Lesiones deportivas en squash: estudio prospectivo en jugadores federados / Sports injuries in squash: Prospective study in federated players

Objetivo Analizar de manera prospectiva el patrón de lesión deportiva y su incidencia en función del tiempo de práctica, en una muestra de jugadores de squash de distinto nivel deportivo y de edad. Material y métodos Se realizó un estudio de cohortes prospectivo con jugadores de squash españoles que estuviesen federados y con ránking, durante la temporada 2018-2019. Se solicitó a los participantes que cubriesen un cuestionario «on line» cada vez que se registrase una lesión. Además, se registró el tiempo de entrenamiento y de competición de todos los jugadores, al objeto de establecer la incidencia lesional por cada 1.000h de práctica. Resultados Se obtuvo información de un total de 38 jugadores (17 veteranos, 13 senior y 8 sub-19). Se registraron un total de 22 lesiones, observándose que el 27,7, el 45,45 y el 27,27% de los jugadores veteranos, seniors y sub-19, respectivamente, reconocieron haberse lesionado durante la temporada. Ningún jugador se lesionó más de una vez. Las lesiones más habituales fueron las musculoesqueléticas y los miembros inferiores fueron la zona más frecuentemente afectada. La incidencia lesional fue de 1,41/1.000h. No se observó influencia del sexo o de la categoría en el riesgo de lesión. Conclusión La práctica del squash se puede considerar como potencialmente lesiva, dado que más de la mitad de los jugadores veteranos, senior y sub-19 se lesionan al menos una vez por temporada, con independencia de su edad, sexo o ránking. (AU)

Objective To prospectively analyse the pattern of sports injuries and their incidence as a function of practice time in a sample of squash players of different sporting levels and ages. Material and methods A prospective cohort study was carried out with Spanish squash players who were federated and ranked during the 2018-2019 season. Participants were asked to complete an online questionnaire each time they registered. In addition, the training and competition time of all players was also recorded in order to establish the injury incidence per 1000h of practice. Results Information was obtained from a total of 38 players (17 veterans, 13 seniors and 8 U19). A total of 22 injuries were recorded, with 27.7%, 45.45% and 27.27% of the veteran, senior and U19 players, respectively, acknowledging injuries during the season. No player was injured more than once. The most common injuries were musculoskeletal injuries, with the lower limbs being the most frequently affected area. The incidence of injury was 1.41/1000h. No influence of gender or category on injury risk was observed. Conclusion Squash can be considered as potentially injurious, given that more than half of the senior, senior and more than half of the veteran, senior and U19 players are injured at least once a season, regardless of at least once per season, irrespective of age, gender, or ranking. (AU)

Lesiones deportivas en squash: estudio prospectivo en jugadores federados / Sports injuries in squash: Prospective study in federated players

Objetivo Analizar de manera prospectiva el patrón de lesión deportiva y su incidencia en función del tiempo de práctica, en una muestra de jugadores de squash de distinto nivel deportivo y de edad. Material y métodos Se realizó un estudio de cohortes prospectivo con jugadores de squash españoles que estuviesen federados y con ránking, durante la temporada 2018-2019. Se solicitó a los participantes que cubriesen un cuestionario «on line» cada vez que se registrase una lesión. Además, se registró el tiempo de entrenamiento y de competición de todos los jugadores, al objeto de establecer la incidencia lesional por cada 1.000h de práctica. Resultados Se obtuvo información de un total de 38 jugadores (17 veteranos, 13 senior y 8 sub-19). Se registraron un total de 22 lesiones, observándose que el 27,7, el 45,45 y el 27,27% de los jugadores veteranos, seniors y sub-19, respectivamente, reconocieron haberse lesionado durante la temporada. Ningún jugador se lesionó más de una vez. Las lesiones más habituales fueron las musculoesqueléticas y los miembros inferiores fueron la zona más frecuentemente afectada. La incidencia lesional fue de 1,41/1.000h. No se observó influencia del sexo o de la categoría en el riesgo de lesión. Conclusión La práctica del squash se puede considerar como potencialmente lesiva, dado que más de la mitad de los jugadores veteranos, senior y sub-19 se lesionan al menos una vez por temporada, con independencia de su edad, sexo o ránking. (AU)

