BACKGROUND:Lower extremity injuries are common in professional soccer and can significantly impact return to play (RTP) and player performance. While individual injuries have been studied, comparative data across injury types remain limited. PURPOSE:To systematically evaluate return to play rate (RTPR), return to play time (RTPT), and post-injury performance outcomes following lower extremity injuries in professional European soccer players. STUDY DESIGN:Systematic review and meta-analysis; Level of evidence, 4. METHODS:A systematic search of PubMed and Embase was performed in accordance with PRISMA guidelines, covering database inception through May 2026 (initial search conducted January 2024; updated May 2026). Studies evaluating professional European soccer players with lower extremity injuries and reporting RTP outcomes were included. Primary outcomes were RTPR and RTPT. Secondary outcomes included post-injury performance metrics. A random-effects meta-analysis of proportions was performed for anterior cruciate ligament (ACL) injuries and Achilles tendon ruptures. RESULTS:Twenty-nine studies met inclusion criteria. ACL injuries demonstrated RTPR ranging from 80% to 95%, with RTPT of 215-267 days, and were associated with persistent declines in performance metrics, including minutes played and offensive production. Achilles tendon ruptures had RTPR of 70% to 78% and RTPT of 119-161 days, with significant short-term reductions in performance. Meniscus and medial collateral ligament (MCL) injuries demonstrated lower RTPR (approximately 70%) but shorter recovery timelines. Adductor and hamstring injuries were associated with the shortest RTPT (approximately 15-24 days) and minimal long-term performance decline. Meta-analysis demonstrated a pooled RTPR of 90.3% (95% CI, 81.2%-95.2%; I2 = 70.6%) for ACL injuries and 76.6% (95% CI, 69.2%-82.7%; I2 = 0%) for Achilles tendon ruptures. CONCLUSION:Among lower extremity injuries in professional European soccer, ACL injuries and Achilles tendon ruptures are associated with the greatest impact on RTP and player performance, whereas muscle injuries are associated with faster recovery and less sustained performance decline. As all included studies were observational, these findings represent associations rather than causal relationships and should be interpreted accordingly. These findings may assist clinicians and teams in prognostication and return-to-play decision-making.
OBJECTIVE:To examine variability in baseline concussion symptom burden and symptom reporting among UK university student athletes (SA) with preexisting neurodevelopmental, psychological, or mental health (NP/MH) conditions, with/without concussion history (CH), to inform clinical interpretation and best practice. METHODS:A total of 404 SA (male = 188, female = 216) from the University of Chichester, across 12 sports, completed baseline screening using the Sports Concussion Assessment Tool (SCAT) 22‑item symptom checklist (severity scored 0 = none to 6 = severe; total severity score range 0-132) prior to participation over three university sports seasons. Symptom distributions were summarized using medians and interquartile ranges (IQR). Prevalence of ≥1 symptom was compared using χ2 tests, with differences in symptom burden between concussion groups within NP/MH conditions assessed using Mann-Whitney U tests. Hierarchical linear regression analyses examined variance in symptom burden determined by NP/MH diagnosis and CH. RESULTS:SA with NP/MH diagnosis reported a higher overall symptom burden than those without. SA without NP/MH diagnosis but with CH had a greater symptom count (p < .001) and severity (p < .002). Hierarchical regression indicated that NP/MH explained 12% of variance in symptom count (R2 = .12) and 16% in symptom severity (R2 = .16), with previous concussion and depression/anxiety adding significant incremental variance (p < .001). Chi-square analysis showed that SA with NP/MH and CH were more likely to report ≥1 symptom (χ2 (1) = 9.96, p < .001). Symptom pattern analysis revealed difficulty concentrating, fatigue/low energy, and trouble sleeping as the most frequent baseline symptoms, with females reporting consistent prevalence. CONCLUSION:Preexisting NP/MH conditions and CH can substantially influence baseline symptom reporting in UK SA. Clinicians should consider these factors when interpreting SCAT symptom checklists, as variability is expected, and the management of SA return to sport is often determined by baseline values.
