ABC of Sports and Exercise Medicine

Gregory Whyte, Mike Loosemore, Clyde Williams, Gregory Whyte, Mike Loosemore, Clyde Williams

• Publisher: BMJ Books
• Year: 2015
• Print ISBN: 9781118777527
• eBook ISBN: 9781118777510
• Edition: 4
• Topic: Medicine
• Subtopic: Sports Medicine

The ABC of Sports and Exercise Medicine provides general practitioners with a comprehensive overview of the field of sports medicine. This highly illustrated and thoroughly revised and updated new edition:

• Reflects new developments and current practice
• Includes new chapters on medical care at sporting events, environmental factors of sports and exercise, benefits of exercise in health and disease, nutrition and ergogenic supplements, and the use of drugs in sport
• Covers the benefits of exercise among special populations such as the disabled, obese, pregnant, children and the elderly

Covering the latest topics and including case studies of common sports and exercise medicine conditions, the ABC of Sports and Exercise Medicine is an essential practical guide for general practitioners, family physicians, junior doctors, medical students, physiotherapists, and all health professionals dealing with the treatment and prevention of sports-related injuries.

Chapter 1
Epidemiology of Sports Injuries and Illnesses

Debbie Palmer-Green

Senior Research Fellow, Arthritis Research UK, Centre for Sport, Exercise & Osteoarthritis, University of Nottingham, Nottingham, UK

OVERVIEW

• Sports injury and illness epidemiology research is continuing to grow
• Study design and methods can influence the conclusions made
• The definition of injury/illness, and rate and severity indices should be appropriate to the cohort of interest
• Identifying injury and illness causes will help to provide additional risk information
• Prevention initiatives should target the injury/illness issues posing the greatest risk

Introduction

Recognition of the importance of sports injury and illness epidemiology research has grown in the last 10 years with national and international governing bodies of sport regularly conducting surveillance at major sporting events. Most sports involve some element of risk with regard to athlete injury or illness, some significantly more so than other (Table 1.1).

Table 1.1 Rates of overall injuries and illnesses in the Olympic sports

Sport	No. of athletes	No. of injuries (%)	No. of illnesses (%)
Archery	128	2 (1.6)	10 (7.8)
Athletics	2079	368 (17.7)	219 (10.5)
Diving	136	11 (8.1)	7 (5.1)
Swimming	931	50 (5.4)	68 (7.3)
Synchronised swimming	104	14 (13.5)	13 (12.5)
Water polo	260	34 (13.1)	21 (8.1)
Badminton	164	26 (15.9)	5 (3.0)
Basketball	287	32 (11.1)	9 (3.1)
Beach volleyball	96	12 (12.5)	18 (18.8)
Boxing	283	26 (9.2)	18 (6.4)
Canoe slalom	83	2 (2.4)	4 (4.8)
Canoe sprint	249	7 (2.8)	14 (5.6)
BMX	48	15 (31.3)	2 (4.2)
MTB	76	16 (21.1)	5 (6.6)
Road cycling	210	19 (9.0)	7 (3.3)
Track cycling	167	5 (3.0)	16 (9.6)
Equestrian	199	9 (4.5)	11 (5.5)
Fencing	246	23 (9.3)	13 (5.3)
Football	509	179 (35.2)	62 (12.2)
Artistic gymnastics	195	15 (7.7)	5 (2.6)
Rhythmic gymnastics	96	7 (7.3)	1 (1.0)
Trampoline	32	2 (6.3)	1 (3.1)
Handball	349	76 (21.8)	17 (4.9)
Hockey	388	66 (17.0)	29 (7.5)
Judo	383	47 (12.3)	16 (4.2)
Modern pentathlon	72	6 (8.3)	1 (1.4)
Rowing	549	18 (3.3)	40 (7.3)
Sailing	380	56 (14.7)	38 (10.0)
Shooting	390	15 (3.8)	17 (4.4)
Table tennis	174	11 (6.3)	12 (6.9)
Taekwondo	128	50 (39.1)	14 (10.9)
Tennis	184	21 (11.4)	4 (2.2)
Triathlon	110	16 (14.5)	7 (6.4)
Volleyball	288	20 (6.9)	8 (2.8)
Weightlifting	252	44 (17.5)	10 (4.0)
Wrestling	343	41 (12.0)	16 (4.7)

Source: Adapted from Engebretsen et al. 2013. Reproduced with permission from BMJ Publishing Group Ltd.

Although much of the literature is focused on rehabilitation of athlete injuries (and illnesses), it is just as important to try and prevent them from occurring, or if it is not possible to prevent them completely at least lessen the severity and impact when injuries and illnesses do occur. In order to correctly prioritise and accurately target prevention initiatives to reduce injuries and illnesses in sport, it is important to understand the magnitude of the problem, that is, the rate and severity, and the causes. Conducting systematic monitoring of athlete injuries and illnesses in sport is essential to provide the evidence base to inform these prevention strategies. In order to get accurate and reliable data epidemiological study designs must be robust, and issues related to the design and implementation of injury and illness surveillance studies are discussed later, with illustrative examples provided.

Study design and population

The ability to describe the incidence, nature and causes of injuries and illnesses reliably has been recognised through the development of injury/illness surveillance consensus statements. Standardising study design and data collection makes it possible to compare results between studies. Firstly, the target population (or cohort) to be studied must be identified. Sometimes what defines a population is obvious, for example, in a study recording the number of injuries during the 2011 Rugby World Cup, the players competing during the World Cup are the population cohort. It is important to note the period of observation (i.e. again this may be naturally dictated by the cohort): who is going to record the data (i.e. team physician for medical data; coaches for training and competition exposure data), the methods of data collection (paper or electronic) and the type of study. Retrospective studies collect historical data over a set period of time, while prospective studies follow the cohort over a set future period of time. Prospective studies are generally more reliable than retrospective studies due to issues with the latter of memory recall bias, where even over short periods of time, more severe or more recent injuries and illness are likely to be remembered, but the less severe and more historical episodes are more likely to be forgotten.

Injury/illness definition

A universal definition of injury and illness, applicable to all sports, would be convenient and simple. Although this has not yet been achieved, the development of consensus statements has unified much of the research cur...

Table of contents

• Cover
• ABS Series
• Title Page
• Copyright
• Table of Contents
• List of Contributors
• PART I: INJURY
• PART II: SYSTEM SPORT AND EXERCISE MEDICINE
• PART III: ENVIRONMENTAL SPORT AND EXERCISE MEDICINE
• PART IV: SPECIAL POPULATIONS
• PART V: NUTRITION AND DOPING
• Index
• End User License Agreement