Impact of the COVID-19 Pandemic Hiatus From Sports Activities on Injuries Observed Among Division I NCAA Athletes

Sex and age-specific analysis of basketball-related shoulder dislocations in the United States: a national injury data review

HYPOTHESIS

Basketball-related shoulder dislocations frequently present to emergency departments in the US. This study aimed to identify the primary mechanisms, distributions, and trends of these injuries.

METHODS

All data were extracted from the National Electronic Injury Surveillance System, a public database representing approximately 100 US emergency departments. National Electronic Injury Surveillance System was queried for all basketball-related injuries and shoulder dislocations from January 1, 2013 to December 31, 2022. Clinical narratives were used to assign injury mechanisms and the presence of player contact.

RESULTS

Between 2013 and 2022, 52,417 basketball-related shoulder dislocations were reported. A total of 30.9% of all basketball-related shoulder injuries were dislocations and 30.5% of all joint dislocations occurred at the shoulder. Basketball-related shoulder dislocations decreased significantly from 2013 to 2022 (P < .001). From 2019 to 2020, a 31.0% decrease was identified. The most common mechanism of shoulder dislocation was falling (36.9%). Males accounted for 92.5% of all shoulder dislocations. However, females were significantly more likely than males to dislocate their shoulders from player contact (15.5% of female dislocations vs. 10.0% of male dislocations, P < .001). Only 0.2% of all dislocations resulted in hospitalization. A total of 10.4% of dislocations resulted from contact with another player. Compared to other age groups, young adults (43.3%) and adolescents (42.7%) presented with the majority of shoulder dislocations. Children were more likely to dislocate their shoulder from sustaining a direct blow (25.5%), while all other age groups were more likely to have fallen. Children were also the most likely to sustain a dislocation involving player contact (23.9%).

CONCLUSION

Basketball-related shoulder dislocations decreased significantly from 2013 to 2022. Females and children were significantly more likely to present with a dislocation by sustaining player contact. Across all demographics, teaching athletes how to break their falls safely may decrease rates of dislocation by minimizing impacts on a posteriorly outstretched arm.

Examining the Prevalence of Sports-Related Injuries in Collegiate Baseball Players

Background

Sports-related injuries remain a significant problem for collegiate baseball players. Although some studies reported the epidemiology of sports-related injuries among collegiate baseball players, the latest information on sport-related injuries should be provided.

Purpose

To examine the current trends of sports-related injuries among collegiate baseball players in the Pacific 12 (PAC-12) Conference.

Study Design

Descriptive epidemiology study.

Methods

Demographic and injury data were obtained from a database of the PAC-12 Health Analytics Program between 2016 and 2021. Injury incidence, type, mechanism, and outcome were analyzed. The annual incidence of injuries was defined as the number of injuries per total players for 1 year. Detailed reports of the 20 most common specific diagnoses were generated.

Results

A total of 1434 sports-related injuries occurred in 6 years, with the number increasing from 2016 (n = 75; incidence, 8.5 per 100 player-years) to 2021 (n = 378; incidence, 43 per 100 player-years). Most of the injuries occurred in pitchers (33.6%), were acute (76.6%), resulted in missed time (68.8%), and were new injuries (86.9%). In addition, most injuries were caused by noncontact events (53.2%) and occurred during in-season games (39.9%) and practice (47.4%). Only 1.3% of sports-related injuries did not result in a return to the previous activity level. Rotator cuff tendon injuries were the most common specific diagnoses (n = 98), followed by ulnar collateral ligament (UCL) injuries (n = 63), hamstring muscle strains (n = 60), ankle ligament sprains (n = 46), and hand/wrist fractures (n = 40). UCL injuries had the highest proportion of surgical interventions (41.3% of all UCL injuries) and the longest days to clearance (167 ± 197 days) among the 20 most common diagnoses.

Conclusion

The number of sports-related injuries among PAC-12 collegiate baseball players has increased by approximately 5 times over the past 6 years. Rotator cuff tendon injuries followed by UCL injuries, hamstring muscle strains, ankle ligament sprains, and hand/wrist fractures are the most common specific diagnoses among this cohort of collegiate baseball players. Of the 20 most common specific diagnoses, UCL injuries most often require surgical interventions and had the longest return to playtime.

Image Timing After COVID-19 Infection in Athletes

BACKGROUND

Coronavirus disease 2019 (COVID-19) has significantly impacted National Collegiate Athletic Association (NCAA) athletics, with specific concerns for cardiac involvement after infection. Pericardial abnormalities have been seen in up to 39.5% of athletes after COVID-19 infection, while myocardial involvement has been reported at a lower rate of 2.7%. To date, myocardial injury has been seen in 0.6% to 0.7% of athletes when using symptom screening and imaging as clinically indicated, which increases to 2.3% to 3.0% when all athletes with COVID-19 undergo cardiac magnetic resonance (CMR) imaging.

PURPOSE

This study will examine whether there exists an ideal time from positive COVID-19 results to obtaining imaging to increase the likelihood of finding abnormalities.

STUDY DESIGN

Prospective cohort study.

LEVEL OF EVIDENCE

Level 3.

METHODS

NCAA athletes at West Virginia University who were found to be COVID-19 positive on routine screening were required to undergo echocardiography (ECG) and CMR. These data were reviewed by cardiology and determined to be normal or abnormal. Statistical analysis with logistic regression and descriptive statistics was performed to evaluate whether a time existed where abnormalities on imaging were most likely to be found.

RESULTS

A total of 41 athletes were included in this study. ECG was performed earlier on average than CMR imaging, at 18.2 days versus 27.5 days. No significant difference was found in timing from COVID-19 infection diagnosis and abnormalities seen on imaging for either ECG or CMR imaging.

CONCLUSION

The risk of cardiac involvement in athletes in the setting of COVID-19 has already been documented. This study suggests that imaging timing is independent of cardiac involvement with no correlation to specific time periods where more abnormalities may be found. However, CMR imaging showing changes at day 54 after infection suggests cardiac findings can be seen months after imaging.

CLINICAL RELEVANCE

Cardiac imaging for athletes after contracting COVID-19 does not show a significant relationship to time of imaging. However, given the cardiac involvement seen months after diagnosis, further examination of prolonged cardiac effects must be carried out.

Longitudinal analysis of the incidence rate of injury in elite youth football: Trends over six years including the COVID-19 pandemic period

OBJECTIVES

We aimed to analyze injury trends and the possible effects of the coronavirus disease (COVID-19) pandemic on the incidence rates of injury in young elite football players.

DESIGN

A prospective cohort study design was adopted.

PARTICIPANTS

Our study included 832 male football players who suffered an injury during any of the six competitive seasons.

SETTING

An elite youth football academy.

MAIN OUTCOME MEASURE

Descriptive data and the incidence of injury were calculated. A generalized linear mixed model was used to assess differences in the occurrence of injury among the various age groups. Joinpoint regression was used to analyze injury trends.

RESULTS

Joinpoint regression models showed a statistically significant decrease in the incidence of injury in all age groups with an average annual percent change (AAPC) of 13.9 (95 %Confidence Interval [CI]:-23.2 - 3.4) and -13.5 (95 %CI:-24.5 to -0.9) for models with zero and one joinpoint, respectively. Football players in older age groups sustain a higher number of injuries, probably due to a higher number of matches and greater training intensity.

CONCLUSION

This study showed a downward trend in injuries in the participants prior to the pandemic, with an evident increase in the incidence rate of injury during the COVID-19 pandemic.