OBJECTIVES:This prospective cohort observational study aimed to describe the prevalence of injuries among national-level female sprinters and to explore associations between event types (curved versus straight line) and other relevant factors. METHOD:A total of 81 Japanese female sprinters competing at the national level participated in this study, of whom 41 (50.6%) specialized in straight‑line events. The Oslo Sports Trauma Research Center overuse injury questionnaire was distributed every other week for 6 months (overall response rate was 46.2%). Additionally, athletes completed a survey and performed a single-leg squat test once at the beginning. RESULTS:During the 6 months, 39 athletes (48.2%) experienced at least one substantial health problem, with 90% of these being injuries. Athletes with substantial health problems were significantly taller, slept less, and had more often specialized in curved events. Logistic regression analysis revealed shorter sleep duration was associated with higher odds of sustaining a substantial injury (OR = 0.60, 95% CI 0.37-0.97, p = 0.04). Furthermore, athletes specializing in straight‑line events had a lower risk of substantial injuries compared to those specializing in curved events (OR = 0.19, 95% CI 0.06-0.60, p <0.01). CONCLUSION:Limited sleep and specialization in curved events were significant risk factors for substantial injuries among national-level female sprinters. These findings highlight potentially important factors for injury monitoring and prevention strategies in sprint athletes, while reflecting associations observed within this cohort.
OBJECTIVES:To investigate the epidemiological characteristics of injuries sustained at the under 20s (U20) Men's European Lacrosse Championships. METHOD:Injury surveillance data was prospectively collected during the 2024 U20 European Lacrosse Championships (Wrocław, Poland). A standardized electronic reporting system based on the 2020 IOC consensus statement was used. Injury incidence was reported per 1000 match-player-hours (match-p-h). RESULTS:A total of 55 match-related injuries were reported with an injury incidence rate of 88.7 injuries per 1000 match-p-h (66.8-115.5 CI). The majority of injuries were non-time-loss (82%, 72.6 per 1000 match-p-h, 52.9-97.1 CI), 15% resulted in time-loss (>24 hours lost due to injury, 12.9 per 1000 match-p-h, 5.6-25.4 CI), and 4% reported as unknown (3.2 per 1000 match-p-h, 0.4-11.7 CI). Most injuries had a time-loss lasting between 0-1 day (73%; 64.5 per 1000 match-p-h, 46.1-87.9 CI). The onset of injury was predominantly as a result of sudden-acute trauma (73%; 64.5 per 1000 match-p-h, 46.1-87.9 CI), with contact mechanisms accounting for 67% (59.7 per 1000 match-p-h, 42.0-82.3 CI). The most frequent injuries reported were anterior thigh muscle contusion (9%; 8.1 per 1000 match-p-h, 2.6-18.8 CI), calf muscle injury (9%; 8.1 per 1000 match-p-h, 2.6-18.8 CI), ankle sprain (7%, 6.5 per 1000 match-p-h, 1.8-16.5 CI), and knee contusion (7%, 6.5 per 1000 match-p-h, 1.8-16.5 CI). CONCLUSIONS:The injury incidence during the 2024 U20 Men's European Lacrosse Championships was high compared to similar youth field sports, though most injuries did not result in time-loss. The findings should be used to inform preparations for future age-group international lacrosse tournaments.
BACKGROUND:Meniscus injuries are one of the most common orthopedic pathologies. Arthroscopic partial meniscectomy can be performed if the injury has failed nonoperative management or is irreparable. Socioeconomic disparities within health insurance coverage have been known to hinder access to surgical intervention. PURPOSE:The purpose of this study is to examine the impact of insurance status and socioeconomic demographics on the timeliness of care for meniscus tears in a high-volume urban safety-net hospital. METHODS:A retrospective review was conducted of patients aged 18 or older who underwent partial meniscectomy at a single center between January 2018 and December 2022. Patients were categorized based on insurance status. Demographic data, clinical timeliness, and non-operative treatments were analyzed. Insurance groups were compared between key time intervals, including injury-to-diagnosis, injury-to-decision, diagnosis-to-decision, decision-to-procedure, and total injury-to-surgery duration. Chi-square and multivariate regression analyses assessed the relationship between insurance type and delays in care. RESULTS:Publicly insured patients composed 67% of the 288 patients. Public insurance patients were predominantly Black (48%) and Hispanic (32%) compared to private insurance patients, where Black and Hispanic patients constituted 33% and 10%, respectively. Public insurance patients experienced significantly longer injury-to-diagnosis intervals, averaging 115 days more than private insurance patients. Delays persisted at every stage of care, with public insurance patients demonstrating longer injury-to-decision and decision-to-procedure intervals. No significant differences were found in pre-operative management, including physical therapy and bracing. White race was an independent predictor of delays in diagnosis, surgical decision, and procedure time. Male sex had quicker diagnosis to decision times. CONCLUSION:This study demonstrates significant disparities in the timeliness of surgical care for meniscus tears, with public insurance status and minority race, mainly Black and Hispanic, serving as key predictors of care delays. Public insurance patients faced prolonged intervals across all stages of care, including a 115-day delay from injury to diagnosis. Structural inefficiencies, such as lower reimbursement rates and administrative complexity of public insurance programs, combined with patient-specific barriers like financial instability and mistrust, contribute to these delays. These findings underscore the need for systemic reforms to improve equity in healthcare access.
