Roisin Cahalan

Inability to perform because of pain/injury in elite adult Irish dance: A prospective investigation of contributing factors.

Previous research in Irish dancing (ID) has recorded high levels of pain/injury. Screening protocols in other genres have been developed to identify at‐risk dancers. The aims of the study were to examine the factors that relate to absence from dancing because of musculo‐skeletal pain/injury in ID, and to inform guidelines for the development of an evidence‐based screening protocol. Baseline subjective data (n = 85) and physical data (n = 84) were gathered. Subjects completed a monthly online questionnaire for 1 year providing data on general physical and psychological health and rates of pain/injury. Subjects were allocated to a “More Time Absent (MTA)” or “Less Time Absent (LTA)” category depending on their duration of absence from performance over the year. Eighty‐four subjects completed the year‐long follow‐up (MTA: n = 32; LTA: n = 52). Two hundred seventy‐eight complaints of pain/injury were recorded. Factors significantly associated with membership of the MTA group included greater anger‐hostility (P = 0.003), more subjective health complaints (P = 0.026), more severe previous pain/injury (P = 0.017), more general everyday pain (P = 0.020), more body parts affected by pain/injury (P = 0.028), always/often dancing in pain (P = 0.028), and insufficient sleep (P = 0.043). Several biopsychosocial factors appear to be associated with absence from ID because of pain/injury. Biopsychosocial screening protocols and prevention strategies may best identify at‐risk dancers.

The Incidence of Injury in Amateur Male Rugby Union: A Systematic Review and Meta-Analysis

BackgroundRugby union is a physically demanding, full-contact team sport that has gained worldwide popularity. The incidence of injury in rugby union has been widely reported in the literature. While comprehensive injury surveillance and prevention programmes have been implemented within the professional game, there is a need for similar strategies in the amateur game. Despite recent increases in the volume of research in rugby, there is little consensus regarding the true incidence rate of match and training injuries in senior amateur male rugby union players.ObjectiveThe aim of the current review was to systematically review the available evidence on the epidemiology of time-loss injuries in senior amateur male rugby union players and to subsequently conduct a meta-analysis of the findings.MethodsA comprehensive search of the PubMed, Scopus, SportDiscus and Google Scholar electronic databases was performed using the following keywords; (‘rugby’ OR ‘rugby union’) AND (‘amateur’ OR ‘community’) AND (‘injur*’ OR ‘pain*’). Six articles regarding the incidence of injury in senior amateur male rugby union players, in both matches and training, were retrieved and included in the meta-analysis to determine the overall incidence rate of match injury, with descriptive analyses also provided for other reported variables.ResultsThe overall incidence rate of match injuries within senior amateur rugby union players was 46.8/1000 player hours [95% confidence interval (CI) 34.4–59.2]. Contact events accounted for the majority of injuries, with the tackler more at risk than the player being tackled, and with respective incidence rates of 15.9/1000 player hours (95% CI 12.4–19.5) and 12.2/1000 player hours (95% CI 9.3–15.1).ConclusionThis meta-analysis found that the incidence rate of injury in amateur rugby union players was lower than that in professional players, but higher than the incidences reported in adolescent and youth rugby players. By understanding the true incidence and nature of injuries in rugby, injury prevention strategies can best be implemented. Future prevention strategies may best be aimed towards the tackle area, specifically to the tackler, in order to minimize injury risk.

The associations between training load and baseline characteristics on musculoskeletal injury and pain in endurance sport populations: A systematic review

