 Philly.com Sports Doc
Posted: Monday, May 12, 2014, 9:37 AM Unlike other collegiate sports, there have been no studies published on track and field injuries using the NCAA injury surveillance system. Therefore, we will look at the few studies that analyze injury prevalence in track and field. A 2005 article published by Zemper in the journal Medicine and Sports Science suggested that 70-80 percent of all track and field injuries are the result of running events. 75 percent of all injuries are to the lower extremity and the overwhelming majority of injuries occur during practice. A 2011 article by Jacobsson et al in the American Journal of Sports Medicine showed a strong dominance of overuse-related conditions such as tendinopathies and stress fractures in track and field athletes. These overuse injuries account from 60-90 percent of injuries in various published papers. An article by Alonso et al in 2012’s British Journal of Sports Medicine looked at track and field injuries during the period of the Daegu 2011 IAAF World Championships. Sprint events accounted for 27.7% of all injuries followed by long distance at 17.3%, and jump events at 14.1%. Let’s look at the some of the different events and the injuries that go along with them. Sprints and Relays The most common injury in sprint events is muscle strain, specifically hamstring strain. The mechanism of hamstring injuries is still being debated. These include neuromuscular inhibition, eccentric overload, over-striding, and decreased muscular endurance to name a few. To simplify hamstring injuries, these can be broken down into acute and chronic injuries. Acute hamstring injuries are the result of a distinct injury such as a sprinter pulling out of a race. These usually involved a tear of the hamstring muscle. These can be minor or more serve where bruising, swelling, and a defect are noted. Hamstring injuries can result in significant time away from training and competition, and early return frequently results in re-injury. Treatment involves management of pain in the acute phase of injury followed by rehabilitation to regain ROM, strength, and eccentric control prior to initiating a running program. Chronic hamstring pain can be due to a variety of underlying causes. These include incomplete rehabilitation from a previous hamstring injury, overuse injury, and referred pain from other areas such as the lumbar spine. A thorough evaluation from an athletic trainer or physical therapist is needed to determine the underlying cause and to develop an appropriate rehab program. Middle Distance Middle distance injuries are a combination of sprint injuries and distance injuries. The event distance and the training methods will dictate which type of injury is more likely to occur. As with any injury, the athlete should be evaluated by the team’s athletic trainer in order to develop an appropriate rehab program. Long distance Unlike sprints, long distance injuries are primarily overuse and repetitive stress injuries. These include sprains, strains, and tendinopathies as well as stress fractures, shin splints, and exertional compartment syndrome. Treatment should not only focus on resolving the symptoms but also include a thorough biomechanical evaluation to correct the underlying cause. This should include assessment of footwear, lower extremity alignment, and lower extremity flexibility and strength. This may also include modification of the athletes training program with decreases in frequency, intensity, and/or duration. Hurdles and Steeple Chase Hurdles and steeple chase have injuries similar to the above running events but also include more traumatic injuries. With hurdles, injuries can occur from hitting the hurdle or from catching a hurdle resulting in a fall or awkward landing. Steeple chase injuries can occur from stepping onto the obstacle, not clearing the obstacle, or landing from/over the obstacle. Traumatic injuries can include contusions, ligament sprains, knee internal derangements (meniscus tear, ACL injury) and fractures. These injuries should be evaluated by the team’s athletic trainer and treated accordingly or referred to a sports medicine physician for more serious injuries. These more serious injuries usually require significant time away from training and competition. Long jump and triple jump Long jump and triple jump are horizontal jumping events with specific associated injuries. These injuries can be broken down into overuse and traumatic. Overuse injures include tendinopathies and repetitive stress injuries as seen in other events and should be treated as noted previously. Traumatic injuries occur either at takeoff or landing and can include fractures, acute muscle tears, dislocations, serious ligament sprains (such as ankle sprains), tendon ruptures, and knee internal derangements. These more serious injuries should be evaluated by your team’s athletic trainer and referred to a sports medicine physician for appropriate care. These more serious injuries usually require significant time away from training and competition. High Jump and Pole Vault High jump and pole vault are vertical jumping events with similar injuries to horizontal jumping events. These injuries can also be broken down into overuse and traumatic. Besides