Injury incidence, severity and profile in Olympic combat sports: a comparative analysis of 7712 athlete exposures from three consecutive Olympic Games

Epidemiology of causes and management of severe spinal injuries in elite male wrestlers

Spinal injuries are common in wrestlers. This study aimed to investigate the characteristics and post-injury management practices of severe spinal injuries among elite male wrestlers, with a comparative analysis between Greco-Roman and freestyle wrestling styles. A total of 110 elite male wrestlers (55 Greco-Roman and 55 freestyle athletes) were participated in the study, interviews were conducted severe spinal injuries and their post-injury management practices. Approximately 30.9% of participants reported experiencing severe spinal injuries, and among them, 58.8% were reinjury. These injuries predominantly occurred during technical training sessions due to overuse mechanisms during offensive maneuvers. Among the injured athletes, only 38.2% received specialized rehabilitation, and 35.3% obtained medical clearance before returning to play. The Greco-Roman style was found to have a significantly higher risk of reinjury than the freestyle (odds ratio=5.24 and 95% confidence interval=1.09-21.25). There were significant differences in the specific situations causing spinal injuries between wrestling styles (p=0.018). In conclusion, this study demonstrates that elite male wrestlers are at high risk of severe spinal injury and reinjury; yet, they often lack adequate post-injury management. Moreover, the differences in reinjury rates and specific situations causing injuries based on wrestling styles emphasize the need for tailored prevention and management strategies for each style.

Concussion history and knowledge among top-level youth karate athletes

OBJECTIVE

To examine concussion experiences and knowledge among top-level youth karate athletes.

METHODS

This cross-sectional study collected data during the 12th World Karate Championships for cadets, juniors and under-21 athletes (held in Konya, Turkey, 2022). All 1414 registered athletes from 95 countries were invited to complete a 16-item paper-based questionnaire assessing demographic data, concussion history and concussion knowledge prior to the competing at the tournament. χ2 and Fisher's exact tests were used to analyse differences by sex, age group and continental karate federation.

RESULTS

A total of 654 athletes (46.3% response rate), including 286 (43.7%) females and 368 (56.3%) males, participated in the study, with 29.9% reporting one or more concussions during participation in karate training or competition. Older age groups (under 21 years) reported significantly higher concussion rates than younger athletes (56.9% vs 31.1% juniors and 24.7% cadets; p<0.001). Concussion knowledge revealed considerable gaps, with only 24.5% of athletes correctly identifying a concussion and 68.9% believing loss of consciousness was required for a concussion diagnosis. Misconceptions varied significantly across geographical regions, with Asian and African athletes demonstrating the greatest need for targeted education. Female athletes demonstrated better concussion reporting attitudes than males (60.4% vs 48.9%, p=0.004).

CONCLUSIONS

This study highlights the prevalence of concussions and significant knowledge gaps among top-level youth karate athletes, emphasising the need for tailored educational interventions to improve concussion recognition and management within the karate community.

Advancements in virtual reality for performance enhancement in combat sports: a mini-review and perspective

This mini-review examines the role of Virtual Reality (VR) in enhancing athletes' performance and reaction abilities in combat sports, aiming to highlight the advantages and potential benefits of VR technology for improving outcomes in various combat disciplines. We identified 13 relevant studies from the Web of Science and Scopus databases, encompassing disciplines such as fencing, taekwondo, karate, judo, and wrestling. The findings indicate that VR training can enhance athletes' sports skills and physical fitness, correct improper movements, provide training feedback, and, in some cases, surpass the effectiveness of traditional training methods. It also significantly enhances athletes' reaction capabilities. Even with these benefits, VR usage in combat training is still quite limited. Future research should focus on how to better leverage the advantages of VR technology in practical combat training for athletes, addressing the lack of tactile feedback, aiding athletes adapt to competition pressure caused by spectators, and examining whether there are gender differences in the use of this technology for training.

Is there a relationship between rapid weight changes and self-reported injury in combat sports athletes? A 14-month study of 24 combat sports events

OBJECTIVES

To explore the potential association between rapid weight changes and self-reported injury status (presence or absence of injury) 7 days following competitive events among male and female combat sports competitors.

DESIGN

A 14-month study of 24 events.

METHODS

A weight management questionnaire was completed 1-day post-competition, and an injury questionnaire was completed 7 days post-competition. These online questionnaires provided data on body mass and injury status. Mixed effects logistic regression models were used to analyse the odds ratios of rapid weight change variables and their impact on athletes' self-reporting as injured or non-injured.

RESULTS

There were 172 responses (155 athletes) to both questionnaires (37 females (24 %) and 118 males (76 %)); 88 athletes (51 %) reported no injury, and 84 (49 %) reported injury. Rapid weight loss 7 days (RWL -7 days) and 24 h (RWL -24 h) before weigh-ins was 4.9 % ± 3.4 % and 2.6 % ± 2.1 % for females, and 6.1 % ± 3.2 % and 3.0 % ± 1.9 % for males. Mixed effects logistic regression models returned the highest odds ratio for male RWL -24 h (odds ratio: 1.20, 95 % confidence interval: 1.00-1.43, p = 0.044). This indicates that for a 1 % increase in male RWL -24 h before official weigh-ins, the likelihood of reporting an injury increases by a factor of 1.2.

