Epidemiology of injuries in U.S. high school track and field throwing events from 2008 to 2019.

BACKGROUND: Injury characteristics of high school track and field throwing athletes in the United States are not well studied. Understanding epidemiology of injuries is important to identify treatment and prevention strategies. OBJECTIVE: To describe injury rates and patterns in U.S. high school track and field throwing events from a longitudinal national sports injury surveillance system. DESIGN: Descriptive epidemiology study. SETTING: Data were provided by the National High School Sports Related Injury Surveillance System, High School RIO (Reporting Information Online). METHODS: Athletic trainers reported injury and exposure data through the High School RIO website on a weekly basis. An athlete exposure (AE) was defined as one athlete participating in one school-sanctioned practice or competition. Throwing events of discus, shot put, and javelin were analyzed in this study. MAIN OUTCOME MEASURES: Injury rate, rate ratios (RR), injury proportion ratios (IPR). PARTICIPANTS: U.S. high school athletes. RESULTS: A total of 267 track and field throwing injuries occurred during 5,486,279 AEs. Overall, the rate of injuries in competition was higher than in practice (RR 1.35, 95% confidence interval [CI] 1.01-1.80). In practice, the rate of injuries was higher for girls than boys (RR 1.53, 95% CI 1.12-2.08). The most frequently injured body part was the shoulder (21.7%), followed by the ankle (16.5%) and knee (12.0%). The most common types of injury were muscle strains (26.14%) and ligament sprains (25%). Recurrent injuries accounted for a higher proportion of chronic injuries compared to new injuries (IPR 1.85, 95% CI 1.16-2.97). CONCLUSION: This study described injury characteristics of high school track and field throwing athletes from 2008 to 2019. Based on our results, injury prevention may be particularly important for female throwers with prior injury.

Incidence of staff injury and illness at the Tokyo 2020 and Beijing 2022 Olympic and Paralympic Games.

Objective: To report epidemiological data regarding injury and illness among the Team USA staff during the Tokyo 2020 Summer Olympic and Paralympic Games and Beijing 2022 Winter Olympic and Paralympic Games. Methods: A retrospective review of all Team USA staff (total staff, N=1703 (62.5% female); total staff days (SD)=34 489) medical encounters during the Tokyo 2020 Games and Beijing 2022 Games was conducted. Details related to injury and illness were evaluated. Incidence with 95% CI per 1000 staff days were calculated. Results: A total of 32 illnesses (incidence [95% CI] 0.9 [0.6, 1.2]) and 23 injuries (incidence 0.7 [0.4, 0.9]) were sustained by the Team USA delegation staff members during the Tokyo 2020 Games and Beijing 2022 Games. Female staff reported more illnesses (illnesses proportion (IP) 2.9%; incidence 1.4 [0.8, 2.0]), while male staff incurred more injuries (IP 1.8%; incidence 0.9 [0.5, 1.3]). When stratified by physiological system, dermatological and infectious were the most common systems involved with illness (IP 0.5%; incidence 0.2 [0.1, 0.4]). Injuries to the upper limb were most common (IP 0.3%; incidence 0.3 [0.1, 0.5]). Conclusion: Injury and illness rates among the Team USA staff during the Tokyo 2020 Games and Beijing 2022 Games were low, but notable. Knowledge of injury and illness risks contributes to staffing decisions and prevention strategies for staff supporting athletes during competition.

Incidence of injury and illness among paediatric Team USA athletes competing in the 2020 Tokyo and 2022 Beijing Olympic and Paralympic Games.

Objective: To describe the incidence of injuries and illnesses among paediatric Team USA athletes competing in the Tokyo 2020 Olympic and Paralympic Games, and the 2022 Beijing Olympic and Paralympic Games. Methods: An electronic medical record system documented all injuries and illnesses that occurred while competing in the four Games periods. Incidence (IR) with 95% CI per 1000 athlete days were calculated for both injuries and illnesses. Incidence rate ratios (IRR) were calculated to compare injury and illness rates based on age (paediatric vs non-paediatric) sex, Games period and sport type. Results: Two hundred paediatric athletes (age range, 15-21 years) competed across the four Games periods, representing 16.1% of all Team USA athletes. The overall injury IR (95% CI) was 13.4 (9.8 to 18.1), and the overall illness IR was 5.5 (3.3 to 8.7). There were no differences in incidence between paediatric and non-paediatric athletes for either injury (IRR (95% CI): 0.9 (0.6 to 1.2)) or illness (IRR (95% CI): 0.9 (0.5 to 1.5)). Female paediatric athletes were more likely to sustain an injury compared with male paediatric athletes (IRR (95% CI): 2.4 (1.1 to 5.3)). The most common mechanism of injury was gradual onset (IR, 4.3 (2.3 to 7.2)), and injuries most commonly occurred during practices (IR, 7.0 (4.5 to 10.5)). Conclusion: Paediatric athletes account for a substantial proportion of Team USA athletes. It is essential that paediatric sports medicine experts are included in the medical team given that paediatric Team USA athletes are just as likely as their adult teammates to sustain an injury or illness.