Objective To prospectively analyse the pattern of sports injuries and their incidence as a function of practice time in a sample of squash players of different sporting levels and ages. Material and methods A prospective cohort study was carried out with Spanish squash players who were federated and ranked during the 2018-2019 season. Participants were asked to complete an online questionnaire each time they registered. In addition, the training and competition time of all players was also recorded in order to establish the injury incidence per 1000h of practice. Results Information was obtained from a total of 38 players (17 veterans, 13 seniors and 8 U19). A total of 22 injuries were recorded, with 27.7%, 45.45% and 27.27% of the veteran, senior and U19 players, respectively, acknowledging injuries during the season. No player was injured more than once. The most common injuries were musculoskeletal injuries, with the lower limbs being the most frequently affected area. The incidence of injury was 1.41/1000h. No influence of gender or category on injury risk was observed. Conclusion Squash can be considered as potentially injurious, given that more than half of the senior, senior and more than half of the veteran, senior and U19 players are injured at least once a season, regardless of at least once per season, irrespective of age, gender, or ranking. (AU)

Catastrophic injuries and exertional medical events in lacrosse among youth, high school and collegiate athletes: longitudinal surveillance over four decades (1982-2020).

OBJECTIVE: To determine the incidence rates (IRs) of catastrophic injuries and exertional medical events in lacrosse athletes. METHODS: Catastrophic injuries and exertional medical events in lacrosse in the US among youth or amateur, high school and college athletes were analysed from the National Center for Catastrophic Sport Injury Research (NCCSIR) database from 1982/83 to 2019/20. Frequencies, IRs per 100,000 athlete-seasons (AS) with 95% confidence intervals (CIs), and incidence rate ratios (IRRs) with 95% CIs were calculated. Participation data were gathered from the National Federation of State High School Associations (NFHS), National Collegiate Athletic Association (NCAA) and USA Lacrosse. RESULTS: Sixty-nine catastrophic events (16 youth or amateur, 36 high school and 17 college; 84% male) occurred in US lacrosse from 7/1/1982 to 6/30/2020. Thirty-six percent of all incidents were fatal. The overall IR was 0.5 per 100,000 AS (95% CI: 0.4-0.7). There were 15 cases of non-traumatic sudden cardiac arrests (SCAs) and 15 incidents of commotio cordis. Fatality rates from SCA and commotio cordis decreased 95% (IRR = 0.05; 95% CI: 0, 0.2) from 1982/83-2006/07 to 2007/08-2019/20. Incidence rates were higher for collegiate versus high school 1982/83-2019/20 (IRR = 3.2; 95% CI: 1.8, 5.7) and collegiate versus youth 2005/06-2019/20 (IRR = 8.0; 95% CI: 3.0, 21.4) level. Contact with a stick or ball (41%) and contact with another player (20%) were the primary mechanisms of injury. CONCLUSIONS: The incidence of catastrophic events during lacrosse was higher among collegiate than high school or youth athletes. SCA from an underlying cardiac condition or from commotio cordis was the most common catastrophic event. Fatality rates from catastrophic injuries have declined significantly over the study period, perhaps driven by protective measures adopted by lacrosse governing bodies.

Key messagesCollegiate athletes had a higher incidence rate of catastrophic events during lacrosse, while high school athletes had the greatest overall number of events.Cardiac-related events were the most common catastrophic event.Fatality rates for non-traumatic sudden cardiac arrest and commotio cordis have decreased 95% over the past several decades, perhaps related to protective measures and increased access to automated external defibrillators promoted by lacrosse governing bodies.

Educational intervention promotes injury prevention adherence in club collegiate men's lacrosse athletes.

