The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Basketball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Basketball (2004-2005 Through 2013-2014)

Epidemiology of injuries in U.S. high school track and field throwing events from 2008 to 2019

BACKGROUND

Injury characteristics of high school track and field throwing athletes in the United States are not well studied. Understanding epidemiology of injuries is important to identify treatment and prevention strategies.

OBJECTIVE

To describe injury rates and patterns in U.S. high school track and field throwing events from a longitudinal national sports injury surveillance system.

DESIGN

Descriptive epidemiology study.

SETTING

Data were provided by the National High School Sports Related Injury Surveillance System, High School RIO (Reporting Information Online).

METHODS

Athletic trainers reported injury and exposure data through the High School RIO website on a weekly basis. An athlete exposure (AE) was defined as one athlete participating in one school-sanctioned practice or competition. Throwing events of discus, shot put, and javelin were analyzed in this study.

MAIN OUTCOME MEASURES

Injury rate, rate ratios (RR), injury proportion ratios (IPR).

PARTICIPANTS

U.S. high school athletes.

RESULTS

A total of 267 track and field throwing injuries occurred during 5,486,279 AEs. Overall, the rate of injuries in competition was higher than in practice (RR 1.35, 95% confidence interval [CI] 1.01-1.80). In practice, the rate of injuries was higher for girls than boys (RR 1.53, 95% CI 1.12-2.08). The most frequently injured body part was the shoulder (21.7%), followed by the ankle (16.5%) and knee (12.0%). The most common types of injury were muscle strains (26.14%) and ligament sprains (25%). Recurrent injuries accounted for a higher proportion of chronic injuries compared to new injuries (IPR 1.85, 95% CI 1.16-2.97).

CONCLUSION

This study described injury characteristics of high school track and field throwing athletes from 2008 to 2019. Based on our results, injury prevention may be particularly important for female throwers with prior injury.

Mechanisms of dental injuries in basketball, United States, 2003-2022

BACKGROUND/AIM

Oral injuries such as oral soft tissue lacerations and contusions can occur in basketball by mechanisms such as running into other players or falling. Given a high enough impact force, dental injuries such as tooth fractures and avulsions can occur. Previous research has studied the different types of oral injuries as well as the mechanisms that cause them. Yet, the mechanisms resulting in dental injuries have remained unexplored. The aims of this study were to investigate the distribution of different oral injuries within each injury mechanism and evaluate which mechanisms were most likely to lead to a dental injury.

MATERIALS AND METHODS

This is a retrospective cohort study using the National Electronic Injury Surveillance System (NEISS). Subjects who experienced oral injuries from basketball between January 1, 2003 and December 31, 2022 were included in this study. The independent variable was the injury mechanism. The dependent variable was the dental injury outcome (yes/no). Multivariate logistic regression was used to measure the association between the injury mechanism and the dental injury outcome. A p < .05 was considered statistically significant.

RESULTS

This study included 4419 subjects who experienced oral injuries (national estimate, 138,980). Approximately 14.7% of oral injuries were dental injuries. Subjects experiencing collisions with objects such as walls or the basketball hoop (odds ratio (OR), 4.39; p < .001), falls (OR, 3.35; p < .001), or contact with the basketball (OR, 1.77; p = .006) had significantly higher odds of sustaining a dental injury relative to those experiencing contact with another player.

CONCLUSIONS

Basketball players experiencing contact to the mouth have high odds of sustaining a dental injury. An understanding of injury mechanisms is important for medical teams to manage these injuries and for coaches to educate athletes on safe and proper playing styles. Furthermore, healthcare providers and basketball staff should encourage athletes to wear mouthguards to reduce the risk of traumatic dental injuries.

The impact of whole-body vibration training and proprioceptive neuromuscular facilitation on biomechanical characteristics of lower extremity during cutting movement in individuals with functional ankle instability: A parallel-group study

BACKGROUND

We compared the effects of whole-body vibration training and proprioceptive neuromuscular facilitation on the biomechanical characteristics of the lower limbs in functional ankle instability patients during cutting movement to ascertain the superior rehabilitation method.

METHODS

Twenty-two male College students with unilateral functional ankle instability volunteered for this study and were randomly divided into whole-body vibration training group and proprioceptive neuromuscular facilitation group. Kinematics data and ground reaction forces were collected using infrared motion capture system and 3-D force plates synchronously during cutting. Repeated measures two-way ANOVA was performed to analyze the data.

FINDINGS

Both training methods reduced the maximum hip abduction angle (p = 0.010, effect size: proprioceptive neuromuscular facilitation = 0.69; whole-body vibration training = 0.20), maximum knee flexion angle (p = 0.008, effect size: proprioceptive neuromuscular facilitation = 0.39, whole-body vibration training = 1.26) and angular velocity (p = 0.014, effect size: proprioceptive neuromuscular facilitation = 0.62, whole-body vibration training = 0.55), maximum ankle inversion angular velocity (p = 0.020, effect size: proprioceptive neuromuscular facilitation = 0.52, whole-body vibration training = 0.81), and knee flexion angle at the time of maximum vertical ground reaction forces (p = 0.018, effect size: proprioceptive neuromuscular facilitation = 0.27, whole-body vibration training = 0.76), and increased the maximum ankle dorsiflexion moment (p = 0.049, effect size: proprioceptive neuromuscular facilitation = -0.52, whole-body vibration training = -0.22). Whole-body vibration training reduced the maximum ground reaction forces value in the mediolateral directions (p = 0.010, effect size = 0.82) during cutting movement.

INTERPRETATION

These findings suggested that the two types of training might increase neuromuscular conduction function around the ankle. After these two types of training, functional ankle instability patients showed a similar risk of injury to the lateral ankle ligaments during cutting.

