athletes. 81.0% of the coaches felt that mouthguard should be worn at all times (during practices and competitions) while 19.0% would prefer the use during competitions only. The majority of the coaches (71.4%) believed that boxing needs mouthguards, 2.4% each indicated football (soccer) and Judo while 11.9% of the coaches did not indicate any sport. The majority of these Nigerian coaches agreed on the protective effectiveness of mouthguard against sport-related oro-facial injuries, but they are yet to be adequately informed about mouthguards generally so as to correctly advise and influence these adolescent athletes in this regard.

An audit of first aid qualifications and knowledge among team officials in two English youth football leagues: a preliminary study

OBJECTIVES

To determine if youth football officials responsible for dealing with injuries have appropriate first aid qualifications and knowledge?

METHODS

Information was collected from two youth football leagues by questionnaire. First aiders were asked to provide details of their qualifications and their response from a list of alternatives to an injury scenario.

RESULTS

Fifty two of 86 respondents did not have a current first aid qualification. Only 12% and 38% respectively gave the correct response to the injury scenarios "player choking" and "player unconscious". Health and injury records for the players were kept by 40% and 19% of teams. Written parental consent to emergency treatment was obtained by 30%.

CONCLUSION

This preliminary study shows an obligation on teams who do not possess a qualified first aider to evaluate their legal and moral responsibilities to their players. The Football Association and Health and Safety Executive should produce a list of recommended equipment, facilities, and first aid qualified personnel to which teams should have access at games and training sessions. Providers of first aid training should reassess their teaching of the management of the choking and unconscious casualty.

Injuries in whitewater kayaking

OBJECTIVE

To provide epidemiological data on whitewater kayaking injuries using a descriptive study.

METHODS

A retrospective survey was distributed at whitewater events and club meetings, and made available and advertised on the world wide web, through postings and announcements to newsgroups, related sites, and search engines. Data on sex, age, experience, and ability were collected. Injury data collected included mechanism, activity, difficulty of rapid, and self reported severity.

RESULTS

Of the 392 kayaking respondents included in the final analysis, 219 suffered 282 distinct injury events. The number of days spent kayaking per season was the only independent predictor of injury. The overwhelming majority of injuries occurred while the kayaker was still in the boat (87%). Striking an object was the most common mechanism of injury (44%), followed by traumatic stress and overuse (25% each). The most common types of injury were abrasion (25%), tendinitis (25%), contusion (22%), and dislocation (17%). The upper extremity, especially the shoulder, was the most commonly injured area of the body. Although half of injured kayakers sought medical care for their injury, and almost one third missed more than one month of kayaking because of the injury, almost all (96%) reported a complete or good recovery.

CONCLUSIONS

Factors relating to likelihood of injury appear to be connected with exposure, namely the number of days a year that the sport was pursued. Except for class V (extreme) kayakers, reports of injuries paralleled the number of participants. Kayakers reported injuries predominantly on rivers that they assessed to be at a level appropriate to their skills.

Common athletic injuries in adolescent girls

Teenaged girls constitute the fastest growing segment of children and adolescents participating in organized athletics. Adolescent girls appear to have similar injury rates as boys in comparable activities but different injury patterns. To properly diagnose and manage athletic injuries in adolescent girls, pediatric health care providers must be aware of these differences, especially as the literature and their knowledge base may be skewed to the traditional predominance of males in sport. This review identifies athletic injuries that are unique to or especially common in adolescent girls, including apophyseal injuries; breast and pelvic injuries; scoliosis and spondylolysis; multidirectional shoulder instability and "gymnast's wrist"; anterior cruciate ligament injuries and patellofemoral pain syndrome; chronic exertional lower-leg compartment syndrome, ankle sprains, and reflex sympathetic dystrophy; and stress fractures. It also briefly discusses possible risk factors for these injuries, emphasizing the female athlete triad.

Sports activities related to injuries? A survey among 9-19 year olds in Switzerland

BACKGROUND

Most data on sports injuries are gathered in clinical settings so that their epidemiology in the general population is not well known.

OBJECTIVE

To explore the link between sports injuries with the type and the amount of sports activity and biological factors.

METHODS

In 1996, 3,609 in-school adolescents 10-19 years (1,847 girls and 1,762 boys) participated in a regional survey. This included anthropometric measurements and a self administered questionnaire.

RESULTS

Altogether 28.2% of girls and 35.9% of boys reported one or more sports injuries during the previous year and 2.1% of girls and 6.5% of boys reported at least one hospitalization due to a sports injury. Using the mean rate of injuries as reference level, some sports are highly related to injury occurrence: body building (relative risk (RR) 1.7, 95% confidence interval (CI) 1.5 to 1.9), skateboarding and rollerskating (RR 1.6, 1.4 to 1.8), athletics (RR 1.5, 1.3 to 1.7), snowboarding (RR 1.5, 1.4 to 1.6), basketball (RR 1.3, 1.2 to 1.4), soccer (RR 1.3, 1.2 to 1.4), and ice hockey (RR 1.2, 1.1 to 1.3). Using a logistic regression, several variables associated with a higher risk of injury were identified: the amount of physical activity, high risk sports, and Tanner pubertal stages.

CONCLUSION

The risk of sports injury increases not so much with age but with exposure to specific sports and with pubertal development.