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PubMedDate not supplied

Incidence, nature, and causes of ice hockey injuries. A three-year prospective study of a Swedish elite ice hockey team.

In this prospective study, we have investigated incidence of injuries of different severity, types of injury, and mechanisms of injury during ice hockey practice and games. One Swedish elite hockey team was closely observed during three seasons (1982 to 1985). There was a total number of 95 injuries and 29 facial lacerations. The majority of injuries were minor (73%) and only 8% were classified as major. Seventy-six percent of the injuries occurred during games and 24% during practice. The incidence of injury during practice was 1.4 per 1,000 player-practice hours and 78.4 per 1,000 player-game hours. In comparison with other sports, the incidence of injury during hockey practice is very low, while that during games is high. Eighty percent of the injuries were caused by trauma and 20% by overuse. The most common types of injury were contusions, strains, and sprains. Complete tear of the medial collateral ligament of the knee was the most common severe injury. Most injuries resulted from body contact, predominantly tackling (checking), and from puck or stick contact. A reduction of the number of minor and moderate injuries should be possible by stricter enforcement of the hockey rules, especially against stick violations, and more widespread use of visors.

Adult↗
PubMed1995

Fabricating a splint for deep friction massage.

Deep friction massage (DFM) is a therapeutic modality for tendinitis, muscle strains, ligamentous sprains, and capsulitis of the trapezio-first-metacarpal joint. Depending on the stage and site of the lesion, treatment sessions may be as brief as 5 minutes or as long as 20 minutes. Many therapists find DFM to be very effective but state that treatment is very fatiguing to administer. Therapists with hypermobile fingers find it particularly difficult to perform. In order to overcome these two problems, a number of splints have been designed to treat various lesions. This article describes how to fabricate one of these splints. This splint is useful for commonly seen lesions such as supraspinatus tendinitis and a sprained acromioclavicular ligament.

Bursitis↗
PubMed2000

The painful shoulder: part II. Acute and chronic disorders.

Fractures of the humerus, scapula and clavicle usually result from a direct blow or a fall onto an outstretched hand. Most can be treated by immobilization. Dislocation of the humerus, strain or sprain of the acromioclavicular and sternoclavicular joints, and rotator cuff injury often can be managed conservatively. Recurrence is a problem with humerus dislocation, and surgical management may be indicated if conservative treatment fails. Rotator cuff tears are often hard to diagnose because of muscle atrophy that impairs the patient's ability to perform diagnostic maneuvers. Chronic shoulder problems usually fall into one of several categories, which include impingement syndrome, frozen shoulder and biceps tendonitis. Other causes of chronic shoulder pain are labral injury, osteoarthritis of the glenohumeral or acromioclavicular joint and, rarely, osteolysis of the distal clavicle.

Acute Disease↗
PubMed1986

Cervical spine injuries.

Drs. Jackson and Lohr review such skeletal injuries as fractures, dislocations and subluxations, cervical disk herniation, degenerative disks, and "stingers." Cervical strains and sprains are also discussed, and evaluation of cervical injuries and immobilization and transportation of the injured player are other topics covered.

Athletic Injuries↗
PubMed1978

Girls' sports injuries in high school athletics.

Because of appreciable increases in the number of participants, injuries resulting from girls' interscholastic athletic activities have become a concern for school administrators and medical care providers. Four girls' high school athletic programs were prospectively studied for two years. Specially trained athletic trainers placed at each school examined each injured athlete and collected epidemiologic data. The 870 participant-seasons in nine sports resulted in 192 injuries. Three times more injuries occurred in practices than in competitive events. Although more than one third required a physician's services, the majority (59%) had returned to full athletic activity within a week of injury. Strains and sprains accounted for nearly two thirds of the injuries. Generally, the type and frequency of injuries were comparable with those seen in noncontact boys' interscholastic sports.

Adolescent↗
PubMed1995

Injury surveillance at the USTA Boys' Tennis Championships: a 6-yr study.

Injuries that required physical or medical assistance were recorded for participants at the United States Tennis Association National Boys' Tennis Championships from 1986-1988, 1990-1992 (N = 1440, 240 athletes per year). Over the 6-yr period, a total of 304 athletes (or 21.1%) sustained new or recurrent injuries that required evaluation by the medical team. New injuries alone numbered 145 (incidence rate of 9.9 per 100 athletes). The analysis of injuries showed a higher rate of lower than upper extremity injuries. When evaluated by anatomic regions, back injuries were most common followed by thigh, shoulder, and ankle injuries, respectively. When evaluated by injury type, strains and sprains were most common (71% of all injuries) with fractures and dislocations being rare (1.3% of all injuries). The lower extremity provided the majority of sprain type injuries with 87.5% of ligament sprains coming from the knee and ankle. Injuries with tennis eponyms (i.e., tennis toe, tennis leg, tennis elbow, and tennis shoulder) were rare (0%-5% of all injuries). It would appear that these young elite athletes are at significant risk of injury.

