Objective: To study the nature and incidence rate of injuries affecting young and adult taekwondo competitors during training and competition and to examine the relationship between injury rates and specific injury risk factors.
Background: Taekwondo is becoming an increasingly popular sport among youth and adult populations. With this increase in popularity, the epidemiology of injury in taekwondo is becoming an increasingly important area of investigation. There has been little research investigating the incidence and distribution of injuries affecting taekwondo athletes, and the research that does exist lacks consistency in research methods. Analytical studies are limited to those which have examined risk factors. The results of these studies are mixed with little consistency in findings across studies.
Method: This study followed both a retrospective and prospective cohort design. Institutional Review Board (IRB) approval was obtained from the University of North Dakota (UND). Taekwondo participants at a local taekwondo academy were invited to participate in this study. Baseline data were collected through a demographic and previous injury history form. Injury surveillance on participants was administered throughout the spring taekwondo season from March 5th, 2013 until May 24th, 2013. Participants were queried on all injuries that they sustained during this period of time. All injuries that were reported to the principal investigator were documented. An injury was defined as any injury to a body part (as a result of taekwondo) that interferes with training or competition and is recorded on the first day of onset and every day thereafter until it does not interfere with training or competition. Additionally, exposure to all training and competition was recorded by the researcher in terms of hours and athletic-exposures (AEs). Once the season was over, study data were entered into a computer system and descriptive analyses were run to determine the incidence and distribution of injury. Due to multiple injuries in some participants, Poisson regression models were fitted using generalized estimating equations to estimate incidence rate ratios (IRR) and to test risk factors. Unadjusted rates were estimated from Poisson regression with each of the following risk factors: age, sex, height, weight, years of experience, rank (high vs. low), previous injury history, specific injury history, and having an unrelated injury during the season. For adjusted rate ratios a multiple-Poisson regression was used with the following risk factors: sex, weight, previous injury history, and having an unrelated injury during the season.
Results: Nine of the 22 participants [14 male (5 youth), 8 female (2 youth)] sustained a total of 16 injuries during the study period. One AE was equal to one hour of exposure. The overall injury rate was 34.86 injuries per 1,000 AEs and 1,000 hours. The overall injury rate for adult males was 68.49 injuries per 1,000 AEs and 1,000 hours, and for adult females was 35.50 injuries per 1,000 AEs and 1,000 hours. There were no youth injuries sustained during this study period. The majority of injuries sustained by males involved the hand/fingers (40%). The majority of injuries sustained by females involved the shoulder (33.33%). The most common injury type in males was laceration and contusion (30%), followed by dislocation (20%). The most common injury type in
females was joint dysfunction in the shoulder (33.33%). All injuries were sudden onset in nature, and 81.25% of the injuries were a new injury. The most common injury situations were blocking a kick (33.33%) and board/brick breaking (33.33%), followed by drills and self-defense holds (16.67%). The most common mechanism of injury was receiving a blow (33.33%) and impact with a surface (33.33%), followed by self-defense holds (16.67%). All injuries were minor in severity.
In the unadjusted Poisson regression analysis of injuries per 1,000 AEs, the following risk factors resulted in a significant effect: age, height, weight, previous injury history, specific injury history, and having an unrelated injury during the season. However, in the multiple Poisson regression, only weight and having an unrelated injury remained significant.
Conclusion: Injury rates reported in this study are generally higher than those reported in previous research. There were no youth injured in this study. Injury rates are reported in athletic-exposures and exposure hours in order to make this study comparable to previous research. Multivariate analyses indicated that weight and having an unrelated injury during the season may be risk factors for injury in taekwondo.
Further research needs to be done on possible risk factors (e.g. height, weight, experience) and preventive measures to further reduce the likelihood for injury during training and competition in taekwondo. Further research should include larger sample sizes, more child subjects, and longer periods of injury surveillance
