IJSPT
ORIGINAL RESEARCH
INJURIES IN DISC GOLF – A DESCRIPTIVE CROSS-SECTIONAL STUDY Martin Amadeus Rahbek, BSc¹ Rasmus Oestergaard Nielsen, PT, MHSc, PhD¹
ABSTRACT Background: Disc golf is rapidly increasing in popularity and more than two million people are estimated to regularly participate in disc golf activities. Despite this popularity, the epidemiology of injuries in disc golf remains under reported. Purpose: The purpose of the present study was to investigate the prevalence and anatomic distribution of injuries acquired through disc-golf participation in Danish disc golf players. Methods: The study was a cross-sectional study conducted on Danish disc-golf players. In May 2015, invitations to complete a web-based questionnaire were spread online via social media, and around disc-golf courses in Denmark. The questionnaire included questions regarding disc-golf participation and the characteristics of injuries acquired through disc golf participation. The data was analyzed descriptively. Results: An injury prevalence of 13.3% (95% CI: 6.7% to 19.9%) was reported amongst the 105 disc-golf players who completed the questionnaire. The anatomical locations most commonly affected by injury were the shoulder (31%) and the elbow (20%). Injuries affecting the players at the time of completion of the questionnaire had a median duration of 240 days (IQR 1410 days), and the majority (93%) had a gradual onset. Conclusions: A 13.3% point prevalence of injury was reported. Most injuries occurred in the shoulder and elbow regions, and were gradual in onset. Injuries affecting the players at the time of data collection had median symptomatic duration of 240 days. Levels of Evidence: 3b Keywords: Disc golf, epidemiology, frisbee golf, injury, overuse
1
Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
Ethics: Observational studies require no ethical approval, in accordance to Danish law. Conflicts of interest: None of the authors has any financial interest in the results presented. No sources of funding were sought or received. R. O. Nielsen was personally salaried by his institution, but no specific salary was set aside or given for the paper. Acknowledgements: The authors would like to give thanks to the Danish Disc Golf Union and DGI Disc Golf, for their support spreading invitations to the study, both online and on courses around Denmark.
CORRESPONDING AUTHOR Martin Amadeus Rahbek Dalgas Avenue 4, DK-8000 Aarhus C Telephone: +45 27 85 25 66 E-mail: [email protected]
The International Journal of Sports Physical Therapy | Volume 11, Number 1 | February 2016 | Page 132
INTRODUCTION Disc golf is rapidly increasing in popularity as a sport and leisure activity, with an average annual growth rate of more than 11% since 2005.1 Today, the Professional Disc Golf Association (PDGA) estimates, that more than two million people around the world regularly participate in disc-golf activities,2 of which an estimated 80,000 reside in Scandinavia.3 Accordingly, the number of disc-golf courses across the world has doubled to more than 4700 between 2007 and 2014,2 further emphasizing the increasing interest in the sport. Formalized in the 1970’s, the rules and terminology of disc golf is similar to regular golf, but contrary to the use of golf balls and clubs, disc golf is played with specially designed frisbees, called discs, which are thrown aimed at elevated baskets. In disc golf, the goal is to complete a round of usually 9 or 18 baskets in the fewest throws possible, using a combination of driver-, midrange- and putter-style discs. Each course, and even each hole, presents with its distinct barriers, including terrain, elevation, curvature, obstacles and wind conditions.4,5 The player then seeks to overcome these barriers using a variety of different types of throws, of which the backhand and the forehand throws are the most common.5 Recreational disc golf appeals to a large portion of the population, as the vast majority of courses are public,4 and the sole requirement to play is a single disc that costs approximately fifteen dollars. Disc golf is a viable option for those who wants to remain active and competitive in middle age, because of the low-intensity non-contact nature of the sport and the social component, inherent to golf-type sports.6 In fact, more than 30% of the registered PDGA players are above 40 years of age.2 Disc golf also utilizes the handicap system, which facilitates high-level competition across differences in skill. Epidemiologic knowledge regarding injuries in disc golf, however, is sparse. A related frisbee-sport, ultimate, has received more scientific attention,7–10 but as more than 40% of injuries in ultimate occurs acutely through player to player contact,10 the injury pattern is likely incomparable to disc golf. Instead, overuse injuries may be prevalent, owing to the repetitive forceful movements of throwing the discs, similar to the injury pattern of regular golf.11 One study