Sex differences in lower extremity kinematics during overhead and single leg squat tests

The Overhead Squat (OHS) and Single-Leg Squat (SLS) are two clinical tests used by practitioners to identify high-risk biomechanical movement patterns. Several published studies have reported sex differences in SLS performance; however, few have investigated variations during the OHS and none has measured kinematics with a marker-less motion capture system. Therefore, this study aimed to compare biomechanical movement patterns between male and female collegiate athletes during OHS and SLS testing. Seventy-five females and 58 male athletes completed OHS and SLS . A Microsoft Kinect sensor using Athletic Movement Assessment software (PhysiMax®) was used to measure kinematics. For the OHS, males displayed greater peak knee frontal plane projection angles (FPPA) (M:26°±10°, F:20°±8°; P < 0.05), peak hip flexion (M:-94°±14°, F:-87°±15°; P < 0.05), and peak trunk flexion angles (M:11°±11°, F:6°±9°; P < 0.05). For the SLS (dominant-limb), males displayed greater peak trunk flexion (M:32°±6°, F:27°±7°; P < 0.05). For the non-dominant limb, females displayed greater peak knee FPPA (F:-12°±9°, M:-8°±9°; P < 0.05) whereas males displayed greater peak trunk flexion angles (M:32°±5°, F:27°±7°; P < 0.05). These findings suggest the need for practitioners to develop sex-specific corrective exercise programmes in effort to improve lower extremity kinematics in athletes.

Injury incidence among adolescent and senior basketball players: a prospective study in 19 teams across an entire season

OBJECTIVE

To quantify and compare injury incidence between national-level, adolescent and regional-level, senior, male basketball players competing in Serbia overall and according to injury mechanism (contact, non-contact, or overuse), exposure setting (training or games), and history (new or recurrent).

METHODS

A total of 218 male basketball players from 19 teams (106 senior and 112 adolescent players) volunteered to participate in the study. Descriptive data regarding game and training injury incidence were gathered across all players and reported per 10,000 athlete-exposures (AE) with 95% confidence intervals.

RESULTS

Overall, 26 injuries were reported across 52,509 AE. Ankle (n = 10, incidence rate [IR] = 1.90 [0.97, 3.40]) and knee injuries (n = 8, IR = 1.52 [0.71, 2.89]) accounted for 69% of all reported injuries, with only 1-2 injuries documented for other body regions. Ankle injuries were attributed to contact (60%, IR = 1.14 [0.46, 2.38]) or non-contact mechanisms (40%, IR = 0.76 [0.24, 1.84]). Most knee injuries occurred due to overuse (50%, IR = 0.76 [0.24, 1.84]) or non-contact mechanisms (38%, IR = 0.57 [0.15, 1.56]). Comparisons according to exposure setting revealed significantly higher knee (incidence rate ratio [IRR] = 9.95 [1.85, 53.41], p = 0.004) and ankle (IRR = 39.79 [7.94, 384.67], p < 0.001) injuries per 10,000 AE during games compared to training. Recurrent injuries were most prominent in the ankle (30% of all ankle injuries, p = 0.11). Total contact (p = 0.04), non-contact (p = 0.04), and recurrent IR (p = 0.005) were significantly higher in senior than adolescent players.

CONCLUSION

The players examined were most susceptible to ankle and knee injuries, particularly during games compared to training. Ankle injuries were mostly attributed to player contact, while knee injuries were mostly attributed to overuse and non-contact mechanisms. Senior players were at a greater risk of sustaining contact, non-contact and recurrent injuries than adolescent players.

A multicomponent neuromuscular warm-up program reduces lower-extremity injuries in trained basketball players: a cluster randomized controlled trial

OBJECTIVE

To assess the effects of a novel multicomponent neuromuscular warm-up program on lower-extremity injury incidence in basketball players competing at the regional level.

METHODS

A cluster randomized controlled experimental design was adopted to compare injury incidence between players exposed to the injury prevention warm-up program and those exposed to a typical warm-up program across an entire basketball season. Four teams consisting of 57 players (male: n = 42; female: n = 15) were allocated to the intervention group (age: 21.6 ± 2.5 years; height: 186.2 ± 8.8 cm; body mass: 80.0 ± 10.4 kg) and four teams consisting of 55 players (male: n = 43; female: n = 12) were allocated to the control group (age: 21.6 ± 2.6 years; height: 186.9 ± 9.1 cm; body mass: 81.5 ± 10.9 kg). The novel warm-up combined running exercises with active stretching, plyometrics, balance, strength, and agility drills. Coaching and medical staff provided details on injury incidence each week. Data analyses included the use of poisson regression analyses and the incidence rate ratio (IRR) with 95% confidence intervals (CI).

RESULTS

The intervention group experienced a significantly lower ankle sprain incidence rate (IRR = 0.26, 95% CI = 0.05, 0.98, p = 0.02) and a tendency toward a lower knee injury incidence rate (IRR = 0.32, 95% CI = 0.03, 1.78, p = 0.07) compared to the control group. Considering only non-contact lower-extremity injuries of any type, the intervention group experienced a significantly lower incidence rate compared to the control group (IRR = 0.26, 95% CI = 0.05, 0.98, p < 0.001).

CONCLUSION

This multi-team study demonstrated a novel multicomponent warm-up program resulted in less lower-extremity injuries, particularly ankle sprains and knee injuries, compared to a typical warm-up program in regional-level male and female basketball players.

The Epidemiology of Pediatric Basketball Injuries Presenting to US Emergency Departments: 2011-2020

OBJECTIVES

The purpose of this study is to describe the national epidemiology of basketball-related injuries in children and adolescents presenting to US emergency departments (EDs) from 2011 to 2020 and to quantify the effect of the COVID-19 pandemic.

METHODS

The National Electronic Injury Surveillance System database was queried for cases of injury in persons aged 0 to 19 years related to product code 1205 (basketball and related equipment) presenting from January 1, 2011 to December 31, 2020. National injury estimates were calculated using National Electronic Injury Surveillance System-recommended weights and strata. The US Census data were used to determine the incidence of injury by age group and by sex. To quantify the effect of COVID-19, an interrupted time series analysis was performed using March 1, 2020 as the interrupting time point. The pre-COVID-19 trend was used to estimate the difference in injuries attributable to the COVID-19 pandemic.