OBJECTIVES To determine the associations between training load, baseline characteristics (e.g. age or previous injury) and rate of musculoskeletal injury and/or pain specifically within an Endurance Sporting Population (ESP). DESIGN Prospectively registered systematic review. METHODS Eight electronic databases were searched by two independent reviewers. Studies were required to prospectively monitor both (i) training loads and (ii) musculoskeletal injury and/or pain for >3 months. Methodological quality and risk of bias were determined utilising the Critical Skills Appraisal Program (CASP). Reported effect sizes were categorised as small, medium or large. RESULTS Twelve endurance sport studies were eligible (running, triathlon, rowing). Increased injury and/or pain risk was associated with: (i) high total training distances per week/month (medium effect size) (ii) training frequency <2 sessions/week (medium effect size) and (iii) both low weekly (<2hours/week) and high monthly (large effect size) training durations. None of the studies reported internal training load data or acute:chronic workload ratios. Baseline characteristics found to increase the rate of injury and/or pain included: (i) a history of previous injury (medium effect size), (ii) age >45 years (small effect size), (iii) non-musculoskeletal comorbidities (large effect size), (iv) using older running shoes (small effect size) and (v) non-competitive behaviour. CONCLUSIONS This review identifies a range of external training load factors and baseline characteristics associated with an increased rate of injury and/or pain within ESPs. There is an absence of research relating to internal training loads and acute:chronic workload ratios in relation to rate of injury and/or pain within ESPs.

Biopsychosocial Factors Associated with Foot and Ankle Pain and Injury in Irish Dance: A Prospective Study

BACKGROUND Foot and ankle pain/injury (FAPI) is the most common musculoskeletal problem suffered in Irish dancing. A prospective examination of risk factors for FAPI in this cohort has never been performed. STUDY DESIGN Prospective study over 1-year. METHODS 85 elite adult Irish dancers were screened at baseline for biopsychosocial factors and followed up prospectively each month for 1 year to evaluate FAPI rates and potential risk factors. Subjects who suffered from multiple incidences of FAPI (with no pain/injury reported elsewhere in the body) or at least one moderate episode of FAPI were allocated to the foot/ankle-injured (FAI) group (n=28, 25 F/3 M). Subjects reporting no pain/injury or only one minor FAPI were allocated to the non-injured group (n=21, 14 F/7 M). Baseline differences in variables between groups were tested with the independent samples t-test, Mann-Whitney U-test for skewed data, and Fishers exact test for categorical variables. RESULTS Baseline factors significantly associated with the FAI group included failing to always perform a warm-up (p=0.042), lower levels of energy (p=0.013), and more bothersome pain (p=0.021). Subjects also scored worse on two dimensions of the Athletic Coping Skills Inventory: i.e., coping with adversity (p=0.035) and goal setting and mental preparation (p=0.009). CONCLUSION Several biopsychosocial factors appear to be associated with FAPI in Irish dancers. Biopsychosocial screening protocols and prevention strategies may best identify and support at-risk dancers.

A CROSS-SECTIONAL STUDY OF THE BIOPSYCHOSOCIAL CHARACTERISTICS OF ELITE ADULT IRISH DANCERS AND THEIR ASSOCIATION WITH MUSCULOSKELETAL PAIN AND INJURY

Background Irish dancing (ID) is a technically demanding art form practised by growing numbers internationally. However, research into musculoskeletal pain and injury in elite adult Irish dancers is scant. Objective To establish the biopsychosocial characteristics of elite adult Irish dancers. To investigate any relationship between these characteristics and musculoskeletal pain and injury. Design 104 elite adult Irish dancers completed a questionnaire providing data on dance and activity levels, physical and psychological health, pain and injury history. 84 of these subjects underwent a physical screen examining lower limb flexibility, balance and endurance, a number of functional tests, anthropometric and biomechanical/anatomical assessments. Setting Testing was completed at a number of sites in Ireland using standardised portable equipment. Participants The study cohort comprised professional Irish dancers (34.6%), elite competitive Irish dancers (26.9%), and dancers in full time education studying ID (38.5%). All participants were 18 years of age or older. Elite dancers from eleven different countries were tested. Main outcome measurements Subjects were dichotomised into “significantly injured (SI)” and “not significantly injured (NSI)” categories based on reported levels of pain and injury. Specific injury data from the previous five years were also recorded. Results 33 (31.7%) subjects were classified as SI, with the remaining 71 (68.3%) subjects classified as NSI. Factors significantly associated being SI were female gender (P=.036), higher number of subjective general health (P=.001) and psychological (P=.036) complaints, low mood (P=.01), higher catastrophising (P=.047) and failure to always warm-up (P=.006). The mean number of injuries sustained to all body parts over the previous five years was 1.49 with a mean of 126.1 days lost to injury. Foot and ankle injuries were most prevalent. Conclusions A complex combination of biopsychosocial factors appears to be associated with a significant level of pain and injury in elite adult Irish dancers.