the traumatic injuries noted for long and triple jump, pole vault accounts for almost all of the catastrophic injuries (fatal, non-fatal but causing permanent severe functional disability) and serious (no permanent disability, but a severe injury). These more serious injuries should be evaluated by your athletic trainer and referred to a sports medicine physician for appropriate care. These injuries usually require significant time away from training and competition. Javelin, shot put, hammer, and discus Throwing events account for the vast majority of upper extremity injuries in track and field. These include injuries to the rotator cuff and shoulder labrum as well as abdominal injuries from the rotational throws, and lower extremity injuries from planting during a throw. One injury specific to the javelin is an ulnar collateral ligament tear (Tommy John injury). UCL injuries in javelin are due to the throwing motion and the stress incurred at the elbow, similar to baseball. Throwing injuries need to be evaluated by the team’s athletic trainer and either treated conservatively through rest and rehabilitation or referred to a sports medicine physician when more a more serious injury occurs such as an ulnar collateral ligament tear. Exertional heat illness Lastly, environmental factors can cause heat related illness in track and field athletes. Athletes, coaches, and medical staff need to be aware of the environmental conditions (heat and humidity) and monitor athletes for any signs or symptoms of heat illness. Heat illness is an urgent and sometimes emergent issue and needs to be address by the event’s medical staff. Signs and symptoms can include finding it hard or impossible to keep playing, loss of coordination, dizziness or fainting, profuse sweating or pale skin, headache, nausea, vomiting or diarrhea, and stomach/intestinal cramps or persistent muscle cramps. To truly evaluate an athlete for heat related injury, an accurate core body temperature needs to be assessed by a trained medical professional such as an athletic trainer. Cooling measures should be implemented with the best method being ice immersion. For those athletes with a core temperature over 104° and showing signs or symptoms of heat illness, immediate cooling should be implemented and emergency response should be initiated as heat stroke is likely. The National Athletic Trainers Association has an excellent web page on How to recognize, prevent, & treat exertional heat illness: http://www.nata.org/nr072606 As you can see, not only do we see lower extremity injuries in track and field, we also see upper extremity injuries and environment injuries such as exertional heat illness. Although most of the injuries are minor, there are urgent and emergent injuries in track and field and these are best managed by the team’s athletic trainer and medical staff.
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 Philly.com Sports Doc Posted: Monday, April 28, 2014 Injury statistics A 2007 study by Dick et al in the Journal of Athletic Training looked at injury rates for the women’s lacrosse using the NCAA injury surveillance system from 1988-2004. The results show the game injury rate was twice the rate for practice (7.15 versus 3.30 injuries per 1000 athlete-exposures [A-Es]). Preseason practice injury rates were almost twice as high as regular-season practice rates. More than 60% of all game and practice injuries were to the lower extremity. Approximately 22 percent of all game injuries and 12 percent of all practice injuries involved the head and neck. In games, ankle ligament sprains (22.6%), knee internal derangement (14.0%), concussions (9.8%), and upper leg muscle strains (7.2%) accounted for the majority of injuries. In practices, ankle ligament sprains accounted for the largest proportion of all injuries (15.5%), followed by upper leg muscle strains (11.7%) and knee internal derangements (6.1%). Participants had almost 5 times the risk of sustaining a concussion or a knee internal derangement during a game compared with practice and 3 times the risk of sustaining an ankle ligament sprain during a game. The greatest proportion of game injuries (44.3%) resulted from no direct contact. A total of 35.9 percent of game injuries were associated with other contact (primarily stick or ball) and 18.6 percent with player contact. The majority of practice injuries (62.0%) involved a non-contact mechanism. A total of 22 percent of game and 24 percent of practice injuries were severe enough to restrict participation for at least 10 days. In games, knee internal derangements accounted for almost half of all severe injuries, followed by ankle ligament sprains. Head injuries represented 7 percent of the severe game injuries. In practices, lower leg stress fractures, knee internal derangements, and ankle ligament sprains were the primary severe injuries. Lower Extremity Lower extremity injuries account for over 60 percent of all collegiate women’s lacrosse injuries. The majority of these injuries can be divided into the following diagnoses: ankle sprains, knee internal derangements, upper leg strains, and lower leg stress injuries. Ankle sprains account for 22.6 percent of game and 15.5 percent of practice injuries. These are primarily