RESULTS

From 2011 to 2020, an estimated 3,210,953 (95% confidence interval = 2,655,812-3,788,094) visits were made to US EDs for basketball-related injuries in those aged younger than 20 years, corresponding to a mean annual incidence of 391 injuries per 100,000 population. The mean age of injury was 14.4 years (95% confidence interval = 14.3-14.5). Boys were more often injured than girls (76% vs 24% of all injuries, respectively). The foot was the most injured body part, accounting for 24% of injuries. Strains or sprains were the most common injury type (38% of injuries). During the COVID-19 pandemic, there were 155,638 fewer injuries than were expected based on pre-COVID-19 trends. During COVID-19, there were no significant differences in the proportions of injury types, body parts involved, sex, or age.

CONCLUSIONS

Basketball remains a frequent cause of injury, especially in adolescents. The COVID-19 pandemic profoundly reduced the frequency of basketball-related injuries, but did not affect the type and body location of injuries presenting to the ED.

Landing Technique and Ankle-dorsiflexion Range of Motion are not Associated with the History of Lower Limb Injuries among Youth Basketball Athletes

Background

Lower limb injuries generate a significant health burden in basketball. Landing technique and ankle-dorsiflexion range of motion have been suggested as risk factors for lower limb injuries among youth athletes, but studies conducted specifically with basketball athletes are lacking.

Hypothesis/Purpose

To describe the period prevalence of basketball-related injuries and to examine the association of the history of lower limb injuries with landing technique and ankle-dorsiflexion range of motion asymmetry among youth basketball athletes.

Study Design

Cross-Sectional Survey.

Methods

Youth basketball athletes were asked to complete a paper-based survey to investigate personal characteristics, training characteristics and their three-month history of basketball-related injuries. The Landing Error Scoring System and the Weight-Bearing Lunge Test were used to evaluate landing technique and ankle-dorsiflexion range of motion. Binary logistic regression was utilized to examine the association of the investigated variables with the presence of history of lower limb injuries among the athletes.

Results

A total of 534 athletes participated. The three-month prevalence of basketball-related injuries was 23.2% (95% CI 19.7 - 27), and the majority of the reported injuries affected the lower limbs (69.7%; n=110). Sprains were the most frequent type of injury (29.1%; n=46), and the ankle (30.4%; n=48) and knee (21.5%; n=34) were the most affected anatomic locations. Landing technique (p = 0.105) and ankle-dorsiflexion range of motion asymmetry (p = 0.529) were not associated with the history of lower limb injuries.

Conclusion

The three-month prevalence of basketball-related injuries was 23.2%. Although ankle sprains were the most frequent injury, landing technique and ankle-dorsiflexion range of motion asymmetry were not associated with the history of lower limb injuries among youth basketball athletes.

Level of Evidence

3.

The incidence rate of ACL injuries and ankle sprains in basketball players: A systematic review and meta-analysis

OBJECTIVE

To quantify the incidence rate of anterior cruciate ligament (ACL) injuries and ankle sprains according to player sex, playing level, and exposure setting (training vs. games) in basketball players.

METHODS

PubMed, MEDLINE, Google Scholar, and ScienceDirect were searched. Only studies reporting the number of ACL injuries and/or ankle sprains alongside the number of athlete-exposures (training sessions and/or games) in basketball players were included.

RESULTS

Thirty studies (17 reporting ACL injuries and 16 reporting ankle sprains) were included in the meta-analysis. Higher (p < 0.05) ACL injury incidence rates per 1000 athlete-exposures were recorded in females (female: 0.20 95% confidence intervals [0.16-0.25]; male: 0.07 [0.05-0.08]; female-to-male ratio: 3.33 [3.10-3.57]), in players competing at higher playing levels (amateur: 0.06 [0.04-0.09]; intermediate: 0.16 [0.13-0.20]; elite: 0.25 [0.14-0.64]), and in games (games: female, 0.27 [0.21-0.32]; male, 0.06 [0.03-0.08]; training: female, 0.03 [0.02-0.05]; male: 0.01 [0.00-0.02]; game-to-training ratio: 7.90 [4.88-12.91]). Higher (p < 0.05) ankle sprain incidence rates per 1000 athlete-exposures were observed in males (female: 0.82 [0.61-1.03]; male: 0.90 [0.61-1.19]; female-to-male ratio: 0.91 [0.83-0.99]), in players competing at higher playing levels (amateur: 0.54 [0.51-0.57]; intermediate: 1.12 [1.00-1.24]; elite: 1.87 [1.29-2.46]), and in games (games: 2.51 [1.85-3.16]; training: 0.80 [0.52-0.80]; game-to-training ratio: 2.77 [2.35-3.26]).

CONCLUSION

According to player sex, ACL injury incidence rate is higher in females, while ankle sprain incidence rate is greater in males. ACL injury and ankle sprain incidence rates are greater in players competing at higher playing levels and during games compared to training.

The Epidemiology of Youth Sport-Related Shoulder Injuries: A Systematic Review

Background

Youth around the globe place their shoulders at risk for injury when participating in sports. Shoulder injuries may vary in severity, produce the potential for time-loss from sport, and result in functional disability. We sought to explore sport-related shoulder injuries in youth by identifying injury rates, risk factors, injury mechanisms, and injury prevention strategies.

Methods

All relevant full-text articles were identified by searching MEDLINE, EMBASE, CINAHL, Sport Discus, and the Cochrane Controlled Trials Registry. No date restrictions were used. All full-text studies reporting original research describing sport-related shoulder injury among female and/or male youth from 5 to 18 years old were included.