Job satisfaction of professional Irish dancers: implications for performer health and well-being.

This study investigates for the first time whether experienced former and current professional Irish dancers (PIDs) would recommend a career in Irish dance, and their perceived positive and negative attitudes toward this occupation. One hundred and sixty-five (71 current, 94 retired) PIDs participated in an online survey. Additional focus group interviews of six current and three retired PIDs were conducted to validate survey findings. PID comments were examined independently by the two investigators using thematic analysis and then cross-indexed and coded into the most common positive and negative themes. Ninety-four percent of surveyed PIDs and 100% of focus group participants stated that they would recommend a career in professional Irish dance. The main positive attributes identified included the opportunity to travel and experience diverse cultures, the development of enduring friendships, the pursuit of a hobby as a financially lucrative career, evolving personal life skills, and the maintenance of good physical health and fitness. The main negative themes included the insecure and short-term nature of the career, physical consequences in terms of pain and injury, potentially damaging psychological consequences, and practical difficulties inherent in a touring lifestyle. The effects of dancer job satisfaction on health, wellbeing, and performance are discussed, and recommendations for company managers and dance captains are developed based on findings.

Poor sleep is related to lower general health, increased stress and increased confusion in elite Gaelic athletes

ABSTRACT Objectives: Persistent poor sleep is associated with a range of adverse health outcomes. Sleep is considered the main method of recovery in athletes; however, studies report that a significant number of athletes are getting insufficient sleep. The purpose of this study was to assess the sleep profiles of elite Gaelic athletes and to compare wellbeing in those with poor sleep and those with good sleep. Methods: 69 elite Gaelic athletes completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Subjective Health Complaints Inventory (SHC), Nordic Musculoskeletal Questionnaire (NMQ), stress subscale of the Depression Anxiety Stress Scale (DASS), the tension-anxiety, anger-hostility and confusion-bewilderment subscales of the Profile of Mood States (POMS) as well as the catastrophising subscale of the Coping Strategies Questionnaire (CSQ). Participants were categorised into poor sleepers (PSQI ≥5) and good sleepers (PSQI <5) and outcome measures of health and wellbeing were analysed between the two groups. Results: 47.8% of athletes were poor sleepers. Self-reported sleep duration was 7.5 ± 0.6 h per night. 63.7% of poor sleepers took >30 min to fall asleep, compared to 5.6% of good sleepers. Poor sleepers had significantly lower general health (SHC) (p = 0.029), increased stress (DASS) (p = 0.035) and increased confusion (POMS-subscale) (p = 0.005). There was no significant difference between groups for number of painful body parts (NMQ) (p = 0.052), catastrophising (CSQ) (p = 0.287), overall mood (POMS) (p = 0.059), or POMS subscales of anger (p = 0.346) or tension (p = 0.593). Conclusion: Nearly 50% of elite Gaelic athletes report poor sleep. There is a significant relationship between poor sleep and lower general health, increased stress and increased confusion, and these factors may interact with each other. Monitoring of and interventions to enhance sleep may be required to improve athletes’ wellbeing.

Current injury monitoring and player education practices in Irish amateur rugby union

OBJECTIVES To ascertain current injury surveillance and player education practices in Irish amateur rugby union. DESIGN Cross-sectional survey. SETTING Amateur rugby clubs in Ireland. PARTICIPANTS Medical professionals and rugby coaches of the top 58 amateur rugby clubs in Ireland. MAIN OUTCOME MEASURES The survey investigated the current injury and training load monitoring practices in operation in Irish amateur rugby. It also explored whether player education sessions regarding injury prevention and concussion recognition and management were conducted in these clubs. RESULTS Forty-four clubs completed the survey, giving an overall response rate of 76%. Ninety-one percent of the responding clubs monitored injuries. Sixty-four percent of these clubs operated return to play protocols for all injuries, while 36% operated return to play protocols for concussion only. Injury prevention education was conducted by 71% of these clubs and 82% educated players on concussion recognition and management. CONCLUSIONS Implementing effective injury monitoring strategies in both amateur and professional sport settings may aid in minimizing injury risk. In Ireland, 91% of the responding clubs monitored injuries and 71% educated players on injury prevention. By implementing one centralized injury surveillance system for Irish amateur rugby, injury trends can be effectively monitored and used to guide prevention strategies.