CONCLUSIONS

Male RWL -24 h before weigh-ins is associated with reporting an injury at 7 days post-competition. Therefore, athletes and coaches should carefully consider and aim to limit pre-competition rapid weight loss to minimise the likelihood of injury.

Occurrence of Injuries in Different Phases of Judo Matches: Analysis Based on International Competitions

BACKGROUND

The specificity of the technical actions that are performed in judo may be dependent on and vary during particular phases of the combat, thus possibly impacting injury prevalence. Therefore, towards the betterment of athletes' safety and considering the importance of the issue of injury prevention in judo, the main goal of this study was to identify the injury occurrence during respective combat phases, i.e., the (a) first half, (b) second half, (c) last minute, and (d) golden score.

METHODS

A total of 26,862 elite judo athletes, including 15,571 men and 11,291 women, participated in the study. The subjects competed in 128 international tournaments of the European Judo Union (EJU) in 2005-2020. The EJU medical questionnaire was utilized to gather information from each injured athlete according to the aforementioned inclusion criteria.

RESULTS

Several statistically significant relationships were found between the differences in the number of injuries between particular combat phases and the athlete's sex.

CONCLUSIONS

A significantly higher number of injuries occurred during the combined second half and the last minute of the judo combat. Males suffered more injuries during the first and second half of the combat compared to females, however, during the last minute of the combat, the number of injuries was greater among women.

Concussion and executive functions in combat sports: A systematic review

Concussion is a diagnosis given due to trauma caused by abrupt acceleration and deceleration of the brain. The consequences involve, among others, impairments in executive functions. Considering the high incidence of concussions in combat sports, this study investigated the impacts of this trauma on core executive functions. A systematic search was carried out until November 2023, using the PRISMA method on the Virtual Health Library (BVS), PubMed, Science Direct and Scielo platforms. 11 studies, including case studies and quantitative empirical studies, met the eligibility criteria. Risk of bias was assessed using the Cochrane Collaboration risk of bias measurement tool. The results produced high and low bias studies, evaluated by three independent evaluators. Of the 11 studies selected, 91% included samples of boxers and 27.3% included mixed samples (men and women). The total sample was 1,130, aged between 15 and 68 years. 81.9% indicate impairment of executive functions in fighters, with impacts most frequently reported on memory (36.5%) and inhibitory control (27.5%). The results suggest that concussion impairs executive functions in boxing and MMA. However, more studies are needed to relate the diagnosis of concussion to possible deficits in executive functions in combat sports.

1-Year Prevalence and Factors Related to Injuries and Illnesses in Japanese Judo Collegiate Athletes

Despite its rich history and widespread participation, the research surrounding injuries and illness in judo remains relatively limited compared to other sports. The primary aim of this research was to investigate injuries and illness within a previous year in Japanese collegiate judo athletes and analyze possible factors associated with these. This was a cross-sectional observational study using a web-based survey to collect data on the 1-year prevalence of injuries and illness. This study involved 564 judo athletes (67% males), aged between 18 and 25 years. Of these, 344 athletes (61%) reported one or more injuries within the previous year, and 49 reported illness (9%). The more judo experiences the athlete acquired, the less likely they were to sustain an injury (OR: 0.9; 95% CI: 0.56-1.10; p-value < 0.05) or illness (OR: 0.9; 95% CI: 0.81-1.00; p-value < 0.05). Support of an athletic trainer was associated with 1.7 times increased odds of sustaining an injury (95% CI: 1.19-2.49; p-value < 0.05). Athletes with obese BMI status (BMI > 30) had 3.1 times higher odds of becoming ill (95% CI: 1.41-6.95; p-value = 0.005), and athletes training more than 5 days per week had the odds of becoming ill increased by 5.1 times (95% CI: 1.11-23.21; p-value = 0.036). Judokas with fewer years of experience and with obese status should be targeted in efforts to prevent injury and illness. Moreover, the support of an athletic trainer and the impact of weekly training days should be targeted in research efforts.

Wrestling injuries during the 2016 Rio and 2020 Tokyo Olympic Games

OBJECTIVES

To evaluate and compare the injuries of Olympic wrestlers during the 2016 Rio and 2020 Tokyo Olympic Games held in August 2021 due to the COVID-19 pandemic.

METHODS

In this descriptive epidemiological study, injury report forms were used to collect and analyse injury data during the competitions.

RESULTS

During 410 matches in the Rio Olympic Games, 21 injuries were recorded among 346 wrestlers (112=women), a rate of 5.1 injuries/100 bouts and 6.1 injuries/100 athletes. During 322 matches in the Tokyo Olympic Games, 28 injuries were recorded among 287 wrestlers (96=women), with 8.7 injuries/100 bouts and 9.8 injuries/100 athletes. However, these apparent differences in injury rates between Tokyo and Rio were not statistically significant (injuries/bout: p=0.057, 95% CI: 0.31 to 1.02; injuries/athlete: p=0.087, 95% CI: 0.33 to 1.08). Mild injuries comprised the greatest proportion of injuries in both Olympic Games. Severe injuries accounted for 0%, 16.7% and 36.4% of injuries in Greco-Roman, Freestyle and Women's wrestling, respectively.