Results

Of 3,889 studies screened, 97 described shoulder injury in youth sports. Shoulder injuries were identified in 24 unique sports. The median seasonal prevalence of shoulder injury was 10.9% (range 1.2-28.2%). The most common injury mechanisms identified were contacted with another player, contact with the playing environment, and falling to the ground. Risk factors for shoulder injury identified were side-to-side strength imbalances, weak external rotator muscles, and scapular dyskinesia. One study evaluated a successful training strategy to prevent shoulder injuries, but two other interventions demonstrated no effect.

Conclusions

Sport-related shoulder injuries are prevalent among youth athletes. Injury risk factors identified included modifiable intrinsic factors such as strength, range of motion, and training load. The most common injury mechanism was direct contact with either another person or an object in the playing environment. Innovative shoulder-specific strategies are needed to reduce shoulder injuries in this population. Trial Registration: PROSPERO ID: CRD42020189142.

Detection of Neuromuscular Deficits in Movement Pattern among Uninjured Federated Youth Basketball Players: A Cross-Sectional Study

(1) Background: The aim of the present study was to evaluate and to detect neuromuscular deficiencies in static and dynamic tests among federated youth basketball players. (2) Methods: Cross-sectional study with 778 basketball players. Specific tests and trials were conducted to evaluate members of teams from several clubs in male and female from under 12 (U12) to under 17 (U17) categories. The evaluations consisted of static physical measurements and dynamic measurements. (3) Results: 575 players were included in this study. A total of 95% of participants are unable to keep their ankle stable in monopodial loading; 86% present dynamic lower extremity valgus with statistically significant differences between categories (p = 0.004); 94% are unable to keep the pelvis stable when performing a single-leg squat; 93% are unable to keep their trunk stable when performing the same movement. During landing, 96% present dynamic lower extremity valgus. The thighs of 92% do not reach parallel (peak of jump). (4) Conclusions: The most frequent neuromuscular deficits in federated youth basketball players are related to instability, the most frequent being ankle instability, followed by lumbo-pelvic instability, dynamic postural instability and dynamic knee valgus. Deficits in jumping/landing technique are also very frequent in all the items analyzed (jumping, landing and plyometrics). The performed tests, which mostly showed a poor performance by the sample, can be indicative of injury probability.

The prevalence of chronic ankle instability in basketball athletes: a cross-sectional study

Background

Ankle sprain is the most common injury in basketball. Chronic ankle instability develops from an acute ankle sprain may cause negative effects on quality of life, ankle functionality or on increasing risk for recurrent ankle sprains and post-traumatic osteoarthritis. To facilitate a preventative strategy of chronic ankle instability (CAI) in the basketball population, gathering epidemiological data is essential. However, the epidemiological data of CAI in basketball is limited. Therefore, this study aims to investigate the prevalence of CAI in basketball athletes and to determine whether gender, competitive level, and basketball playing position influence this prevalence.

Methods

In a cross-sectional study, in total 391 Taiwanese basketball athletes from universities and sports clubs participated. Besides non-standardized questions about demographics and their history of ankle sprains, participants further filled out the standard Cumberland Ankle Instability Tool applied to determine the presence of ankle instability. Questionnaires from 255 collegiate and 133 semi-professional basketball athletes (male = 243, female = 145, 22.3 ± 3.8 years, 23.3 ± 2.2 kg/m²) were analyzed. Differences in prevalence between gender, competitive level and playing position were determined using the Chi-square test.

Results

In the surveyed cohort, 26% had unilateral CAI while 50% of them had bilateral CAI. Women had a higher prevalence than men in the whole surveyed cohort (X²(1) = 0.515, p = 0.003). This gender disparity also showed from sub-analyses, that the collegiate female athletes had a higher prevalence than collegiate men athletes (X²(1) = 0.203, p = 0.001). Prevalence showed no difference between competitive levels (p > 0.05) and among playing positions (p > 0.05).

Conclusions

CAI is highly prevalent in the basketball population. Gender affects the prevalence of CAI. Regardless of the competitive level and playing position the prevalence of CAI is similar. The characteristic of basketball contributes to the high prevalence. Prevention of CAI should be a focus in basketball. When applying the CAI prevention measures, gender should be taken into consideration.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00418-0.

Epidemiology of NCAA Track and Field Injuries From 2010 to 2014

Background:

Track and field (T&F) athletes compete in a variety of events that require different skills and training characteristics. Descriptive epidemiology studies often fail to describe event-specific injury patterns.

Purpose:

To describe the epidemiology of injuries in National Collegiate Athletic Association (NCAA) T&F by sex, setting (practice vs competition), and time of season (indoor vs outdoor) and to compare injury patterns by events within the sport.

Study Design:

Descriptive epidemiology study.

Methods:

Data were obtained from the NCAA Injury Surveillance Program for all indoor and outdoor T&F injuries during the academic years 2009-2010 to 2013-2014. Injury rates, injury rate ratios, and injury proportion ratios (IPRs) were reported and compared by sex, injury setting, season, and event. Analysis included time-loss as well as no-time loss injuries.

Results:

Over the 5 seasons, the overall injury rate was 3.99 injuries per 1000 athletic-exposures (95% CI, 3.79-4.20). After controlling for injury diagnoses, women’s T&F athletes experienced an 18% higher risk of injury (95% CI, 7% to 31%) and missed 41% more time after an injury (95% CI, 4% to 93%) when compared with men. Among all athletes, the injury risk during competition was 71% higher (95% CI, 50% to 95%) compared with practice and required 59% more time loss (95% CI, 7% to 135%). Distance running accounted for a significantly higher proportion of overuse injuries (IPR, 1.70; 95% CI, 1.40-2.05; P < .05) and required 168% more time loss (95% CI, 78% to 304%) than other events. The hip and thigh were the body regions most commonly injured; injury type, however, varied by T&F event. Sprinting accounted for the greatest proportion of hip and thigh injuries, distance running had the greatest proportion of lower leg injuries, and throwing reported the greatest proportion of spine and upper extremity injuries.