Team USA injury and illness incidence at the 2022 Beijing Winter Olympic and Paralympic Games.

OBJECTIVE: The purpose of this study was to determine the injury and illness incidence from Team USA athletes from the 2022 Beijing Winter Olympic and Paralympic Games and assess any sex-based differences or differences between Olympic and Paralympic athletes. METHODS: Team USA Olympic (n=231, 48.5% female) and Team USA Paralympic (n=63, 22.2% female) athletes had medical encounters documented during the Games. Injuries and illnesses were defined according to the 2020 International Olympic Committee Consensus Statement and reviewed for accuracy by a physician. Incidence rates were calculated per 1000 athlete-days and further analysed by sex, sport, anatomical location, type of illness, injury event and injury mechanism, with incident rate ratios (IRRs) used for group comparisons. RESULTS: There were no differences in illness (Olympic illness, IRR=0.99 (95% CI 0.48 to 2.07), p=0.998; Paralympic illness, IRR=1.43 (95% CI 0.41 to 4.97), p=0.572) or injury rates (Olympic injury, IRR=0.63 (95% CI 0.39 to 1.03), p=0.062; Paralympic injury, IRR=1.01 (95% CI 0.43 to 2.35), p=0.988) between male and female (reference group) athletes. However, Olympic athletes had significantly lower illness (IRR=0.41 (95% CI 0.22 to 0.76), p=0.003) and injury (IRR=0.56 (95% CI 0.37 to 0.87), p=0.009) risks compared with Paralympic athletes. CONCLUSION: No significant sex-related differences in injury or illness were detected in Team USA Olympic or Paralympic participating in the 2022 Beijing Winter Games. However, Paralympic athletes exhibited higher rates of injury and illness compared with their Olympic counterparts. This study highlights delegation-specific epidemiological data which may facilitate more focused approaches for injury and illness prevention.

Ultrasound-Guided Fasciotomies of the Deep and Superficial Posterior Leg Compartments for Chronic Exertional Compartment Syndrome: A Cadaveric Investigation.

BACKGROUND: Chronic exertional compartment syndrome (CECS) is a type of leg pain related to elevated intracompartmental pressure with activity in one or more of the four compartments of the leg. Open fasciotomy is the definitive treatment for CECS but has a reported complication rate of up to 15.7% and return to full activity reported up to 16 weeks. Ultrasound-guided (USG) fasciotomy of the anterior and lateral compartments has been translated into clinical practice. OBJECTIVE: To determine the safety and feasibility of a USG fasciotomy of the deep posterior compartment (DPC) and superficial compartment (SPC) of the leg in a fresh-frozen cadaveric model. DESIGN: Prospective, cadaveric laboratory investigation. SETTING: Procedural skills laboratory at an academic institution. CADAVERIC COHORT: Ten fresh-frozen cadaveric knee-ankle-foot specimens from five female and five male donors aged 58 to 93 years (mean 77.4 years) with body mass indexes of 18.1 to 33.5 kg/m2 (mean 25.1 kg/m2 ). METHODS OR INTERVENTIONS: One experienced operator performed 10 USG DPC and SPC fasciotomies. A clinical anatomist performed dissections of each. MAIN OUTCOME MEASURES: Achievement of target length and continuity of release was recorded. Target lengths of 10 cm for the superficial posterior compartment (SPC) and 15 cm for the deep posterior compartment (DPC) were established based on previous studies. Tendinous and neurovascular structures were assessed for damage. RESULTS: No tendon or neurovascular injuries were observed. In the SPC, target length was achieved in 90% and continuous release was observed in 80%. In the DPC, target length was achieved in 60% and continuity observed in 30%. CONCLUSIONS: These findings suggest that SPC USG fasciotomies using the technique described in this study are feasible, may be safe, and warrant further translational research; however, DPC USG fasciotomies are more challenging and require more technical refinement prior to clinical translation.

Shrub and vegetation cover predict resource selection use by an endangered species of desert lizard.

Globally, no species is exempt from the constraints associated with limited available habitat or resources, and endangered species in particular warrant critical examination. In most cases, these species are restricted to limited locations, and the relative likelihood of resource use within the space they can access is important. Using Gambelia sila, one of the first vertebrate species listed as endangered, we used resource selection function analysis of telemetry and remotely sensed data to identity key drivers of selected versus available locations for this species in Carrizo Plain National Monument, USA. We examined the probability of selection given different resource types. Increasing shrub cover, lower and relatively more flat sites, increasing normalized difference vegetation index, and solar radiation all significantly predicted likelihood of observed selection within the area sampled. Imagery data were also validated with fine-scale field data showing that large-scale contrasts of selection relative to available location patterns for animal species are a useful lens for potential habitat. Key environmental infrastructure such as foundation plant species including shrubs or local differences in the physical attributes were relevant to this endangered species.