CONCLUSION

Most wrestling injuries in the 2016 Rio and 2020 Tokyo Olympic Games were mild skin injuries in the head and face regions due to direct body contact during standing positions in the 1/8-final round of wrestling competitions. No critical injury was observed during the recent Olympic Games. Attention should be drawn to preventing upper limb joint dislocations as common severe injuries in both Olympic Games. While not statistically significant, the Tokyo Games, after the COVID-19 pandemic, witnessed a higher injury occurrence than the Rio Games.

Injury Risk Analysis among Judo Athletes with Intellectual Disabilities

The main aim of this study was to evaluate injury prevalence, incidence rate, and burden in judo athletes with intellectual disabilities (ID) who participate in international competitions. This retrospective cross-sectional study analyzed data from the past year for 182 judo athletes with ID. Data was collected using a self-reported questionnaire, adapted from previous research, that included questions about injuries impacting training or competition, injury type, mechanism, severity, diagnosis, and location on the body. The injury prevalence among judo athletes with ID occurred most often during training (68.2%) and primarily affected the lower extremities (35%). Age group and injury prevalence were significantly related (χ2=7.91; P=0.04), while gender, weight, and ability level were not. Results were closer to those previously reported for conventional judo, which is likely due to the lower practice intensity among judo athletes with ID. Injury prevalence was lower than in prior studies, but the incidence rates aligned when considering training time in judo athletes with ID. Injury burden analysis revealed that females had a lower burden than males, while older athletes experienced a higher burden than younger athletes. Most injuries occur during training, which is likely attributable to safety-focused competition rules.

Headguard use in combat sports: position statement of the Association of Ringside Physicians

Headguard use is appropriate during some combat sports activities where the risks of injury to the face and ears are elevated. Headguards are highly effective in reducing the incidence of facial lacerations in studies of amateur boxers and are just as effective in other striking sports. They should be used in scenarios - especially sparring prior to competitions - where avoidance of laceration and subsequent exposure to potential blood-borne pathogens is important. Headguards are appropriate where avoidance of auricular injury is deemed important; limited data show a marked reduction in incidence of auricular injury in wrestlers wearing headguards.Headguards should not be relied upon to reduce the risk of concussion or other traumatic brain injury. They have not been shown to prevent these types of injuries in combat sports or other sports, and human studies on the effect of headguards on concussive injury are lacking. While biomechanical studies suggest they reduce linear and rotational acceleration of the cranium, changes in athlete behavior to more risk-taking when wearing headguards may offset any risk reduction. In the absence of high-quality studies on headguard use, the Association of Ringside Physicians recommends that further research be conducted to clarify the role of headguards in all combat sports, at all ages of participation. Furthermore, in the absence of data on gender differences, policies should be standardized for men and women.

Prevalence of and Factors Associated with Sports Injuries in 11,000 Japanese Collegiate Athletes

BACKGROUND

To establish the 1-year prevalence of sports injuries and explore associations of various factors with a sports injury in Japanese collegiate athletes.

METHODS

The data were collected through a web-based survey of Japanese collegiate athletes associated with UNIVAS (Japan Association for University Athletics and Sport). The survey questions asked about athletes' personal characteristics, sports participation, and injuries sustained within the previous year. Follow-up questions on the details regarding the three most serious injuries were asked. Differences in proportions of athlete characteristics between males and females and between injured and uninjured were explored with the chi-square test. Factors associated with sustaining an injury were determined with regression analysis.

RESULTS

The prevalence of injuries among Japanese collegiate athletes is high, and most of the sustained injuries require athletes to take a considerable time off training and competition indicating their severity. Athletes from year two and higher at the university, overweight or obese, training more often per week, and with longer sports experience were more likely to sustain an injury within the previous year.

CONCLUSIONS

There is compelling evidence to suggest that excessive training and insufficient recovery may be contributing to their increased risk of injury. These findings underscore the importance of implementing evidence-based training programs and recovery strategies to mitigate injury risk and optimize performance outcomes among this population.

Plyometric Training's Effects on Young Male Karatekas' Jump, Change of Direction, and Inter-Limb Asymmetry

This study analysed the effects of performing a plyometric training programme on different types of jumping and specific changes of direction, and their respective asymmetries in karatekas. Twenty male karatekas (age 19 ± 4 years) were distributed in two groups, the control group (CG) and the experimental group (EG). The EG group (n = 10) performed a 6-week intervention of unilateral plyometric training, performing countermovement jumps (CMJ), drop jumps (DJ), and long jumps (SH). The tests performed at the beginning and at the end of the intervention were a unilateral and bilateral countermovement jump test (CMJ), single-leg hop test (SH), single-leg side-hop test (SSH), triple hop test (TH), and change of direction in a karate position test (MKUKS). The EG group obtained improvements in the CMJ with the stronger (p = 0.01; ES = 0.39) and weaker leg (p = 0.01; ES = 0.59), in the SH with the weaker leg (p = 0.01; ES = 0.45), in the SSH with the weaker leg (p = 0.03; ES = 0.33), in the MKUKS (p = 0.00; ES = 0.98), and improved the asymmetries obtained in the TH (p = 0.02; ES = -0.85). The GC group obtained significant differences in the CMJ with the stronger (p = 0.03; ES = 0.46) and weaker leg (p = 0.00; ES = 0.69), in the bilateral CMJ (p = 0.02; ES = 0.24), in the SH with the weaker leg (p = 0.00; ES = 0.34), in the TH with the stronger (p = 0.00; ES = -0.15) and weaker leg (p = 0.01; ES = 0.09), and in the MKUKS test (p = 0.04; ES = -0.94). A between-group analysis showed improvements of the EG over the GC in the TH with the stronger leg (p = 0.02; ES = 1.05). Performing plyometric training provides improvements in jumping, mainly in horizontal jumps, reducing inter-limb asymmetries in repetitive jumps.