CONTEXT: Club sports are intercollegiate athletics that are student-led and not university-funded, many of which are without professional credentialing. Collegiate club athletes have an increased rate of injury compared to their NCAA counterparts. Education and implementation of stretching and strength training have demonstrated decreased rates of noncontact injuries. OBJECTIVES: Educational intervention was given to club collegiate athletes to determine its effect on injury rates, perceived pain, and compliance toward injury-prevention practices. METHODS: Intramural collegiate athletes were educated on injury prevention that focused on targeted stretching. Surveys designed to assess the impact of the education were distributed to three men's club lacrosse teams in Utah at the beginning and end of the season. The questions measured pain and time missed due to noncontact injury. RESULTS: Two-tailed unpaired t tests demonstrated p values <0.05 for: overall decreased levels of pain (p<0.0001); increased range of motion (ROM, p<0.0001); increased frequency of stretching the muscle groups psoas (p<0.0001), calves (p=0.0081), and piriformis (p<0.0001); decreased pain levels for the hamstring (p=0.0274); and increased frequency of stretching after practice (p<0.0001). CONCLUSIONS: The increased frequency of stretching suggests increased compliance toward injury prevention practices. Decreased self-reported levels of overall pain, and decreased pain in the hamstring, show that the subjects surveyed in the sample reported less pain and increased time stretching at the end of the season compared with the beginning of the season. Educational intervention offers an affordable measure to provide club collegiate athletes with resources to reduce injury rates through athlete compliance to targeted stretches.

Scoping review and quality of studies on the epidemiology of pickleball injuries

Pickleball is a sport that combines several elements of tennis, badminton and table tennis. It is played on a court similar to the badminton court and the objective of the game is to hit the ball over a net similar to the tennis net. During these years, its popularity has grown substantially in the United States of America and it has been a sport played by people of different ages. It is important to know the different injuries that can occur in this sport in order to prevent and treat them. The aim is to perform a scoping review following the PRISMA-SCR guidelines to identify the main health problems and injury characteristics suffered in pickleball athletes. A total of 4 articles from different databases were found based on the keywords and boolean operators: ("Pickleball") AND ("injury" OR "injuries" OR "pathology*" OR "illness*" OR " disease*"). The most common injuries that occur are sprains and strains, and they tend to belong to the old age. However, more epidemiological studies about pickleball injuries are needed. Few studies have been found where the data sources show limitations to subsequently be able to carry out epidemiological studies with more precision. Even so, the scientific evidence is limited to provide applicable and conclusive results and more studies are needed on this topic in pickleball. (AU)

Incidence of injuries among lacrosse athletes: a systematic review and meta-analysis.

OBJECTIVES: The purpose of this systematic review was to determine the incidence of injuries among lacrosse athletes and the differences in rates of injury by location and gender. METHODS: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were implemented to conduct this systematic review.[1] The following variables were extracted from each of the included articles: location of injury, gender of patient, and incidence of injury among study population. The methodological quality of the included studies was assessed using mixed-methods appraisal tool (MMAT) version 2018.[2] Estimated rates were reported as pooled proportion with 95% CI. Rates of injury were calculated as a rate per 1000 athletic exposures (AEs), defined as an athlete participating in 1 practice or competition in which he or she was exposed to the possibility of athletic injury. RESULTS: This study found that the highest injury rate among lacrosse athletes was to the lower leg/ankle/foot with a rate of 0.66 injuries per 1000 AEs (95% CI, 0.51, 0.82). This injury pattern was also found to be the highest among both male and female lacrosse athletes. No statistical significance was detected when comparing rates of injury across gender, regardless of location. The injury pattern with the lowest rates of injury for female athletes being to the shoulder/clavicle and the neck for male athletes. CONCLUSION: The highest rate of injury among lacrosse athletes was to the lower leg/ankle/foot. As participation in lacrosse continues to rise, there is a greater need for understanding the rate of injury and injury characteristics for physicians and trainers to provide effective care to lacrosse athletes.

Lacrosse-related injuries in boys and girls treated in U.S. emergency departments, 2000-2016.

