A 2-year prospective study of injury epidemiology in elite Australian rugby sevens: Exploration of incidence rates, severity, injury type, and subsequent injury in men and women

BACKGROUND: Injuries are common in rugby sevens, but studies to date have been limited to short, noncontinuous periods and reporting of match injuries only. PURPOSE: To report the injury incidence rate (IIR), severity, and burden of injuries sustained by men and women in the Australian rugby sevens program and to provide the first longitudinal investigation of subsequent injury occurrence in rugby sevens looking beyond tournament injuries only. STUDY DESIGN: Descriptive epidemiology study. METHODS: Ninety international rugby sevens players (55 men and 35 women) were prospectively followed over 2 consecutive seasons (2015-2016 and 2016-2017). All medical attention injuries were reported irrespective of time loss. Individual exposure in terms of minutes, distance, and high-speed distance was captured for each player for matches and on-field training, with the use of global positioning system devices. The IIR and injury burden (IIR × days lost to injury) were calculated per 1000 player-hours, and descriptive analyses were performed. RESULTS: Seventy-three players (81.1%) sustained 365 injuries at an IIR of 43.2 per 1000 player-hours (95% CI, 43.0-43.3). As compared with male players, female players experienced a lower IIR (incidence rate ratio, 0.91; 95% CI, 0.90-0.91). Female players also sustained a higher proportion of injuries to the trunk region (relative risk, 1.75; 95% CI, 1.28-2.40) but a lower number to the head/neck region (relative risk, 0.58; 95% CI, 0.37-0.93; P = .011). The majority (80.7%) of subsequent injuries were of a different site and nature than previous injuries. A trend toward a reduced number of days, participation time, distance, and high-speed distance completed before the next injury was observed after successive injury occurrence. CONCLUSION: Female players have a lower IIR than male players, with variation of injury profiles observed between sexes. With a surveillance period of 2 years, subsequent injuries account for the majority of injuries sustained in rugby sevens, and they are typically different from previous types of sustained injuries. After each successive injury, the risk profile for future injury occurrence appears to be altered, which warrants further investigation to inform injury prevention strategies in rugby sevens

Comparison of subsequent injury categorisation (SIC) models and their application in a sporting population

Background: The original subsequent injury categorisation (SIC-1.0) model aimed to classify relationships between chronological injury sequences to provide insight into the complexity and causation of subsequent injury occurrence. An updated model has recently been published. Comparison of the data coded according to the original and revised subsequent injury categorisation (SIC-1.0 and SIC-2.0) models has yet been formally compared. Methods: Medical attention injury data was prospectively collected for 42 elite water polo players over an 8 month surveillance period. The SIC-1.0 and SIC-2.0 models were retrospectively applied to the injury data. The injury categorisation from the two models was compared using descriptive statistics. Results: Seventy-four injuries were sustained by the 42 players (median = 2, range = 0-5), of which 32 injuries (43.2%) occurred subsequent to a previous injury. The majority of subsequent injuries were coded as occurring at a different site and being of a different nature, while also being considered clinically unrelated to the previous injury (SIC-1.0 category 10 = 57.9%; SIC-2.0 clinical category 16 = 54.4%). Application of the SIC-2.0 model resulted in a greater distribution of category allocation compared to the SIC-1.0 model that reflects a greater precision in the SIC-2.0 model. Conclusions: Subsequent injury categorisation of sport injury data can be undertaken using either the original (SIC-1.0) or the revised (SIC-2.0) model to obtain similar results. However, the SIC-2.0 model offers the ability to identify a larger number of mutually exclusive categories, while not relying on clinical adjudication for category allocation. The increased precision of SIC-2.0 is advantageous for clinical application and consideration of injury relationships

Establishing the incidence and prevalence of injury and illness in Australian sailing athletes over a full year of training and competition to help determine prevention priorities

Objectives To investigate the prevalence, incidence rate (IR) and burden of health problems (injuries and illnesses) in Australian Olympic class and State Sailing Pathway Program (SSPP) athletes over 12-months of training and competition. Design Descriptive epidemiological study. Methods Ninety-two Australian Sailing and SSPP athletes were prospectively followed during the 2019–2020 season. Medical attention injuries and illnesses were prospectively recorded, and further sub-categorised according to time loss. The IR and burden were calculated per 365 athlete-days, with differences in IR between sexes compared using negative binomial generated rate ratios. Results Three hundred and forty-nine injuries were reported in 53 athletes (57.6 %), with 14.3 % resulting in time loss. Injury IR was 3.71 (95%CI = 3.33–4.12) injuries per 365 athlete–days, with no difference observed between sex (IRR = 1.64; 95%CI = 0.81–3.34). Shoulder injuries were found to have the greatest burden. Fifty-four illnesses were reported in 27 athletes (29.3 %), with 39.0 % resulting in time loss. Respiratory infection (n = 22, 40.7 %) was the most common illness reported. Illness IR was 0.57 (95%CI = 0.43–0.75) illnesses per 365 athlete days, with females found to have a 3.6 fold increase in illness compared to males (IRR = 3.6; 95%CI = 2.0–6.7). Conclusions The majority of health problems reported in sailing athletes did not result in time loss. There were no differences in the injury IR between sexes, however females had a 3.6-fold increase in reported illness. These results can inform future strategies to reduce key health problems in sailors. Future research investigating whether performance is impacted by the high rate of non-time loss health problems is warranted

Injury Incidence and Prevalence in Elite Short-Course Triathletes:A 4-year Prospective Study