Effectiveness of Protective Measures and Rules in Reducing the Incidence of Injuries in Combat Sports: A Scoping Review

In recent years, much effort has been made to reduce the injury rate in combat sports. However, the question remains to what extent these measures are effective. Analysis of studies could provide evidence of the effectiveness of measures aimed at reducing the incidence of injuries. This scoping review aims (1) to map research articles dealing with the effectiveness of proper use of protective measures in reducing the incidence of injuries in combat sports; (2) to investigate to what extent the proper use of protective measures and compliance with sports rules help to reduce the incidence of injuries in combat sports; and (3) to identify gaps in the existing literature and suggest future research on this topic. The literature search was conducted on articles published between 2010 and 2023. The main inclusion criteria were studies investigating the effect of sports rules and protective equipment used during training or competition in combat sports on reducing the incidence of injuries. After meeting the criteria, only seven articles from boxing, karate, and taekwondo were included in this study. Results showed that mandatory head guards, along with modern thicker gloves, significantly reduced the rate of knockouts (KOs) and head injuries in boxing despite an increase in the number of head blows. However, the number of facial cuts increased significantly due to the removal of head guards as a piece of mandatory equipment. The use of mouth guards has significantly reduced the number of oral injuries. Changes in rules, such as shortening the duration of bouts, along with the introduction of greater competencies of referees in the supervision of bouts (the standing count, outclassed rule, and medical stops) have helped to reduce the rate of injuries in boxing. The application of a computerised scoring system also contributed to the rate of injuries reduction. The increase in the number of weight divisions had the same effect on U21 karate athletes. However, a higher incentive to attack the head area in taekwondo did not increase the incidence of injuries in youth athletes. It can be concluded that the proper use of protective measures (head and mouth guards) in combination with the rules established for health protection (higher competencies of referees and more weight divisions in competitions) effectively reduces the occurrence of injuries in combat sports. In all Olympic combat sports, the injury incidence should be regularly assessed using the Injury Incidence Rate (IIR) per 1000 min exposures (MEs). Nonetheless, further studies are needed to monitor how established rules (e.g., prohibited behaviour) affect the IIRs.

Injury Incidence and Its Characteristics in Korean Youth and Collegiate Taekwondo Sparring Athletes: A Retrospective Study

This study aimed to identify the incidence of injury and its characteristics in Korean youth and collegiate Taekwondo athletes during 2021 and to provide a suggestion regarding injury incidence. A total of 183 athletes (95 youth and 88 collegiate athletes) who were registered with the Korea Taekwondo Association (KTA) participated. The research was based on the injury questionnaire developed by the International Olympic Committee (IOC). The questionnaire consists of a total of seven items, including four items related to demographic characteristics and three items related to injuries (locations of injury, types of injury, and causes of injury). A frequency analysis was performed to identify the injury characteristics. Additionally, the injury incidence rate (IIR) was calculated based on 1000 athletic exposures (AEs) during 2021. The IIRs for one recent year (2021) showed 4.43/1000 AEs and 3.13/1000 AEs in youth and collegiate Taekwondo athletes, respectively. The frequency analysis showed that finger (youth: 17.3%, collegiate: 14.6%), contusion (youth: 25.3%, collegiate: 23.8%), and contact with other athletes (youth: 57.6%, collegiate: 54.4%) ranked the highest in terms of the locations of injury, types of injury, and causes of injury, respectively. A continuing injury tracking system can play a key role in accumulating big data for identifying risk factors and developing interventions to reduce injury in Taekwondo sparring.

Incidence Rates and Pathology Types of Boxing-Specific Injuries: A Systematic Review and Meta-analysis of Epidemiology Studies in the 21st Century

Background

To the best of our knowledge, an evidence-based investigation into 21st-century boxing-specific injury rates and types has yet to be performed.

Purpose

To provide an overview and quantitative synthesis of the incidence rates (IRs) and pathological categorizations of boxing-specific injuries in the 21st century.

Study Design

Systematic review; Level of evidence, 3.

Methods

Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched literature published from January 2000 to November 2021 in PubMed and the Cochrane Library systematically for qualifying epidemiology studies of organized boxing activities across the world. Two independent reviewers completed the literature review, data extraction, and quality assessment. The IRs of injuries per 1000 boxers (IR_N), per 1000 competition exposures (IR_E), and per 1000 minutes of competition (IR_C) or training (IR_T) were subsequently calculated. Single-arm meta-analyses were performed for the subgroups of different types of boxing. Sample size weighted means were calculated using a random-effects model in all studies with 95% CIs.