BACKGROUND: Lacrosse is one of the fastest-growing sports in the United States. Its rules regarding permitted contact differ by sex and age. There are no known studies using a nationally representative data set to analyze lacrosse injury patterns over several years by sex and age in the youth population. METHODS: A retrospective analysis was performed using data from the National Electronic Injury Surveillance System for youth aged 11-18 years who were treated for lacrosse-related injuries in U.S. emergency departments from 2000 to 2016. Based on our review of the case narratives, we created and coded a new injury-mechanism variable. We generated national estimates from 6406 cases. RESULTS: An estimated 206,274 lacrosse-related injuries to youths aged 11-18 years were treated in U.S. emergency departments from 2000 to 2016. The rate of injuries per 10,000 significantly increased from 1.9 in 2000 to a peak of 5.3 in 2012 (p < 0.0001), followed by a significant decrease to 3.4 in 2016 (p = 0.020). Injury mechanism, body part injured, and diagnosis differed by sex. Boys were 1.62 times (95% confidence interval (95%CI): 1.25-2.09) more likely than girls to be injured by player-to-player contact. Girls were 2.21 times (95%CI: 1.96-2.49) more likely than boys to have non-contact injuries. Overall, as age increased, the percentage of injuries from lacrosse sticks decreased and player-to-player contact increased. CONCLUSION: Despite additional protective regulations in the sport, lacrosse is an important source of injury where we continue to see differences by sex and age. This study supports the continuation, modification, and addition of rules aimed at reducing lacrosse injury risk.

Acute injuries in Badminton from 10 to 66 years of age: an epidemiological study of 140 cases among all types of practice.

PURPOSE: The main objective of this retrospective study was to establish an epidemiological overview of patients admitted to an Emergency department specialized in musculo-skeletal trauma for acute lesions related to Badminton practice in the period from January 1st 2010 to January 1st 2015. METHODS: There were 135 patients with 140 admissions and 146 total number of injuries. There were 67 females (48%) and 73 males (52%). The mean age was 28 ± 13.8 years, ranging 10-66 years. 91 patients (65%) could be contacted by telephone to fill a questionnaire aimed at completing the information provided by the medical records. RESULTS: 129 lesions (88.3%) were located to the lower limbs, 16 (11%) to the upper limbs, and one (0.7%) at the head. For the whole series, there were 89 sprains (60.9%), 32 tendino-muscular lesions (21.9%), 13 fractures (8.9%), 5 dislocations (3.4%), 3 painful contusions (2.1%), 3 meniscal injuries (2.1%) and one wound (0.7%). In the lower limbs, lateral ankle sprain was the most frequent diagnosis (43.4%), followed successively by rupture of the Achilles tendon (13.9%), tennis leg (8.5%), and mid-foot sprain (6.9%). Of the 146 lesions, 117 (80.1%) received non-operative treatment, 28 (19.1%) received surgical treatment in the operation room, and one simple wound (0.7%) was sutured in the emergency room. CONCLUSIONS: Lateral ankle sprains followed by tendino-muscular lesions of the calf are by far the most frequent lesions of badminton. Modification of the shoes of badminton players should be considered to decrease the high incidence of ankle injuries.

Badminton-related eye injuries: a systematic review.

OBJECTIVES: To report the nature of badminton-related eye injuries in the published literature. METHODS: A review of the literature with key word and MeSH terms: 'Eye injury', 'Ocular trauma', 'Badminton' 'Shuttlecock' using CENTRAL, MEDLINE, EMBASE and Informit Health Collection databases. Papers were reviewed to assess the circumstances of the injury, patient demographics and clinical data. RESULTS: 19 studies from 1974 to 2020 from 12 countries reported 378 monocular badminton-related eye injuries from 378 patients with a male-to-female ratio of 2.5:1. A closed globe injury was sustained in 97% of eyes and a shuttlecock responsible for 85% of injuries. Doubles play, the shuttlecock and a lack of eye protection were associated with eye injury. CONCLUSION: Vision impairment was associated with the majority of badminton-related eye injuries, and doubles play, the shuttlecock and a lack of eye protection were risk factors.