Conclusion:

Injury risk in NCAA T&F varied by sex, season, and setting. Higher injury rates were found in women versus men, indoor versus outdoor seasons, and competitions versus practices. The hip and thigh were the body regions most commonly injured; however, injury types varied by event. These findings may provide insight to programs aiming to reduce the risk of injury and associated time loss in collegiate T&F.

Epidemiology of Pediatric Basketball Injuries Presenting to Emergency Departments: Sex- and Age-Based Patterns

Background:

There is limited epidemiologic data on pediatric basketball injuries and the comparison of these injuries before and after adolescence and between male and female athletes.

Purpose:

To assess common sex- and age-based injury patterns in pediatric basketball players.

Study Design:

Descriptive epidemiology study.

Methods:

Injury data from the National Electronic Injury Surveillance System (NEISS) and participation data from the National Sporting Goods Association were used to complete this study. Data on pediatric basketball injuries between January 2012 and December 2018 in patients aged 7 to 11 years (childhood) and 12 to 17 years (adolescence) were extracted and used to calculate national injury incidence rates with 95% CIs. Sex and age group patterns were examined utilizing Pearson chi-square tests. Z tests were conducted for the comparison of injury rates between female and male athletes in each age group and overall injury rate across age groups.

Results:

An average of 9582 basketball injuries were reported annually in the NEISS, which calculated to an annual national estimate of 294,920 injuries. The most common diagnoses were ankle strain/sprain (17.7%), finger strain/sprain/fracture (12.1%), concussion/head injury (9.4%), knee strain/sprain (4.5%), and facial laceration (3.3%). There was a significant increase in injury prevalence in adolescents (12- to 17-year-old category: 238,678 injuries per year) when compared with childhood (7- to 11-year-old category: 56,242 injuries per year) (P < .0001). Concussions/head injuries occurred at a high rate in childhood, second only to finger strain/sprain/fracture, and at a similar rate in females and males (injuries per 100,000 athlete-days: 4.9 [95% CI, 3.1-6.7] vs. 5.9 [4.3-7.5], respectively; P = .41). From childhood to adolescence, injury prevalence increased for all areas and across both sexes, except for female finger strain/sprain/fracture; however, the rate of increase for concussion/head injuries and knee injuries was significantly higher in female compared with male athletes (P < .0001 for both). In adolescents, ankle injuries were the most common injury overall.

Conclusion:

Ankle injuries continue to be the most predominant pediatric basketball injury. However, disproportionate rates of both knee and concussion/head injuries in female athletes during adolescent basketball are of concern and have implications for injury prevention.

Descriptive epidemiology of injuries in Japanese collegiate men's basketball: 2013/2014 to 2019/2020

Background

Basketball is one of the most played sports in the world. However, only a few studies have examined the epidemiology of Japanese collegiate men’s basketball injuries. This study investigated the incidence of injury among Japanese collegiate men’s basketball from the 2013/2014 to the 2019/2020 seasons and identified unique patterns by comparing our data with the National Collegiate Athletic Association (NCAA) men’s basketball data.

Methods

Data from Japanese collegiate basketball teams of the Kanto Collegiate Basketball Federation Division I League during the 2013/2014 to 2019/2020 academic years (23 team-seasons) were used in this study. Injury rates per 1000 athlete exposures (AEs), injury proportions, and the injury rate ratio (IRR) were calculated according to the events, injury types, body parts, and common injury mechanisms. Injury rates were then compared with that from the time-loss injury data of the NCAA’s previous reports.

Results

In total, 480 injuries during 97,515 AEs were reported, leading to an injury rate of 4.92 per 1000 AEs (95% CI = 4.48–5.36). The overall injury rate was higher in Japan than in the NCAA ([2009/2010–2014/2015] IRR = 1.55, 95% CI = 1.39–1.73; [2014/2015–2018/2019] IRR = 1.64, 95% CI = 1.48–1.82). Lower extremity injuries occurred most frequently (73.5%). Ankle sprain was the most common injury in Japan, with higher injury rates than in the NCAA (IRR = 2.10; 95% CI = 1.72–2.57). The injury rate of concussion was lower in Japan than in the NCAA (IRR = 0.28; 95% CI = 0.14–0.55).

Conclusions

The rates of overall injury and ankle sprain were higher and that of concussion was lower in Japan than in the NCAA. These results suggested the existence of international differences in the pattern or features of injuries in basketball players.

Epidemiology of overuse injuries in U.S. secondary school athletics from 2014-2015 to 2018-2019 using the National Athletic Treatment, Injury and Outcomes Network Surveillance Program

CONTEXT

With 8 million annual participants in the United States, the epidemiology of sports-related injuries in high school athletics has garnered significant interest. The most recent studies examining overuse injury rates in high school sports reported data from 2012-2013 and therefore may not reflect current overuse injury rates in high school sports.

OBJECTIVE

To 1) to determine overuse time-loss (TL) and non-time-loss (NTL) injury rates among high school student athletes using NATION-SP data collected from 2014-2015 to 2018-2019 and 2) compare overuse injury rates based on student-athlete gender defined by sport, sport, and injury location.

DESIGN

Descriptive epidemiology study.

SETTING

Online injury surveillance from 211 high schools (345 individual years of high school data).

PATIENTS OR OTHER PARTICIPANTS

Athletes participating in secondary school-sponsored boys' and girls' sports.

MAIN OUTCOME MEASURES

Boys' and girls' overuse injury data from the National Athletic Treatment, Injury and Outcomes Network Surveillance Program (NATION-SP) from the 2014-2015 to 2018-2019 school years were analyzed. Overuse injuries were identified using a combination of reported injury mechanism and diagnosis. TL injuries resulted in restriction from participation beyond the day of injury; a NTL injury did not result in restriction from participation beyond the day of injury or lost no time due to the injury. Injury counts, rates, and rate ratios (IRRs) were reported with 95% confidence intervals (CIs).

