Orthopaedic injuries (ages 6 to 17)
in athletes
Comparison of injuries occurring in six sports RICHARD B. CHAMBERS,* M.D.,
From the
Cincinnati, Ohio Department of Orthopaedic Surgery, Munson Army Hospital, Fort Leavenworth, Kansas
ABSTRACT A
prospective study of orthopaedic injuries to children (ages 6 17) was conducted for a calendar year in the controlled environment of a military post. Data were collected on the number of participants, the hours of participation, and the number of injuries for six supervised sports (football, soccer, basketball, baseball, swimming, and gymnastics). An injury index factor was derived by a formula: (number of injuries x ) divided by [(number of participants) x (average number of 4 10 hours of participation) × (number of weeks in the season of the sport)]. When the injury index factors were compared, the risk a participant has for sustaining an injury in football was twice as high (1.72) as its nearest competitors, basketball (0.88) and gymnastics (0.85). Soccer had an index factor of 0.29; baseball, 0.14; and swimming had a factor of zero. Eighty percent of all sports-related orthopaedic injuries involved the upper extremities. Lower extremity orthopaedic injuries occurred only in football and gymnastics. The evidence suggests that those persons concerned with reducing the number of injuries to the growing athlete in supervised sports should focus their attention on reducing the risk of injury to the upper extremities.
to
Injuries parents,
in the immature athlete represent an important confor coaches, and recreation directors when strucindividual or group sports activities or when looking at turing precautions to be instituted to safeguard athletes. As physical fitness takes a more prominent role in the minds of our citizenry, vigorous but safe sports are being sought. In analyz-
cern
* Present address: Department of Orthopaedic Surgery, University of Cincinnati Medical Center, College of Medicine, 231 Bethesda Avenue, Cincinnati, Ohio 45267.
for children, we must look for individual and team activities which provide the healthful opportunity to develop strength, endurance, and agility, while not exposing the developing skeleton to temporary or permanent damage. In a prospective study of the six supervised sports scheduled for children (6 to 17 years old) on a military post, the evidence shows that in the group of over 800 participants, football
ing sports
players sustained twice as many orthopaedic injuries as those participating in any of the other sports and that no orthopaedic injuries were sustained by swimmers. More than 80% of the orthopaedic injuries involved the upper extremities. MATERIALS AND METHODS A prospective study of all orthopaedic injuries in children (6 to 17 years old) was undertaken at Fort Leavenworth (September 1976 to September 1977). The controlled environment of a military post assured consistent collection of data and a uni-
form administration of sports activities. All sports activities took place in post facilities and all participants were military dependents. All injuries, whether sports related or not, were treated at the single medical facility. From the vantage point of a two-man orthopaedic department, few (if any) clinically severe orthopaedic injuries were treated by other than our staff. Sprains, strains, and soft tissue injuries, although tabulated, are not reported since many may have received no medical treatment or may have been treated by emergency room personnel without orthopaedic referral. All sports activities, in both training and competitive stages, were supervised and coached by military personnel. All activities were coordinated by a single recreational services office, thus assuring accurate data recording of numbers of participants, as well as frequency and duration of practice periods. Playing surfaces, safety equipment, and playing rules within each organized sport are likewise uniform, allowing us to eliminate many variables which may affect meaningful sport by sport comparisons. 195
TABLE I -
&dquo;
Calculated
Injuries summarized by sport
by the following formula: TABLE 2
TABLE 3
Safety measures
Injuries cataloged by sports
RESULTS Table 1 summarizes the analyses of the six sports studied. All sports had sizable numbers of participants (range, 140 to 800) and were similar in coach to player ratios. Safety measures were observed in all sports (Table 2). Of the six sports evaluated, more injuries occurred in football than in any of the other sports. The injury index factor nearly doubled its nearest competitors (basketball and gymnastics). Table 3 lists the injuries by sports which were treated by the orthopaedic staff during the year of the study. The injuries that occurred in football were clinically more severe to the growing athlete than injuries sustained in other sports. Eighty percent of all sports-related injuries involved the upper extremities. Lower extremity injuries occurred only in football and gymnastics in the groups reported in this yearlong study.