OBJECTIVE:To compare the incidence, characteristics, and risk factors of injuries among youth athletes participating in American football and soccer in the United States, with a focus on injuries presenting to emergency departments (EDs) and factors associated with hospitalization. METHODS:A retrospective analysis of the National Electronic Injury Surveillance System (NEISS) database from 2014 to 2023 was conducted. Youth athletes aged 5-10 years (childhood), 11-13 years (early adolescence) and 14-18 years (adolescence) presenting to EDs with football- or soccer-related injuries were included. NEISS provides nationally representative estimates based on a stratified sample of approximately 100 hospital EDs and includes demographic characteristics, injury diagnoses, body regions affected, and patient disposition. Weighted national estimates, standard errors, and 95% confidence intervals (CIs) were calculated. Multivariable regression analysis was performed to identify risk factors associated with hospitalization. RESULTS:During the 10-year study period, 110,521 injury cases were identified in the NEISS sample, representing an estimated 3,228,911 injuries nationally (95% CI: 2,431,796-4,027,828). Of these, American football accounted for a significantly greater proportion of injuries than soccer (64.7% vs. 35.3%, p < 0.001). No significant temporal increase in injury incidence was observed for either sport between 2014 and 2023. Compared with soccer, football demonstrated significantly higher injury rates across all body regions, including the head/neck, trunk, and extremities (p < 0.001). Multivariable logistic regression identified several factors associated with increased odds of hospitalization, including adolescents aged 14-18 years (OR 1.13, 95% CI 1.02-1.26), male gender (OR 1.92, 95% CI 1.59-2.33), Hispanic ethnicity (OR 1.07, 95% CI 1.02-1.12), and football-related injuries (OR 1.34, 95% CI 1.20-1.50). CONCLUSIONS:Youth athletes participating in American football experience significantly more injuries and a higher risk of hospitalization compared with those participating in soccer. These findings highlight the need for targeted injury prevention strategies aimed at reducing injury severity in youth football.
OBJECTIVE:Recent studies show that former professional football players have an increased mid-life risk of cardiovascular disease (CVD), including hypertension related to their prior concussion exposure while playing football. Adolescent football players at risk of concussion are exposed to biopsychosocial risk factors of CVD that increase the likelihood of stroke in adulthood. This study aims to examine the association between concussion history and hypertension among adolescent football athletes, adjusting for health-related anthropometric measures, post-concussion symptoms, and behavioral/environmental factors. METHODS:Data were drawn from a prospective cohort study's cross-sectional baseline containing self-reported concussion history. A total of 390 adolescent football athletes (mean age = 15.8 ± 1.2 years) in secondary schools participated in the study. The primary exposure included concussion history (yes/no). Other independent variables included post-concussion symptom scale (PCSS) severity, subjective social status (SSS), sleep disturbance score, and anthropometric measures (waist circumference, BMI, body fat, obesity level). The main outcome variable was blood pressure in the hypertensive range, defined as a binary-coded variable (SBP ≥130 mmHg, DBP ≥80 mmHg). A multivariable logistic regression model was conducted with complete cases (n = 327). RESULTS:A total of 31.4% of individuals (n = 121) had blood pressure in the hypertensive range. The multivariable logistic regression analysis showed that body fat is significantly and positively associated with blood pressure in the hypertensive range (AOR = 1.06, p = 0.03). However, concussion history, PCSS severity, SSS, sleep disturbance, waist circumference, and obesity level were not significantly associated (all ps > 0.05). CONCLUSION:Body fat percentage was positively associated with blood pressure in the hypertensive range in this sample, whereas no association with concussion history was observed. The results suggest that risk factors noted in former professional football athletes may not strongly impact blood pressure in adolescence but could raise concerns for increased CVD risk as these athletes move through the lifespan.