Adolescent↗
PubMed2005

Comparison of minitrampoline- and full-sized trampoline-related injuries in the United States, 1990-2002.

OBJECTIVE: To compare mini- and full-sized trampoline-related injuries in the United States. METHODS: A retrospective analysis of data was conducted for all ages from the National Electronic Injury Surveillance System (NEISS) of the US Consumer Product Safety Commission from 1990 to 2002. We compared 137 minitrampoline-related injuries with 143 full-sized trampoline-related injuries, randomly selected from all full-sized trampoline-related injuries reported to the NEISS during the study period. RESULTS: Patients ranged in age from 1 to 80 years (mean [SD]: 13.9 [17.7]) and 2 to 52 years (mean [SD]: 11.0 [8.0]) for mini- and full-sized trampoline-related injuries, respectively. Most patients were younger than 18 years (82% mini, 91% full-sized). Thirty-two percent of minitrampoline- and 19% of full-sized trampoline-related injuries were to children who were younger than 6 years; girls predominated (63% mini, 51% full-sized). Children who were younger than 6 years were more likely to be injured on a minitrampoline than on a full-sized trampoline, when compared with 6- to 17-year-olds (odds ratio [OR]: 2.43; 95% confidence interval [CI]: 1.33-4.47). The majority of injuries occurred at home (87% mini, 89% full-sized). All patients who were injured on a minitrampoline were treated and released, whereas 5% of patients who were injured on a full-sized trampoline were admitted to the hospital. On minitrampolines, children who were younger than 6 years were at risk for head lacerations (OR: 4.98; 95% CI: 1.71-16.03), and children who were 6 to 17 years were at risk for lower extremity strains or sprains (OR: 6.26; 95% CI: 1.35-59.14). Children who were 6 to 17 years and injured on a full-sized trampoline were at risk for lower extremity strains or sprains (OR: 4.85; 95% CI: 1.09-44.93). Lower extremity strains or sprains were the most common injury sustained by adults (18 years and older; 33% mini, 15% full-sized). CONCLUSIONS: Injury patterns were similar for mini- and full-sized trampolines, although minitrampoline-related injuries were less likely to require admission to the hospital and more commonly resulted in head lacerations among children who were younger than 6 years. Risk for injury could not be determined because of the lack of data regarding duration of exposure to risk. We therefore conclude that the use of full-sized trampolines by children should follow the policy recommendations of the American Academy of Pediatrics. Trampolines, including minitrampolines, should be regarded as training devices and not as toys. Until more data are available regarding exposure to risk, we caution against the use of the minitrampoline as a play device by children in the home, which is where most minitrampoline-related injuries occur.

Adolescent↗
PubMed1999

The effects of prework functional screening on lowering an employer's injury rate, medical costs, and lost work days.

STUDY DESIGN: The data in this study were gathered retrospectively after the progress of program development in terms of employee outcomes within an organization. This design characterizes a retrospective longitudinal study. OBJECTIVE: To determine whether prework functional screens are effective in lowering the incidence of work-related back sprains or strains, related medical costs, and lost work days within an organization. SUMMARY OF BACKGROUND: Musculoskeletal injuries are considered the leading cause of disability for people during their working years. Back injuries are the most common reason for workers' decreased work capacity and reduced leisure time. The increased rate of injury and escalating workers' compensation costs are are a major force motivating companies to implement a tool that can be effective in lowering back sprain or strain injuries and containing their workers' compensation costs. The U.S. Department of Health and Human Services reports a major objective of increasing the number of companies offering back injury prevention programs by the year 2000. METHODS: The study follows the effects realized when a medical center institutes close case management, early return to work policies, and prework functional screens in three stages over the course of 10.5 years. RESULTS: The severity of back sprains or strains, related medical costs, and lost work days were significantly lower with the use of prework functional screens on all new employees hired into physically laborious jobs. CONCLUSIONS: This study offers employers a proven effective tool that can be used to help lower the severity of on-the-job back sprains or strains, resulting medical costs, and lost work days in their organization.

Back Injuries↗
PubMed1993

The Duke Severity of Illness Checklist (DUSOI) for measurement of severity and comorbidity.

