A Prospective Cohort Study of Collegiate Fencing Injuries

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.

EPIDEMIOLOGY OF SPORTS INJURIES IN KOREAN ELITE FEMALE FENCING ATHLETES: A PROSPECTIVE COHORT STUDY

ABSTRACT Objectives: We aimed to assess the risk of injury associated with training activities of Korean elite female fencing athletes by weapon category. Methods: We prospectively collected 2021 data on 80 elite female fencing athletes at the Korean Training Center. Injury incidence rates were expressed as Poisson rates with a 95% confidence interval. We used χ2 tests to compare injury locations and recovery times by weapon category. Results: A total of 233 injuries were recorded, averaging 3.27 (95% CI, 2.86–3.72) injuries per 1,000 training hours. The sabre had the highest injury incidence rate, followed by the epee and the foil. Injuries to fencing athletes were the most common in the lower extremities (46.35%), followed by the upper extremities (24.03%), trunk (20.17%), and head and neck area (9.44%). The weapon category did not affect the body regions (p=0.425). However, recovery time differed significantly by body region (p=0.021). Conclusions: The weapon category was found to affect the injury incidence rate. In addition, recovery time varied depending on body region. Further research is needed to clarify these results. Level of evidence II; Therapeutic studies - investigation of treatment results.

EPIDEMIOLOGIA DAS LESÕES ESPORTIVAS EM ATLETAS COREANAS DE ESGRIMA DE ELITE: UM ESTUDO PROSPECTIVO DE COORTE

RESUMO Objetivos: Nosso objetivo foi avaliar o risco de lesão associado às atividades de treinamento de acordo com a categoria de arma de atletas coreanas de esgrima de elite. Métodos: A partir de 2021, coletamos prospectivamente dados de 80 atletas de elite de esgrima no Centro de Treinamento Coreano. As taxas de incidência de lesões foram expressas como taxas de Poisson com intervalo de confiança de 95%. Usamos o teste de χ2 para comparar os locais de lesão e os tempos de recuperação de acordo com a categoria da arma. Resultados: Um total de 233 lesões foi registrado, com média de 3,27 (IC 95%, 2,86–3,72) lesões por 1.000 horas de treinamento. O sabre teve a maior taxa de incidência de lesões, seguido pela espada e pelo florete. As lesões dos atletas de esgrima foram mais comuns nos membros inferiores (46,35%), seguidas pelos membros superiores (24,03%), tronco (20,17%) e região da cabeça e pescoço (9,44%). A categoria da arma não influenciou as regiões do corpo (p = 0,425). No entanto, o tempo de recuperação diferiu significativamente de acordo com a região do corpo (p = 0,021). Conclusão: Verificou-se que a categoria de arma afeta a taxa de incidência de lesões. Além disso, o tempo de recuperação variou de acordo com a região do corpo. São necessárias mais pesquisas para esclarecer esses resultados. Nível de evidência II; Estudos terapêuticos – investigação de resultados de tratamento.

Asymptomatic foot and ankle structural injuries: a 3D imaging and finite element analysis of elite fencers

BACKGROUND

Fencing is a highly asymmetrical combat sport, that imposes high mechanical demands over repeated exposures on the musculoskeletal structures, a primary cause of injuries in fencers. However, there are limited epidemiological studies on the structural injuries of the foot and ankle in fencers. This study aimed to investigate foot and ankle structural injuries, and explore how metatarsophalangeal joint structural changes may affect the mechanisms of foot and ankle injuries in asymptomatic fencers.

METHODS

3D images of foot and ankle morphology using computed tomography were obtained from ten elite fencers. We then constructed finite element models of the first metatarsophalangeal joint in the foot of their trail legs. The validated models were used to simulate stress distribution changes from different ankle joint angles during lunging.

RESULTS

The findings showed that stress distribution changes at the medial and lateral sesamoid may have caused sesamoid fractures, and that habitual and concentrated stress on the metatarsal bones might have flattened the sesamoid groove. This process may damage the integrity of the first metatarsophalangeal joint, and consequently affect the efficiency of the windlass mechanism in fencers. During lunging, different ankle joint angles of the trail foot increased the total stress difference of the medial and lateral foot, and thus influenced the lunging quality and its stability.

CONCLUSIONS

Our findings revealed that the asymmetric nature of fencing might have caused asymptomatic foot and ankle structural injuries, and finite element analysis results indicated that this might increase the incidence of the serious injuries if unattended. Regular computed tomography examination should be introduced to monitor elite fencers' lower limb alterations, permitting unique angle adjustments in the trail foot without sacrificing technical or physiologic properties based on the exam results and reduce the lower limb injury risk.

Epidemiology of Musculoskeletal Injuries in Adult Athletes: A Scoping Review

Background and Objectives: Sport-related musculoskeletal injuries (MSK-Is) are a common health issue in athletes that can lead to reduced performance. The aim of this scoping review was to synthetize available evidence on injury incidence rates (IIRs), types, and sites that affect the musculoskeletal (MSK) system of adult athletes. Materials and Methods: We performed a scoping review on the Pubmed database limiting our search to 33 Olympic sports. Results: We identified a total of 1022 papers, and of these 162 were examined in full for the purpose of this review. Archery was the sport with the highest risk of injuries to the upper extremities, marathons for the lower extremities, and triathlon and weightlifting for the body bust. In the majority of the sports examined, muscle/tendon strain and ligament sprain were the most common MSK-Is diagnoses, while athletics, karate, and football were the sports with the highest IIRs, depending on the methods used for their calculations. Conclusions: Our scoping review highlighted the general lack and dishomogeneity in the collection of data on MSK-Is in athletes.