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SPORTS MEDICINE : SPORTS: INJURIES: These Are the Most Common Sports Injuries

David P. Dillard
 

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SPORTS MEDICINE :

SPORTS: INJURIES:

These Are the Most Common Sports Injuries

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These Are the Most Common Sports Injuries

Business Insider

Science

http://www.businessinsider.com/most-common-sports-injuries-2016-11

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That's one of the main takeaways from a newly released CDC study that documents sports- and recreation-related injuries. Every year, there are about 8.6 million of these injuries requiring medical attention in the US. About half are treated at doctor's offices or clinics instead of emergency rooms or hospitals.

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More than a quarter of those injuries, 27.9%, are caused by falls. Other common injury causes include overexertion, "being struck by or against a person or object," and injuries sustained in transportation related to sports or recreation. These are each responsible for somewhere between 12% and 17% of sports injuries.

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The most common actual injuries are strains or sprains (41%), broken bones (20%), and bruises or superficial injuries (19%). Brain injuries like concussions represent only about 4.5% of the total.

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National Health Statistics Reports

Number 99 November 18, 2016

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Sports- and Recreation-related Injury Episodes in the
United States, 2011-2014

by Yahtyng Sheu, Ph.D., Li-Hui Chen, Ph.D., and Holly Hedegaard, M.D.,

Office of Analysis and Epidemiology

https://www.cdc.gov/nchs/data/nhsr/nhsr099.pdf

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Abstract


Objective


Much of the research on sports- and recreation-related injuries
focuses on a specific population, activity, or type of injury, and national estimates
of the total burden of sports- and recreation-related injuries are limited. This study
provides national estimates of the injury burden and examines the distribution of
sports- and recreation-related injuries across demographic groups, activities, and injury
circumstances.


Methods


Information on medically attended injury episodes for persons aged 5 years and over were obtained from the 20112014 National Health Interview Survey.


Sports- and recreation-related injuries are categorized by the associated activity using a classification scheme based on the International Classification of External Causes of Injury.


Results

An average annual estimate of 8.6 million sports- and recreation-related injury episodes was reported, with an age-adjusted rate of 34.1 per 1,000 population. Males (61.3%) and persons aged 524 years (64.9%) accounted for more than one-half of injury episodes. Injury rates were higher among males, children aged 514 years, and non-Hispanic white persons than for their counterparts. One-half of the sports- and recreation-related injury episodes (50.0%) resulted in treatment at a doctors office or other health clinic without an emergency department visit or hospitalization. Overall, general exercise was the most frequently mentioned activity associated with sports- and recreation-related injuries, but types of activities varied across sex and age groups. Body regions injured while engaging in sports and recreation activities included the lower extremity (42.0%), upper extremity (30.3%), and head and neck (16.4%). ConclusionAs the nation continues to recognize the importance of physical activity to maintain health, more research efforts are needed to examine sport and recreation injury across various activities, demographic groups, and health care settings, especially settings other than emergency departments and hospitals.


Keywords: exercise nonfatal injury National Health Interview Survey


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Introduction


Clinicians and public health advocates frequently promote physical activity to maintain health and reduce the risk of obesity. Recent estimates show that 213 million Americans aged 6 years and over took part in sports and fitness activities in 2015, up from 209 million in 2014 (1). As more people engage in sports and recreation activities, injuries resulting from these activities pose an increasingly important public health concern (25).


Many epidemiological studies of sports- and recreation-related injuries focus on specific populations, activities, and outcomes. For example, multiple studies have looked at sports injuries among pediatric patients and athletes in organized sports (6). Football, soccer, and basketball are among the most frequently studied sports, and knee injuries, ankle sprains, and concussions are common outcomes in studies identifying risk factors for sports-related injuries (6). A limited number of studies provide national estimates on sports- and recreation-related injuries among all populations. These studies generally focus on emergency department (ED) visits using data from the National Center for Health Statistics (NCHS) National Hospital Ambulatory Medical Care Survey (NHAMCS) (5,79), or the Consumer Product Safety Commissions National Electronic Injury Surveillance SystemAll Injury Program (2,1012). Using NHAMCS data, researchers have provided several national estimates of sports- and recreation-related injury visits to the ED. For example, during 1997 1998, an estimated 3.7 million visits were made annually, and among them, 2.6 million involved persons aged 524 years (7). Sports and recreation activities were also the most frequently reported cause of injury-related ED visits among pediatric patients, representing approximately 1 in 5 injury-related ED visits among patients aged 19 and under (8,9). One study using data from 1999 2008 showed that sports accounted for 14% of all ED visits for life-threatening injuries, with a higher proportion seen for children aged 18 and under (32%) than for adults aged 19 and over (9%) (5). Because they tend to include more severe injuries, studies using ED data may underestimate the overall burden of injury from sports and recreation activities. For a more comprehensive look, researchers have used NCHS National Health Interview Survey (NHIS) to obtain estimates on all medically attended injuries, not just those resulting in an ED visit or hospitalization. A study using NHIS data from 19971999 estimated that 7 million Americans received medical attention for sportsand recreation-related injuries each year, and found that men, persons aged 524 years, and white persons reported higher rates than their counterparts (13). With increased participation in sports and recreation activities in recent years, updated estimates of the burden of sports- and recreation-related injuries in the United States are needed. In this study, the overall sex- and age-specific estimated numbers, percentages, and rates of medically attended sports- and recreation-related injuries are described across various demographic groups, sport activities, and injury circumstances using NHIS data from 20112014.