RESULTS

The overall overuse injury rate was 5.3/10,000 AEs (95%CI=5.1, 5.7), the NTL overuse injury rate was 3.4/10,000 AEs (95%CI=3.1, 3.6), and the TL overuse injury rate was 2.0/10,000 AEs (95%CI=1.8, 2.2). The overuse injury rate was greater in girls' sports compared to boys' sports (IRR=1.9; 95%CI=1.7, 2.1). The highest rates of overuse injury were reported in girls' cross-country (19.2/10,000 AEs; 95%CI=15.0, 24.2), girls' track and field (16.0/10,000 AEs; 95%CI=13.5, 18.8), and girls' field hockey (15.1/10,000 AEs; 95%CI=10.2, 21.6). Overuse injury rates were highest for the lower extremity compared to the upper extremity (IRR=5.7; 95%CI=4.9, 6.7) and for the lower extremity compared to the trunk and spine (IRR=8.9; 95%CI=7.3, 10.8).

CONCLUSIONS

Awareness of overuse injury risk as well as prevention and intervention recommendations are necessary and should be specifically targeted towards cross-country, field hockey, and track and field athletes.

Hand and wrist injuries among collegiate athletes vary with athlete division

BACKGROUND

The rates, severity and consequences of hand and wrist injuries sustained by National Collegiate Athletic Association athletes are not well characterized. This study describes the epidemiology of hand and wrist injuries among collegiate athletes competing in different divisions.

METHODS

The National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) was accessed from 2004 to 2015 for the following sports: baseball, basketball, football, ice hockey, lacrosse, soccer, wrestling, field hockey, gymnastics, softball and volleyball. The data were used to identify all hand and wrist injuries, the specific injury diagnosis, mean time loss of activity following injury, and need for surgery following injury. These were then stratified by gender. Descriptive statistics were performed to examine the association between sports, event type and division. Student's t test was used to calculate p-values for independent variables. Chi-Square test was used to calculate odds ratio. P < 0.05 was considered significant.

RESULTS

103,098 hand and wrist injuries were reported in in the studied NCAA sports from 2004 to 2015. Male athletes sustained 72,423 injuries (6.01/10,000 athlete exposure) and female athletes sustained 30,675 injuries (4.13/10,000 athlete exposure). Division I athletes sustained significantly more injuries compared to divisions II and III. Overall, 3.78% of hand and wrist injuries required surgical intervention. A significantly higher percentage of division I athletes (both male and female) underwent surgical intervention compared to divisions II and III. The mean time lost due to hand and wrist injury was 7.14 days for all athletes. Division I athletes missed the fewest days due to injury at 6.29 days though this was not significant.

CONCLUSIONS

Hand and wrist injuries are common among collegiate athletes. Division I athletes sustain higher rates of injuries and higher surgical intervention rates, while tending to miss fewer days due to injury. Improved characterization of divisional differences in hand and wrist injuries can assist injury management and prevention.

Sport Specialization Behaviors Are Associated With History of Reported Injury in Youth Basketball

BACKGROUND

There is significant emerging evidence that early sport specialization is a potential risk factor for injury in youth sports. Despite basketball being the most popular youth team sport in the United States, sport specialization research, specifically in youth basketball players, has been limited. The purpose of this paper was to examine the association of sport specialization behaviors with injury history by surveying a nationally representative sample of parents of youth basketball athletes. We hypothesized that athletes who specialized in basketball, participated on multiple teams at the same time, and traveled regularly for basketball competitions would be more likely to report a basketball-related injury in the previous year.

METHODS

A nationally representative sample of 805 parents of 805 youth basketball players (female N=241, 29.9%; age: 12.9±2.5 y old) completed an online questionnaire that had 3 sections: (1) parent/child demographics, (2) child basketball participation information for the previous year, and (3) child basketball injury history in the previous year. Multivariate logistic regression examined the associations between variables of interest and injury history, adjusting for covariates. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated for the variables of interest from the logistic regression model.

RESULTS

Highly specialized athletes were more likely than low specialization athletes to report history of basketball injury in the previous year [OR (95% CI): 2.47 (1.25-4.88), P=0.009]. The odds of reporting an injury in the previous year were twice as great among athletes who played on a basketball team at the same time as another sport team compared with those who played basketball only [OR (95% CI): 1.98 (1.30-3.01), P=0.001]. The odds of reporting an injury in the previous year were 3 times greater among athletes who received private coaching compared with those who did not receive private coaching [OR (95% CI): 2.91 (1.97-4.31), P<0.001].

CONCLUSION

Specialization in basketball, along with several other behaviors that have become typical of modern youth sport participation, were associated with reported injury history. Further prospective research is necessary to determine whether sport specialization behaviors increase the risk of injury in youth basketball.

LEVEL OF EVIDENCE

Level III-cross-sectional study.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Basketball: 2014-2015 Through 2018-2019

CONTEXT

Basketball has remained a popular sport for players and spectators in the United States since before the first National Collegiate Athletic Association men's championship tournament in 1939.

BACKGROUND

Routine examinations of men's basketball injuries are important for identifying emerging temporal patterns.

METHODS

Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014-2015 through 2018-2019 athletic seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates.

RESULTS

The overall injury rate was 7.28 per 1000 athlete exposures, with competition rates twice those of practices (injury rate ratio = 2.07; 95% CI = 1.93, 2.22). Injuries to the ankle (22.2%), knee (13.0%), head/face (11.3%), and hand/wrist (10.1%) accounted for most reported injuries, with sprains (30.4%), contusions (14.3%), and strains (13.9%) most commonly reported. Ankle sprain rates initially trended upward and decreased between 2017-2018 and 2018-2019; concussion rates remained relatively stable during 2014-2015 through 2018-2019.

CONCLUSIONS

Findings suggest that common injury rates are trending downward relative to previous study findings.

