Patrick Luig

Sportunfälle im Vereinssport in Deutschland

BACKGROUND Almost one of four Germans is registered in a sports club. Nowadays, sport is acknowledged as an integral component of a healthy lifestyle. Numerous studies provide evidence of the benefits of sports on health. However, about 2 million sports injuries per year diminish the health benefits of sport. OBJECTIVE (a) Description of the epidemiology of sports injuries in German sports club between 1987 and 2012 and (b) identification of focal areas for the development and implementation of prevention measures. METHODS Continuous questionnaire-based injury monitoring of club sports injuries that have been reported to the respective sports insurance. Full survey among selected federal sports associations. RESULTS Since 1987, a sample of 200,884 sports injuries has been established. About two thirds of the injuries are reported in soccer, handball, basketball, and volleyball, although only one third of all sports club members are registered in these team sports. The number of womens soccer injuries has risen from 7.5 to 15.6 %. Ankle injuries have decreased from 28.7 to 16.9 %. By contrast, the rate of knee injuries has increased from 18.4 to 20.3 %. Days of disability have dropped steadily since the 1990s. Inpatient hospital days have decreased from 10 to 5 days, whereas the share of injuries that needed surgery increased from 30 to 40 %. CONCLUSION Team ball sports are still a clear focal area for injury prevention, as participation and injury risk are highest in this group. While the prevention of ankle injuries seems to be headed in the right direction, knee injuries are increasing. As team ball sports become more popular among women, who are more prone to severe knee injuries, prevention programs should be tailored toward the specific situation and needs of the targeted sports participants.

[Sports injuries in German club sports, Aspects of epidemiology and prevention].

BACKGROUND Almost one of four Germans is registered in a sports club. Nowadays, sport is acknowledged as an integral component of a healthy lifestyle. Numerous studies provide evidence of the benefits of sports on health. However, about 2 million sports injuries per year diminish the health benefits of sport. OBJECTIVE (a) Description of the epidemiology of sports injuries in German sports club between 1987 and 2012 and (b) identification of focal areas for the development and implementation of prevention measures. METHODS Continuous questionnaire-based injury monitoring of club sports injuries that have been reported to the respective sports insurance. Full survey among selected federal sports associations. RESULTS Since 1987, a sample of 200,884 sports injuries has been established. About two thirds of the injuries are reported in soccer, handball, basketball, and volleyball, although only one third of all sports club members are registered in these team sports. The number of womens soccer injuries has risen from 7.5 to 15.6 %. Ankle injuries have decreased from 28.7 to 16.9 %. By contrast, the rate of knee injuries has increased from 18.4 to 20.3 %. Days of disability have dropped steadily since the 1990s. Inpatient hospital days have decreased from 10 to 5 days, whereas the share of injuries that needed surgery increased from 30 to 40 %. CONCLUSION Team ball sports are still a clear focal area for injury prevention, as participation and injury risk are highest in this group. While the prevention of ankle injuries seems to be headed in the right direction, knee injuries are increasing. As team ball sports become more popular among women, who are more prone to severe knee injuries, prevention programs should be tailored toward the specific situation and needs of the targeted sports participants.

INJURIES IN GERMAN CLUB SPORTS – 1987 TO 2012

Background In Germany 26 million citizens, almost 30% of the total population, are registered in sports clubs. Nowadays, sport as part of a healthy and physically active lifestyle is virtually accepted as medicine against widespread diseases. The positive effects of sports on wellbeing and health are undoubted. However, about 2 million sports injuries occur annually. 700,000 of these result from club sports. Objective To describe and analyse the epidemiology of sports injuries and to identify focal areas for sports injury prevention programmes on the basis of 25 years of injury surveillance data for German club sports. Design Retrospective longitudinal study with questionnaire-based injury registration. Since 1987 a database of more than 200 000 sports injuries has been established. Athletes that report a sports accident to the ARAG sports insurance are asked to complete an anonymized questionnaire on the accident, injury, treatment and sports behaviour. Setting Non-professional club sports participants. Results 75% of the injuries are registered in soccer, handball, basketball and volleyball, although only 30% of all sports club members are organized in these sports. The number of womens soccer injuries has risen from 7% to 15%. Ankle injuries have decreased from 30% to 19%, whereas the rate of knee injuries has increased slightly from 17% to 21%. Days of disability have dropped steadily since the 1990s, whereas inpatient hospital days have doubled from 5 to 10 days. The share of injuries that need surgery increased from 30% to 40%. Injuries to the knee, lower leg and upper arm have the highest surgery rate, indicating more serious injuries here. Conclusion Team sports are a clear focal area for injury prevention, in particular as the number of female participants in these sports has dramatically increased since 1987. For tailoring the prevention measures more specific to the target groups the following differentiation of prevention approaches is useful: Training & Physical Preparation, Technical & Political Approaches, Equipment & Facilities, Medical & Non-medical Support.