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Results


Overall estimates


From 2011 through 2014, Americans aged 5 years and over sustained an average 8.6 million sports- and recreation-related injury episodes per year, or 34.1 episodes per 1,000 persons (Table 1). Sixty-five percent of these injury episodes involved persons aged 524 years, with the highest rate observed among children aged 514 years (76.6 per 1,000 persons). Males accounted for 61% of the sports- and recreation-related injury episodes, with a rate of 41.2 per 1,000 persons. In both sexes, the highest rate was seen for children aged 514, with rates of 86.0 episodes per 1,000 persons for boys and 66.8 episodes per 1,000 persons for girls. Among racial and ethnic groups, non-Hispanic white persons had the highest age-adjusted sports- and recreation-related injury rate (42.5 per 1,000 persons).


Among place of injury occurrence, approximately one-third of the sportsand recreation-related injury episodes occurred at a sport facility, athletic field, or playground, representing about 2.9 million episodes annually. One-half of the sports- and recreation-related injury episodes (or 4.3 million annually) resulted in treatment at a doctors office or other health clinic without an ED visit or hospitalization, and more than onethird (36.6% or 3.2 million) resulted in an ED visit without further hospitalization. Approximately 230,000 sports- and recreation-related injury episodes (2.7%) resulted in hospitalization. Activity-specific estimates, by sex


Table 2 shows the estimated annual number, percentage, and rate of sportsand recreation-related injury episodes by type of activity. General exercise was the most frequently mentioned activity in injury episodes for all persons (16.3%) and for females (18.6%). For males, the most frequently mentioned activities were general exercise (14.9%), football (12.4%), and basketball (12.2%) (estimates were not significantly different), followed by pedal cycling (7.1%) and recreational sports (6.5%). General exercise was further categorized into Aerobics, exercising or weighttraining, Running or jogging, and School related (non-specific) activity such as recess or a physical education class without a specific sport mentioned. For all persons and for males, injury episodes resulting from aerobics, exercising, or weight training were more common than episodes resulting from running or jogging or nonspecific school-related activities. For females, the proportion of injuries that involved aerobics, exercising, or weight training (8.2%) was similar to the proportion involving running or jogging (7.2%). Activity-specific estimates, by age group


The sports and recreation activity at the time of injury also differed by age group. Table 3 shows the top five activities among age groups 514 years, 1524, and 25 and over. General exercise was frequently mentioned in all three age groups, accounting for 13.1%, 14.3%, and 21.9% of the injury episodes for age groups 514 years, 1524, and 25 and over, respectively. While gymnastics/ cheerleading and football were frequently identified in the age groups 514 and 1524, basketball was most common in age groups 1524 and 25 and over.


Pedal cycling was among the top five activities for age groups 514 years and 25 and over, but not for teenagers and younger adults aged 1524. Injuries from playground activity were frequently seen for age group 514 years, and injuries from recreational sports and water-related activities were frequently seen for those aged 25 and over.


Estimates of injury by external cause, nature of injury, and body part injured More than one-quarter of sports- and recreation-related injury episodes (27.9%) resulted from falls. Other causes such as overexertion, being struck by or against a person or object, or transportation each accounted for 12%17% of the injury episodes (Table 4). The majority of the injury diagnoses involved strains and sprains (41.4%), fractures (20.0%), and superficial injuries and contusions (19.0%). Sports-related TBI, which has received increasing public and research attention, accounted for 4.5% of the total injury diagnoses. The parts of the body most frequently injured while engaging in sports and recreation activities were lower extremity (42.0%), upper extremity (30.3%), and head and neck (16.4%).



Discussion


Research efforts to understand the patterns, risk factors, and physiology of sport injuries provide insights that can help inform prevention and treatment approaches. While many studies have focused on specific sport activities, particularly organized sports, the patterns of injury associated with individual sports, especially those engaged in by nonathletes, have not been welldescribed. The narratives from NHIS injury data not only provide an in-depth understanding of the circumstances surrounding the injury event, but also enable researchers to better estimate the burden of sports- and recreation-related injuries for both organized and individual activities. In addition, the inclusion of all medically attended injury episodes in NHIS provides estimates on injury episodes beyond traditional ED visits and hospitalizations.


