Contact Breast Injuries Among Female Athletes: A Systematic Review.

BACKGROUND: Robust surveillance of injury aetiology and epidemiology is recognised as fundamental for effective injury reduction and management programmes. However, while sex-specific differences in injury type and nature are noted in the literature, it is unclear if these are reflected in surveillance practices, and how the athlete is affected. OBJECTIVE: Therefore, this study aimed to systematically review contact breast injuries (CBIs) among adult female athletes. METHODS: The following databases were searched: PubMed, EMBASE, SPORTDiscus including MEDLINE, Web of Science and Scopus. The literature search was conducted in May 2023 and the search was limited to articles in the English and German language. Studies including female athletes, aged 18 years and above, in any sports (team or individual) at any level (amateur, semi-professional and professional), where an occurrence of CBI was documented were included. Studies were included irrespective of their investigated timeframes (e.g. the whole career, one or multiple seasons). Findings were categorised (e.g. sport, level of competition and investigated timeframe of the study) to enable possible comparisons. Case studies were excluded due to the non-generalisability of findings. RESULTS: Of the six studies included, rugby codes (rugby union, rugby league and rugby sevens) had the highest occurrence rate (62.0%) of CBIs among eight different investigated sports (rugby codes 62.0%, softball 59.5%, Australian Football League (AFL) 51.0%, water polo 50.0%, soccer 46.7%, basketball 27.6-48.8%, volleyball 34.6%, boxing 0.0%). Between 25.6% and 62.0% of participants reported incurring a CBI and between 0.0% and 42.9% of CBIs were reported to a medical professional or support staff. The reported treatment rate for CBIs ranged between 0.0% and 2.1%, The main mechanisms for CBIs (where reported) were contact with another athlete (AFL 37.6%, rugby codes 56%) the ball (AFL 31.6%, rugby codes 25.5%) and the ground (AFL 6.6%, rugby codes 22%). Between 18.2% and 48% of the participants reported that CBIs negatively affected their performance. Risk factors increasing CBIs were positional differences, larger breast size and higher body mass index (BMI). In-season injury data collection and surveillance supported through education of both players and medical staff were identified to be of relevance for future CBI prevention. None of the studies reported incidence rate. CONCLUSION: Despite the frequent occurrence of CBIs among female athletes, reporting and treatment remains low. Awareness and education of all stakeholders are fundamental to ensuring better breast safety in female sport. Identifying the mechanics, severity and risk factors of CBIs through thorough injury surveillance must be a focus of further research. REGISTRATION: The study was preregistered on Open Science Framework (OSF).

Differences and correlations between horizontal and vertical single-leg jump performance, dynamic balance, and ankle dorsiflexion range of motion in male amateur rugby players according to playing positions.

OBJECTIVES: To explore the differences and correlations in the Y-Balance Test (YBT) scores, ankle-dorsiflexion range of motion (ADFROM), single-leg drop jump (SLDJ) and single-leg hop for distance (SLHD) in amateur male rugby players by playing positions and limb dominance. DESIGN: Cross-sectional study. SETTING: Argentinian amateur rugby club. PARTICIPANTS: Male (n = 58) senior amateur rugby players. MAIN OUTCOME MEASURES: ADFROM, YBT (anterior [AN], posteromedial, posterolateral, and composite [COM]), SLDJ and SLHD performances. RESULTS: Forwards demonstrated different anthropometric traits than backs (p < 0.001 to 0.003; ES: -0.508 to -1.331), whereas the latter attained better jump performance (p < 0.001-0.05; ES: 0.297-1.349) and YBTCOM scores compared to the former, irrespective of limb dominance (p: 0.007-0.034; ES: 0.569-0.730). With regards to the associations, forwards' BMI (rho: -0.35 to -0.52, ES: 0.184) and ADFROM values (rho: 0.41 to 0.53, ES: 0.184; r: 0.43 to 0.50, ES: 0.184) were associated to jump performance among both limbs. In contrast, for the backs, leg length was associated with SLHD (rho: 0.42-0.45, ES: 0.214) and YBTCOM (rho: -0.67 to -0.76, ES: 0.215). Likewise, ADFROM values (r: 0.44-0.56, ES: 0.185) were moderately associated to YBTAN in both limbs. CONCLUSIONS: Backs attained better dynamic balance, wider ADFROM, and better unilateral vertical and horizontal jumps performances in dominant and non-dominant limb, compared to forwards. Additionally, ADFROM maybe an important aspect to consider when aiming to improve balance and jump performance among forwards and backs.

Coaches of youth field sports as delivery agents of injury prevention programmes: how are we training the trainers? A scoping review.