Impact Mitigation Properties and Material Characterization of Women's Lacrosse Headgear.

The purpose of this study was to examine the impact attenuation properties of women's lacrosse headgear and to characterize mechanical properties of the materials of which they are composed. Impacts using a linear impactor (2.2, 2.9, and 5.0 m/s) and a projectile shooter (13.4 and 27.0 m/s) were applied to a Hybrid III 50th male head-neck assembly at six impact locations to replicate realistic women's lacrosse head impacts. Individual materials that make up the headgear were tested in compression at two quasi-static strain rates, 0.01/s and1/s, and 100/s using uniaxial test machines. For the linear impactor tests, results showed a significant decrease in peak linear and rotational acceleration (PLA and PRA), peak rotational velocity (PRV), head injury criteria and brain injury criteria in the helmeted impacts (p < 0.022). During the ball impacts PRV and PRA were significantly lower for both helmeted conditions compared with no helmet (p < 0.01). Material characterization tests indicated a range of rate effects in these materials ranging from weak to pronounced, and these effects correspondingly influenced the strain energy density graphs. The connection of the materials' rate effects to the performance of the headgear is described in general and in relation to the impact tests.

Association of headgear mandate and concussion injury rates in girls' high school lacrosse.

OBJECTIVES: Headgear use is a controversial issue in girls' lacrosse. We compared concussion rates among high school lacrosse players in an American state with a headgear mandate (HM) to states without an HM. METHODS: Participants included high schools with girls' lacrosse programmes in the USA. Certified athletic trainers reported athlete exposure (AE) and injury data via the National Athletic Treatment, Injury and Outcomes Network during the 2019-2021 seasons. The HM cohort was inclusive of high schools from the state of Florida, which mandates the use of ASTM standard F3137 headgear, while the non-HM (NHM) cohort was inclusive of high schools in 31 states without a state-wide HM. Incidence rate ratios (IRRs) and 95% CIs were calculated. RESULTS: 141 concussions (HM: 25; NHM: 116) and 357 225 AEs were reported (HM: 91 074 AEs; NHM: 266 151 AEs) across all games and practices for 289 total school seasons (HM: 96; NHM: 193). Overall, the concussion injury rate per 1000 AEs was higher in the NHM cohort (0.44) than the HM cohort (0.27) (IRR=1.59, 95% CI: 1.03 to 2.45). The IRR was higher for the NHM cohort during games (1.74, 95% CI: 1.00 to 3.02) but not for practices (1.42, 95% CI: 0.71 to 2.83). CONCLUSIONS: These findings suggest a statewide HM for high school girls' lacrosse is associated with a lower concussion rate than playing in a state without an HM. Statewide mandates requiring ASTM standard F3137 headgear should be considered to reduce the risk of concussion.

Clinical Recovery Timelines After Sport-Related Concussion in Men's and Women's Collegiate Sports.