This study presents updated estimates on nonfatal medically attended sports- and recreation-related injuries across various demographic groups, activities, and injury circumstances in the United States. From 2011 through 2014, an estimated 8.6 million sportsand recreation-related injury episodes occurred annually, with a rate of 34.1 episodes per 1,000 persons for persons aged 5 years and over. Although the 20112014 estimate was greater than that reported in 19971999 (6.8 million episodes, 27.2 per 1,000 persons) (13), suggestion of an increase in the sportsand recreation-related injuries in the past 15 years should be considered with caution. Differences in survey design, duration of reference (recall) period, and classification of certain sport and recreation activities may hinder direct comparison. However, this studys findings of higher proportions and rates of sports- and recreation-related injuries for males, non-Hispanic white persons, and persons aged 24 and under were consistent with the earlier NHIS study (13).


Although differences in methodology limit the direct comparison of estimates between 19971999 and 20112014, distribution of the injury episodes by activity provides insight into the patterns of these injuries in recent years. In 20112014, general exercise (16.3% of sports- and recreation-related injury episodes), basketball (9.9%), and football (8.3%) were among common activities resulting in sports- and recreation-related injury. In contrast, during 19971999, the most common activities identified were basketball (14.4%), pedal cycling (9.6%), and recreational sports (9.5%).


Results from this study also indicate that the activities at the time of sportsand recreation-related injuries differ by sex and age group. In contrast to males, none of the three most frequently mentioned activities for females included team sports. While injuries related to general exercise, playground equipment, and gymnastics were more common for children aged 514, injuries from organized sports such as basketball, soccer, and football were frequently seen among those aged 1524. For adults aged 25 and over incurring injuries, individual activities such as general exercise, recreational sports, pedal cycling, and water sports were more common.


The differences in the distribution of activities among sports- and recreationrelated injury episodes by sex and age group may be partially explained by the level of participation in these sports. According to the Sport and Fitness Industry Association (19), from 2009 through 2012, the U.S. population aged 6 years and over showed a trend in higher participation rates in exercise and fitness activities, particularly in aerobic activities (including use of stationary exercise machines), running and jogging, strengthtraining activities, and gymnastics than in organized sports. Among organized sports, more Americans participated in basketball than any other team sports, while participation rates from 2009 through 2012 decreased for baseball and football (19). In addition, according to a 2015 telephone poll developed by Harvard Opinion Research Program (20) and the 20032010 American Time Use Survey (21), males are more likely to participate in sports and exercise than females. Compared with males, females also had a lower participation rate in team sports but a higher participation rate in aerobics, yoga, and dancing (21).


In terms of the cause or mechanism of injury, this study found that falls, overexertion, and being struck by or against an object or a person accounted for more than one-half of the injury episodes (60.1%), with falls being the most common cause. This finding was similar to that reported in a study using NHIS data, which identified the most common mechanisms involved in recreational injury (22). In the body regions injured and the type of anatomical injury that occurred, the upper and lower extremities were the most common body regions associated with sports and recreation injuries. Similar to other studies, the most common injury diagnoses were sprains and strains, fractures, superficial injuries, contusions, and open wounds (7,9,13).


National Health Statistics Reports ? Number 99 ? November 18, 2016 Page 5 One-half of the sports- and recreation-related injury episodes were presented to a doctors office or other health clinic without a further ED visit or hospitalization (4.3 million episodes). This supports earlier observations from the Netherlands that one-half of all sports- and recreation-related injuries were seen by general practitioners (23). The current study estimates that 2.2 million sports- and recreation-related injury episodes among children aged 519 years were presented to a doctors office annually, which is similar to estimates from a study using National Ambulatory Medical Care Survey data from 19971998 (2.7 million injury visits to a primary care office) (24). Although sports- and recreation-related injuries presenting to a doctors office are likely to be less severe than ones presenting to EDs, the findings suggest a need for more injury research in alternative non-ED and nonhospitalization settings.


Several study limitations should be noted. NHIS injury data may be subject to recall bias due to the retrospective reporting method and use of proxy. Although NHIS interviews are conducted year-round and weights are used for annualized estimates, the 5-week recall period used in this study may still introduce seasonal effects. In addition, the narratives for approximately 10% of the sports- and recreation-related injury episodes lacked essential details for categorizing the sport activity involved.


It is unknown how the appropriate categorization of these episodes would affect the overall distribution across the sport activity categories. Compared with episodes that mention specific sports and recreation activities, episodes that could not be categorized had a similar demographic distribution but were less likely to occur at school or on a river, lake, stream, or ocean, or to result from transportation-related events (data not shown).


Finally, the lack of data on participation rates for different sports and recreation activities prevents evaluation of the risk of injury for individual sports. The findings from this study provide updated information on the demographics, types of activity, and injury diagnoses associated with sports- and recreation-related injuries.