OBJECTIVE: To systematically map the coach education (CE) component of injury prevention programmes (IPPs) for youth field sports by identifying and synthesising the design, content and facilitation strategies used to address competency drivers and behaviour change. DESIGN: Scoping review. DATA SOURCES: PubMed, PsycInfo, EMBASE, CINAHL, SportDiscus and Google Scholar electronic databases were searched using keywords related to IPPs and youth field sports. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies of IPPs in youth field sports, that provided 'train-the-trainer' education to coaches as designated delivery agents. RESULTS: 20 studies from two field sports (soccer/football; n=17, Rugby Union; n=3) fulfilled the eligibility criteria. Eleven CE interventions occurred in the preseason and 18 occurred at one time-point (single day). Five studies cited use of a behavioural change theory or model in the design of their CE, most frequently the Health Action Process Approach model (n=5); and use of behavioural change techniques varied. Twelve of twenty studies (60%) reported some form of ongoing support to coaches following the CE primary intervention concurrent with IPP implementation. CONCLUSION: CE that occurs on 1 day (one time-point) is most popular for preparing coaches as delivery agents of IPPs in youth field sports. While recognising pragmatic barriers, more expansive in-service training, support and feedback may enhance the effective implementation of IPPs. TRIAL REGISTRATION NUMBER: https://doi.org/10.17605/OSF.IO/FMHGD.

Injury Trends for School Rugby Union in Ireland: The Need for Position-specific Injury-prevention Programs.

BACKGROUND: Concern has been raised over the injury risk to school Rugby union (Rugby) players and the potential long-term health consequences. Despite the increase in studies for this cohort, the influence of playing position on injury incidence and presentation is unclear. PURPOSE: To describe the incidence, nature and severity of match injuries for school Rugby in Ireland overall, and as a function of playing position. STUDY DESIGN: Prospective cohort study. METHODS: Data were collected from 15 male (aged 16-19 years) school Senior Cup teams across 2 seasons. In total, 339 players participated in season 1, whereas 326 players participated in season 2. Injury data were recorded onto a bespoke online platform. Match exposure was also recorded. RESULTS: The incidence rate of match injuries (24-hour time loss) was 53.6 per 1000 hours. Across both seasons, 6810 days were lost from play due to injury. Forwards (65.4 per 1000 hours) sustained significantly more (P < 0.05) injuries than backs (40.5 per 1000 hours). The head, shoulder, knee, and ankle were the most common injured body regions; however, forwards sustained significantly more (P < 0.05) head and shoulder injuries than backs. The tackle was responsible for the majority of injuries in both groups. The highest proportion of injuries occurred during the third quarter. CONCLUSION: Clear differences in injury presentation and incidence were evident when comparing forwards versus backs. The high rate of head and shoulder injuries in the forwards suggest the need for more targeted injury-prevention strategies and further research on education and laws around the tackle event. The spike of injuries in the third quarter suggests that fatigue or inadequate half-time warm-up may be a contributing factor warranting further exploration. CLINICAL RELEVANCE: This study demonstrates clear differences in injury presentation according to playing position in school Rugby and highlights the need for a more tailored approach to the design and implementation of injury-prevention strategies. LEVEL OF EVIDENCE: Level 3.

Effect of COVID-19 lockdown on injury incidence and burden in amateur rugby union.

OBJECTIVES: To analyse match and training injury incidence rates and burden from pre-(2019) and post-COVID-19 (2021) seasons; To analyse injury related variables as mechanisms, type, body locations, severity and the differences of the most common injuries according to playing positions. DESIGN: An observational study was performed according to the consensus statement on injury definitions and data collection from World Rugby. Injury variables were collected retrospectively for 2019 season and prospectively during 2021 season. SETTING: Argentinian amateur rugby club. PARTICIPANTS: Male (n = 110) senior amateur rugby players. MAIN OUTCOME MEASURES: Match and training time loss injuries, time of exposures and injury related variables. RESULTS: Training incidence rate during post-lockdown season (4.2/1000 player-training-hours) was significantly higher (p < 0.001) than the pre-lockdown season (0.9/1000 player match hours). Post-lockdown hamstring strain injury (HSI) and concussions match incidence rates were significantly (p < 0.001; p < 0.05 respectively) higher in comparison with 2019 season. Regarding playing positions, backs showed a significantly increase (p < 0.05) in HSI match incidence rate post lockdown. CONCLUSIONS: After the COVID-19 lockdown, training incidence rate was significantly higher than previous season (2019), showing the impact of the lockdown restrictions. Coaches and medical staff must consider that players probably need more lead-in time for conditioning and more monitoring after periods of no rugby.

Profiling elite male 100-m sprint performance: The role of maximum velocity and relative acceleration.