The Duke Severity of Illness Checklist (DUSOI) was evaluated on 414 primary care adult patients using data collected both by medical providers at the time of the patient visit and later by a chart auditor. Severity scores for individual diagnoses were determined by summing the ratings for four non-disease-specific parameters: symptom level, complications, prognosis without treatment, and expected response to treatment. Mean diagnosis severity scores (scale 0-100) among the 21 most prevalent diagnoses varied from a low of 13.9 for menopausal syndrome to a high of 43.0 for sprains and strains. An overall severity score was calculated by combining diagnosis severity scores and giving highest weights to the most severe diagnoses. Provider-generated overall severity scores (mean = 43.3) and auditor-generated overall severity scores (mean = 38.9) were significantly correlated (coefficient of agreement = 0.59, p < 0.0001). Diagnoses varied in their individual contribution to the overall severity score, from 8.9% for lipid disorder to 90.0% for sprains and strains. Separate comorbidity severity scores were calculated to measure the severity of all of each patient's health problems except the diagnosis under study. For example, patients with menopausal syndrome had co-existing health problems which generated a high mean comorbidity severity score of 43.2, while patients with sprains and strains had a low mean comorbidity score of 4.7. The DUSOI Checklist can be used in the clinical setting by both providers and auditors to produce quantitative severity scores (by diagnosis, overall, and for comorbidity) which are based entirely upon clinical judgment. This method should be useful in controlling for severity of illness in clinical studies and indicating the outcome of medical care in terms of reduction in severity of illness following medical interventions.

Adolescent↗
PubMed1985

Complications that may occur in those with spinal cord injuries who participate in sport.

The purpose of this study was to determine the risk of developing complications in paraplegics taking part in sport. It is a retrospective study of patients with complete spinal cord injury at the spinal level of C7--cauda equina/conus injury, and consists of 61 patients admitted to the Beitostølen Healthsportcenter, Norway. All of them had achieved satisfactory bladder/bowel function. The wheelchair dependents were all skilled in the use of the wheelchair. They participated in a training programme with an average duration of 25 days. Different activities were tried, such as weight-lifting, pulking, swimming, volleyball, calisthenics in a group, horseback-riding, archery, tabletennis, canoeing, totalling 11 955 training hours. During the training period the following complications were observed: urinary tract infections, pressure sores, and sprains and strains. There were 30 complications, most of them only of minor type. The incidence of complications, expressed as number of complications/1000 training-hours was, for urinary tract infections--0,50, pressure sores 0,42, sprains/strains 1,33, others 0,25: in all 2,51. Sprains and strains were the most common complications, accounting for about 55 per cent of the total, all of which were successfully treated before discharge. Sport activities are an important part of the rehabilitation of the spinal cord injured and the risk of serious complications appears to be low.

Athletic Injuries↗
PubMed2004

Evaluation of protective equipment for prevention of injuries in rugby union.

BACKGROUND: Rugby union has a high rate of injury. The increased use of protective equipment may help mitigate these injuries. This study investigated the injury prevention effectiveness of the protective equipment used in rugby union. METHODS: A cohort of 304 rugby players in Dunedin, New Zealand was followed weekly during the 1993 club season to assess protective equipment use, participation in rugby, and injury outcomes. Generalized Poisson regression was used to model the rate of injury while adjusting for covariates such as level of competition, playing position, and injury history. RESULTS: The use of mouthguards appeared to lower the risk of orofacial injury [rate ratio (RR) = 0.56, 95% confidence interval (CI): 0.07-4.63], and padded headgear tended to prevent damage to the scalp and ears (RR = 0.59, 95% CI: 0.19-1.86). Support sleeves tended to reduce the risk of sprains and strains (RR = 0.58, 95% CI: 0.26-1.27). The risk of concussion was not lessened by the use of padded headgear (RR = 1.13, 95% CI: 0.40-3.16) or mouthguards (RR = 1.62, 95% CI: 0.51-5.11). There was no evidence of protective effects for any other equipment item (taping, shinguards, and grease). CONCLUSIONS: The protective equipment used in rugby union has limited effectiveness in preventing injuries. The results are supportive, however, of a role for mouthguards and padded headgear in preventing orofacial and scalp injuries, respectively, and for support sleeves in preventing sprains and strains.

Athletic Injuries↗
PubMed2005

Score-celebration injuries among soccer players: a report of 9 cases.