BACKGROUND:Lateral ankle sprain is a common and recurrent injury among adolescent athletes, particularly in team sports that involve jumping, cutting, and single-leg landing. Identifying practical preseason predictors may help guide targeted injury-prevention strategies. OBJECTIVE:This prospective cohort study aimed to determine whether preseason measures of core muscle endurance, static balance, and dynamic balance could predict future lateral ankle sprain in adolescent male team-sport athletes. DESIGN:A prospective cohort study. METHODS:A total of 152 male adolescent athletes competing in soccer, volleyball, basketball, and handball were followed prospectively for 20 months. Baseline assessments included trunk flexor and extensor endurance, right and left side plank endurance, static balance, and dynamic balance in three directions (anterior, posteromedial, posterolateral) as well as a composite score. Lateral ankle sprain was defined as a non-contact inversion injury that caused time loss from training or competition. Variables with p < 0.20 in the univariate analyses were entered into a multivariable logistic regression model using forward stepwise (likelihood ratio) selection. Model performance was evaluated using odds ratios, Nagelkerke's R2, Hosmer-Lemeshow goodness-of-fit, and receiver operating characteristic (ROC) analysis. RESULTS:During follow-up, 34 athletes (22.4%) sustained a lateral ankle sprain. In the multivariable model, two independent predictors were retained: trunk extensor endurance (OR =0.989, 95% CI: 0.980-0.998, p = 0.020) and dynamic balance composite score (OR =0.937, 95% CI: 0.901-0.975, p = 0.001). The model demonstrated good calibration (Hosmer-Lemeshow p = 0.616) and explained 22.4% of the variability in injury status (Nagelkerke R2 = 0.224). The combined model showed moderate discriminative ability (AUC = 0.751, 95% CI: 0.664-0.837, p < 0.001), with an optimal cutoff yielding 88.2% sensitivity and 55.1% specificity. CONCLUSION:In adolescent team-sport athletes, lower trunk extensor endurance and poorer dynamic balance were associated with a higher likelihood of lateral ankle sprain. Assessment of these two simple field-based measures may aid preseason injury risk screening. However, the model should be validated in independent cohorts before clinical application.
PURPOSE:To evaluate the impact of Achilles tendon ruptures (ATRs) on return to play, longitudinal performance, and career longevity in National Football League (NFL) players using a matched cohort design. METHODS:A retrospective matched cohort study of 62 NFL players who sustained ATRs between 2008 and 2022, matched 1:1 to 62 non-injured controls by position, age (±1 year), height (±2 inches), weight (±10 lbs), and years in league (±1 year). Return-to-play (RTP) was assessed using multivariable logistic regression. Performance was measured using Approximate Value (AV) across three seasons before and after injury. Mixed-effects difference-in-differences modeling with placebo testing and survival analysis were the primary analytic methods. RESULTS:Mean age at injury was 27.24 ± 3.46 years. The RTP rate was 80.6% (50/62). Defensive position was the only independent predictor of RTP (OR 8.30, 95% CI 1.48-42.08; p = .015). ATR was associated with a 20.7% injury-attributable performance decline beyond natural career aging (DiD β = -1.24 AV; p = .043), with the largest decrement in the first post-injury season. Of 48 players with valid pre- and post-injury data, only 27.1% recovered to their pre-injury performance level. ATR independently increased the hazard of career termination by 68% (HR 1.68, 95% CI 1.18-2.39; p = .004), with injured players accruing 1.4 fewer active seasons over 10 years. CONCLUSIONS:ATRs in NFL players are associated with significant and persistent performance decline beyond natural career aging, despite a high RTP rate. Return to play does not equate to restoration of pre-injury performance or preservation of career longevity. LEVEL OF EVIDENCE:Level III, retrospective matched cohort study.
