Injuries of the cervical spine in high school wrestling

Epidemiology of Spine Injuries in National Collegiate Athletic Association Men's Wrestling Athletes

Background:

Spine injuries are common in collegiate wrestlers and can lead to reinjury, persistent pain, and time lost from participation.

Purpose:

To describe the epidemiology of spine injuries in National Collegiate Athletic Association (NCAA) wrestlers between academic years 2009 to 2010 and 2013 to 2014.

Study Design:

Descriptive epidemiology study.

Methods:

The incidence and characteristics of spine injuries were identified utilizing the NCAA–Injury Surveillance Program database. Spine injuries were assessed for injury type, injury mechanism, time of season, event type, recurrence, participation restriction, and time lost from participation. Rates of injury were calculated as the number of injuries divided by the total number of athlete-exposures (AEs). Injury rate ratios (IRRs) were calculated for event type and time of season, and results with 95% confidence intervals that did not include 1.0 were considered statistically significant.

Results:

There were an estimated 2040 spine injuries reported in the database over the 4-year period, resulting in an injury rate of 0.71 per 1000 AEs.  Spine injuries were over twice as likely to occur in competitions as in practices (IRR, 2.02; 95% confidence interval, 1.10-3.69). More injuries occurred in both the preseason (0.94 per 1000 AEs) and the postseason (1.12 per 1000 AEs) compared with the regular season (0.55 per 1000 AEs). Contact injuries (42%) were the most common mechanism of injury, and brachial plexus injury (20%) was the most common diagnosis. Only 1.3% of injuries required surgery, and athletes most commonly returned to sport within 24 hours (33%) or within 6 days (25%).

Conclusion:

This investigation found an overall injury rate of 0.71 per 1000 AEs in wrestling athletes between academic years 2009 to 2010 and 2013 to 2014. The majority of these injuries were new, and athletes most commonly returned to sport within 24 hours. The injury rate was highest in competition, and both the preseason and the postseason showed a higher injury rate than that in season. Efforts to improve injury prevention and management should be informed by these findings.

Sports-Related Cervical Spine Injuries - Background, Triage, and Prevention

ABSTRACT

Cervical spinal injuries are a rare, but potentially devastating occurrence in sports. Although many of these injuries occur in unsupervised sports, they are also seen in organized sports - most commonly in football, wrestling, and ice hockey. Additionally, although each sport is associated with its own unique injury patterns, axial loading remains a common theme seen in cervical injuries associated with significant neurologic impairment. Regardless of the mechanism, a cautious and conservative approach should be taken with regards to evaluation, management, and return to play.

Catastrophic head and neck injuries in judo players in Japan from 2003 to 2010

BACKGROUND

Few studies have documented catastrophic head and neck injuries in judo, but these injuries deserve greater attention.

PURPOSE

To determine the features of catastrophic head and neck injuries in judo.

STUDY DESIGN

Descriptive epidemiological study.

METHODS

This study was based on the accident reports submitted to the All Japan Judo Federation's System for Compensation for Loss or Damage. A total of 72 judo injuries (30 head, 19 neck, and 23 other injuries) were reported between 2003 and 2010. The investigated parameters were mechanism of injury, age at time of injury, length of judo experience, diagnosis, and outcome.

RESULTS

Among head injuries, 27 of 30 (90%) occurred in players younger than 20 years of age. The relationship between age, mechanism, and location of injury was more relevant when players younger than 20 years incurred head injury while being thrown (P = .0026). Among neck injuries, 13 of 19 (68%) occurred in players with more than 36 months of experience. The relationship between experience, mechanism, and location of injury was more relevant when experienced players incurred neck injury while executing an offensive maneuver (P = .0294). Acute subdural hematoma was diagnosed in 94% of head injuries. The outcomes of head injury were as follows: 15 players died; 5 were in a persistent vegetative state; 6 required assistance because of higher brain dysfunction, hemiplegia, or aphasia; and 4 had full recovery. Among neck injuries, 18 players were diagnosed with cervical spine injury, 11 of whom had fracture-dislocation of the cervical vertebra; there was also 1 case of atlantoaxial subluxation. The outcomes of neck injury were as follows: 7 players had complete paralysis, 7 had incomplete paralysis, and 5 had full recovery.

