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Int J Sports Med 2017; 38(11): 847-856
DOI: 10.1055/s-0043-114864
Orthopedics & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

Epidemiology of Overuse Injuries in Youth Team Sports: A 3-year Prospective Study

Mari Leppänen
1   The UKK Institute for Health Promotion Research, Tampere Research Center of Sports Medicine, Tampere, Finland
,
Kati Pasanen
1   The UKK Institute for Health Promotion Research, Tampere Research Center of Sports Medicine, Tampere, Finland
,
Pekka Kannus
2   The UKK Institute for Health Promotion Research, Injury and Osteoporosis Research Center, Tampere, Finland
,
Tommi Vasankari
3   The UKK Institute for Health Promotion Research, Tampere, Finland
,
Urho M. Kujala
4   Faculty of Sport and Health Sciences University of Jyväskylä, Jyväskylä, Finland
,
Ari Heinonen
4   Faculty of Sport and Health Sciences University of Jyväskylä, Jyväskylä, Finland
,
Jari Parkkari
1   The UKK Institute for Health Promotion Research, Tampere Research Center of Sports Medicine, Tampere, Finland
› Author Affiliations
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Publication History



accepted after revision 02 June 2017

Publication Date:
11 September 2017 (online)

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Abstract

Prospective studies on overuse injuries and their impact on athletic training among youth team sports are scarce. The purpose of this study was to investigate the incidence, severity and player related risk factors of overuse injuries among young (12–20 years) basketball and floorball players. A total of 387 players participated in a 3-year prospective study. Each player completed a baseline questionnaire regarding their background information. Overuse injuries that prevented players to fully or partly participate in their regular training were collected. In all, 204 overuse injuries were registered (injury incidence 1.51 injuries/1 000 h of exposure; 95% CI 1.35–1.78). Most of the injuries involved the knee (35%) and lower back (21%), and were classified as severe (44%). Injury incidence was 1.51 (95% CI 1.2–1.82) and 1.61 (95% CI 1.32–1.91) in basketball and floorball, respectively. Incidence was significantly higher among female compared with male players (incidence rate ratio 1.58; 95% CI 1.20–2.09). Previous injury and playing at adult level were the strongest factors associated with occurrence of an overuse injury. In conclusion, overuse injuries of the knee and low back are relatively common in youth basketball and floorball. Effective prevention strategies as well as training load monitoring is needed in youth team sports.