CONTEXT: Researchers have identified sex differences in sport-related concussion incidence and recovery time; however, few have examined sex differences in specific recovery trajectories: time to symptom resolution, return to academics, and return to athletic activity across collegiate sports. OBJECTIVE: To examine sex differences in sport-related concussion recovery trajectories across a number of club and varsity sports with different levels of contact. DESIGN: Descriptive epidemiology study. SETTING: Collegiate varsity and club sports. PATIENTS OR OTHER PARTICIPANTS: Sport-related concussions sustained by student-athletes (n = 1974; women = 38.8%) participating in Ivy League sports were monitored between 2013-2014 and 2018-2019. MAIN OUTCOME MEASURE(S): Athletic trainers collected concussive injury and recovery characteristics as part of the Ivy League-Big Ten Epidemiology of Concussion Study's surveillance system. Time to symptom resolution, return to academics, and return to limited and full sport participation were collected. Survival analyses determined the time from injury to each recovery outcome for male and female athletes by sport. Peto tests were used to compare recovery outcomes between men's and women's sports and by sport. RESULTS: The median (interquartile range [IQR]) was 9 days (IQR = 4-18 days) for time to symptom resolution overall, 8 days (IQR = 3-15 days) for return to academics, 12 days (IQR = 8-23 days) for return to limited sport participation, and 16 days (IQR = 10-29 days) for return to full sport participation. We observed differences overall between sexes for median time to symptom resolution (men = 8 days [IQR = 4-17 days], women = 9 days [IQR = 5-20 days]; P = .03) and return to academics (men = 7 days [IQR = 3-14 days], women = 9 days [IQR = 4-17 days]; P < .001) but not for median time to return to athletics (limited sport participation: P = .12, full sport participation: P = .58). Within-sport comparisons showed that women's lacrosse athletes had longer symptom resolution (P = .03) and return to academics (P = .04) compared with men's lacrosse athletes, whereas men's volleyball athletes took longer to return to limited (P = .02) and full (P = .049) sport participation than women's volleyball athletes. CONCLUSIONS: Recovery timelines between sexes were different. Athletes in women's sports experienced longer symptom durations and time to return to academics compared with men's sports, but athletes in men's and women's sports presented similar timelines for return to athletics.

Prevalence, patterns and factors associated with injury: comparison between elite Malaysian able-bodied and para-badminton players.

OBJECTIVES: This study aimed to determine and compare the prevalence, patterns and factors associated with injury between elite Malaysian able-bodied and para-badminton players. METHODS: Medical records from July 2007 to December 2017 were reviewed. RESULTS: Among 209 able-bodied players, 1010 injuries were reported. The injuries affected the lower limb (67.2%), sustained during training (94.2%), overuse in nature (38.7%), and involving mostly junior players (62.4%). The injury rate was 94/year, lower than previously reported. Patellar tendinopathy and muscle strain to the upper limb and torso were the commonest. Age, sex and history of injury were predictors of injury. Lower limb injury was a predictor of upper limb and torso injuries, while history of injury to the upper limb and/or torso was a predictor of lower limb injury. Meanwhile, among 18 para-badminton players, 62 injuries were reported from July 2014 to December 2017, which involved the lower limb (45.2%), sustained during training (87.1%), overuse in nature (54.8%), and involved mostly standing-class players (77.8%). The injury rate was 10/year. Patellar tendinopathy, rotator cuff tendinopathy and back muscle strain were the commonest. The patterns of injury (site, occasion and nature) were similar between groups, except for the shoulder where nature was overuse in para-badminton players compared to acute in able-bodied players. CONCLUSIONS: All players are susceptible to training-related injuries, particularly to the lower limb. Over the last decade, an increase in the injury index for the lower limb and a shift from chronic to acute for the upper limb were observed among able-bodied players. Age, sex and history of injury expose able-bodied players to greater risk. Meanwhile, for para-badminton players, overuse shoulder and knee injuries are commonest. These findings necessitate a comprehensive injury prevention program that encompasses all body regions with an emphasis on the lower limb among elite Malaysian able-bodied and para-badminton players.

A comparative study of the effectiveness of an osteopathic primary care sports medicine led intervention on performance in men's collegiate lacrosse players.