Methods of the National Collegiate Athletic Association Injury Surveillance Program, 2014-2015 Through 2018-2019

BACKGROUND

Since 1982, the National Collegiate Athletic Association (NCAA) has collaborated with athletic trainers (ATs) to create the largest ongoing collegiate sports injury database in the world. This report provides an operational update of the NCAA Injury Surveillance Program (NCAA ISP) during the academic years 2014-2015 through 2018-2019.

SURVEILLANCE SYSTEM STRUCTURE

The NCAA ISP used a convenience sampling technique via a rolling recruitment model. The ATs at contributing institutions voluntarily submitted data into their respective electronic medical record systems; common data elements were pushed to and maintained by the Datalys Center. The ATs provided information about all team-related activities, even if no injury occurred during that activity, as well as detailed reports on each injury, including condition and circumstances.

SUMMARY

The NCAA ISP has a long-standing role in supplying NCAA stakeholders with crucial injury surveillance data, playing a critical part in safeguarding student-athletes participating in collegiate sports.

Heads Up Play: Acute Assessment and Management of Basketball-Related Craniofacial Injuries by On-Court Personnel

INTRODUCTION

With a following of over 825 million people, basketball currently ranks amongst the world's most popular sports. Despite a number of concussion awareness and player safety protocols that have been implemented at the professional level of organized play, a standardized, layperson-friendly algorithm for the acute management of basketball-related craniofacial injuries does not appear to presently exist.

METHODS

This 10-year retrospective cohort study was conducted using the National Electronic Injury Surveillance System database to examine basketball-related craniofacial injuries from 2010 to 2019. Within the National Electronic Injury Surveillance System dataset, factors including patient age, gender, diagnosis, injury type, and injury location were included in our analysis.

RESULTS

Overall, 22,529 basketball-related craniofacial injuries occurred between 2010 and 2019 in players ages 5 to 49 years old. Adolescent (12-18-year-old) and young adult (19-34-year-old) age groups had the highest incidence of craniofacial injuries. The adolescent cohort experienced a significantly greater proportion of concussions and lower proportion of both facial lacerations and fractures compared with the within group null hypothesis of equal proportions (P < 0.05). The young adult cohort experienced a significantly greater proportion of facial lacerations and fractures and lower proportion of concussions, contusions/abrasions, hematomas, and internal injuries compared to this cohort's null hypothesis (P < 0.05). Males experienced a significantly greater proportion of fractures, lacerations, and dental injuries and lower proportion of concussions, contusions/abrasions, and internal injuries compared to the hypothesized equality of proportions (P < 0.05). Females experienced a significantly greater proportion of concussions, contusions/abrasions, and internal injuries and lower proportion of fractures, lacerations, and dental injuries compared to the hypothesized equality of proportions (P < 0.05).

CONCLUSIONS

Although several steps have already been taken at the professional level to try to promote player safety, particularly with concussion protocols and prevention of lower extremity injuries, there remains a paucity of resources to guide management of other types of acute craniofacial injury. The role of layperson-friendly educational interventions remains intriguing as a potential means of improving outcomes regardless of socioeconomic status or health literacy. Additional studies still need to be completed to determine efficacy and best future direction.

The 2020 NBA Orthobiologics Consensus Statement

This 2020 NBA Orthobiologics Consensus Statement provides a concise summary of available literature and practical clinical guidelines for team physicians and players. We recognize that orthobiologic injections are a generally safe treatment modality with a significant potential to reduce pain and expedite early return to play in specific musculoskeletal injuries. The use of orthobiologics in sports medicine to safely reduce time loss and reinjury is of considerable interest, especially as it relates to the potential effect on a professional athlete. While these novel substances have potential to enhance healing and regeneration of injured tissues, there is a lack of robust data to support their regular use at this time. There are no absolutes when considering the implementation of orthobiologics, and unbiased clinical judgment with an emphasis on player safety should always prevail. Current best evidence supports the following: Key Points There is support for the use of leukocyte-poor platelet-rich plasma in the treatment of knee osteoarthritis. There is support for consideration of using leukocyte-rich platelet-rich plasma for patellar tendinopathy. The efficacy of using mesenchymal stromal cell injections in the management of joint and soft tissue injuries remains unproven at this time. There are very few data to suggest that current cell therapy treatments lead to any true functional tissue regeneration. Meticulous and sterile preparation guidelines must be followed to minimize the risk for infection and adverse events if these treatments are pursued.Given the high variability in orthobiologic formulations, team physicians must stay up-to-date with the most recent peer-reviewed literature and orthobiologic preparation protocols for specific injuries.Evidence-based treatment algorithms are necessary to identify the optimal orthobiologic formulations for specific tissues and injuries in athletes.Changes in the regulatory environment and improved standardization are required given the exponential increase in utilization as novel techniques and substances are introduced into clinical practice.

Data-Driven Risk Classification of Concussion Rates: A Systematic Review and Meta-Analysis

BACKGROUND

Concussion is a growing public health concern and generating concussion prevention programs depends on identifying high-risk sports and characteristics. Identifying the roles of sport, sex, and participation level (e.g., high school versus collegiate athletics) in concussion risk would facilitate more informed decision-making regarding sports participation and generate better targeted prevention strategies.

OBJECTIVES

The current study's objectives were to: (1) determine the magnitude and hierarchy of sports-related concussion (SRC) risk across an array of events and (2) evaluate the modifying roles of sex, participation level, and session type on SRC rates.

METHODS

A literature search was conducted on PubMed, searching concussion studies published between 2001 and December 2019. Inclusion criteria for studies required: (1) concussion occurred during sport, (2) that the SRC was clinically diagnosed, and (3) athlete exposures and concussions could be extracted or estimated. A study was excluded if it: (1) was not an original research article, (2) was not written in English language, (3) was an animal study, (4) did not have enough data to calculate SRC rates, (5) included professional or youth sample, and/or (6) contained data collected prior to 2001. The meta-analysis and meta-regression analyses were fit using a random effects model.