Key words

sports injuries - basketball - floorball - adolescents
 

  • References

  • 1 Agel J, Olson DE, Dick R, Arendt EA, Marshall SW, Sikka RS. Descriptive epidemiology of collegiate women’s basketball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 through 2003–2004. J Athl Train 2007; 42: 202
    PubMedGoogle Scholar
  • 2 Andersson SH, Bahr R, Clarsen B, Myklebust G. Preventing overuse shoulder injuries among throwing athletes: A cluster-randomised controlled trial in 660 elite handball players. Br J Sports Med 2016; DOI: 10.1136/bjsports-2016-096226.
    PubMedGoogle Scholar
  • 3 Bahr R. No injuries, but plenty of pain? On the methodology for recording overuse symptoms in sports. Br J Sports Med 2009; 43: 966-972
    CrossrefPubMedGoogle Scholar
  • 4 Baranto A, Hellström M, Cederlund C, Nyman R, Swärd L. Back pain and MRI changes in the thoraco-lumbar spine of top athletes in four different sports: A 15-year follow-up study. Knee Surg Sports Trauma Arthrosc 2009; 17: 1125-1134
    CrossrefPubMedGoogle Scholar
  • 5 Bjørneboe J, Flørenes TW, Bahr R, Andersen TE. Injury surveillance in male professional football; Is medical staff reporting complete and accurate?. Scand J Med Sci Sports 2011; 21: 713-720
    CrossrefPubMedGoogle Scholar
  • 6 Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A. A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: The Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. Am J Sports Med 2009; 37: 2108-2116
    CrossrefPubMedGoogle Scholar
  • 7 Borowski LA, Yard EE, Fields SK, Comstock RD. The epidemiology of US high school basketball injuries, 2005–2007. Am J Sports Med 2008; 36: 2328-2335
    CrossrefPubMedGoogle Scholar
  • 8 Bourne MN, Opar DA, Williams MD, Shield AJ. Eccentric knee flexor strength and risk of hamstring injuries in rugby union: A prospective study. Am J Sports Med 2015; 43: 2663-2670
    CrossrefPubMedGoogle Scholar
  • 9 Clarsen B, Bahr R, Heymans M, Engedahl M, Midtsundstad G, Rosenlund L, Thorsen G, Myklebust G. The prevalence and impact of overuse injuries in five Norwegian sports: Application of a new surveillance method. Scand J Med Sci Sports 2015; 25: 323-330
    CrossrefPubMedGoogle Scholar
  • 10 Clarsen B, Myklebust G, Bahr R. Development and validation of a new method for the registration of overuse injuries in sports injury epidemiology: The Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire. Br J Sports Med 2013; 47: 495-502
    CrossrefPubMedGoogle Scholar
  • 11 Cumps E, Verhagen E, Meeusen R. Prospective epidemiological study of basketball injuries during one competitive season: Ankle sprains and overuse knee injuries. J Sports Sci Med 2007; 6: 204-211
    PubMedGoogle Scholar
  • 12 Dean A, Sullivan K, Soe M. OpenEpi: Open source epidemiologic statistics for public health, version.Availabe from: www.OpenEpi.com (accessed 2015/09/17) 2014
    PubMed
  • 13 Deitch JR, Starkey C, Walters SL, Moseley JB. Injury risk in professional basketball players: A comparison of Women’s National Basketball Association and National Basketball Association athletes. Am J Sports Med 2006; 34: 1077-1083
    CrossrefPubMedGoogle Scholar
  • 14 Dick R, Hertel J, Agel J, Grossman J, Marshall SW. Descriptive epidemiology of collegiate men’s basketball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 through 2003–2004. J Athl Train 2007; 42: 194-201
    PubMedGoogle Scholar
  • 15 DiFiori JP, Benjamin HJ, Brenner JS, Gregory A, Jayanthi N, Landry GL, Luke A. Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Br J Sports Med 2014; 48: 287-288
    CrossrefPubMedGoogle Scholar
  • 16 Drakos MC, Domb B, Starkey C, Callahan L, Allen AA. Injury in the National Basketball Association: A 17-year overview. Sports Health 2010; 2: 284-290
