Epidemiology and and Aetiology of Injury

Question 1

Acute Injury

Answer 1

Injury of sudden onset due to obvious trauma. e.g. ligament rupture, bone fracture, muscle strain

Question 2

Overuse Injury

Answer 2

Injury of gradual onset due to repetitive microtrauma (like during training). e.g. tendinopathy, stress fracture

Question 3

Incidence Rate

Answer 3

The number of new injuries occurring in a population at risk over a specific time period, or the number of new injuries during a period divided by the total number of sports people at that period.

Rate per 1000 hours or per player exposure/ risk hours

= (No. of injuries x 1000) / (No. of matches x No. of players x Match duration (1.33 hrs) )

Question 4

Acute vs Overuse injuries prevalence

Answer 4

50:50

Sport specific rate; contact sports higher acute, endurance sports higher overuse

Question 5

Rugby

Answer 5

Adults pro 81 : 1,000 player hours; 3 : 1,000 during training
Children/adolescents 26.7 : 1,000 player hours

Muscle/tendon & ligament injuries
Lower limb more common, upper limb more severe

Question 6

Netball

Answer 6

54% match rate

Knee injuries and ankle strains

Question 7

Track & Field

Answer 7

Knee (48%) … ankle, hip, lower leg

overuse

Question 8

Swimming

Answer 8

Swimmer’s shoulder = rotator cuff + shoulder laxity

overuse

Question 9

Golf

Answer 9

Lumbar spine for amateur (26%)

overuse

Question 10

Kick boxing

Answer 10

109.7 : 1,000 fight participants
64% bruising, lacerations
52.5% head and neck

Question 11

Football

Answer 11

Thigh, knee, ankle

31% strains, 20% sprain

Question 12

Cycling

Answer 12

For professionals - 1.2 injury/ cyclists/ yr

Knee (18%), wrist and elbow (16%), shoulder and clavicle (16%), contusions, abrasions, elbow, femur

Question 13

Cheerleading

Answer 13

65% of all high school female athletes catastrophic injuries

Question 14

Intrinsic Risk Factors

Answer 14

Factors specific to the athletes; biomechanical, anatomical, physiological

e.g. age, gender, lack of flexibility, hypermobility, poor muscle strength/imbalance, fatigue, etc.

Question 15

Extrinsic Risk Factors

Answer 15

Factors specific to the sport/ external to the athlete

e.g. type of sport, contact sport, surface, footwear, style of play, opponent, equipment, technique, etc.

Question 16

Over-pronation

Answer 16

Eversion + dorsiflexion + abduction of the foot (‘flat foot’)

Predisposes to: plantar fascitis, patellofemoral syndrome, shin pain, stress fracture

Question 17

Over-supination

Answer 17

Inversion + plantarflexion + abduction

Stiff foot - poor shock absorption.
Predisposes to: plantar fascitis, patellofemoral syndrome, shin pains, stress fractures, ankle sprains

Question 18

Normal Gait Cycle

Answer 18

Stance phase (60%)
- Neutral alignment of lower limb
- WB line through ASIS, patella and 2nd MT
- Normal lumbar lordosis, hips neutral, knees extended, patellae neutral
- Calcaneus in line with tibia and perpendicular to forefoot
=> affected by genu varum and genu valgus

Swing phase (40%)

• Shoulder symmetry, arm swing
• Pelvic tilt
• Patella is over the 2nd toe
• During leg swing position of foot changes accordingly; rear foot during heel strike, mid foot during midstance, forefoot during toe off

Question 19

Prevention of Injury measures

Answer 19

Warmup
stretching and flexibility
core stability
lower limb proprioception
sport specific fitness
training
ground surface
protective and appropriate equipment
cool down
hydration and nutrition
strapping

Question 20

Female Athlete Triad

Answer 20

Eating disorder + Oligo/Amenorrhoea + Osteoporosis

Predisposes to stress fractures which are potentially fatal.
Common in distance runners, gymnasts, dancers
Ix - Bloods, BMD (low)
Sx - Increased healing, fatigue, dry skin, hair loss, weight loss, predisposed to depression, anxiety, perfectionism, low self-esteem
Involve coach, dietitian, psychiatrist/ psychologist, +/- medication