Objective To characterise the prevalence, incidence rate (IR) and burden of injuries in elite short-course triathletes over a 4-year training and competition period.Methods Fifty elite Australian triathletes were prospectively monitored for injury during four consecutive seasons (2018–2021). Injuries requiring medical attention were prospectively recorded and further subcategorised according to time loss. The IR and burden (injury IR×mean injury severity) were calculated per 365 athlete days, with sex differences in IR compared using IR ratios (IRR) from negative binomial regression models.Results Two hundred and sixty-six injuries were reported in 46 (92.0%) athletes, of which 67.3% resulted in time loss. The injury IR was 1.87 injuries per 365 athlete days (95% CI 1.70 to 2.80), and comparable between sexes (IRR 0.82, 95% CI 0.64 to 1.04, p=0.109). Most injuries (70.7%) were training related. The most frequently injured body sites were the ankle (15.8%), foot (12.4%) and lower leg (12.0%). Bone stress injuries (BSIs) were the most burdensome injury type with 31.38 days of time loss per 365 days (95% CI 24.42 to 38.34). Twenty athletes (40.0%) reported at least one bone stress injury (BSI) (range 0–3). The rate of BSIs in female athletes was three times greater compared with male athletes (IRR 2.99, 95% CI 1.26 to 7.07, p=0.013).Conclusion Two-thirds of injuries reported in elite short-course triathletes resulted in time loss, with the majority occurring during training activities. Foot, ankle and other lower leg injuries had the highest incidence, with BSIs carrying the highest injury burden. The considerably higher rate of BSI observed in female athletes warrants consideration for future prevention strategies in female triathletes

Is subsequent lower limb injury associated with previous injury?:A systematic review and meta-analysis

Background Previous injury is a strong risk factor for recurrent lower limb injury in athletic populations, yet the association between previous injury and a subsequent injury different in nature or location is rarely considered. Objective To systematically review data on the risk of sustaining a subsequent lower limb injury different in nature or location following a previous injury. Methods Eight medical databases were searched. Studies were eligible if they reported lower limb injury occurrence following any injury of a different anatomical site and/or of a different nature, assessed injury risk, contained athletic human participants and were written in English. Two reviewers independently applied the eligibility criteria and performed the risk of bias assessment. Meta-analysis was conducted using a random effects model. Results Twelve studies satisfied the eligibility criteria. Previous history of an ACL injury was associated with an increased risk of subsequent hamstring injury (three studies, RR=2.25, 95% CI 1.34 to 3.76), but a history of chronic groin injury was not associated with subsequent hamstring injury (three studies, RR=1.14, 95% CI 0.29 to 4.51). Previous lower limb muscular injury was associated with an increased risk of sustaining a lower limb muscular injury at a different site. A history of concussion and a variety of joint injuries were associated with an increased subsequent lower limb injury risk. Conclusions The fact that previous injury of any type may increase the risk for a range of lower limb subsequent injuries must be considered in the development of future tertiary prevention programmes. Systematic review registration number CRD42016039904 (PROSPERO). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted

Injury epidemiology in male and female competitive diving athletes:A four-year observational study

OBJECTIVES: To describe the incidence, severity, burden and sport specific characteristics of injuries reported in elite diving athletes.DESIGN: Descriptive epidemiology study.METHODS: Medical attention and time-loss injuries from 63 (43 female, 20 male) Australian national diving programme athletes were prospectively collected over four seasons (September 2018-August 2022). Injury incidence rates and burden were calculated, standardised per 365 athlete days, and compared across groups using negative binomial generalised linear models.RESULTS: In total 421 injuries were reported (female = 292, male = 129) at an injury incidence rate of 2.36 (95 % confidence interval = 2.14-2.60) per 365 athlete days. Annual injury prevalence ranged from 70.0 to 85.1 %. Approximately two-thirds of injuries (67.2 %) resulted in a period of time-loss. The overall injury burden was 91 days of absence (95 % confidence interval = 81-102) per 365 athlete days. Stress fractures in springboard diving athletes incurred the largest mean days of time-loss compared to other injured tissue types. The majority of injuries were reported to occur during training (79.3 %) as opposed to competition (2.4 %), with more than half (55.3 %) of all reported injuries occurring during pool training sessions. Water entry (30.4 %) or take-off (27.8 %) were the most frequently reported mechanism of injury.CONCLUSIONS: Annual injury prevalence reported in competitive Australian diving athletes was found to be high. Contrary to existing literature, competitive diving injuries were reported to occur within the daily training environment, with few injuries occurring during competition. Notable injury differences between springboard and platform athletes were observed.</p

Injury and illness in short-course triathletes:A systematic review

Background: Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies. This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting health problems (injury and illness) in triathletes (all sexes, ages, and experience levels) training and/or competing in short-course distances were included. Six electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, APA PsychINFO, Web of Science Core Collection, and SPORTDiscus) were searched. Risk of bias was independently assessed by 2 reviewers using the Newcastle–Ottawa Quality Assessment Scale. Two authors independently completed data extraction. Results: The search yielded 7998 studies, with 42 studies eligible for inclusion. Twenty-three studies investigated injuries, 24 studies investigated illnesses, and 5 studies investigated both injuries and illnesses. The injury incidence rate ranged 15.7–24.3 per 1000 athlete exposures, and the illness incidence rate ranged 1.8–13.1 per 1000 athlete days. Injury and illness prevalence ranged between 2%–15% and 6%–84%, respectively. Most injuries reported occurred during running (45%–92%), and the most frequently reported illnesses affected the gastrointestinal (7%–70%), cardiovascular (14%–59%), and respiratory systems (5%–60%). Conclusion: The most frequently reported health problems in short-course triathletes were: overuse and lower limb injuries associated with running; gastrointestinal illnesses and altered cardiac function, primarily attributable to environmental factors; and respiratory illness mostly caused by infection