Development and Implementation of a Modular Return-to-Play Test Battery After ACL Reconstruction

Several studies in football have demonstrated a significant reduction of injuries through various preventive measures. However, even under ideal conditions, injuries will occur in contact team sports like football. As injuries are expected to be part of the game, there is a certain need to develop proper concepts for secondary and tertiary prevention. In this context the return-to-play decision is a decisive aspect, in particular with regard to frequently reoccurring as well as severe injuries like ACL tears. Rather than time, which is an important factor in biological healing, objective parameters are needed to monitor, control, and optimize the rehabilitation process. Especially when it comes to the final return-to-play decision after an ACL injury, it is advisable to carry out a comprehensive test battery that considers clinical, physiological, and psychological aspects. Moreover, this testing should anticipate the specificity of the sport the injured athlete is returning to. With regard to the right timing of the comeback, individual baseline values from pre-injury screenings are superior to the frequently used limb symmetry index (LSI) or data from reference populations. Particularly in football where lower limb asymmetries due to leg dominances have to be taken into consideration when interpreting test results, solely usage of the LSI seems to be questionable. In the light of the ambitions to develop a standardized test battery, the Verwaltungs-Berufsgenossenschaft (VBG), the statutory accident insurance for German professional sports, conducted a consensus conference bringing together accredited experts and working groups from all professions that are typically involved in the rehabilitation process. As a result of this conference, a modular test battery was introduced for multicentric test implementation in real-world sports settings.

Handball Injuries: Epidemiology and Injury Characterization: Part 1

Handball (also referred to as “team handball”) is an Olympic team ball sport of worldwide popularity. The sport has continuously developed during recent years, with major evolutions in players’ speed, strength, and technique, and as a consequence adaptive changes in tactics and rules of the game. Handball is characterized by intense body contact, frequent intermittent running, pace changes, one-on-one confrontations, and quick direction changes in combination with challenging technique and coordination elements like catching, throwing, passing, and dribbling.

INJURIES IN MEN'S PROFESSIONAL FOOTBALL

Background The first step on the way to developing preventive measures is the description of epidemiology within the target group. This is not known for German Mens Professional Football so far. Objective Analysis of injury risk and description of injury patterns. Design Prospective observational cohort study of the season 2014–15. Setting Two highest leagues in German mens football (i.e. Bundesliga, 2. Bundesliga). Patients (or Participants) All first and second division football players who played at least one competitive club match (n=1,358) during the 2014–15 season were included. Interventions (or Assessment of Risk Factors) Analysis of all injuries of the participants that were registered by clubs or physicians with the VBG as part of the occupational accident reporting and that either led to the players short-term disability (time-loss) or to medical treatment costs (medical-attention). Main Outcome Measurements Prevalence rate and injury incidence, injured body regions, type of injury, medical costs and time loss. Results 1,076 of the 1,358 players (79.2%) were injured. A total of 3,385 injuries were recorded (training: 62.3%, match: 37.3%) which led to a cumulative incidence rate of 2.5 injuries per player and season. Goalkeeper had lower overall risk of injury (2.1 inj./season), but a 3.7 times higher relative risk of concussions than field players. 70.7% of all injuries were lower extremity injuries. Thigh injuries (21.3%) and knee injuries (15.8%) were the most frequent injuries. However, knee injuries caused 37.0% of overall time-loss and 48.4% of overall medical-attention. Conclusions German mens professional football shows a high risk of injury. Injury risk and injury patterns differ by playing position, probably reflecting the specific performance profiles of the respective playing position. Thus prevention needs to be individualised and at least must consider different characteristics of playing positions. For development of expedient preventive measures, injury mechanisms need to be analysed.

