4. â˘There have been recent studies on Athletics injury epidemiology.
â˘Osaka 2007 World IAAF Outdoors Championships FIRST INJURY SURVEILLANCE
â˘IAAF injury reporting system 2007-2013: 15 international championships
â˘There is a lack of prospective studies
âBennell published Athletics prospective study in 1996
âJacobsson published in 2012/13 another research
Background
Watson MD. Am J Sports Med 1987. Ahuja Br J Sports Med 1985. BennellK. AustJ SciMed Sport 1996. Jacobsson J. Br J Sports Med 2013. Alonso JM. Clin J Sports Med 2009. Feddermann-Demont N. Br J Sports Med 2014.
5. Methods
Differences in
â˘Design: prospective Vs retrospective
â˘Populationselection
â˘Observation period
â˘Injury Definition
â˘Data recording
â˘Reporting: incidences / exposure
6. All Season:
Incidence: 1.7-3 injuries/athlete/season
3.7-3.9 injuries/1000 h
Prevalence:46-78% athletes injured/season
Recurrence:8-33%
Subsequent Inj:54%
42-47 % athletes sustain > 1 injury/season
Up to 10% athletes drop out during the season
Injury Rates
Watson MD. Am J Sports Med 1987. Ahuja Br J Sports Med 1985. BennellK. AustJ SciMed Sport 1996. Jacobsson J. Am J Sports Med 2012. Jacobsson J. Br J Sports Med 2013.
7. Competition:
â˘Incidence: 81.1 injuries/1000 registrations (time-loss 36.7)
âHighest in Combined events
(169 x 1000 registrations)
âMarathon (113) and
âLong (77.6) and middle distance (71.5).
â˘Lowest incidence was
âThrowing events (19.7)
âJumps and short distances (43)
Injury Rates
Feddermann-Demont N. J. Br J Sports Med 2014.
8. Chime out data
During the season:
â˘Half to 2/3 of the squad will get injured
â˘Average: 2-3 injuries per athlete
Competition:
â˘10% of your team could get injured
â˘More injured athletes at combined events, middle and long distance
10. Onset
All Season
â˘70-96 % Overuse
â55% Gradual onset
â41% Sudden onset
â˘4-20% Traumatic
Competitions
â˘60 % Overuse
â37% Sudden
â23% Gradual
â˘30 % Traumatic
Sprint/Hurdles/Jumps/Combined events HIGHER % of Acute Injuries. However, Overuse >50%
BennellK, AustJ SciMed Sport 1996. Jacobsson J. Br J Sports Med 2013. Alonso JM, Med Sci Sports Exerc 2009. Alonso JM. Clin J Sports Med 2009. Alonso JM, Br J Sports Med 2012.
11. When?
All Season
50
30
73
20
TRAINING
COMPETITION
When?
Bennell
Jacobsson
BennellK, AustJ SciMed Sport 1996. Jacobsson J. Br J Sports Med 2013.
12. â˘Lower extremity 75-89%
âThighAll Season 21,5 %/ Competition 34.5 %
âLower leg 15 %
âFoot 10 %
âKnee 10 %
â˘Injury location affected most frequently
âthe thigh in Jumps, Sprints/Hurdles, Middle distance, Race walk and Combined events
âthe foot in Marathon
âthe leg in Long distance
âthe upper extremity in Throws
Injury Site
BennellK, AustJ SciMed Sport 1996. Feddermann-Demont NJ,Br J Sports Med 2014.
13. Thigh 19-24%
Upper extremity 8-12%
Trunk 12-13%
Head & Neck 1-3%
Knee 13-15%
Lower leg 13-23%
Ankle 5-10%
Foot 6-8%
Hip & Groin 3-4%
Achilles tendon 4%
Alonso JM, Clin J Sports Med 2009.
Alonso JM, Br J Sports Med 2012.
14. Thigh 27-33%
Upper extremity 5-8%
Trunk 14%
Head & Neck 1%
Knee 7-10%
Lower leg 11-20%
Ankle 6-8%
Foot 5-9%
Hip & Groin 6-8%
Achilles tendon 4-5%
Alonso JM, Clin J Sports Med 2009.
Alonso JM, Br J Sports Med 2012.
.