BACKGROUND:Trail running is a growing sport with increased injury and illness risk. We investigate the epidemiology of running-related injuries (RRI) and illnesses in male and female trail runners in the lead-up to the 2022 Magoebaskloof Forest Marathon, South Africa. METHODS:A descriptive cross-sectional study across 10 km, 20 km, 30 km, and 50 km distances using pre-race medical screening data completed 2 weeks before the event. We report frequency (n, %), prevalence ratio (PR, %), incidence (per 1000 trail running-hours), severity [% time-loss; Burden (days lost/1000 running-hours)], and associated risk factors (odds ratio, OR) of chronic and acute injuries and illness. RESULTS:The annual injury incidence was 2.79/1000 trail running-hours, with most injuries affecting the lower limb in both males (47.15%) and females (45.53%; PR = 0.99). Muscle/tendon injuries (49.59%) and muscle strains (21.95%) were most common, with no statistical significant difference between sexes. The overall injury burden was 32.7 days lost/1000 running-hours. Chronic conditions were reported by 14.22% of runners, while only seven reported acute illnesses. Although 46.62% of runners had > 5 years total overall running experience, only 22.14% had equivalent years of trail running experience. Injury risk increased with longer race distances entered and >3 weekly training sessions. CONCLUSION:One in four trail runners reported a RRI within the 6 months prior to the event, mainly affecting the lower limb. Chronic conditions were present in 14% of trail runners. While this study offers key insights into trail running injury and illness, further research on risk factors is needed.
OBJECTIVE:This study aimed to examine the relationship between psychological well-being and aggression among handball players and to determine whether exercise addiction mediates this relationship. METHODS:A descriptive, cross-sectional, and correlational design was used. The population consisted of players competing in the Turkish Handball Leagues during the 2024-2025 season, and 442 athletes participated using a non-probability sampling method. Data were collected via an online survey including a personal information form, the Psychological Well-Being Scale, the Buss-Perry Aggression Questionnaire, and the Exercise Addiction Inventory. RESULTS:Psychological well-being showed a significant negative correlation with aggression (r = -0.242, p < 0.001). Exercise addiction was positively associated with both psychological well-being (r = 0.212, p < 0.001) and aggression (r = 0.105, p = 0.027). Mediation analysis indicated that exercise addiction significantly and partially mediated the relationship between psychological well-being and aggression (indirect effect 95% CI: 0.0246-0.1654). The direct effect of psychological well-being on aggression remained significant (β = -0.7093, p < 0.001). CONCLUSION:Higher psychological well-being was associated with lower aggression among handball players, whereas exercise addiction was associated with both higher psychological well-being and higher aggression and emerged as a partial statistical mediator of this relationship. These findings may help inform future studies and preventive strategies focusing on athlete mental health and behavioral regulation. However, because of the cross-sectional design, causal inferences cannot be drawn.
OBJECTIVES:To evaluate whether 100 consecutive pitches induce clinically meaningful increases in medial elbow joint space gap (MJS) in high school baseball players and to examine associations with player characteristics, including early multi-sport participation. METHODS:In a randomized controlled trial, 34 healthy male high school baseball players were allocated to a pitching group (n = 17) or a control group (n = 17). The pitching group threw 100 fastballs at maximal effort, whereas controls rested for an equivalent duration. MJS was measured by ultrasonography before and after pitching or rest. The minimal clinically important difference (MCID) for MJS change (mm and %) was calculated using a distribution-based method (0.5 × SD of the pitching group's MJS increase). Group × time effects were tested using a two-way repeated-measures ANOVA, and univariate analyses explored relationships between MJS change and participant characteristics. RESULTS:No significant group × time interaction was observed (p = 0.427). In the pitching group, MJS increased by 0.2 ± 1.1 mm (8.3 ± 24.6%), remaining below the MCID thresholds (0.55 mm; 12.3%). Early multi-sport experience during elementary school was associated with smaller MJS expansion (p = 0.009), and the number of non-baseball sports correlated negatively with MJS change (r = -0.628, p = 0.007). No associations were found with pitch velocity or body composition. CONCLUSION:A single bout of 100 pitches did not produce clinically meaningful MJS widening in high school baseball players. However, early multi-sport participation was related to reduced MJS expansion, suggesting that diversified sport experience may be an important background factor when refining pitch-count guidance.