Results

Out of an initial 9584 articles, 14 studies were included, with most (11/14) having a moderate level of quality. The pooled IR_N in overall injuries was 223.9 (95% CI, 157.5-290.4), the IR_E was 233.3 (95% CI, 161.3-305.2), and the IR_C was 13.0 (95% CI, 8.9-17.1). In professional boxing, the IR_N (399.8), IR_E (379.8), and IR_C (23.9) were all significantly higher than in the amateur and female groups. The IR_E (76.6 vs 250.6; P < .000) and IR_C (9.2 vs 15.4; P < .000) in amateur boxing were significantly lower in studies between 2010 and 2019 than in earlier studies. For pathology categorization, the pooled frequencies were 12.3% (95% CI, 8.7%-15.9%) for concussion, 21.4% (95% CI, 14.1%-28.6%) for skin laceration, 30.2% (95% CI, 22.1%-38.2%) for soft tissue contusion, 15.3% (95% CI, 7.7%-22.9%) for sprain and muscle/ligament injury, and 11.4% (95% CI, 2.7%-20.1%) for fracture.

Conclusion

IRs of injury remain high in professional boxing, although they have decreased in the past 10 years in amateur boxing. Soft tissue contusion was the most common injury type. Better exposure measurements and epidemiologic indicators should be applied in future studies.

Registration

CRD42021289993 (PROSPERO).

Epidemiology of Injuries during Judo Tournaments

Objective

To determine the injury incidence proportion, distribution of injuries by anatomical location; injury type; injury severity, time loss; mechanism and situations of injuries; and the relative risk of injuries by gender, age, and weight categories during judo tournaments. Study Design. It is a systematic review. Data Sources. A systematic review of the literature was conducted via searches in PubMed, EMBASE, Web of Science, CINAHL, SPORTDiscus, Google Scholar, and PEDro. Eligibility Criteria. All original studies on the incidence of injuries during judo tournaments were included.

Results

Twenty-five studies were included out of the 1979 studies. Using the modified AXIS tool score for quality assessment, seven were rated as having good quality, nine were rated as having fair quality, and four were rated as having poor quality. The injury incidence proportion during tournaments ranged from 2.5% to 72.5% for injuries requiring medical evaluation and 1.1% to 4.1% for injuries causing time loss (i.e., inability to continue game participation). The most commonly reported injury location was the head, followed by the hand, knee, elbow, and shoulder. The most frequent types of injury were sprains, followed by contusions, skin lacerations, strains, and fractures. In judo tournaments, injuries were more often sustained during standing fights (tachi-waza) than in ground fights (ne-waza).

Conclusion

The tournament injury incidence proportion ranged from 2.5% to 72.5% for injuries requiring medical attention and 1.1% to 4.1% for injuries causing time loss. The head was the most frequently injured body part, and sprain was the most frequent injury type. However, current reports on injuries during judo tournaments are heterogeneous and inconsistent, limiting our understanding of in-match injury risks. Future studies should utilize the guidelines of the International Olympic Committee consensus meeting statement on the methodological approach to injury reporting. We recommend a judo-specific extension of this statement to fit the unique features of judo sports practice.

Incidence of Sport Injuries in the Manchester 2019 World Taekwondo Championships: A Prospective Study of 936 Athletes from 145 Countries

We aimed to describe injury incidence and patterns at the 2019 World Taekwondo Championships (WTC), and to compare them with those of previous WTCs, based on new World Taekwondo (WT) competition rules, medical codes, and the Protector and Scoring System (PSS). This prospective cohort study utilized data obtained through the WT Injury Surveillance System. All athletes with injuries were evaluated by on-site sports medicine specialists, and ultrasonography was used to assess all musculoskeletal injuries. Of 936 athletes, 60 injuries were recorded (6.4 injuries/100 athletes, 95% confidence intervals [CI]: 4.8-8.0), and 4.5% (n = 42) sustained at least one injury. Males had a higher risk of sustaining injuries than females (incidence rate ratio: 1.57; 95% CI: 0.89-2.76). The most common sites, type, and mechanism were lower extremities (n = 26, 43.33%), contusion/hematoma/bruises (n = 33, 55.0%), and contact with another athlete (n = 50, 83.33%). Overall, the injury patterns associated with the mechanism of injury were similar in both the 2019 and 2017 WTCs. Refined WT competition rules and a re-established PSS at the 2019 WTC reduced the overall and severe injury incidence. Our findings can help revise Taekwondo competition rules, enhance protective equipment, optimize on-site venue medical systems, and develop injury prevention projects.