    CrossrefPubMedGoogle Scholar
  • 17 Freckleton G, Pizzari T. Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-analysis. Br J Sports Med 2013; 47: 351-358
    CrossrefPubMedGoogle Scholar
  • 18 Fuller CW, Ekstrand J, Junge A, Andersen TE, Bahr R, Dvorak J, Hägglund M, McCrory P, Meeuwisse WH. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Scand J Med Sci Sports 2006; 16: 83-92
    CrossrefPubMedGoogle Scholar
  • 19 Gabbett TJ. The training-injury prevention paradox: Should athletes be training smarter and harder?. Br J Sports Med 2016; 50: 273-280
    CrossrefPubMedGoogle Scholar
  • 20 Giroto N, Hespanhol Junior L, Gomes M, Lopes A. Incidence and risk factors of injuries in Brazilian elite handball players: A prospective cohort study. Scand J Med Sci Sports 2015; 27: 195-202
    PubMedGoogle Scholar
  • 21 Greene HS, Cholewicki J, Galloway MT, Nguyen CV, Radebold A. A history of low back injury is a risk factor for recurrent back injuries in varsity athletes. Am J Sports Med 2001; 29: 795-800
    CrossrefPubMedGoogle Scholar
  • 22 Hägglund M, Waldén M. Risk factors for acute knee injury in female youth football. Knee Surg Sports Trauma Arthrosc 2016; 24: 737-746
    CrossrefPubMedGoogle Scholar
  • 23 Harriss D, Atkinson G. Ethical standards in sport and exercise science research: 2016 update. Int J Sports Med 2015; 36: 1121-1124
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Hewett TE, Myer GD, Ford KR, Heidt Jr RS, Colosimo AJ, McLean SG, van den Bogert AJ, Paterno MV, Succop P. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: A prospective study. Am J Sports Med 2005; 33: 492-501
    CrossrefPubMedGoogle Scholar
  • 25 Junge T, Runge L, Juul-Kristensen B, Wedderkopp N. Risk factors for knee injuries in children 8–15 years: The CHAMPS-Study DK. Med Sci Sports Exerc 2015; 48: 655-662
    PubMedGoogle Scholar
  • 26 Kujala UM, Taimela S, Erkintalo M, Salminen JJ, Kaprio J. Low-back pain in adolescent athletes. Med Sci Sports Exerc 1996; 28: 165-170
    PubMedGoogle Scholar
  • 27 Külling FA, Florianz H, Reepschläger B, Gasser J, Jost B, Lajtai G. High prevalence of disc degeneration and spondylolysis in the lumbar spine of professional beach volleyball players. Orthop J Sports Med 2014; 2 DOI: 10.1177/2325967114528862.
    PubMedGoogle Scholar
  • 28 Leppänen M, Aaltonen S, Parkkari J, Heinonen A, Kujala UM. Interventions to prevent sports related injuries: A systematic review and meta-analysis of randomised controlled trials. Sports Med 2014; 44: 473-486
    CrossrefPubMedGoogle Scholar
  • 29 Leppänen M, Pasanen K, Kujala UM, Parkkari J. Overuse injuries in youth basketball and floorball. OA J Sports Med 2015; 6: 173-179
    PubMedGoogle Scholar
  • 30 Leppänen M, Pasanen K, Kujala UM, Vasankari T, Kannus P, Äyrämö S, Krosshaug T, Bahr R, Avela J, Perttunen J, Parkkari J. Stiff landings are associated with increased acl injury risk in young female basketball and floorball players. Am J Sports Med 2017; 45: 386-393
    CrossrefPubMedGoogle Scholar
  • 31 Lian ØB, Engebretsen L, Bahr R. Prevalence of jumper’s knee among elite athletes from different sports: A cross-sectional study. Am J Sports Med 2005; 33: 561-567
    CrossrefPubMedGoogle Scholar
  • 32 Malone S, Roe M, Doran DA, Gabbett TJ, Collins KD. Aerobic fitness and playing experience protect against spikes in workload: the role of the acute: chronic workload ratio on injury risk in elite Gaelic football. IJSPP 2016; DOI: 10.1123/ijspp.2016-0090.
    PubMedGoogle Scholar
  • 33 McCarthy MM, Voos JE, Nguyen JT, Callahan L, Hannafin JA. Injury profile in elite female basketball athletes at the Women’s National Basketball Association combine. Am J Sports Med 2013; 41: 645-651