OBJECTIVE:Rotator cuff disorders (RCD) are among the most common causes of shoulder pain and functional limitation in clinical practice. Ultrasound (US)-guided subacromial corticosteroid injections are frequently used as a conservative treatment option for symptom relief in these patients. This study aimed to investigate the impact of subacromial bursitis on treatment outcomes following these injections. METHODS:This single-center observational study included 55 adult patients diagnosed with RCD who underwent US-guided subacromial corticosteroid injections. Patients were categorized into two groups based on the presence of subacromial bursitis, as determined by ultrasound imaging. The primary outcome was the change in pain intensity, measured by the Visual Analog Scale (VAS). Secondary outcomes included changes in shoulder function (Constant-Murley Score, CMS), disability (Shoulder Pain and Disability Index, SPADI), and shoulder range of motion (ROM). Comparative statistical analyses were conducted to assess pre- and post-injection changes between groups. RESULTS:Patients with subacromial bursitis showed significantly greater improvements in pain (VAS, p = 0.009), shoulder function (CMS, p < 0.001), disability (SPADI, p < 0.001), and ROM (p < 0.001) at the three-week follow-up compared to those without bursitis. Apart from age, no significant differences were observed in sex, symptom duration, or baseline clinical scores (VAS, CMS, SPADI, ROM) (all p > 0.05). CONCLUSION:Subacromial bursitis may be associated with a better short-term response to US-guided corticosteroid injections in RCD patients and could serve as a potential predictive marker for favorable outcomes. However, further studies are needed to confirm these findings and assess long-term effects.
OBJECTIVES:Tennis is a sport which can result in a range of injuries due to the extensive use of both the upper and lower extremities during play. Although tennis injuries are described in the literature, data specifically characterizing injury patterns in pediatric populations remain limited. This study aims to identify the epidemiology of pediatric tennis injuries presenting to US emergency departments (ED) over the past 10 years through both a sex and age specific analysis. METHODS:The National Electronic Injury Surveillance System (NEISS) wQuery ID:AQ1 Page No:1 Query ID:AQ2 Page No:1 Query ID:AQ3 Page No:2 Query ID:AQ4 Page No:3 Query ID:AQ5 Page No:3 Query ID:AQ6 Page No:4 as queried for pediatric (2-18) tennis injuries presenting to U.S. EDs from 1 January 2014-31 December 2023. Patient demographics, injury site, diagnosis, and disposition were recorded. National estimates (NE) were calculated using the NEISS statistical sample weight. Differences in injury distributions by age and sex were evaluated using Rao-Scott adjusted chi-square tests. Individual injury frequency differences across subgroups are presented descriptively. RESULTS:A total of 1,672 NEISS cases were identified, corresponding to an estimated 48,378 pediatric tennis-related injuries. Sprains/strains were the most commonly observed diagnosis among both sexes, followed by contusions/abrasions and fractures. Ankles were the predominant body part afflicted in sprains/strains and overall. Within contusions/abrasions, the face and eyeball were most commonly affected across sex and age subgroups. Children most commonly had lacerations and facial injuries, while adolescents most commonly had strains/sprains and ankle injuries. The distribution of injury types and locations significantly differed between males and females, and children and adolescents (p < 0.01). Fewer than 1% of injuries required hospitalization following ED presentation. CONCLUSION:Sprains/strains were the most common injuries, with distinct age-related patterns observed, including a higher proportion of facial injuries in children and ankle injuries in adolescents. Most injuries were minor, reflecting a relatively safe injury profile. These findings highlight potential targets for injury prevention strategies, such as protective eyewear and neuromuscular training.
OBJECTIVES:The objective of this study is to investigate the characteristics and trends of boxing injuries treated in United States (US) emergency departments. METHODS:Using a retrospective cohort study design, data from the National Electronic Injury Surveillance System for 2000-2023 were analyzed, including estimated national boxing injury frequencies and annual population-based rates. RESULTS:An estimated 362,869 boxing injuries were seen in US emergency departments from 2000 to 2023 with a 46.6% nonlinear increase in the boxing injury rate per one million US population from 4.38 in 2000 to 6.42 in 2023. Injuries were most common among males (87.5%) and individuals 18-24 years old (34.7%). Fractures were the most frequent diagnosis (24.6%), followed by soft tissue injuries (21.2%), and sprains/strains (20.9%). Concussions/closed head injuries accounted for 6.9% of injuries and were more likely to be admitted to the hospital (risk ratio [RR]: 4.37, 95% confidence interval [CI]: 2.54-7.51) than other diagnoses. Concussions/closed head injuries were also comparatively more common among younger age groups, accounting for 11.7% of injuries among children 6-11 years old. Most (86.6%) injuries occurred during practice or training. Competition-related injuries were more likely to involve the head/neck region (RR: 2.66, 95% CI: 2.25-3.15), be diagnosed as concussion/closed head injury (RR: 3.30, 95% CI: 2.58-4.22), or be admitted to the hospital (RR: 2.40, 95% CI: 1.43-4.03) than injuries occurring during practice or training. The most frequent injury mechanisms were 'struck opponent or object' (55.8%) and 'struck by opponent' (14.6%), while 'fall' was the mechanism associated with the highest proportion of hospital admissions (4.6%). CONCLUSIONS:Treatment of boxing injuries in US emergency departments is increasing, and concussions/closed head injuries disproportionately affect the vulnerable pediatric age group. The findings of this study improve our understanding of the epidemiology of boxing injuries, which will help inform targeted injury prevention efforts.
