The average adult Irish sports person suffers from two sports injuries per year. This is about average for athletes from the UK and the rest of Europe. Our athletes suffer from the effects of injuries for an average of 52 days or 14% of the year. This is a lot of time and is probably higher than in other parts of the EU. I don’t know why this is. It may be due to less effective treatment and rehabilitation here. Perhaps some enterprising school could attempt to find out.
Not all of the 52 days are without sports activity. For about half this time the sports person is able to train or play but activity is restricted. Competition in sport is now so intense that such a restriction often has very serious consequences for the athlete. Some conditions like shin splints and sore backs, that do not prevent activity completely, nag on-and-on for months or even years. They often have more serious consequences than an acute injury that requires a couple of days in hospital but then resolves completely within two weeks. I will say more about the difference between acute and overuse injuries a little later on.
The newspapers have recently given a lot of attention to death in sport and which sports carry the greatest risks. Once again, clear definitions are very important. Traumatic death in sport is due to violence intrinsic in the activity being undertaken. Non-traumatic death is due to pre-existing medical conditions that become acute during sports activity or shortly afterwards. This kind of death is sport is by far the most common. When non-traumatic deaths in sport are considered you will be surprised to learn that the most dangerous activities turn out to be golf and bowls ! This unexpected result is due to the fact that many individuals of advanced years, who have coronary heart disease, are players of golf and bowls.
Non-traumatic death in sport occasionally occurs in young people but it is extremely rare. It is not something that you should worry about. When traumatic deaths in sports are considered, the most dangerous activities turn out to be climbing and "air sports" - activities like parachuting and hang gliding, followed by sports that take place over water. Much publicity has been given recently to boxing injuries and fatalities but amateur boxing is quite a safe activity. The risk of death in any sport is very small. In climbing and air sports the estimated death rate is about 800 per 100 million man days and this drops to about 70 for water sports, 30 for horse riding, 16 for rugby and 5 for boxing.
The concept of "Danger" in sport is very difficult to quantify and anyone attempting to study sports injuries needs to give this matter very careful consideration. In field games like rugby, soccer, football, hurling, hockey and camogie, knocks and bangs are extremely common. So are pulled muscles and sprains of joints. The horse rider is largely immune from such trauma being isolated from other individuals, well out of the way, on top of the horse. But if he or she is thrown off at high speed the consequences are often very serious. Thus although the risk of minor injury is lower in equestrian activities than in field games, the possibility of serious injury and death is much higher.
It is also necessary to be extremely careful when comparing injuries in different field games and other sports. In Europe, more injuries occur in soccer than in any other activity. This is partly because such a large number of people play soccer. Although there are less injuries in rugby than in soccer, the risk of injury in this sport is greater. In studies on sports injuries the risk of injury is normally expressed as the number of injuries per 10,000 hours of participation. In the UK this is 422 injuries per 10,000 hours for soccer and 636 injuries per 10,000 hours for rugby.
Even this figure does not give the full picture, because injuries in some sports are more serious than those in others. A study in the University of Limerick has found that injuries to jumpers and sprinters take a particularly long time to resolve. Thus another way of quantifying sports injuries is in terms of the number of days of incapacity per 1000 hours of participation.
Some injuries occur almost instantaneously. Fractures, sprains, and strains (pulled muscles) are examples. One minute the athlete is in top form: the next he or she is bunched up in agony on the ground. Such conditions are known as acute injuries. These are the most well-known conditions. Less dramatic and much less well-known, but just as important, are overuse injuries. These conditions come on gradually, as a result of repeating an action over-and-over again. Runners often suffer from overuse injuries of the shins or knees; swimmers are more likely to develop overuse injuries of the shoulder. Some common acute and overuse injuries are listed in Figure 1.
The type of injury that is most common varies with the age of the subject and the level of competition. In young children most injuries are due to falling. In older children injuries that result from collisions and violence are more common. In older age groups and in top level sportsmen and women there are less acute injuries and more overuse injuries and those that are due to intrinsic factors.
Figure 2 classifies the factors causing injuries into intrinsic factors and extrinsic factors. Extrinsic factors are external to the injured person: things like uneven playing surfaces, faulty equipment, bad weather, poor rules, foul play by an opponent, bad lighting or poor acoustics. Sports persons in school generally have less control over extrinsic factors than intrinsic ones. Even so they should avoid obvious dangers as much as possible.
Intrinsic factors are ones that are characteristics of the person who is injured. There are a large number of intrinsic factors that pre-dispose to injury but I will give some examples. The body derives much of its stability from the muscles that pass over joints. The knee joint would be very weak were it not for several muscles that give it strength: the rectus femoris, sartorius, vastus medials and the hamstrings are some of the most important. Strengthening these muscles protects the knee joint: athletes with weak muscles are much more likely to sustain knee injuries - especially in games likes soccer where the knee is subjected to pressure from the side.
There are also many other intrinsic factors that predispose the athlete to different kinds of injury. Tight muscles make strains (pulled muscles) more likely. Thus good flexibility is important for injury prevention. Many posture defects place extra strain on certain muscles and joints and thus increase the risk of several different kinds of injury. For example, an excessive hollow in the lower back predisposes to back pain and back overuse injuries. Flat feet predispose the individual to shin splints - a very common overuse injury. Some intrinsic factors that predispose to sports injury are summarised in Figure 4.
The rates of incidence of the most common sports injuries to serious Irish sportspeople are shown in Figure 5. Strain (or pulled muscle) is the most common sports injury in this country. This is followed by sprains, knee overuse injuries, shin splints, back overuse injuries and then contusions. (Contusions are injuries that result in bruises). Together these six conditions account for 71% of the sports injuries that occur in this country.
A good deal can be done to reduce the risk of such injuries. Some possible measures are summarised in the table below. The study of sports injuries and their prevention is an interesting topic involving the application of statistics, physiology and mechanics to sport. Anyone requiring further information is referred to a text book that contains a chapter on sports injuries and their prevention and two research papers that have been produced at the University of Limerick.