lateral ankle sprains which are caused by the ankle rolling inward during cutting and pivoting. Most ankle sprains are minor and players can return quickly to practice and competition. These injuries should initially be evaluated by your team’s athletic trainer. Depending on the severity, players with minor injuries may return immediately with taping or bracing. More severe injuries may require time away from the sport and more substantial treatment including evaluation by a sports medicine physician and subsequent rehab. There may be a period of immobilization and limited weight bearing depending on the extent of the injury. Rehab involves regaining range of motion and flexibility, strength, and balance with a gradual progression to full sports activities. Knee internal derangements account for 14 percent of game and 6.1 percent of practice injuries. The two most common diagnoses are ACL tears and meniscal tears. In women’s lacrosse, ACL injuries account for a great number of knee internal derangement due to the significantly higher rate of ACL injury in female athletes compared to males. Both meniscus tears and ACL tears are serious injuries and should be evaluated by a sports medicine physician. Although most of these injuries require surgery, there are some players who can finish the season. If an athlete is to finish the season with one of these injuries, she needs to undergo a structured rehabilitation program and meet specific objective goals before being cleared to return to sports. Upper leg strains account for 7.2 percent of games; 11.7 percent of practice injuries. These injuries are primarily hamstring strains. Hamstring injuries can be difficult to treat and there is still debate on the best course of treatment. In my experience, the initial phase of treatment focuses on reducing pain and inflammation while regaining flexibility. The second phase involves regaining strength in the injured and initiating lower level sport specific activities. The final phase involves higher level sport specific activities and a structured return to sport progression. 6.5 percent of practice injuries involve lower extremity stress injuries. These can include stress reaction or exertional compartment syndrome, which combined are commonly called shin splints, as well as stress fractures. Lower extremity stress injuries are almost always due to repetitive overload stress. This can be caused by increased training loads in under conditioned athletes, overtraining, lower extremity biomechanical issues, or a combination of all three. The first treatment is to reduce the volume and/or intensity of training. At times, athletes need to be shut down depending on the severity of symptoms. These injuries should be evaluated by both the athlete’s athletic trainer and a sports medicine physician to rule out more serious diagnoses such as a stress fracture. The athlete should also have a biomechanical analysis performed to help correct any underlying dysfunction that may be contributing to the problem such as over pronation or weak gluteus medius. Concussions Concussions are the 3rd most common game injury and 6th most common practice injury in collegiate women’s lacrosse. In this study, concussions resulted in 7 percent of all injuries requiring greater than 10 days of missed time. This correlates with concussion research showing that that most concussions resolve within that time frame. As we have learned from contact sports such as football and hockey, concussions are serious injuries and should be treated as such. An evaluation by a sports medicine clinician trained in concussion assessment should be performed in order to develop an appropriate treatment plan. This may include time away from the classroom as well as from the playing field. Upper Extremity Injuries Upper extremity injuries in women’s lacrosse account for less than 1 percent of all injuries and therefore were not tabulated in this study. This is likely due to the rules that prohibit checking in women’s lacrosse. As you can see, ankle sprains and knee internal derangements (ACL tears and meniscus tears) are the two most common injuries followed by upper leg muscle-tendon strains (hamstrings) and concussions. Upper extremity injuries are uncommon in women’s lacrosse. Any injury should be evaluated by your athletic trainer to assess the severity of the injury and determine the appropriate plan of care. 
Philly.com Sports Doc
Posted: Friday, April 4, 2014, 5:45 AM Injury statistics A 2007 study by Dick et al in the Journal of Athletic Training looked at injury rates for the men’s lacrosse using the NCAA injury surveillance system from 1988-2004. The results show a nearly 4 times higher rate of injury in games than in practice (12.58 versus 3.24 injuries per 1000 athlete-exposures [A-Es]). Pre-season practice injury rates were more than twice that of in-season. In-season game injury rates were almost twice as high as those in the postseason (12.60 versus 7.54 injuries per 1000 A-Es). A total of 48.1% of all game and 58.7% of all practice injuries were to the lower extremity. The upper extremity accounted for another 26.2% of game injuries and 16.9% of practice injuries, whereas 11.7% of game and 6.2% of practice injuries involved the head and neck.