COMMENT
Only
one-third of the
clinically
severe
orthopaedic injuries
(fractures and joint dislocations) we treated in the age group (6 to 17 years) during the year of our study occurred in children in supervised athletics. Unsupervised recreational activities (tree climbing, running, and especially skateboarding) contributed twice as many extremity injuries as those occurring
engaged
196
during organized sports events. No accurate estimate of the time spent by the Little Leaguer, in unsupervised activity could be made, but subjective estimates would indicate that the young athlete, who engages in sports on a military post, devotes more (average) time to supervised sports than his civilian community counterpart. The fact that nearly 80% of the post’s population in this age group were involved in at least one organized sport attests to the emphasis on this type of activity. Despite this emphasis, most of our injuries occurred amount of
backyards and basements and not on the playing field. our study, soccer as a team sport and swimming as an individual sport provide better than average opportunity for the growing athlete to develop physical fitness. Neither sport has a high injury index factor. Soccer as a team sport, although it does not develop the upper extremities to any significant degree, has several other advantages for the young athlete. Little specialized equipment is required; a grassy field with simply constructed goal posts are ubiquitous and inexpensive. Likewise, individual equipment requirements are simple; for little more than plastic shinguards are required to be added to the usual sneakered attire of those in the age group concerned. Soccer’s emphasis is on dexterity rather than strength and its constant running develops endurance rather than power. This makes soccer, like swimming, less discriminating with regard to sex, age, or body
in
From
build than other sports. All in all we must recommend soccer and swimming as the best fitness &dquo;buys.&dquo; Swimming probably provides the most balanced form of exercise. With variation in technique; emphasis can be placed on upper extremities, lower extremities, or the entire body. Endurance as well as power can be developed along with agility and coordination. With its versatility, swimming does not favor either sex, a particular body type, or age. This makes a fitting sport for the developing athlete. Anatomically, the majority of injuries to the participants occurred in the upper extremities, particularly the fingers. Thus, those persons responsible for injury prevention should focus their attention on the risk of injuries to the fingers of the growing athlete and make every effort to provide reasonable safety measures that will help to prevent injury to the upper extremities.
197
in athletes
Comparison of injuries occurring in six sports RICHARD B. CHAMBERS,* M.D.,
From the
Cincinnati, Ohio Department of Orthopaedic Surgery, Munson Army Hospital, Fort Leavenworth, Kansas
ABSTRACT A
prospective study of orthopaedic injuries to children (ages 6 17) was conducted for a calendar year in the controlled environment of a military post. Data were collected on the number of participants, the hours of participation, and the number of injuries for six supervised sports (football, soccer, basketball, baseball, swimming, and gymnastics). An injury index factor was derived by a formula: (number of injuries x ) divided by [(number of participants) x (average number of 4 10 hours of participation) × (number of weeks in the season of the sport)]. When the injury index factors were compared, the risk a participant has for sustaining an injury in football was twice as high (1.72) as its nearest competitors, basketball (0.88) and gymnastics (0.85). Soccer had an index factor of 0.29; baseball, 0.14; and swimming had a factor of zero. Eighty percent of all sports-related orthopaedic injuries involved the upper extremities. Lower extremity orthopaedic injuries occurred only in football and gymnastics. The evidence suggests that those persons concerned with reducing the number of injuries to the growing athlete in supervised sports should focus their attention on reducing the risk of injury to the upper extremities.
to
Injuries parents,
in the immature athlete represent an important confor coaches, and recreation directors when strucindividual or group sports activities or when looking at turing precautions to be instituted to safeguard athletes. As physical fitness takes a more prominent role in the minds of our citizenry, vigorous but safe sports are being sought. In analyz-
cern
* Present address: Department of Orthopaedic Surgery, University of Cincinnati Medical Center, College of Medicine, 231 Bethesda Avenue, Cincinnati, Ohio 45267.