These findings can be used to develop recommendations for prevention strategies and further research. Results from this study also suggest that a substantial proportion of sports- and recreation-related injuries are treated in health care facilities other than a hospital or ED. As the nation continues to recognize the importance of physical activity, more research efforts are needed to address the complexity of these injuries across various activities, demographic groups, and medical settings.


References



1. Physical Activity Council. 2016 participation report: The Physical Activity Councils annual study tracking sports, fitness, and recreation participation in the US. 2016.


2. CDC. Nonfatal traumatic brain injuries related to sports and recreation activities among persons aged = 19 yearsUnited States, 20012009. MMWR 60(39):1337 42. 2011.


3. Marshall SW, Gilchrist J, Taneja G, Liller KD. Sports and recreational injuries. In: Liller KD, editor. Injury prevention for children and adolescents: Research, practice and advocacy. 2nd ed. Washington DC: American Public Health Association. 2012.


4. Merkel DL. Youth sport: Positive and negative impact on young athletes. Open Access J Sports Med 4:15160. 2013.


5. Meehan WP 3rd, Mannix R. A substantial proportion of life-threatening injuries are sport-related. Pediatr Emerg Care 29(5):6247. 2013.


6. McGuine T. Sports injuries in high school athletes: A review of injury-risk and injury-prevention research. Clin J Sport Med 16(6):48899. 2006.


7. Burt CW, Overpeck MD. Emergency visits for sports-related injuries. Ann Emerg Med 37(3):3018. 2001.


8. Simon TD, Bublitz C, Hambidge SJ. External causes of pediatric injury-related emergency department visits in the United States. Acad Emerg Med 11(10):10428. 2004.


9. Simon TD, Bublitz C, Hambidge SJ. Emergency department visits among pediatric patients for sports-related injury: Basic epidemiology and impact of race/ethnicity and insurance status. Pediatr Emerg Care 22(5):30915. 2006.


10. CDC. National estimates of nonfatal injuries treated in hospital emergency departmentsUnited States, 2000. MMWR 50(17):3406. 2001.


11. Yard EE, Comstock RD. Injuries sustained by pediatric ice hockey, lacrosse, and field hockey athletes presenting to United States emergency departments, 1990 2003. J Athl Train 41(4):4419. 2006.


12. CDC. Nonfatal traumatic brain injuries from sports and recreation activities United States, 20012005. MMWR 56(29):7337. 2007.


13. Conn JM, Annest JL, Gilchrist J. Sports and recreation related injury episodes in the US population, 199799. Inj Prev 9(2):11723. 2003.


14. Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 20062015. National Center for Health Statistics. Vital Health Stat 2(165). 2014.


15. Barell V, Aharonson-Daniel L, Fingerhut LA, Mackenzie EJ, Ziv A, Boyko V, et al. An introduction to the Barell body region by nature of injury diagnosis matrix. Inj Prev 8(2):916. 2002.


16. Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States: Emergency department visits, hospitalizations and deaths 20022006. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. 2010.


17. Warner M, Schenker N, Heinen MA, Fingerhut LA. The effects of recall on reporting injury and poisoning episodes in the National Health Interview Survey. Inj Prev 11(5):2827. 2005.


18. ICECI Coordination and Maintenance Group. International classification of external causes of injuries (ICECI), version 1.2: A related classification in the World Health Organization family of internal classifications. Consumer Safety Institute, Amsterdam, Netherlands, and AIHW National Injury Surveillance Unit, Adelaide, Australia. 2004. Available from: http://www.rivm.nl/who-fic/ICECI/ ICECI_1-2_2004July.pdf.


19. Sports and Fitness Industry Association. 2013 sports, fitness and leisure activities topline participation report. 2013.


20. National Public Radio, Robert Wood Johnson Foundation, Harvard T.H. Chan School of Public Health. Sports and health in America. 2015.


21. Deaner RO, Geary DC, Puts DA, Ham SA, Kruger J, Fles E, et al. A sex difference in the predisposition for physical competition: Males play sports much more than females even in the contemporary U.S. PLoS One 7(11):e49168. 2012. Page 6 National Health Statistics Reports ? Number 99 ? November 18, 2016


22. Ni H, Barnes P, Hardy AM. Recreational injury and its relation to socioeconomic status among school aged children in the US. Inj Prev 8(1):605. 2002.


23. Baarveld F, Visser CA, Kollen BJ, Backx FJ. Sports-related injuries in primary health care. Fam Pract 28(1):2933. 2011.


24. Hambidge SJ, Davidson AJ, Gonzales R, Steiner JF. Epidemiology of pediatric injury-related primary care office visits in the United States. Pediatrics 109(4):559 65. 2002.



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The complete article may be read at the URL above.

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