Most game injuries (45.9%) resulted from player contact, whereas the rest were equally distributed between other contact (primarily contact with the stick) and no direct contact to the injured body part. In games, knee internal derangements accounted for 27.3% of all severe injuries, followed by acromioclavicular joint injuries (7.3%), ankle ligament sprains (7.1%), and upper leg muscle strains (5.6%). Concussions accounted for 3% of severe game injuries. In practices, these same areas, except for acromioclavicular joint injuries, accounted for most of the severe injuries. 45.9% of game injuries were associated with player contact, and 12.9% were associated with stick contact. Contact with the ball was associated with only 3% of all game injuries. Most concussions (78.5%) were associated with player contact, with stick contact accounting for another 10.4%. The majority of practice injuries (50.0%) involved no direct contact. 21% of both game and practice injuries restricted participation for at least 10 days. Lower Extremity Lower extremity injuries account for roughly half of all collegiate lacrosse injuries. The majority of injuries can be divided into the following for diagnoses: ankle sprains, knee internal derangements, upper leg strains, and upper leg contusions. Ankle sprains account for 11.3% of game and 16.4% of practice injuries. These are primarily lateral ankle sprains which are caused by the ankle rolling inward during cutting and pivoting. Most ankle sprains are minor injuries and players can return quickly to practice and competition. These injuries should initially be evaluated by your team’s athletic trainer. Depending on the severity, players with minor injuries may return immediately with taping or bracing. More severe injuries may require time away from the sport and more substantial treatment including evaluation by a sports medicine physician and subsequent rehab. There may be a period of immobilization and limited weight bearing depending on the extent of the injury. Rehab involves regaining range of motion and flexibility, strength, and balance with a gradual progression to full sports activities. Knee internal derangements account for 9.1% of game and 7.1% of practice injuries. The two most common diagnoses are meniscus tears and ACL tears. Both of these are serious injuries and should be evaluated by a sports medicine physician. Although most of these injuries require surgery, there are some players who can finish the season. If an athlete is to finish the season with one of these injuries, he needs to undergo a structured rehabilitation program and meet specific objective goals before being cleared to return to sports. Upper leg strains account for 7.5% of game injuries; 11.4% of practice injuries. These injuries are primarily hamstring strains. Hamstring injuries can be difficult to treat as seen by looking at the length of time missed on an NFL injury report. There is still debate on the best course of treatment for hamstring injuries. In my experience, the initial phase of treatment focuses on reducing pain and inflammation while regaining flexibility. The second phase involves regaining strength in the injured and initiating lower level sport specific activities. The final phase involves higher level sport specific activities and a structured return to sport progression. Lastly, upper leg contusions account for 8% of game and 3% of practice injuries. These contusions are usually the result of players being hit by balls, sticks, or other players. These injuries are usually minor and involve decreasing pain, regaining flexibility, and regaining strength. Return to sports is usually fairly quick for most of these injuries. Concussions Concussions are the 3rd most common game injury and 5th most common practice injury in collegiate lacrosse. The high rate of concussion is likely due to the contact form both stick and body checking. In this study, concussions resulted in only 3% of all injuries requiring greater than 10 days of missed time. This correlates with concussion research showing that that most concussions resolve within that time frame. As we have learned from contact sports such as football and hockey, concussions are serious injuries and should be treated as such. An evaluation by a sports medicine clinician trained in concussion assessment should be performed in order to develop an appropriate treatment plan. This may include time away from the classroom as well as from the playing field. Upper Extremity Injuries AC joint injuries are the most common upper extremity injury in lacrosse accounting for 5.1% of game injuries and 1.9% of practice injuries. These injuries are usually self-resolving and improve with conservative care. AC joint injuries should be evaluated and treated by your athletic trainer. Treatment usually involves a period of rest and immobilization if needed. Initially, goals are to reduce pain and regain range of motion. Once symptoms resolve, a strength program should be initiated with a gradual progression back to sports. Shoulder sprains/strains account for less than 3% of all injuries in men’s lacrosse. These are minor injuries that resolve with conservative care. As any injury, they should be evaluated by your athletic trainer who will develop a program to regain range of motion and strength with a supervised return to play, if any time away from the sport is needed. Shoulder subluxations/dislocations account for less than 3% of all injuries. These are more serious and need immediate evaluation by your team’s athletic trainer with a referral to a sports medicine physician. These injuries require a longer time away from sports and a more prolonged rehabilitation program. Dislocations may require surgical stabilization which is why a physician consultation is needed. Thumb fractures are another uncommon injury in lacrosse. They are almost always the result of being hit by a stick. These injuries are usually significant and require time away from sports and some type of physician treatment. This can be as minimal as splinting or as significant as surgery, depending on the severity of the fracture. As you can see, ankle sprains and knee internal derangements (meniscus tears and ligament injuries) are the two most common injuries followed by concussions. Upper extremity injuries are much less common and usually less severe as well. Any injury should be evaluated by your athletic trainer to assess the severity of the injury and determine the appropriate plan of care.  (AP Photo/The Oregonian, Ross William Hamilton) Philly.com Sports Doc POSTED: MONDAY, MARCH 24, 2014, 9:40 AM Baseball and softball may be similar sports, but the injury data differs quite a bit. Let’s see what the research says. Injury statistics A 2007 paper in the Journal of Athletic Training looked at softball injuries from 1988-2004 using the NCAA injury surveillance system. Over the 16 years of data collection, the rate of injury was 1.6 times higher in games than in practices (4.3 versus 2.7 injuries per 1000 athlete-exposures). Preseason injury rates were more than double the regular season injury rates. Postseason injury rates were lower than preseason and in-season rates. 43% of injuries occurred to the lower extremity while 33% were to the upper extremity. For game injuries, ankle sprains and knee internal derangements accounted for 19% of all injuries. Concussions accounted for 6% of all game injuries and players were 3 times more likely to sustain a concussion and 2 times more likely to suffer a knee internal derangement in a game versus practice. Of the three mechanisms of injury, contact with something other than another player accounted for 51% of all game injuries followed by non-contact at 27%. Sliding was the highest mechanism for game injuries at 27% while only accounting for a small percentage of practice injuries. Non-contact injuries accounted for 55% of all practice injuries. When looking at injury severity, more than 22% of all game and practice injuries required time missed from participation of 10 days or more. Knee internal derangements and ankle ligament sprains accounted for the majority of injuries requiring time away from sports (30.4%). In games, the base runner, batter, pitcher, and catcher were the positions with the highest risk of injury. (62.3%) Upper Extremity Upper extremity injuries are significantly less common in softball than baseball. This is likely due to the underhand pitching motion for softball which places less stress on the shoulder and elbow. Although injuries such as rotator cuff and labral tears do occur, they are not common in softball. The majority of upper extremity injuries are traumatic injuries to the shoulder wrist and hand such as fractures and dislocations. These traumatic injuries should be evaluated by your athletic trainer who will refer to a sports medicine physician for more server injuries such as dislocations and fractures. Minor injuries such as sprains and strains are usually treated with rest, rehabilitation, and taping/bracing if needed. Lower Extremity Ankle sprains and knee internal derangements are the most common softball injuries. Combined, they account for more than 22% of all injuries requiring 10+ days away from participation. Ankle sprains are the most common injury in softball and are usually the result of sliding into a base. The majority of ankle sprains are minor injuries and can be treated conservatively. Treatment can involve a short time off from play (if needed) with rehabilitation consisting of regaining range of motion/flexibility, strength, and balance. All of this should be done under the guidance of an athletic trainer or physical therapist. Knee internal derangements are the second most common injury and consist primarily of meniscal tears and ACL tears. Whereas ACL injuries require a surgical consult and are almost always season ending, some athletes are able to finish their season with meniscal tears if they are only mildly symptomatic. Once again, a consultation with an orthopedic surgeon should be made to discuss the severity of the injury and treatment options. Other injuries Softball has almost twice as many concussions during games as baseball. This is likely due to the shorter distance to the pitching mound and the smaller infield. The shorter pitching distances may place batters at increased risk of being hit by a pitch. The smaller infield places the players closer to the batter giving less time to react in order to avoid being hit by a batted ball. The smaller infield may also increase the risk of contact with another player. As we have learned from contact sports such as football and hockey, concussions are serious injuries and should be treated as such. An evaluation by a sports medicine clinician trained in concussion assessment should be performed in order to develop an appropriate treatment plan. This may include time away from the classroom as well as from the playing field. Unlike baseball, lower extremity injuries account for the majority of both minor and severe injuries in softball. As with any injury, players should be evaluated by a sports medicine specialist and an appropriate plan of care should be developed.  Philly Sports Doc