PURPOSE: This study aimed to determine the accuracy of a 4 split time modelling method to generate velocity-time and velocity-distance variables in elite male 100-m sprinters and subsequently to assess the roles of key sprint parameters with respect to 100-m sprint performance. Additionally, this study aimed to assess the differences between faster and slower sprinters in key sprint variables that have not been assessed in previous work. METHODS: Velocity-time and velocity-distance curves were generated using a mono-exponential function from 4 split times for 82 male sprinters during major athletics competitions. Key race variables-maximum velocity, the acceleration time constant (τ), and percentage of velocity lost (vLoss)-were derived for each athlete. Athletes were divided into tertiles, based on 100-m time, with the first and third tertiles considered to be the faster and slower groups, respectively, to facilitate further analysis. RESULTS: Modelled split times and velocities displayed excellent accuracy and close agreement with raw measures (range of mean bias was -0.2% to 0.2%, and range of intraclass correlation coefficients (ICCs) was 0.935 to 0.999) except for 10-m time (mean bias was 1.6% ± 1.3%, and the ICC was 0.600). The 100-m sprint performance time and all 20-m split times had a significant near-perfect negative correlation with maximum velocity (r ≥ -0.90) except for the 0 to 20-m split time, where a significantly large negative correlation was found (r = -0.57). The faster group had a significantly higher maximum velocity and τ (p < 0.001), and no significant difference was found for vLoss (p = 0.085). CONCLUSION: Coaches and researchers are encouraged to utilize the 4 split time method proposed in the current study to assess several key race variables that describe a sprinter's performance capacities, which can be subsequently used to further inform training.

Epidemiology of Shoulder Injuries in Schoolboy Rugby Union in Ireland.

BACKGROUND: The shoulder has been reported as a frequent location of injury in adult professional and amateur rugby, with match injury incidence rates ranging from 1.8 to 3 per 1000 player-hours (h). An increased understanding of the incidence and mechanism of shoulder injuries in school rugby players is vital to establish effective injury preventive strategies and advise on appropriate rehabilitation. PURPOSE: To describe the incidence, nature, and severity of shoulder injuries in schoolboy rugby in Ireland. STUDY DESIGN: Descriptive epidemiology study. METHODS: Injury surveillance was carried out for Senior Cup teams across two seasons (N = 665 players aged 17-19 years) in Ireland from 2018 to 2020. Match and training injury data were recorded using an online system by trained nominated injury recorders. Match exposure was also recorded. RESULTS: Shoulder match injury incidence was 12.2 per 1000 h (95% CI, 9.1-16.2), with a mean severity of 47 days' time loss and an overall burden of 573 days per 1000 h. In total, 47 match and 5 training shoulder injuries were recorded. The most common injuries were shoulder dislocations/subluxations (34%), followed by acromioclavicular joint sprains (30%). Shoulder dislocations/subluxations represented the most burdensome injury (280 days per 1000 h). The tackle accounted for the majority (81%) of shoulder injuries. Forwards sustained a significantly higher incidence of shoulder injuries (8.3/1000 h) in comparison with backs (3.9/1000 h), with a rate ratio of 2.13 (95% CI, 1.15-3.94; P = .015). CONCLUSION: We found a notably higher injury incidence rate in schoolboy rugby as compared with the adult amateur and professional game. Shoulder injuries were responsible for more days lost than any other injury, and shoulder dislocations were the most severe. This is of particular concern so early in a player's career and warrants further investigation into potential risk factors and mechanisms associated with shoulder injuries in school-age players.

Training load monitoring in team sports: a practical approach to addressing missing data.

Training load (TL) is a modifiable risk factor that may provide practitioners with opportunities to mitigate injury risk and increase sports performance. A regular problem encountered by practitioners, however, is the issue of missing TL data. The purpose of this study was to examine the impact of missing TL data in team sports and to offer a practical and effective method of missing value imputation (MVI) to address this. Session rating of perceived exertion (sRPE) data from 10 male professional soccer players (age, 24.8 ± 5.0 years; height, 181.2 ± 5.1 cm; mass, 78.7 ± 6.4 kg) were collected over a 32-week season. Data were randomly removed at a range of 5-50% in increments of 5% and data were imputed using 12 MVI methods. Performance was measured using the normalized root-mean-square error and mean of absolute deviations. The best-fitting MVI method across all levels of missingness was Daily Team Mean (DTMean). Not addressing missing sRPE data may lead to more inaccurate calculations of other TL metrics (e.g., acute chronic workload ratio, training monotony, training strain). The DTMean MVI method may provide practitioners with a practical and effective approach to addressing the negative consequences of missing TL data.