INFLUENCE OF SPORTS INJURIES AND RESISTANCE TRAINING ON SKIERS’ BONE MASS

ABSTRACT Introduction: With the preparation and development of the Winter Olympic Games, there has been an increase in the popularity of skiing. Driven by this demand, the professional development of coaches requires updates in the analysis of skiers’ sports injuries, elaboration of corresponding prevention and treatment strategies, and resistance training to promote the development of athletes’ physical quality, such as bone mass and mineral density. Objective: Study the sports injuries of skiers and explore needs and ways of applying resistance training in skiing. Methods: The questionnaire survey was used to explore the main types of injuries and their influencing factors. Then, 20 volunteers were selected for the resistance training experiment; each group of 10 people included five men and five women. The control group maintained a normal daily life, while resistance training was added to the experimental group three times a week, based on the control group. Results: The research results showed that the current proportion of skiing injuries was relatively high, mainly in mild injuries. After nine weeks in the experimental resistance training group, both men and women had positive bone mass development. Conclusion: Resistance training can improve physical quality and reduce the occurrence of sports injuries, demonstrating the benefits of its implementation in endurance training for skiers. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Injury Symmetry in Judo

Background: Each combat sport carries different risks of injury due to the specifics of the sport (including the weight categories and sex) and the fighting techniques used according to different sports regulations. The purpose of this study is to examine injury symmetry in judo. Methods: Injuries recorded in 195 people (93 women, 102 men) suffered during top-level judo tournaments were verified. Using the European Judo Union medical questionnaire, information on injuries was obtained from each injured athlete. Results: Based on the analysis of the results, it can be concluded that injuries are almost evenly distributed on the left and right sides of the body in both men and women. In women, there were 129 injuries to the left side (41.2%), 134 injuries to the right (42.8%), and 50 (16.0%) to the middle part of the body. Conclusions: injuries in judo are evenly distributed and slightly more common on the right side. Injuries occur at a greater rate during defending maneuvers than attacking maneuvers in judo. Identification and monitoring of who (tori or uke) and which side of the body sustains an injury are crucial and important in injury prevention. This knowledge makes it possible to modify existing sports regulations by eliminating behaviors (e.g., certain types of defense) to improve the safety of athletes participating in top-level competitions and the training process in terms of ensuring safety in both attack and defense.

Sports injuries in amateur recreational Taekwondo athletes

ABSTRACT Combat sports are very common in sport mega-events. Taekwondo is a combat sport that prioritizes direct contact between participants, specially by kicks and punches, and provides ambiguity in the health-sport relationship, as its practice could be harmful. This study aimed to quantify the prevalence of injuries in amateur Taekwondo athletes, from training or competitions, and assess their association with intrinsic and extrinsic factors. This is a descriptive, observational, and retrospective study that assessed injuries by a reported morbidity inquiry. Information on sports injuries considered the last six months of 2018. Participants were athletes aged from 12 to 25 years old, of both sexes, practicing Taekwondo in the city of Pelotas, Rio Grande do Sul, Brazil. The prevalence of sports injuries in amateur Taekwondo athletes in Pelotas was 26.2% (n=1), without significant differences between sexes. The main reason for the practice was physical conditioning (35.7%). The main mechanism of injury was kick when attacking (45.4%), followed by impact when defending (27.3%). The most frequent type of injury was sprain (27.3%). followed by contusion (18.2%), and the most injured body parts were knees (36.4%) and ankles (36.4%). The prevalence of sports injuries in amateur Taekwondo athletes in Pelotas was lower than the one found in the literature, and it may be due to the nature of the practice, as they are recreational amateur athletes aiming to improve physical conditioning.

Lesões desportivas em atletas recreacionais amadores de taekwondo

RESUMO As modalidades esportivas de combate (MEC) são muito frequentes em megaeventos esportivos e, dentre elas, destaca-se o taekwondo, que prioriza o contato direto entre os participantes principalmente a partir de chutes e socos, e proporciona ambiguidade na relação saúde-desporto, pois sua prática pode ser lesiva. O objetivo do estudo foi quantificar a prevalência de lesões em atletas recreacionais de taekwondo, oriundas de treinos ou competições, e testar sua associação a fatores intrínsecos e extrínsecos. Trata-se de estudo observacional descritivo, de natureza retrospectiva, que empregou inquérito de morbidade referida para registro dos agravos. As informações quanto à lesão desportiva foram registradas considerando os últimos seis meses de 2018. Participaram atletas com idade entre 12 e 25 anos, de ambos os sexos, praticantes de taekwondo na cidade de Pelotas, no Rio Grande do Sul. A prevalência de lesões desportivas em praticantes recreacionais de taekwondo na cidade de Pelotas é 26,2% (n=11), sem diferenças significantes entre sexos. O principal motivo de prática é o condicionamento para saúde (35,7%); o principal mecanismo de lesão foi chute atacando (45,4%), seguido de impacto ao realizar defesa (27,3%); o tipo de lesão mais frequente foi entorse (27,3%), seguido de contusão (18,2%); e os segmentos corporais mais lesionados foram joelho (36,4%) e tornozelo (36,4%). A prevalência de lesões desportivas em praticantes recreacionais de taekwondo da cidade de Pelotas é inferior à encontrada na literatura, e isto pode decorrer da natureza da prática, dado que eles são atletas recreacionais amadores, com a prática direcionada ao condicionamento para a saúde.

PHYSICAL TRAINING TO PREVENT SPORTS INJURIES IN ATHLETES

ABSTRACT Introduction: The purpose of physical training for athletes is to maintain and improve athletes’ coordination, reaction ability, spatial orientation, anti-load ability, endurance, and other abilities. But the problem of injury in sports must be solved. Objective: To investigate the causes of athletes’ injuries during physical training and proposes solutions for them. Methods: A questionnaire was applied to athletes to learn about their injuries in recent sports and their methods to avoid injuries. Results: Insufficient warm-up is the most common cause of injury. Other causes include site factors, fatigue, and excessive load. Sports injuries are the most common in extracurricular activities, while injuries are the least in sports training. The season in which the most damage occurs is winter, followed by autumn, and while spring shows the least injuries. Conclusion: The cause of sports injuries in physical training is related to insufficient warm-up activities. Physical training instructors should continuously improve their teaching level and provide athletes with the correct knowledge and skills to prevent sports injuries and protect themselves. As a result, the probability of sports injuries can be reduced as much as possible. Level of evidence II; Therapeutic studies - investigation of treatment results.