Nutrition knowledge of Irish Dancers

It has long been known that the effect of nutrition intake on sports performance is significant. There is a lack of information on the effect of nutrition specifically on dance performance but as dance has been described as a high intensity intermittent exercise it is similar to that of a multi-sprint team sport. There is evidence that dancers do not consume an adequate intake of some nutrients. Before dietary behaviour can change in athletes and dancers, knowledge of desired behaviour is required. While there is some information available as to the nutrition knowledge of dancers, there is none as yet on Irish Dancers. This study looks at initial questionnaires from a longitudinal study on nutrition knowledge and intakes in Irish Dancers. 32 Irish dancers (30 female, 2 male, mean age 21·5 years, SD2·7) either in full time vocational training or professional dancers were recruited in Limerick. All participants were screened with EAT-26 and completed a validated sports nutrition knowledge questionnaire modified only for local foods/drinks. Ethical approval was granted through the procedures of the University of Roehampton and the University of Limerick. Mean score for the questionnaire was 30·3/65, SD7·9 (47 %, SD12 %), range 9–44 (14–68 %). This compared with 85 % scored by nutrition students, 45 % scored by business students and 59 % scored by fitness students in the validation of the original questionnaire. The ability of the Irish dancers to correctly identify foods as being high or low in carbohydrate, protein and fat varied widely. Mean (SD) score for correctly identifying foods high or low in carbohydrate was 4·1(1·4) out of 6, for foods high or low in protein 4·7 (1·6) out of 6, for foods high or low in fat 2·8 (1·4) out of 7. 11 participants (34 %) identified pasta as a high fat food, while 10 (31 %) participants identified butter as a high carbohydrate food. Although 11 (34 %) believed that salt tablets should be used to treat cramp in dancers, 30 (94 %) were able to correctly identify suitable drinks for after a training session. Nutrition knowledge amongst Irish dancers is variable, and knowledge of macronutrient content is not consistent. Without knowledge of macronutrient content of foods making choices based on recommendations to support dance training and performance will be difficult. These findings highlight the importance of providing accurate information to this group to allow them to make the best choices of food to support dance training and performance.

Musculoskeletal pain and injury in Irish dancing: A systematic review

BACKGROUND: The popularity of Irish dancing has increased enormously since the success of “Riverdance, The Show”. The evolution of Irish dance to professional status has placed increased demands on dancers, yet scant investigation of musculoskeletal pain and injury among Irish dancers has been undertaken. This review examined the evidence regarding the rate of injury among Irish dancers, and the factors associated with injury risk. METHODS: Electronic databases were searched by two independent assessors. Studies were included if they examined the rate of musculoskeletal pain or injury among Irish dancers, and/or the factors associated with musculoskeletal pain or injury among Irish dancers. Study quality was assessed using the Oxford levels of evidence scale. RESULTS: Only two retrospective studies met the eligibility criteria, with no prospective studies on injury rate having been published. These studies indicate that lower limb injuries, especially in the foot and ankle, are most common in Irish dancers. There is preliminary evidence that dancers who did not complete a warm-up and cool-down, who did not use split-shoe sneakers while training, and who perform at higher levels of competition may be at greater risk of injury. CONCLUSIONS: No high quality prospective studies of injury have been completed in Irish dance. The existing retrospective studies demonstrate that foot and ankle injuries are the most common, and some potential contributing factors to injury have been identified. However, prospective studies which evaluate these risk factors for injury, as well as common injury risk factors identified in other forms of dance, are required.