    CrossrefPubMedGoogle Scholar
  • 34 Meeuwisse WH, Sellmer R, Hagel BE. Rates and risks of injury during intercollegiate basketball. Am J Sports Med 2003; 31: 379-385
    CrossrefPubMedGoogle Scholar
  • 35 Messina DF, Farney WC, DeLee JC. The incidence of injury in Texas high school basketball: a prospective study among male and female athletes. Am J Sports Med 1999; 27: 294-299
    CrossrefPubMedGoogle Scholar
  • 36 Moller M, Attermann J, Myklebust G, Wedderkopp N. Injury risk in Danish youth and senior elite handball using a new SMS text messages approach. Br J Sports Med 2012; 46: 531-537
    CrossrefPubMedGoogle Scholar
  • 37 Myer GD, Ford KR, Foss KDB, Goodman A, Ceasar A, Rauh MJ. Divine JG, Hewett TE. The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clin Biomech 2010; 25: 700-707
    CrossrefPubMedGoogle Scholar
  • 38 Myklebust G, Hasslan L, Bahr R, Steffen K. High prevalence of shoulder pain among elite Norwegian female handball players. Scand J Med Sci Sports 2011; 23: 288-294
    PubMedGoogle Scholar
  • 39 Nilstad A, Bahr R, Andersen TE. Text messaging as a new method for injury registration in sports: A methodological study in elite female football. Scand J Med Sci Sports 2014; 24: 243-249
    CrossrefPubMedGoogle Scholar
  • 40 Olsen OE, Myklebust G, Engebretsen L, Holme I, Bahr R. Exercises to prevent lower limb injuries in youth sports: Cluster randomised controlled trial. BMJ 2005; 330 doi:10.1136/bmj.38330.632801.8F
    PubMedGoogle Scholar
  • 41 Ong A, Anderson J, Roche J. A pilot study of the prevalence of lumbar disc degeneration in elite athletes with lower back pain at the Sydney 2000 Olympic Games. Br J Sports Med 2003; 37: 263-266
    CrossrefPubMedGoogle Scholar
  • 42 Pasanen K, Ekola T, Vasankari T, Kannus P, Heinonen A, Kujala U, Parkkari J. High ankle injury rate in adolescent basketball: A 3-year prospective follow-up study. Scand J Med Sci Sports 2016
    PubMed
  • 43 Pasanen K, Parkkari J, Kannus P, Rossi L, Palvanen M, Natri A, Järvinen M. Injury risk in female floorball: a prospective one-season follow-up. Scand J Med Sci Sports 2008; 18: 49-54
    PubMedGoogle Scholar
  • 44 Pasanen K, Rossi MT, Parkkari J, Heinonen A, Steffen K, Myklebust G, Krosshaug T, Vasankari T, Kannus P, Avela J. Predictors of lower extremity injuries in team sports (PROFITS-study): A study protocol. BMJ Open Sports Exerc Med 2015; 1: e000076
    PubMedGoogle Scholar
  • 45 Pasanen K, Parkkari J, Pasanen M, Kannus P. Effect of a neuromuscular warm-up programme on muscle power, balance, speed and agility: A randomised controlled study. Br J Sports Med 2009; 43: 1073-1078
    CrossrefPubMedGoogle Scholar
  • 46 Pasanen K, Rossi M, Parkkari J, Kannus P, Heinonen A, Tokola K, Myklebust G. Low back pain in young basketball and floorball Players. Clin J Sport Med 2016; 26: 376-380
    CrossrefPubMedGoogle Scholar
  • 47 Randazzo C, Nelson NG, McKenzie LB. Basketball-related injuries in school-aged children and adolescents in 1997–2007. Pediatrics 2010; 126: 727-733
    CrossrefPubMedGoogle Scholar
  • 48 Roos KG, Marshall SW, Kerr ZY, Golightly YM, Kucera KL, Myers JB. Rosamond WD, Comstock RD. Epidemiology of overuse injuries in collegiate and high school athletics in the United States. Am J Sports Med 2015; 43: 1790-1797
    CrossrefPubMedGoogle Scholar
  • 49 Schroeder GD, LaBella CR, Mendoza M, Daley EL, Savage JW, Patel AA, Hsu WK. The role of intense athletic activity on structural lumbar abnormalities in adolescent patients with symptomatic low back pain. Eur Spine J 2016; 25: 2842-2848
    CrossrefPubMedGoogle Scholar
  • 50 Snellman K, Parkkari J, Kannus P, Leppälä J, Vuori I, Järvinen M. Sports injuries in floorball: A prospective one-year follow-up study. Int J Sports Med 2001; 22: 531-536