Justin Shaginaw, M.P.T., A.T.C. Posted: Monday, March 10, 2014 It’s that time of year. Spring sports are in the air, even if the spring weather isn’t. Let’s head to the ballpark and start with baseball. Upper Extremity Upper extremity injuries are the most common area injured for both college and pro baseball players. Shoulder injuries account for approximately 20 percent of all injuries in both pro and college players. These injuries include dislocations, sprains and strains, labral injuries, and rotator cuff injuries. Stats and facts about baseball injuries Dislocations are an emergent injury and immediate medical attention should be sought. In the above research studies, injuries diagnosed as sprains and strains were likely either misdiagnosed or players were given this diagnosis to down play the severity of the injury. Sprains and strains are more likely an underlying rotator cuff or labral injury. Both of these are usually the result of a kinetic chain dysfunction, which is like having your car’s steering out of alignment. By correcting the alignment issues, most shoulder problems can be resolved as long as they haven’t passed the point of no return. Once this happens, surgery is usually the only option to truly fix the problem. Elbow injuries account for approximately 16 percent of pro and 8 percent of college injuries. These injuries include sprains and strains, contusions, and more severe injuries such as ulnar collateral ligament injuries (Tommy John) and posterior impingement. As with the shoulder, elbow injuries diagnosed as sprains and strains were either misdiagnosed or players were given this diagnosis to down play the severity of the injury. Elbow sprains and strains are more likely the precursor to an ulnar collateral injury. And just as in the shoulder, by correcting alignment issues, most elbow problems can be resolved as long as they haven’t passed the point of no return. Pediatric and early adolescent shoulder and elbow injuries need to be assessed by a physician who specializes in pediatric sports medicine. These injuries can be different than the adult injuries due to open growth plates. Two such examples are little leaguer’s elbow and osteochondritis dissecans (OCD). These injuries are the result of throwing too much and overloading the elbow. This is why pitch counts are so important in little league through high school aged players. The first step in treating upper extremity problems in a throwing athlete is to be evaluated by a sports medicine clinician who specializes in the assessment of the kinetic chain. These problems include loss of shoulder range of motion (specifically internal rotation), scapular dyskinesia (shoulder blade weakness/abnormal movement), trunk and hip range of motion, core strength/stability, balance, and lower extremity flexibility and strength (specifically hip rotation range of motion and gluteus medius strength). Rehabilitation is the first step in correcting the underlying kinetic chain issues. Please be aware that not all rehab is the same. An athlete that did rehab and did not get better may not have done the correct rehab. Players should not throw until significant improvement has been made with rehab. In cases where players do not improve with the correct rehab, surgical consultation is the next step if the athlete wants to continue to play. Lower Extremity The 3 main lower extremity injuries in baseball are:
Hand/wrist Hand and wrist injuries account for approximately 10 percent of baseball injuries. These can be minor such as contusions to more serious injuries such as fractures and dislocations. The majority of these injuries are from being hit by a pitch or from sliding. Hand and wrist injuries should be evaluated by your athletic trainer who will refer to a sports medicine physician for more server injuries such as dislocations and fractures. Minor injuries are usually treated with rest, rehabilitation, and taping/bracing if needed. Other injuries Facial injuries are rare in baseball. When they occur, they are usually the result of being hit by a pitch. Examples of these injuries include facial fractures and eye injuries. These can be very serious and need immediate medical attention. Other less common injuries seen in baseball include core injuries/sports hernia, back/neck pain, and foot injuries. All of these should be initially evaluated by your athletic trainer who can develop an appropriate rehab plan as these injuries are usually minor and resolve with conservative treatment. As you can see, upper extremity injuries in baseball are the most common and tend to be the ones that will cause significant time missed from play. The cause of most shoulder and elbow injuries is an underlying kinetic chain problem. Brian Cammarota, MEd, ATC, CSCS, CES, another contributor to the Sports Doc blog, has some great posts on kinetic chain problems, throwing programs, and injury prevention for throwers. Please review some of his posts for further insight into upper extremity injuries in throwers. Philly Sports Doc
Justin Shaginaw, M.P.T., A.T.C. POSTED: MONDAY, MARCH 10, 2014 A 2007 study by Dick et al in the Journal of Athletic Training looked at injury rates for the men’s baseball using the NCAA injury surveillance system from 1988-2004.
Upper leg strains (11%) Ankle sprains (7.4%) Shoulder strains (6.5%). The most common practice injuries were: Shoulder strains (10%) Ankle sprain (8.5%) Upper leg strain (8.3%) Regarding mechanisms of injury, contact with something other than another player accounted for 45% of injuries while 42% of injuries were non-contact. For game injuries resulting in 10 or more days off, lower extremity injuries accounted for 19.7% followed by shoulder and elbow injuries at 4.3%. For practice, shoulder injuries were the major cause of significant time off. Of all shoulder and elbow injuries, pitching accounted for 73.0% and 78.4% respectively. When looking at injuries by position:
A 2011 study in the American Journal of Sports Medicine by Posner et al looked at Major League Baseball injuries from 2002-2008 using information obtained from the MLB disabled list since there is no injury surveillance system in place. They found the general rate of injury was 3.61 per 1000 A-Es. Pitchers had 34% higher injury rate then fielders. Among all player injuries, upper extremity injuries accounted for 51.4%, while lower extremity injuries were 30.6%.