16. 0
10
20
30
40
50
60
70
80
90
THIGH INJURIES
Injuries/1000 competing athletes
Athletics AthleticsOlympics Athletics Football
All Injuries 2012 OG 2012 OG 2012
Injuries/1000 competing athletes
Feddermann-DemontN. Br J Sports Med 2014. EngebretsenL. Br J Sports Med 2013.
17. Hamstring injuries in Athletics
â˘No data of recurrence
â˘No data on time-loss impact
18. Diagnosis
0
5
10
15
20
25
30
Thigh (Hamstring) Strain
Stress Fractures
Ankle Sprain
Overuse Knee Injuries
Achilles / Foot Tendinosis
Medial Tibial Stress Syndrome
Lumbar Pain
Hip (adductor) strain
Lower Leg Strain
Plantar Fasciitis
Competition
All Season
AhujaBr J Sports Med 1985. BennellK, AustJ SciMed Sport 1996. Jacobsson J. Br J Sports Med 2013. Solaja A, Med Pregl 2013. Feddermann-Demont NJ Br J Sports Med 2014.
19. â˘Competition
â45 % absence 1 day
â30% absence 1-7 days
â3% absence higher than 4 weeks
â˘All season 50 % absence higher than 3 weeks
â˘Subsequent / Recurrent injuries more severe than first/index injuries
â˘Catastrophic
âPole Vault
âThrowing
Injury Severity
Jacobsson J. Br J Sports Med 2013. Feddermann-Demont NJ Br J Sports Med 2014. Alonso JM, Br J Sports Med 2012
20. â˘Competition
âAthletes presenting with health problem
âTraining more 12 h/week
âCombined events
â˘All season
âSevere injury (3 weeks) previous season
âHigher training hours and hard workouts
âHighest ranked athletes
âIncreased age
âHigher flexibility
âMenstrual disturbances
Risk Factors
Bennell K, Aus J Sci Med Sport 1996. Jacobsson J. Br J Sports Med 2013. Feddermann-Demont NJ Br J Sports Med 2014. Edouard P, Br j Sports Med 2014
21. Limitations
â˘Competitions mainly
âWorld, Europe
âLack of data from Africa, Asia, America, Oceania
âNewly incurred injuries
âLack of information on overuse injuries
â˘Scarce prospective studies in athletics
22. â˘Prospective whole season surveillance
âAppropriate methods
âOveruse injuries
â˘Prevention interventions on:
âHamstring Injuries
âAnkle injuries
âStress Fractures
âTendinopathies
Future Research Directions
23. Prospective Whole Season Cohort Studies
CHALLENGES:
â˘Athletics Training Structure
âClubs seldom professional
âRarely employ any health staff
âAthletes live apart from the club
âAthletes train individually/groups not linked to clubs
âSome (few) athletes have their own medical team
â˘Specificities Athletics Culture
âTendency to medical nomadism
âLack of concern by the medical follow-up
â˘Not well structured Medical organisation around athletes
âNational Federations providing medical care ONLY in training camps or domestic/international competitions
Edouard P, Branco P Alonso JM. Br j Sports Med 2014
24. â˘Special attention should be paid to injuries in:
âCombined events
âLong distance including Marathon
âShort Distance
â˘Future prevention studies should focus on Thigh Strain
â˘Improve understanding of injury mechanisms and risk factors
â˘Analyse efficacy of adapted preventive measures
Prevention implications
25. Conclusions
â˘On average, 1 out of each 12 registered athletes (81.1 injuries per 1000 registrations) suffered one injury during 2007-2012 international Athletics competitions
â˘More injuries were incurred during competition that in training.
â˘The incidence of all and of time-loss was higher in outdoor than in indoor or youth/junior championships
26. Conclusions
â˘High injury incidence
â˘Overuse traumatic
â˘Training Competition
â˘4/5 Lower limb, 3/10 thigh
â˘Hamstring strain, stress fractures, ankle sprain
â˘Disciplines different locations and diagnosis
â˘Half of injuries more thatn 3 weeks
â˘Risk factors to be elucidated
27. Take home message
IF YOU WORK OR WANT TO WORK IN ATHLETICS EXPECT
â˘Half to 2/3 of your team will get injured
â˘Many of your athletes will suffer from 2-3 injuries/season
â˘10% of your team could get injured in competition
â˘You have to be good clinician dealing with:
âOveruse Injuries
âHamstring and Calf Strains,
âAchilles, Patellar, Knee, Foot, Hip Tendinopathies,
âStress Fractures,
âAnkle Sprains
âLumbar Spine