OBJECTIVE:The implementation of a headgear mandate in girls' lacrosse has encountered concerns that the use of headgear may lead to risk-taking behaviors, thereby causing more aggressive gameplay. This study aims to investigate perceptions of headgear use and the potential effect of headgear on risk compensation. METHODS:Adolescent female aged 13-19 years participating on a high school or club girls' lacrosse team completed a Qualtrics survey consisting of questions about age, years of experience, player position, headgear use, the effect headgear would have on their gameplay and completed the Brief Sensation Seeking Scale (BSSS-8). RESULTS:A total of 315 survey responses were collected. The average age of participants was 17 ± 1.5 years, with 46% possessing 1-3 years of experience. A total of 61.9% of participants reported not wearing headgear. The average Brief Sensation Seeking Scale score across all participants was 2.96 ± 0.86, with 3.14 ± 0.89 in the headgear group and 2.84 ± 0.82 in the non-headgear group, respectively. There was a statistically significant difference between headgear groups (p = 0.002) with a moderate effect size [t(311) = -3.08]. Significant positive correlations were found between headgear use and BSSS score (r = .17, p = .022, 95.00% CI = [.06, .27]), headgear use and age (r = .32, p < .001, 95.00% CI = [.22, .42]), and BSSS scores and age (r = .20, p = .002, 95.00% CI = [.10, .31]). CONCLUSIONS:A relationship between headgear use and BSSS scores was confirmed through multiple statistical approaches, with headgear wearers consistently showing higher risk perception scores than non-headgear wearers. This finding persisted even when controlling for other variables, suggesting that headgear usage may positively influence safety awareness among female lacrosse players.
OBJECTIVES:Basketball is a high-intensity contact sport with a substantial risk of injury. However, epidemiological data on injuries in Mongolian basketball players remain limited. The objective of this study was to investigate the epidemiology, mechanisms, and burden of injuries in the Mongolian National Basketball League (MNBL) over three consecutive seasons. METHODS:A retrospective epidemiological study was conducted on 374 male professional basketball players during the 2022-2023 to 2024-2025 seasons. Injury data and athlete exposures (AEs) were collected using standardized medical reporting forms. Incidence rates (IR) per 1,000 AEs, injury rate ratios (IRRs), and injury burden (days lost per 1,000 AEs) were calculated with 95% Poisson-based exact confidence intervals (CIs). RESULTS:A total of 105 injuries were recorded during 28,804 AEs. The overall IR was 3.65 (95% CI: 3.00-4.41). The injury risk was significantly higher during games (IR: 7.45) than in training (IR: 2.49), with an IRR of 2.99 (95% CI: 2.04-4.39, p < 0.001). The ankle was the most frequently injured anatomical site (32.38%; IR: 1.18), and sprains were the most common injury type (32.38%; IR: 1.18). Player-to-player contact was the primary injury mechanism (53.33%), showing a five-fold higher risk in games than in training (IRR = 5.48, p < 0.001). Moderate and severe injuries predominated (87.62% of total injuries), contributing to a substantial injury burden of 91.55 days lost per 1,000 AEs. CONCLUSIONS:Professional basketball in Mongolia is characterized by a high risk of injury during competitive play, particularly contact-related injuries. The prolonged recovery times and high severity of injuries highlight the critical need for evidence-based prevention, including neuromuscular control training, and the enhancement of on-court medical infrastructure to optimize athlete safety and professionalization in the MNBL.