RESULTS

Search results returned 2695 unique research articles, with 83 studies included in analyses. Sport, sex, participation level, and session type all significantly influenced SRC rates. Overall, rugby had the highest concussion rate and was classified as the highest risk sport (28.25 concussions per 10,000 athlete exposures). Overall, females had a higher concussion rate than males. Only lacrosse demonstrated a higher concussion rate for males compared to females. Collegiate athletes had higher concussion rates than high school athletes. Games were associated with 2.01 more concussions per 10,000 AEs than practices.

CONCLUSIONS

This meta-analysis demonstrated rugby has the highest concussion risk, followed by American Football, ice hockey, and wrestling. Concussion risk was influenced by sport, sex, participation, and session. Identifying the factors and environments that influence concussion risk can facilitate risk reduction and prevention strategies.

An analysis of Google Trends following athletic injuries by high profile NBA players during the 2019 NBA finals

CONTEXT

Injuries are common among high profile players in the National Basketball Association (NBA), and could provide an opportunity for physicians to provide accurate sports injury information and reliable rehabilitation data to the general public in the immediate aftermath.

OBJECTIVES

To evaluate social media trends to investigate public interest in athletic injuries in the NBA and to evaluate the length of maintained interest in these injuries.

METHODS

The Google Trends tool was used to analyze search data around two high profile players-Kevin Durant and Klay Thompson-who suffered injuries during the 2019 NBA Finals. The results were compared to the expected search forecast derived from an autoregressive integrated moving algorithm model.

RESULTS

Both players were associated with a mean increase of 1,052.4% (standard deviation [SD], 703.96%) in relative search volumes for terms related to their injuries. This data showed a significant increase in search engine activity related to injuries associated with NBA players in the first 6.13 days (SD, 3.14 days) following the injuries, marking a substantial timeframe for public engagement.

CONCLUSIONS

Search traffic information may be beneficial to the sports medicine community, as social media can provide a platform for patient education in a limited timeframe. By increasing patient awareness and knowledge regarding athletic injuries, social media can expand the pool of potential patients for physicians and surgeons.

Epidemiology of Sport-Related Concussion

Sport-related concussions are common in the United States. Concussion rates have increased over time, likely due to improved recognition and awareness. Concussion rates vary across level (high school vs college), sex, and sport. Concussion rates are the highest among men, particularly in football, wrestling, ice hockey, and lacrosse where collisions and contact are inherent to the sports, although girls'/women's soccer rates are high. In gender-comparable sports, women have higher concussion rates. Continued data collection will increase understanding of sport-related concussion and provide areas for targeted prevention in the future.

Upper Extremity Pain Is Associated with Lower Back Pain among Young Basketball Players: A Cross-Sectional Study

Basketball is a major sport worldwide among different age groups that leads to a high frequency of injuries at multiple body sites. Upper and lower extremities and lower back are common pain sites in basketball players; however, there is little information about the relationship between upper or lower extremity pain and lower back pain. This study elucidated the associations between upper extremity (shoulder and elbow) pain and lower back pain (LBP) among young basketball players. We conducted a cross-sectional study using self-reported questionnaires mailed to 25,669 young athletes; the final study population comprised 590 basketball players, and their median age was 13 years (range: 6-15 years). The point prevalence rates of lower back, shoulder, elbow, and upper extremity pain among young basketball players were 12.9% (76/590), 4.6% (27/590), 2.7% (16/590), and 7.1% (42/590), respectively. Multivariate logistic regression analyses revealed that upper extremity pain was significantly associated with LBP (adjusted odds ratio [OR]: 7.86; 95% confidential interval [CI], 3.93-15.72). Shoulder pain was significantly associated with training per week (> 4 days) (adjusted OR: 4.15; 95% CI: 1.29-13.40) and LBP (adjusted OR: 13.77; 95% CI: 5.70-33.24). This study indicates that upper extremity and shoulder pain is associated with LBP among young basketball players. Assessing for lower back pain, as well as elbow and/or shoulder pain, may help prevent severe injuries in young basketball players. In conclusion, parents and coaches should be properly re-educated to help improve lower back, upper extremity, and shoulder pain among young basketball players.

Associations between sport participation and knee symptoms: a cross-sectional study involving 3053 undergraduate students

Background

While a number of studies have investigated knee symptoms among elite athletes, few have directly compared the association between engagement in different sports and knee symptoms among young adults in the general population. The current study aimed to investigate the relation between sports participation hours, type/ number of sports engaged, self-rated competitiveness and knee symptoms among undergraduates.

Methods

Undergraduates were invited to participate in a self-administered online survey through invitation emails. Respondents were instructed to provide demographic information (e.g., age, gender, sports participation hours, types of engaged sports, self-rated competitiveness in sports and anxiety level etc.) and to report knee symptoms (current, the last 7 days, the last 12 months, and lifetime). Multiple logistic regressions were conducted to investigate the association between sports participation and current knee symptoms.

Results

Of 17,552 invitees, 3744 responded to the survey. Valid data from 3053 respondents was used for analysis. Forty-four percent of the respondents engaged in sports regularly (≥once per week). Running, cross-training and swimming were the most frequently participated sports among the respondents. The current prevalence rate of knee symptoms was 6.4%. Hours spent participating in combat sports, soccer, yoga, and basketball participation hours were significantly associated with current knee symptoms. Respondents who rated themselves as “competitive” demonstrated a higher risk of having current knee symptoms than “recreational” players. Number of engaged sports was not associated with current knee symptoms among undergraduates.

Conclusions

Certain sports types were associated with current knee symptoms. Compared to self-rated “recreational” players, self-rated “competitive” players were more likely to have current knee symptoms. Students should take preventive measures to minimize their risk of developing knee symptoms, especially when participating in combat sports, soccer, yoga, and basketball, or engaging in sports at a highly competitive level.