CONTEXT: Comprehensive sports medicine care goes beyond the treatment of injuries resulting from athletic activities. Ultimately, it is a competence that includes knowledge in physical therapy, training, nutrition, coaching, motivation, competition, mentoring, psychology, and spirituality that allows the physician and patient to collaborate on promoting the patient's health goals. The current literature demonstrates a lack of knowledge in the Osteopathic Primary Care Sports Medicine Model's effectiveness in performance. OBJECTIVES: To determine whether a comprehensive osteopathic primary care sports medicine approach can improve performance and health outcomes in collegiate athletes. METHODS: A randomized controlled trial commenced just prior to the start of the lacrosse season and concluded at the end of the season. All the New York Institute of Technology (NYIT) collegiate lacrosse players were educated first in a 1-day seminar of the core competencies, and all participants had access to ask questions on their own volition. Then they were randomized into two groups, either the experimental group receiving the direct osteopathic primary care sports medicine intervention (n=18) or the control group not having active intervention (n=19). Also, the overall team winning percentage for that season was computed and compared to that for the previous years and the following year. Participants were assessed before and after the intervention with the Patient Health Questionnaire (PHQ-9), the 36-Item Short Form Survey (SF-36), custom Osteopathic Primary Care Sports Medicine questionnaire, and body fat composition, and their changes were compared between the experimental group and the control group. Collected data were analyzed using the repeated-measures analysis of variance. RESULTS: Thirty-seven participants were enrolled in the study. After 14 participants were excluded due to being lost to follow-up, 23 athlete records were analyzed. The winning percentage of the team was highest during the year of the study period time than in the 3 previous years and the following year. The test group did not have any statistically significant change in the PHQ-9, SF-36, custom Osteopathic Primary Care Sports Medicine questionnaire, as well as in body fat composition. CONCLUSIONS: When used during a collegiate lacrosse season, this Osteopathic Primary Care Sports Medicine intervention did not significantly improve health outcomes. This preliminary study, despite its limitations in compliance and study population size, did demonstrate improvement in overall team performance when comparing the intervention sport season to other seasons but was not statistically significantly. Therefore, further studies are warranted to improve the understanding in this approach to athlete health outcomes and performance.

Sport-Specific Increased Risk of Anterior Cruciate Ligament Injury Following a Concussion in Collegiate Female Lacrosse.

ABSTRACT: Poor neurocognitive performance has been associated with a greater risk of musculoskeletal injury, and anterior cruciate ligament (ACL) injury prevention protocols include exercises to improve neuromuscular control. Research shows that a concussion elevates the risk for subsequent lower-extremity injury, because concussions lead to lower neurocognitive performance. Studies have been conducted using data within individual male sports, such as football and rugby, or across collegiate sports in aggregate; no study has focused on women's sports. Using 7 years of data collected by athletic training staff at Davidson College, this paper evaluates preconcussive versus postconcussive lower-extremity injury risk across five collegiate women's sports: field hockey, soccer, basketball, volleyball, and lacrosse. Using incidence rate ratios, lacrosse athletes had a five-fold increase in ACL injury risk within 365 d following a concussion. Recognizing that postconcussive ACL tear risk varies across different women's sports is important in informing sport-specific concussion return to play protocols.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Lacrosse: 2014-2015 Through 2018-2019.

CONTEXT: Lacrosse is an increasingly popular sport; the number of teams participating in collegiate women's lacrosse has increased by 21.4% in the past 5 years. BACKGROUND: The growth of National Collegiate Athletic Association women's lacrosse, coupled with the ongoing discussions surrounding protective equipment, necessitates further epidemiologic studies in this population. METHODS: Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios with 95% CIs were used to examine differential injury rates. RESULTS: The overall injury rate was 4.99 per 1000 athlete exposures. Less than 30% of injuries were time-loss injuries; injuries were most commonly attributed to noncontact (26.6%) and overuse (25.2%) mechanisms. The most commonly reported specific injuries were lateral ligament complex tears (ankle sprains; 9.1%), concussions (7.2%), and hamstring tears (3.8%). SUMMARY: Findings from this study were consistent with the existing epidemiologic evidence in previous studies. Injury incidence in practices, in preseason, and as a result of player contact warrant further attention in this population.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Lacrosse: 2014-2015 Through 2018-2019.