AIMS AND OBJECTIVES:To determine whether week-to-week schedule variability predicts severe muscle injury in elite football when controlling for absolute workload, and to evaluate this relationship using a time-varying exposure model. MATERIALS AND METHODS:We conducted a retrospective cohort study of 30,097 player-seasons from Europe's top five leagues between 2012 and 2024. Match schedule variability was calculated using a 4-week rolling window for every week of the season. Match schedule variability, defined as the Coefficient of Variation (CV) of weekly match minutes over the same 4-week rolling window; this term is used consistently throughout to refer to this operational measure. We used logistic regression with clustered standard errors to estimate the odds of severe muscle injury (>28 days absence) in the subsequent week, controlling for mean workload, age, position, and time-varying injury history. RESULTS:Analysis of total volume revealed that rolling match workload was not significantly associated with injury risk (Adjusted OR 1.06, 95% CI 0.99-1.15, p = 0.102). However, schedule variability emerged as an independent risk factor. In multivariable models adjusting for rolling workload, age, position, and prior injury history, a one-standard-deviation increase in 4-week Schedule Variability (CV) was associated with increased odds of severe muscle injury (Adjusted OR 1.08, 95% CI 1.01-1.16, p = 0.02). CONCLUSION:Schedule instability is associated with increased injury risk. Injury prevention strategies should consider prioritizing load smoothing over simple volume restriction.
OBJECTIVE:To prospectively examine training-related injury incidence, anatomical distribution, and return-to-sports according to sex, weapon category, injury onset (acute vs. overuse), and tissue type in elite fencing athletes. METHODS:This prospective injury surveillance study followed elite fencing athletes training at a high-performance facility for 12 months. All acute and overuse training-related injuries were recorded using the International Olympic Committee injury report form. Injury incidence was calculated per 1,000 training hours. Injury location, tissue type, injury onset, and return-to-sports were analyzed according to sex and weapon category. RESULTS:A total of 471 injuries were recorded, yielding an overall incidence of 3.22 injuries per 1,000 training hours. Overuse injuries demonstrated a significantly higher incidence than acute injuries (2.59 vs. 0.63 injuries per 1,000 training hours; p < 0.001). Female athletes had a higher injury incidence than male athletes (3.86 vs. 2.66 injuries per 1,000 training hours; p < 0.001). Saber athletes exhibited the highest injury incidence, followed by epee and foil athletes. The lower extremity was the most frequently injured region (57.54%). Return-to-sports differed significantly by sex, injured body region, and tissue type (p < 0.05), with ligament injuries requiring the longest return-to-sports duration (p < 0.001). CONCLUSION:Elite fencing athletes experience a substantial burden of training-related injuries, with overuse injuries predominating during training exposure. Injury patterns and return-to-sports vary according to sex, weapon category, and tissue type. These findings support the development of sex- and weapon-specific injury prevention strategies, particularly targeting lower extremity injuries and ligament-related time loss.
PURPOSE:Exercise-induced cardiac adaptation in female athletes with extreme anthropometry remains poorly defined. The aim of this study is to analyze cardiovascular and hematological features of female athletes with extreme anthropometric indices. METHODS:Olympic female athletes underwent medical evaluation including CPET and echocardiography. According to BMI and height athletes were divided into Group A (height > 186.1 cm and BMI < 27.7 kg/m2), Group B (height ≤ 186.1 cm and BMI > 27.7 kg/m2), and Group C (height 164-175 cm and BMI between 20.4 kg/m2 and 23.5 kg/m2). RESULTS:1137 athletes were enrolled (mean age 25.2 ± 5 years old, mean height 169.9 ± 8.1 cm, and mean BMI 22.1 ± 2.8 kg/m2). Athletes with extreme anthropometry showed same functional parameters (p = 0.071) although different relative VO2max (VO2 max = 39.8 ± 6.1 mL/min/kg in group C, 33.5 ± 5.5 mL/min/kg in group B, and 29.2 ± 7.4 mL/min/kg in group A, p < 0.0001), larger LV (LVEDD = 52.7 ± 3.2 mm in A, 50.9 ± 3.2 mm in B, and 49.4 ± 3 mm in control group, p < 0.0001), and, particularly in Group B, thicker IVS and PWT (p < 0.0001). Athletes with higher BMI showed a globally higher CV risk profile. CONCLUSION:Athletes with extreme anthropometry exhibit, especially those with a high BMI, worse cardiovascular risk despite the same cardiorespiratory function. Athletes with high BMI exhibit increased LV thickness, while athletes with high height showed increased LV dimensions. Indexing for weight should not be used in extreme anthropometry.