The Groot Effect: Plant facilitation and desert shrub regrowth following extensive damage.

Deserts are increasing in extent globally, but existing deserts are decreasing in health. The basic biology and ecology of foundation plant species in deserts are limited. This is a direct study that provides an estimate of the capacity for a locally dominant foundation shrub species in California to recover from damage. Desert shrubs are cleared and damaged by humans for many purposes including agriculture, oil and gas production, and sustainable energy developments; we need to know whether foundation species consistently facilitate the abundance and diversity of other plants in high-stress ecosystems and whether they can recover. A total of 20 Ephedra californica shrubs were clipped to the ground at a single site and systematically resampled for regrowth 2 years later. These shrubs were damaged once and regrew rapidly, and relatively, larger shrubs were not more resilient. This study provides evidence for what we termed the "Groot Effect" because smaller individuals of this shrub species can recover from significant aboveground damage and continue to have positive effects on other plant species (similar to the popular culture reference to a benefactor tree species). The density of other plant species was consistently facilitated while effects on diversity varied with season. These findings confirm that E. californica is a foundation species that can be an important restoration tool within the deserts of California in spite of extreme cycles of drought and physical damage to its canopy.

A test of desert shrub facilitation via radiotelemetric monitoring of a diurnal lizard.

Preservation of desert ecosystems is a worldwide conservation priority. Shrubs can play a key role in the structure of desert communities and can function as foundation species. Understanding desert shrub ecology is therefore an important task in desert conservation. A useful model for the function of shrubs in deserts is ecological facilitation, which explores benefits that shrubs confer on their community. Facilitation has been well developed in the context of shrub-plant interactions but less well studied for plant-animal interactions. We used radiotelemetry to test the hypothesis that a dominant desert shrub facilitates one species of diurnal lizard. We hypothesized that the blunt-nosed leopard lizard Gambelia sila would spend some part of its daily activity cycle associated with California jointfir Ephedra californica, and that lizard association with shrubs would increase during the afternoon peak temperature period. We relocated lizards three times daily for 24 days and scored whether lizards were within 0.5 m of a shrub, which we used as an indicator of shrub association. For each relocation, we also scored lizard association with a set of predefined microhabitat features. We also scored lizard behavior according to a set of predefined behavioral traits. We constructed home ranges following the minimum convex polygon method and generated estimates of shrub density and relative shrub area within each home range polygon. We obtained 1,190 datapoints from a sample of 27 lizards. We found that lizards were associated with open sites significantly more often than with shrubs but were associated with shrubs more than predicted by percent shrub area within their home ranges. Lizards were associated significantly more often under shrubs during the afternoon peak temperature period, and lizards were observed cooling under shrubs significantly more often. The frequency of association of individual lizards with shrubs was not correlated with the density of shrubs within their home range. Synthesis and Applications. Shrubs can be considered as a component of high-quality habitat for ectothermic desert vertebrates for the purposes of restoration and management. Furthermore, radiotelemetry provides a novel methodological approach for assessing shrub-animal facilitative interactions within desert communities.

A picture is worth a thousand data points: an imagery dataset of paired shrub-open microsites within the Carrizo Plain National Monument.

BACKGROUND: Carrizo Plain National Monument (San Joaquin Desert, California, USA) is home to many threatened and endangered species including the blunt-nosed leopard lizard (Gambelia sila). Vegetation is dominated by annual grasses, and shrubs such as Mormon tea (Ephedra californica), which is of relevance to our target species, the federally listed blunt-nosed leopard lizard, and likely also provides key ecosystem services. We used relatively nonintrusive camera traps, or trail cameras, to capture interactions between animals and these shrubs using a paired shrub-open deployment. Cameras were placed within the shrub understory and in open microhabitats at ground level to estimate animal activity and determine species presence. FINDINGS: Twenty cameras were deployed from April 1st, 2015 to July 5th, 2015 at paired shrub-open microsites at three locations. Over 425,000 pictures were taken during this time, of which 0.4 % detected mammals, birds, insects, and reptiles including the blunt-nosed leopard lizard. Trigger rate was very high on the medium sensitivity camera setting in this desert ecosystem, and rates did not differ between microsites. CONCLUSIONS: Camera traps are an effective, less invasive survey method for collecting data on the presence or absence of desert animals in shrub and open microhabitats. A more extensive array of cameras within an arid region would thus be an effective tool to estimate the presence of desert animals and potentially detect habitat use patterns.