INJURIES IN GERMAN MEŃS PROFESSIONAL ICE HOCKEY

Background Injury incidences during international major ice hockey events are high, but information about ice hockey injuries in Germany, particularly in regular league play, is lacking. Objective Analysis of injury characteristics in German professional ice hockey. Design Prospective observational cohort study. Setting Two highest German professional leagues in mens ice hockey. Participants All first and second division ice hockey players who played at least in one competitive club match during the season 2014/15 season (n=812). Assessment of Risk Factors Analysis of all injuries of these players that were registered by clubs or physicians with the VBG as a part of the occupational accident reporting and that either led to the players short-term disability (time-loss) and/or to medical treatment costs (medical-attention). Main Outcome Measurements Injury prevalence and incidence, injured body parts, type of injury, medical treatment costs, days of absence. Results A total of 2.045 injuries were recorded. 76.7% of all players were injured at least once. In mean each player had 2.52 injuries per season. Incidence rate in the first division (2.7 injuries/season) was significantly higher than in second division (2.3 injuries/season). The majority of injuries (69.1%) occurred during matches with a match incidence of 136.8 injuries per 1000 h. Nearly one third (30.7%) of all training injuries occurred during the pre-season. The head (17.9%), the shoulder (10.7%) and the thigh (10.1%) were the body parts most frequently affected. Shoulder injuries lead to the highest share of overall time-loss (20.5%) and medical treatment costs (22.0%). Goalkeeper had significant lower overall risk of injury (1.5 injuries/season), but higher risk of knee and thigh injuries. Conclusions Injury Risk in German professional ice hockey is high, especially during match play. Preventive measures should aim at sport- and position-specific risk factors. Special focus should be laid on player preparedness after off-season break.

INJURY PATTERNS IN GERMAN MEN'S PROFESSIONAL BASKETBALL AND HANDBALL – A COMPARISON

Background Basketball (BB) and handball (HB) are both dynamic and physical indoor transition team sports. However, performance profiles, specifically with regard to allowed legal physical contact, differ widely. Knowledge of injury risk and injury patterns, particularly in regular league play, is limited. Objective Comparative analysis of injury risk and injury patterns in German mens professional BB and HB. Design Prospective observational cohort study. Setting Two highest German professional leagues in mens BB and HB. Participants All first and second league BB (n=514) and HB (n=804) players who played in at least one competitive club match during the 2014–2015 season. Interventions (or Assessment of Risk Factors) Analysis of all injuries that were registered by clubs or physicians with the VBG as part of the occupational accident reporting and that either led to players short-term disability (time-loss) and/or to medical treatment costs (medical-attention). Main Outcome Measurements Injury prevalence, injury incidence, injured body parts, type of injury, medical costs, short-term disability. Results 992 of the 1.318 observed players were injured. A total of 3,071 injuries were recorded. Prevalence rate (BB: 70.0%; HB: 78.6%) and cumulative incidence rate (BB: 2.0 injuries/season; HB: 2.5 injuries/season) were significantly higher in HB. By contrast, BB (95.4 injuries/1,000 h) showed higher match incidences than HB (74.7 injuries/1,000 h). The ankle (19.6%) in BB and the knee (15.2%) in HB were the body parts most commonly affected. Moreover, in both sports injury risk and patterns varied considerably according to level of play (league) and playing position. Conclusions Both, German mens professional BB and HB are associated with a high risk of injury in regular league play. However, injury patterns in professional mens BB and HB differ extensively reflecting varying performance profiles. Preventive strategies and measures should therefore be tailored towards sport-specific and, moreover, position-specific risks and patterns.

Sportunfälle im Vereinssport in Deutschland@@@Sports injuries in German club sports: Aspekte der Epidemiologie und Prävention@@@Aspects of epidemiology and prevention

BACKGROUND Almost one of four Germans is registered in a sports club. Nowadays, sport is acknowledged as an integral component of a healthy lifestyle. Numerous studies provide evidence of the benefits of sports on health. However, about 2 million sports injuries per year diminish the health benefits of sport. OBJECTIVE (a) Description of the epidemiology of sports injuries in German sports club between 1987 and 2012 and (b) identification of focal areas for the development and implementation of prevention measures. METHODS Continuous questionnaire-based injury monitoring of club sports injuries that have been reported to the respective sports insurance. Full survey among selected federal sports associations. RESULTS Since 1987, a sample of 200,884 sports injuries has been established. About two thirds of the injuries are reported in soccer, handball, basketball, and volleyball, although only one third of all sports club members are registered in these team sports. The number of womens soccer injuries has risen from 7.5 to 15.6 %. Ankle injuries have decreased from 28.7 to 16.9 %. By contrast, the rate of knee injuries has increased from 18.4 to 20.3 %. Days of disability have dropped steadily since the 1990s. Inpatient hospital days have decreased from 10 to 5 days, whereas the share of injuries that needed surgery increased from 30 to 40 %. CONCLUSION Team ball sports are still a clear focal area for injury prevention, as participation and injury risk are highest in this group. While the prevention of ankle injuries seems to be headed in the right direction, knee injuries are increasing. As team ball sports become more popular among women, who are more prone to severe knee injuries, prevention programs should be tailored toward the specific situation and needs of the targeted sports participants.