 Justin Shaginaw, M.P.T., A.T.C.
POSTED: WEDNESDAY, FEBRUARY 5, 2014, 6:00 AM This is the last blog of a three part series on winter scholastic sports. Let’s head to the mat. Sprains/Strains Sprains and strains account for nearly half of all wrestling injuries with the shoulder being more common in high school wrestlers and the knee more common in college. About 40 percent of those injured return to the mat within 1 week. These injuries should be evaluated by your team’s athletic trainer and appropriate treatment plan developed. This usually includes some time off the mat, rehabilitation exercises (strengthening, stretching, balance, etc), and modalities (heat, ice, etc). For more serious injuries, schedule an appointment with a sports medicine physician for further work up (x-rays, MRI, etc) and other treatment options . Dislocations/subluxations Dislocations/subluxations account for approximately 10% of all wrestling injuries. These are urgent and often times emergent injuries requiring immediate care from an athletic trainer followed by a referral to a sports medicine physician or the emergency room. These injuries most commonly occur to the shoulder, elbow, and patella and require a prolonged period off the mat and rehabilitation. Lacerations Lacerations are much more common in college wrestling and account for approximately 10 percent of collegiate injuries. These injuries vary in severity with some being managed by your athletic trainer with an immediate return to practice or the match while others require physician referral for sutures. Suturing may require a period of time off the mat depending on the location. Fractures Fractures are the second most common injury in high school wrestlers accounting for approximately 15 percent of all injuries. These are emergent injuries requiring immediate care from an athletic trainer and referral to a sports medicine physician or the emergency room. Fractures require a significant period of time off the mat and are often season-ending. Concussions Concussions account for approximately 5 percent of injuries for both high school and college wrestlers. The majority of concussions resolve within a week. A small portion will require a prolonged recovery period and may require a significant amount of time away from the sport. All concussions should be taken seriously and evaluated initially by the team’s athletic trainer with a referral to s sports medicine physician trained in evaluation and management of athletic concussions. Skin infections Skin infections represented 8.5% and 20.3% of all reported high school and college adverse events respectively.
All wrestlers with a skin infection should be evaluated by a physician for appropriate medical treatment as dictated by National Federation of State High School Associations (NFHS) and the National Collegiate Athletic Association (NCAA). Wrestlers will also need a clearance letter from their physician clearing them to return to practice and competition. There are also prophylactic treatment options for some dermatologic conditions such as herpes which can be prescribed by a physician. Wrestling injuries are usually due to the combative nature of the sport. As you can see, sprains and strains account for the majority of wrestling injuries. Most of these are minor and can be managed conservatively with a quick return to sports. The above treatment recommendations are just a guideline and any injury should be evaluated by your team’s athletic trainer or a sports medicine physician to accurately diagnose the injury and provide appropriate care. Justin Shaginaw, M.P.T., A.T.C.
POSTED: WEDNESDAY, FEBRUARY 5, 2014, 6:00 AM A 2008 article by Yard et al in The American Journal of Sports Medicine calculated rates of injury among high school and college wrestlers during the 2005-2006 season using the High School Reporting Information Online (RIOTM) and the NCAA Injury Surveillance System (ISS). It also characterized the incidence and type injuries and compared risk factors for high school and college wrestling injuries. There were 387 injuries among participating high school wrestlers during 166,279 athlete-exposures, for an injury rate of 2.33 injuries per 1000 athlete-exposures (AE). 258 injuries occurred among college wrestlers during 35,599 athlete-exposures, for an injury rate of 7.25 injuries per 1000 AE. The injury rate was higher in college than in high school. Injury rates were higher in matches than in practices for both high school and college. Strains/sprains accounted for approximately half of all high school (48.1%) and college (49.2%) injuries. The most common high school injury sites were the shoulder (18.6%) and knee (15.4%) while the knee (24.8%), shoulder (17.8%), and head/face (16.6%) were most common in college. The most frequent high school injuries were:
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