BACKGROUND: Professional and amateur soccer players often perform dramatic on-field feats of celebration after scoring a goal. Injuries may occur during these activities. PURPOSE: With the aim of preventing such "score-celebration injuries" in the future, the authors examine these events in professional soccer players and discuss potential avenues for prevention. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Over the course of 2 seasons (1996-1998), 152 soccer players were evaluated at an orthopaedic clinic for injuries incurred during matches. Nine players (6%) had injured themselves while celebrating after scoring goals in a match. The type of celebration, injury type, treatment, and mean duration of recovery were noted. RESULTS: Seven of the 9 patients were male professional soccer players with ages ranging between 17 and 29 years (mean age, 24 years). The injuries occurred when the playing ground was natural turf in 8 cases; most injuries occurred in the second half of the game. The types of celebration maneuvers were sliding (prone or supine) and sliding while kneeling in 5 cases, piling up on jubilant teammates in 3 cases, and being tackled while racing away in 1 case. Injuries included ankle, clavicle, and rib fractures; medial collateral ligament sprain; low back strain; hamstring and adductor muscle strain; quadriceps muscle sprain; and coccyx contusion. The mean duration for recovery was 6.2 weeks. Rival team players were usually not responsible for such trauma. CONCLUSION: Exaggerated celebrations after making a goal, such as sliding, piling up, and tackling a teammate when racing away, can result in serious injury. In addition to general measures for preventing soccer injuries, coaches and team physicians should teach self-control and behavior modification to minimize the risk of such injuries. More restrictive rules, which penalize such behavior, may assist in the prevention of score-celebration injuries.

Adolescent↗
PubMed1991

Low back pain in young athletes. A practical approach.

Lumbar spine pain accounts for 5 to 8% of athletic injuries. Although back pain is not the most common injury, it is one of the most challenging for the sports physician to diagnose and treat. Factors predisposing the young athlete to back injury include the growth spurt, abrupt increases in training intensity or frequency, improper technique, unsuitable sports equipment, and leg-length inequality. Poor strength of the back extensor and abdominal musculature, and inflexibility of the lumbar spine, hamstrings and hip flexor muscles may contribute to chronic low back pain. Excessive lifting and twisting may produce sprains and strains, the most common cause of low back pain in adolescents. Blows to the spine may create contusions or fractures. Fractures in adolescents from severe trauma include compression fracture, comminuted fracture, fracture of the growth plate at the vertebral end plate, lumbar transverse process fracture, and a fracture of the spinous process. Athletes who participate in sports involving repeated and forceful hyperextension of the spine may suffer from lumbar facet syndrome, spondylolysis, or spondylolisthesis. The large sacroiliac joint is also prone to irritation. The signs and symptoms of disc herniation in adolescents may be more subtle than in adults. Disorders simulating athletic injury include tumours and inflammatory connective tissue disease. Often, however, a specific diagnosis cannot be made in the young athlete with a low back injury due to the lack of pain localisation and the anatomic complexity of the lumbar spine. A thorough history and physical examination are usually more productive in determining a diagnosis and guiding treatment than imaging techniques. Diagnostic tests may be considered, though, for the adolescent athlete whose back pain is severe, was caused by acute trauma, or fails to improve with conservative therapy after several weeks. Radiographs, bone scanning, computed tomography, and magnetic resonance imaging may help identify, or exclude serious pathology. Fortunately, the majority of cases of low back pain in adolescents respond to conservative therapy. Immediate treatment of an acute injury, such as a sprain or strain, includes cryotherapy, electrogalvanic stimulation, anti-inflammatory medications and gentle exercises. Prolonged bed rest should be avoided since atrophy may occur rapidly. Strong analgesics are also usually contraindicated, except for sleep, since they mask pain and may allow overvigorous activity. Early strengthening exercises include the Williams flexion exercises and/or McKenzie extension exercises. Both exercise motions may often be prescribed. Athletes with an acute disc herniation, however, should only perform extension exercises initially. Athletes with spondylolysis, spondylolisthesis and facet joint irritation should initially be limited to flexion exercises.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed2006

Injury patterns in children with frequent emergency department visits.

OBJECTIVES: To compare injury patterns in children with many and few emergency department (ED) visits in order to reveal the causes for the frequent visits. METHODS: Three cohorts of Danish children (total 579 721 children) were followed for three years when their ages were 0-2, 6-8, and 12-14 years. Information on all ED visits was obtained from the Danish National Patient Registry. Injury type, place of accident, injury mechanism, admission, and distance to ED were compared between children with frequent ED visits (five or more during the three years) and children with only one visit. RESULTS: Children with frequent visits had a different injury pattern with 0-46% more superficial injuries and 25-82% more dislocations, sprains, and strains. There was 20-30% fewer fractures and 12% fewer falls from a higher level. 15-51% fewer were admitted. CONCLUSIONS: Children with many ED visits had less severe injuries and more dislocations, sprains, and strains.

Adolescent↗