including disc-golf players was recently conducted by Nelson and colleagues,5 revealing an 81.8% alltime prevalence of injury sustained through disc golf. However, in their study no definition of injury was provided.5 In other sports, varying injury definitions has shown to affect the number, and even location, of injuries reported.12 Therefore, more studies on injury occurrence in disc golf are needed using well-defined injury definitions. The purpose of the present study was to investigate the prevalence and anatomic distribution of injuries acquired through disc-golf participation in Danish disc golf players. METHODS Study design The study was designed as a cross-sectional, epidemiological study. Data collection was conducted during a six-week timeframe beginning in May 2015, using a web-based questionnaire developed by the authors. In accordance to Danish legislation, no ethical approval was sought because of the observational design. Participants Invitations to complete the web-based questionnaire were uploaded to the website of the Danish Disc Golf Union (DDGU), and were sent by e-mail to all members of DGI disc golf organization (n = 80). Online invitations were shared on the social media site Facebook, at 17 Danish disc-golf groups. Posters were put up at five popular disc golf courses nationwide, two of which hosted the Danish discgolf tour during the data collection phase. A participant needed to have played disc golf at least once, and be at least 18 years of age to be included in the study. Participation in the study was voluntary and all participants gave informed written consent, after reading the purposes and procedures of the study. Data collection The questionnaire included details of demographics (gender, age, body mass), disc-golf characteristics (e.g. hours of weekly disc-golf participation, tournament participation, experience, warm-up routines, score), and details of disc-golf injuries (e.g. anatomic region, duration/time to recovery, acute/gradual onset, treatment, workdays lost) sustained throughout the player’s
The International Journal of Sports Physical Therapy | Volume 11, Number 1 | February 2016 | Page 133
entire disc-golf career. Score was defined as the number of throws ± par used on a typical 18-basket course, as a substitute for handicap, as many recreational players may not be aware of their actual handicap. Participants were also asked to allocate themselves to either of four groups; “Novice”, “Amateur”, “Intermediate” and “Professional”, inspired by the PDGA player classifications. In the present study, the “Novice” group was pooled to the amateur group, since only few (n=4) were classified as Novice. Due to the self-reporting and retrospective design of the study, only anatomic region of the injury and not specific diagnosis was collected. Prior to the study, the questionnaire was pilot-tested on a small group of disc-golf players with various disc-golf experience (range
ORIGINAL RESEARCH
INJURIES IN DISC GOLF – A DESCRIPTIVE CROSS-SECTIONAL STUDY Martin Amadeus Rahbek, BSc¹ Rasmus Oestergaard Nielsen, PT, MHSc, PhD¹
ABSTRACT Background: Disc golf is rapidly increasing in popularity and more than two million people are estimated to regularly participate in disc golf activities. Despite this popularity, the epidemiology of injuries in disc golf remains under reported. Purpose: The purpose of the present study was to investigate the prevalence and anatomic distribution of injuries acquired through disc-golf participation in Danish disc golf players. Methods: The study was a cross-sectional study conducted on Danish disc-golf players. In May 2015, invitations to complete a web-based questionnaire were spread online via social media, and around disc-golf courses in Denmark. The questionnaire included questions regarding disc-golf participation and the characteristics of injuries acquired through disc golf participation. The data was analyzed descriptively. Results: An injury prevalence of 13.3% (95% CI: 6.7% to 19.9%) was reported amongst the 105 disc-golf players who completed the questionnaire. The anatomical locations most commonly affected by injury were the shoulder (31%) and the elbow (20%). Injuries affecting the players at the time of completion of the questionnaire had a median duration of 240 days (IQR 1410 days), and the majority (93%) had a gradual onset. Conclusions: A 13.3% point prevalence of injury was reported. Most injuries occurred in the shoulder and elbow regions, and were gradual in onset. Injuries affecting the players at the time of data collection had median symptomatic duration of 240 days. Levels of Evidence: 3b Keywords: Disc golf, epidemiology, frisbee golf, injury, overuse
1
Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
Ethics: Observational studies require no ethical approval, in accordance to Danish law. Conflicts of interest: None of the authors has any financial interest in the results presented. No sources of funding were sought or received. R. O. Nielsen was personally salaried by his institution, but no specific salary was set aside or given for the paper. Acknowledgements: The authors would like to give thanks to the Danish Disc Golf Union and DGI Disc Golf, for their support spreading invitations to the study, both online and on courses around Denmark.