Diagnostics of tissue involved injury occurrence of top-level judokas during the competition: suggestion for prevention

Background

Judo, as a high-intensity contact sport, may lead to the occurrence of injuries, especially in competitions. This work aims to assess the likelihood of soft and hard tissue injuries in top-level judokas during competition with defining factors that determine the probability of injury occurrence.

Methods

The injuries that occurred in 123 official international competitions from 2005-2019 were recorded by the European Judo Union (EJU) Medical Commission as a survey that was a part of the EJU Injury Registration form with internal consistency shown by a Crombach Alpha of 0.69. This survey data identified factors such as: sex, anatomical localisation of injury, type of injury, tissue involved and mechanisms of the injury. A total of 650 tissue injuries were reported correctly in terms of tissue injury definition.

Results

The most frequent soft tissue injury (STI) reported was a ligament STI (48.15%), closely followed by skin STI (12.15%) and muscles STI (11.38%). In turn, the most frequent hard tissue injury occurred in bones (8.56%). The highest rates of injuries occurred during the fight in the standing position (78%). Injuries in the standing position mainly occurred while executing a throw (25.85%) and followed by the attempt to throw, i.e., the action of reaching the throwing position (22.30%), grip fighting (15.07%), and during falls (14.77%). Opposite to this, fight in groundwork reached only 18.30% soft and hard tissue injuries combined. The ongoing registration of injuries during judo combat and training and the early diagnosis of risk factors for injuries are the basis for the development of effective strategies for injury prevention and further treatment.

A Systematic Review on the Biomechanics of Breakfall Technique (Ukemi) in Relation to Injury in Judo within the Adult Judoka Population

Objectives: To investigate the biomechanics of Ukemi in relation to head and neck injury in adult judokas with varying skill sets. Design: Narrative systematic review. Methods: An extensive literature search was performed using PubMed, Google Scholar, Science direct and EMBASE from inception to April 2021. Studies were included if they: (1) reported biomechanical analysis of judo throws and Ukemi; (2) were on adult judoka populations; (3) discussed injury related to judo technique. The included studies were assessed for risk of bias using a five-part modified STROBE checklist. A narrative synthesis was performed due to the heterogeneity of included studies. Results: 173 titles and abstracts were screened with 16 studies (158 judokas, 9 of which were female) included. All studies used 3D biomechanical analysis to assess Ukemi. Ukemi implementation produced reduced kinematic data in comparison to direct occipital contact, which was always below the injury threshold. Analysis of lower limb and trunk kinematics revealed variances in Ukemi between novice and experienced judoka. Whilst no significant differences were seen in neck flexion angles, hip, knee and trunk angle time plots revealed greater extension angles in experienced judokas. Conclusions: Ukemi is essential in preventing head and neck injuries; however, technique differs between experienced and novice judoka. Larger flexion angles of the hip, knee and trunk are seen in novice judoka, which correlate with increased kinematic data. The association of greater neck muscle strength with improved Ukemi is weak. However, a negative correlation was established between fatigue and breakfall skill by one study.

CHARACTERISTICS AND PREVENTION OF SPORTS INJURIES IN TAEKWONDO TRAINING

ABSTRACT Introduction: With the extensive and in-depth development of Taekwondo in China, more and more people participate in Taekwondo training. Due to the lack of experience of some coaches and the misunderstanding of scientific sports training by young athletes, injuries occur from time to time. This has a bad effect on Taekwond itself, and it can also damage the health of athletes. Objective: This article discusses joint injuries in Taekwondo and analyzes the characteristics of Taekwondo sports injuries and preventive methods. Methods: This article uses a questionnaire applied to young athletes to gain an understanding of the sports injuries situation. Results: The most common injury sites were feet and joints. The nature of the injuries is mostly soft tissue injury, ligament laceration, and muscle strain. The most serious injuries are kidney and perineal damage. Conclusion: Improving the level of training, strengthening medical supervision, and paying attention to the timely treatment of acute injuries are important ways to reduce the occurrence of trauma. Level of evidence II; Therapeutic studies - investigation of treatment results.

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

Background

Brazilian jiu jitsu (BJJ) is a growing martial art that focuses on grappling techniques.

Purpose

To quantify the 3-year incidence of BJJ-related injuries and detect common injury patterns as well as risk factors among those practicing BJJ. It was hypothesized that there would be a high incidence of injuries, they would be caused by submissions in sparring situations, and they would occur predominantly at the extremities.

Study Design

Descriptive epidemiology study.

Methods

Active BJJ athletes were invited to take an English-language online survey developed by orthopaedic surgeons together with BJJ athletes and a sports scientist. Data were recorded regarding athlete demographics, sporting activity level, injuries within the past 3 years that caused at least a 2-week time loss, injury mechanisms, and return to sport.