for children, we must look for individual and team activities which provide the healthful opportunity to develop strength, endurance, and agility, while not exposing the developing skeleton to temporary or permanent damage. In a prospective study of the six supervised sports scheduled for children (6 to 17 years old) on a military post, the evidence shows that in the group of over 800 participants, football
ing sports
players sustained twice as many orthopaedic injuries as those participating in any of the other sports and that no orthopaedic injuries were sustained by swimmers. More than 80% of the orthopaedic injuries involved the upper extremities. MATERIALS AND METHODS A prospective study of all orthopaedic injuries in children (6 to 17 years old) was undertaken at Fort Leavenworth (September 1976 to September 1977). The controlled environment of a military post assured consistent collection of data and a uni-
form administration of sports activities. All sports activities took place in post facilities and all participants were military dependents. All injuries, whether sports related or not, were treated at the single medical facility. From the vantage point of a two-man orthopaedic department, few (if any) clinically severe orthopaedic injuries were treated by other than our staff. Sprains, strains, and soft tissue injuries, although tabulated, are not reported since many may have received no medical treatment or may have been treated by emergency room personnel without orthopaedic referral. All sports activities, in both training and competitive stages, were supervised and coached by military personnel. All activities were coordinated by a single recreational services office, thus assuring accurate data recording of numbers of participants, as well as frequency and duration of practice periods. Playing surfaces, safety equipment, and playing rules within each organized sport are likewise uniform, allowing us to eliminate many variables which may affect meaningful sport by sport comparisons. 195
TABLE I -
&dquo;
Calculated
Injuries summarized by sport
by the following formula: TABLE 2
TABLE 3
Safety measures
Injuries cataloged by sports
RESULTS Table 1 summarizes the analyses of the six sports studied. All sports had sizable numbers of participants (range, 140 to 800) and were similar in coach to player ratios. Safety measures were observed in all sports (Table 2). Of the six sports evaluated, more injuries occurred in football than in any of the other sports. The injury index factor nearly doubled its nearest competitors (basketball and gymnastics). Table 3 lists the injuries by sports which were treated by the orthopaedic staff during the year of the study. The injuries that occurred in football were clinically more severe to the growing athlete than injuries sustained in other sports. Eighty percent of all sports-related injuries involved the upper extremities. Lower extremity injuries occurred only in football and gymnastics in the groups reported in this yearlong study.
COMMENT
Only
one-third of the
clinically
severe
orthopaedic injuries
(fractures and joint dislocations) we treated in the age group (6 to 17 years) during the year of our study occurred in children in supervised athletics. Unsupervised recreational activities (tree climbing, running, and especially skateboarding) contributed twice as many extremity injuries as those occurring
engaged
196
during organized sports events. No accurate estimate of the time spent by the Little Leaguer, in unsupervised activity could be made, but subjective estimates would indicate that the young athlete, who engages in sports on a military post, devotes more (average) time to supervised sports than his civilian community counterpart. The fact that nearly 80% of the post’s population in this age group were involved in at least one organized sport attests to the emphasis on this type of activity. Despite this emphasis, most of our injuries occurred amount of
backyards and basements and not on the playing field. our study, soccer as a team sport and swimming as an individual sport provide better than average opportunity for the growing athlete to develop physical fitness. Neither sport has a high injury index factor. Soccer as a team sport, although it does not develop the upper extremities to any significant degree, has several other advantages for the young athlete. Little specialized equipment is required; a grassy field with simply constructed goal posts are ubiquitous and inexpensive. Likewise, individual equipment requirements are simple; for little more than plastic shinguards are required to be added to the usual sneakered attire of those in the age group concerned. Soccer’s emphasis is on dexterity rather than strength and its constant running develops endurance rather than power. This makes soccer, like swimming, less discriminating with regard to sex, age, or body
in
From
build than other sports. All in all we must recommend soccer and swimming as the best fitness &dquo;buys.&dquo; Swimming probably provides the most balanced form of exercise. With variation in technique; emphasis can be placed on upper extremities, lower extremities, or the entire body. Endurance as well as power can be developed along with agility and coordination. With its versatility, swimming does not favor either sex, a particular body type, or age. This makes a fitting sport for the developing athlete. Anatomically, the majority of injuries to the participants occurred in the upper extremities, particularly the fingers. Thus, those persons responsible for injury prevention should focus their attention on the risk of injuries to the fingers of the growing athlete and make every effort to provide reasonable safety measures that will help to prevent injury to the upper extremities.
197