CONTEXT: The popularity of National Collegiate Athletic Association (NCAA) men's lacrosse has been steadily increasing since the early 1980s. BACKGROUND: Injury surveillance is an important tool to aid in identifying emerging patterns of sport-related injury in NCAA men's lacrosse. METHODS: Injury data collected from a sample of men's lacrosse teams through the NCAA Injury Surveillance Program for the academic years 2014-2015 through 2018-2019 were analyzed. Athlete exposures were estimated and computed based on collected exposure data. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated to estimate differences in injury rates. RESULTS: The overall injury rate was 4.90 per 1000 athlete exposures (AEs), and the competition injury rate was higher than the practice injury rate (IRR = 2.59; 95% CI = 2.35, 2.84). The overall preseason injury rate was higher than the regular and postseason injury rates. The most reported injuries were concussions (8.0%), ankle sprains (7.7%), and hamstring tears (6.9%). CONCLUSIONS: Study findings were comparable with existing epidemiological evidence. The overall burden of concussions and lower extremity injuries warrant further attention in this population.

Rule Modifications to Reduce Checking-Related Injuries in High School Boys' Lacrosse.

CONTEXT: The National Federation of State High School Associations previously implemented 2 lacrosse rule modifications: Rule 5.4 in the 2012-2013 academic year to heighten the penalty for a head or neck hit to the head, face, or neck (HFN) and Rule 5.3.5 in the 2013-2014 academic year to minimize body checking. OBJECTIVE: To determine if the rates of overall injury, HFN injuries, and concussions due to intentional contact (checking) differed for boys' high school lacrosse players after Rule 5.4 and 5.3.5 modifications were enacted. DESIGN: Descriptive epidemiology study. SETTING: Web-based online surveillance system. PATIENTS OR OTHER PARTICIPANTS: Boys' high school lacrosse players during the 2008-2009 to 2016-2017 seasons whose teams involved athletic trainers participating in the High School Reporting Information Online sports injury-surveillance system. INTERVENTION(S): Rule 5.4 in the 2012-2013 academic year increased the penalty for any intentional hits to the HFN, and Rule 5.3.5 in the 2013-2014 year eliminated body checking to a player in a defenseless position. MAIN OUTCOME MEASURE(S): Overall, HFN, and concussion injury rate ratios (IRRs) by checking mechanism; overall and checking-related injury ratios by competitions and practices. RESULTS: A decrease was shown in checking-related HFN injuries (IRR = 0.29, 95% CI = 0.13, 0.65) and checking-related concussions (IRR = 0.29, 95% CI = 0.12, 0.70) during practices in the seasons after both rule modifications were imposed, but no decreases occurred in any checking-related injuries during competitions. By injury mechanism, no decreases were evident after the Rule 5.4 modification. When both rule modifications (Rules 5.4 and 5.3.5) were enacted together, concussion rates due to delivering body checks (IRR = 0.51, 95% CI = 0.29, 0.91) and overall injury risk due to being body checked (IRR = 0.72, 95% CI = 0.53, 0.97) decreased. CONCLUSIONS: When both Rule 5.4 and 5.3.5 modifications were in effect, concussion and overall injury risks decreased for the body checker and the player being body checked, respectively.

Epidemiology and pain in elementary school-aged players: a survey of Japanese badminton players participating in the national tournament.

Pain is common in athletes which should be well managed. To identify risk factors for shoulder pain, and the association between shoulder pain, lower back pain and knee pain among elementary school-aged badminton players, we conducted a cross-sectional study to collect data of the past year among 611 elementary school age (7-12 years old) badminton players belonging to the Japan Schoolchildren Badminton Federation using a questionnaire. Odds ratio (OR) and 95% confidence interval (CI) were estimated by multivariate logistic regression analysis. The overall incidence rate of shoulder injuries, lower back injuries and knee injuries was 0.38 injuries per 1000 h of badminton training. Players with training time per day > 2.5 h were 2.64 times (95% CI 1.03-6.78, p = 0.043) more likely to sustain shoulder pain than those with training time per day ≤ 2.5 h. A significant association was revealed between shoulder pain and knee pain as well as between lower back pain and knee pain as training hours per day > 2.5 h. Moreover, lower back pain was significantly associated with shoulder pain independent of training hours per day (≤ 2.5 h: p = 0.001; > 2.5 h: p < 0.001). These findings indicate that training time per day is risk factor, and shoulder pain, lower back pain and knee pain were associated with each other in elementary school-aged badminton players.