    Article in Thieme ConnectPubMedGoogle Scholar
  • 51 Soligard T, Myklebust G, Steffen K, Holme I, Silvers H, Bizzini M, Junge A, Dvorak J, Bahr R, Andersen TE. Comprehensive warm-up programme to prevent injuries in young female footballers: Cluster randomised controlled trial. BMJ 2008; 337: a2469
    CrossrefPubMedGoogle Scholar
  • 52 Starkey C. Injuries and illnesses in the National Basketball Association: A 10-year perspective. J Athl Train 2000; 35: 161-167
    PubMedGoogle Scholar
  • 53 Suni J, Rinne M, Natri A, Statistisian MP, Parkkari J, Alaranta H. Control of the lumbar neutral zone decreases low back pain and improves self-evaluated work ability: A 12-month randomized controlled study. Spine 2006; 31: E611-E620
    CrossrefPubMedGoogle Scholar
  • 54 Suni JH, Taanila H, Mattila VM, Ohrankammen O, Vuorinen P, Pihlajamaki H, Parkkari J. Neuromuscular exercise and counseling decrease absenteeism due to low back pain in young conscripts: A randomized, population-based primary prevention study. Spine 2013; 38: 375-384
    CrossrefPubMedGoogle Scholar
  • 55 Tranaeus U, Götesson E, Werner S. Injury profile in Swedish elite floorball: A prospective cohort study of 12 teams. Sports Health 2016; 8: 224-229
    CrossrefPubMedGoogle Scholar
  • 56 van der Does HT, Brink MS, Benjaminse A, Visscher C, Lemmink KA. Jump landing characteristics predict lower extremity injuries in indoor team sports. Int J Sports Med 2016; 37: 251-256
    Article in Thieme ConnectPubMedGoogle Scholar
  • 57 van der Worp H, van der Does HT, Brink MS, Zwerver J, Hijmans JM. Prospective study of the relation between landing biomechanics and jumper’s knee. Int J Sports Med 2016; 37: 245-250
    Article in Thieme ConnectPubMedGoogle Scholar
  • 58 Visnes H, Bahr R. Training volume and body composition as risk factors for developing jumper’s knee among young elite volleyball players. Scand J Med Sci Sports 2013; 23: 607-613
    PubMedGoogle Scholar
  • 59 Walden M, Atroshi I, Magnusson H, Wagner P, Hagglund M. Prevention of acute knee injuries in adolescent female football players: Cluster randomised controlled trial. BMJ 2012; 344: e3042
    CrossrefPubMedGoogle Scholar
  • 60 Weiss KJ, Allen SV, McGuigan MR, Whatman CS. The relationship between training load and injury in men’s professional basketball players. IJSPP 2017; DOI: 10.1123/ijspp.2016-0726.
    PubMedGoogle Scholar
  • 61 Weiss K, McGuigan M, Besier T, Whatman C. The application of a simple surveillance method for detecting the prevalence and impact of overuse injuries in professional men’s basketball. J Strength Cond Res 2016; DOI: 10.1519/JSC.0000000000001739.
    PubMedGoogle Scholar
  • 62 Wikström J, Andersson C. A prospective study of injuries in licensed floorball players. Scand J Med Sci Sports 1997; 7: 38-42
    PubMedGoogle Scholar
  • 63 Windt J, Gabbett TJ. How do training and competition workloads relate to injury? The workload-injury aetiology model. Br J Sports Med 2017; 51: 428-435
    CrossrefPubMedGoogle Scholar
  • 64 Wright AA, Taylor JB, Ford KR, Siska L, Smoliga JM. Risk factors associated with lower extremity stress fractures in runners: A systematic review with meta-analysis. Br J Sports Med 2015; 49: 1517-1523
    CrossrefPubMedGoogle Scholar
  • 65 Yang J, Tibbetts AS, Covassin T, Cheng G, Nayar S, Heiden E. Epidemiology of overuse and acute injuries among competitive collegiate athletes. J Athl Train 2012; 47: 198-204
    CrossrefPubMedGoogle Scholar
  • 66 Zwerver J, Bredeweg SW, van den Akker-Scheek I. Prevalence of jumper’s knee among nonelite athletes from different sports: A cross-sectional survey. Am J Sports Med 2011; 39: 1984-1988
    CrossrefPubMedGoogle Scholar