CONCLUSION

Neck injuries were associated with having more experience and executing offensive maneuvers, whereas head injuries were associated with age younger than 20 years and with being thrown.

Indirect catastrophic injuries in olympic styles of wrestling in iran

Background:

Data on indirect catastrophic injuries in wrestling are scarce.

Objectives:

To develop a profile of indirect catastrophic injuries in international styles of wrestling and to describe possible risk factors.

Study Design:

Retrospective case series; Level of evidence, 3.

Methods:

Indirect catastrophic injuries that occurred in wrestling clubs in Iran from July 1998 to June 2005 were identified by contacting several sources. The cases were retrospectively reviewed.

Results:

The injuries included 9 indirect catastrophic injuries. The injury rate was 0.62 injuries per 100 000 wrestlers per year. The majority of indirect injuries were cardiovascular events in veteran groups of wrestlers.

Conclusions:

Indirect catastrophic wrestling injuries are rare and present most commonly in older athletes. Coronary artery disease was the main cause.

Epidemiology of athletic head and neck injuries

In this article, we review the available data on sporting injuries to the head and neck and discuss sport-specific injury risk and prevention strategies, as well as the costs of head and neck injuries.

Catastrophic injuries in wrestlers

BACKGROUND

There is a paucity of comprehensive information on catastrophic wrestling injuries.

OBJECTIVE

Our objective was to develop a profile of catastrophic injuries in wrestling and a list of relevant risk factors.

STUDY DESIGN

Retrospective review.

METHODS

We retrospectively reviewed 35 incidents that were reported to the National Center for Catastrophic Sports Injury Research over an 18-year period from 1981 until 1999.

RESULTS

Except in the case of one male college athlete, all injuries occurred in male high school wrestlers. There were 2.11 direct catastrophic injuries per year or 1 per 100000 participants. The majority of injuries occurred in match competitions (80%), with a trend toward more injuries in the low- and middle-weight classes. The position most frequently associated with injury was the defensive position during the takedown maneuver (74%), followed by the down position (23%), and the lying position (3%). Catastrophic injuries included 27 cervical fractures or major cervical ligament injuries, 4 spinal cord contusions with transient quadriparesis, 3 severe head injuries, and an acutely herniated lumbar disc. The injuries resulted in quadriplegia in 11, residual neurologic deficits in 6, paraplegia in 1, and death in 1 head-injured athlete.

CONCLUSIONS

Although catastrophic injuries in wrestling are rare, they do occur. Referees can help prevent such injuries by strictly enforcing penalties for slams and by gaining more awareness of dangerous holds. Coaches may also prevent serious injuries by emphasizing proper wrestling techniques.

Wrestling causing paraplegia

This report deals with 4 patients who had a spinal cord injury resulting from wrestling. The cause and the results are discussed.

The epidemiologic, pathologic, biomechanical, and cinematographic analysis of football-induced cervical spine trauma

Epidemiologic, pathologic, biomechanical, and cinematographic data on head and neck injuries occurring in tackle football have been compiled since 1971 by the National Football Head and Neck Injury Registry. Preliminary analysis performed in 1975 indicated that the majority of serious cervical spine football injuries were caused by axial loading. Based on this observation, the National Collegiate Athletic Association (NCAA) and National Federation of High School Athletic Associations (NFHSAA) implemented rule changes banning "spearing" and the use of the top of the helmet as the initial point of contact in striking an opponent during a tackle or block. Between 1976 and 1987, as a result of these rule changes, the Registry has documented a dramatic decrease in both the total number of cervical spine injuries and those resulting in quadriplegia at both the high school and college level. It is suggested that development and implementation of similar preventative measures based on clearly defined injury mechanisms would decrease injury rates in diving, rugby, ice hockey, trampolining, wrestling, and other high-risk sports as well.