CORRESPONDING AUTHOR Martin Amadeus Rahbek Dalgas Avenue 4, DK-8000 Aarhus C Telephone: +45 27 85 25 66 E-mail: [email protected]
The International Journal of Sports Physical Therapy | Volume 11, Number 1 | February 2016 | Page 132
INTRODUCTION Disc golf is rapidly increasing in popularity as a sport and leisure activity, with an average annual growth rate of more than 11% since 2005.1 Today, the Professional Disc Golf Association (PDGA) estimates, that more than two million people around the world regularly participate in disc-golf activities,2 of which an estimated 80,000 reside in Scandinavia.3 Accordingly, the number of disc-golf courses across the world has doubled to more than 4700 between 2007 and 2014,2 further emphasizing the increasing interest in the sport. Formalized in the 1970’s, the rules and terminology of disc golf is similar to regular golf, but contrary to the use of golf balls and clubs, disc golf is played with specially designed frisbees, called discs, which are thrown aimed at elevated baskets. In disc golf, the goal is to complete a round of usually 9 or 18 baskets in the fewest throws possible, using a combination of driver-, midrange- and putter-style discs. Each course, and even each hole, presents with its distinct barriers, including terrain, elevation, curvature, obstacles and wind conditions.4,5 The player then seeks to overcome these barriers using a variety of different types of throws, of which the backhand and the forehand throws are the most common.5 Recreational disc golf appeals to a large portion of the population, as the vast majority of courses are public,4 and the sole requirement to play is a single disc that costs approximately fifteen dollars. Disc golf is a viable option for those who wants to remain active and competitive in middle age, because of the low-intensity non-contact nature of the sport and the social component, inherent to golf-type sports.6 In fact, more than 30% of the registered PDGA players are above 40 years of age.2 Disc golf also utilizes the handicap system, which facilitates high-level competition across differences in skill. Epidemiologic knowledge regarding injuries in disc golf, however, is sparse. A related frisbee-sport, ultimate, has received more scientific attention,7–10 but as more than 40% of injuries in ultimate occurs acutely through player to player contact,10 the injury pattern is likely incomparable to disc golf. Instead, overuse injuries may be prevalent, owing to the repetitive forceful movements of throwing the discs, similar to the injury pattern of regular golf.11 One study
including disc-golf players was recently conducted by Nelson and colleagues,5 revealing an 81.8% alltime prevalence of injury sustained through disc golf. However, in their study no definition of injury was provided.5 In other sports, varying injury definitions has shown to affect the number, and even location, of injuries reported.12 Therefore, more studies on injury occurrence in disc golf are needed using well-defined injury definitions. The purpose of the present study was to investigate the prevalence and anatomic distribution of injuries acquired through disc-golf participation in Danish disc golf players. METHODS Study design The study was designed as a cross-sectional, epidemiological study. Data collection was conducted during a six-week timeframe beginning in May 2015, using a web-based questionnaire developed by the authors. In accordance to Danish legislation, no ethical approval was sought because of the observational design. Participants Invitations to complete the web-based questionnaire were uploaded to the website of the Danish Disc Golf Union (DDGU), and were sent by e-mail to all members of DGI disc golf organization (n = 80). Online invitations were shared on the social media site Facebook, at 17 Danish disc-golf groups. Posters were put up at five popular disc golf courses nationwide, two of which hosted the Danish discgolf tour during the data collection phase. A participant needed to have played disc golf at least once, and be at least 18 years of age to be included in the study. Participation in the study was voluntary and all participants gave informed written consent, after reading the purposes and procedures of the study. Data collection The questionnaire included details of demographics (gender, age, body mass), disc-golf characteristics (e.g. hours of weekly disc-golf participation, tournament participation, experience, warm-up routines, score), and details of disc-golf injuries (e.g. anatomic region, duration/time to recovery, acute/gradual onset, treatment, workdays lost) sustained throughout the player’s
The International Journal of Sports Physical Therapy | Volume 11, Number 1 | February 2016 | Page 133
entire disc-golf career. Score was defined as the number of throws ± par used on a typical 18-basket course, as a substitute for handicap, as many recreational players may not be aware of their actual handicap. Participants were also asked to allocate themselves to either of four groups; “Novice”, “Amateur”, “Intermediate” and “Professional”, inspired by the PDGA player classifications. In the present study, the “Novice” group was pooled to the amateur group, since only few (n=4) were classified as Novice. Due to the self-reporting and retrospective design of the study, only anatomic region of the injury and not specific diagnosis was collected. Prior to the study, the questionnaire was pilot-tested on a small group of disc-golf players with various disc-golf experience (range
![[Shoulder injuries in golf].](/assets/img/hold.png)