Results

Overall, 1140 responses were received from 62 different countries; 88.9% of all athletes were male, and 63.9% were regular competitors. Within the investigated cohort, 1052 injuries were recorded in 784 athletes, for an injury incidence of 308 per 1000 athletes per year. The lower extremity (45.7%) and upper extremity (30.2%) were predominant sites of injury, with injuries to the knee (27.1%) being the most common. The most frequent knee injuries were meniscal injuries (n = 65), anterior cruciate ligament (ACL) tears (n = 36), and medial collateral ligament injuries (n = 36). ACL tears were especially associated with long time frames for return to sport. Most injuries occurred during sparring (77.6%) and were caused by submissions (29.7%) and takedowns (26.4%). Competing regularly (P = .003), older age (P < .001), and higher belt rank (P = .003) were significant risk factors for injury.

Conclusion

Injury incidence was high among BJJ athletes surveyed, with 2 out of 3 athletes reporting at least 1 injury within a 3-year period that caused a 2-week absence from training. Most injuries occurred during sparring, and we believe that a high potential for injury reduction lies in drawing awareness to common injury patterns and sites in athletes.

Nutritional Considerations for Injury Prevention and Recovery in Combat Sports

Sports participation is not without risk, and most athletes incur at least one injury throughout their careers. Combat sports are popular all around the world, and about one-third of their injuries result in more than 7 days of absence from competition or training. The most frequently injured body regions are the head and neck, followed by the upper and lower limbs, while the most common tissue types injured are superficial tissues and skin, followed by ligaments and joint capsules. Nutrition has significant implications for injury prevention and enhancement of the recovery process due to its effect on the overall physical and psychological well-being of the athlete and improving tissue healing. In particular, amino acid and protein intake, antioxidants, creatine, and omega-3 are given special attention due to their therapeutic roles in preventing muscle loss and anabolic resistance as well as promoting injury healing. The purpose of this review is to present the roles of various nutritional strategies in reducing the risk of injury and improving the treatment and rehabilitation process in combat sports. In this respect, nutritional considerations for muscle, joint, and bone injuries as well as sports-related concussions are presented. The injury risk associated with rapid weight loss is also discussed. Finally, preoperative nutrition and nutritional considerations for returning to a sport after rehabilitation are addressed.

Analysis of Different Key Behavioral Patterns to Score in Elite Taekwondoists According to the Weight Category and Gender

Traditionally, research in taekwondo has focused on athletes' overall performance considering the entire sample of the tournament or analyzed selected bouts while ignoring behavioral differences of athletes according to their gender and weight category. Thus, the aim of this study was to analyze the behavioral patterns used to score points in the London Olympic Games according to gender and weight category [fin (FW), feather (FTW), light (LW), and heavy (HW)] of the athletes. A total of 24,940 actions were analyzed by using observational methodology, a mixed method methodology where lag sequential and polar coordinate analysis were applied. Different patterns could be seen in the actions performed prior to score between the weight categories for both genders. To score one point, females FW performed dodges, LW used indirect attacks and HW used direct attacks, posterior counterattacks, dodges and blocks. After scoring one-point, female athletes used a variety of actions, defensives like dodges (FW/LW) and blocks (LW), and offensives like simultaneous counterattacks (FW, FTW, LW) and posterior (FTW) as well as direct (FTW, HW) and indirect (FW) attacks. No patterns were found in males when scoring one-point, only LW competitors performed a sequence characterized by the performance of dodges followed by indirect attacks prior scoring while simultaneous counterattacks occurred after score one point. To score two points, similar patterns were found for all weight groups among female competitors. Females performed openings prior to scoring (LW/HW), while anticipatory (FW/FTW) and posterior counterattacks (LW) occurred after scoring, followed by cuts (FW), direct attacks (LW) and openings (HW). In males, FTW and HW used counterattacks prior to scoring (posterior and simultaneous), while FTW and LW also used counterattacks after scoring (anticipatory and simultaneous). Prior to scoring three points different patterns were found according to the weight category, while FW females used cuts and openings, LW used dodges and posterior counterattacks. After scoring three points, FW continued to use cuts, openings and posterior counterattacks while FTW used indirect attacks and HW used simultaneous counterattacks. On the contrary, similar behavior was found in males. FW and LWs used simultaneous counterattacks prior to scoring while they used defensive actions such as openings (FW) and dodges (LW) after scoring. Male FTW used also posterior counterattacks after scoring. Prior to scoring four points females reported different key behaviors. FW used anticipatory counterattacks and LW direct attacks whereas after scoring, FTW used dodges and openings. Similarities were found in males to score four points. LW and HW performed blocks prior scoring, FW and HW performed also direct attacks while FTW performed posterior counterattacks prior score. After scoring, defensives actions were performed such as dodges (LW) or cuts (FW, FTW, HW) and indirect attacks (LW, HW). This is one of the first studies analyzing behavioral patterns in taekwondo according to the weight category and gender of the athletes. The observed relationships identified different behavioral patterns according to the weight category for each gender and demonstrate the necessity to individualize trainings according to the athlete's characteristics (weight and gender). It is suggested that coaches and psychologists train athletes to improve their decision-making according to the successful patterns extracted in this study.