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Int J Sports Med 2023; 44(12): 919-924
DOI: 10.1055/a-2108-6463
Orthopedics & Biomechanics

Previous Injury and Lower Well-being Increase Injury Risk in Female Adolescent Athletes

Linda Ekenros
1   Department of Neurobiology, Care Sciences, and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
,
Cecilia Fridén
1   Department of Neurobiology, Care Sciences, and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
2   Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
,
Philip von Rosen
1   Department of Neurobiology, Care Sciences, and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
› Author Affiliations Funding Information Centrum för idrottsforskning — http://dx.doi.org/10.13039/ 501100005350; D2020–0040
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Abstract

Several risk factors for injury have been suggested in female elite athletes. However, there is a lack of prospective studies in young female athletes where multiple risk factors have been studied. The aim of this study was to identify risk factors for injury in female adolescent elite athletes. Substantial injuries were monitored in 222 athletes using the validated Oslo Sports Trauma Research Centre Questionnaire over 20 weeks. Over 20 potential risk factors were explored. Based on a binomial generalized linear mixed model, two significant (p<0.05) risk factors for injury were identified; previous injury within the last 12 months (OR 2.55) and well-being (OR 0.97). An athlete with a previous injury had twice as high a risk of injury (13% vs. 6%) compared to an athlete with no previous injury. Higher perceived well-being was associated with a decreased risk of injury. Based on a prospective design with a large sample of female adolescent elite athletes, investigating over 20 potential risk factors for injury, our results suggest that a previous injury and well-being are risk factors for injury.

Key words

injury surveillance - risk factors - youth - girls


Publication History

Received: 11 November 2022

Accepted: 17 May 2023

Article published online:
25 July 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Abernethy L, Bleakley C. Strategies to prevent injury in adolescent sport: A systematic review. Br J Sports Med 2007; 41: 627-638
    CrossrefPubMedGoogle Scholar
  • 2 DiFiori JP, Benjamin HJ, Brenner JS. et al. 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
  • 3 van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports injuries. A review of concepts. Sports Med Auckl NZ 1992; 14: 82-99
    CrossrefPubMedGoogle Scholar
  • 4 von Rosen P, Frohm A, Kottorp A. et al. Multiple factors explain injury risk in adolescent elite athletes: Applying a biopsychosocial perspective. Scand J Med Sci Sports 2017; 27: 2059-2069
    CrossrefPubMedGoogle Scholar
  • 5 Chia L, De Oliveira Silva D, Whalan M. et al. Non-contact anterior cruciate ligament injury epidemiology in team-ball sports: A systematic review with meta-analysis by sex, age, sport, participation level, and exposure type. Sports Med Auckl NZ 2022; 52: 2447-2467
    CrossrefPubMedGoogle Scholar
  • 6 Huston LJ, Greenfield ML, Wojtys EM. Anterior cruciate ligament injuries in the female athlete. Potential risk factors. Clin Orthop 2000; 50-63
    CrossrefPubMedGoogle Scholar
  • 7 Thein-Nissenbaum JM, Rauh MJ, Carr KE. et al. Menstrual irregularity and musculoskeletal injury in female high school athletes. J Athl Train 2012; 47: 74-82
    CrossrefPubMedGoogle Scholar
  • 8 Slauterbeck JR, Hardy DM. Sex hormones and knee ligament injuries in female athletes. Am J Med Sci 2001; 322: 196-199
    CrossrefPubMedGoogle Scholar
  • 9 Gornitzky AL, Lott A, Yellin JL. et al. Sport-specific yearly risk and incidence of anterior cruciate ligament tears in high school athletes: A systematic review and meta-analysis. Am J Sports Med 2016; 44: 2716-2723
    CrossrefPubMedGoogle Scholar
  • 10 Bram JT, Magee LC, Mehta NN. et al. Anterior cruciate ligament injury incidence in adolescent athletes: A systematic review and meta-analysis. Am J Sports Med 2021; 49: 1962-1972
    CrossrefPubMedGoogle Scholar
  • 11 Abbott A, Bird ML, Wild E. et al. Part I: Epidemiology and risk factors for stress fractures in female athletes. Phys Sportsmed 2020; 48: 17-24
    CrossrefPubMedGoogle Scholar
  • 12 De Souza MJ, Nattiv A, Joy E. et al. 2014 Female athlete triad coalition consensus statement on treatment and return to play of the female athlete triad: 1st International conference held in San Francisco, California, May 2012 and 2nd International conference held in Indianapolis, Indiana, May 2013. Br J Sports Med 2014; 48: 289
    CrossrefPubMedGoogle Scholar
  • 13 von Rosen P, Heijne A, Frohm A. et al. Menstrual irregularity and use of oral contraceptives in female adolescent athletes in Swedish National Sports High Schools. Int J Adolesc Med Health 2017; 32 DOI: 10.1515/ijamh-2017-0113.
    CrossrefPubMedGoogle Scholar
  • 14 Ekenros L, von Rosen P, Solli GS. et al. Perceived impact of the menstrual cycle and hormonal contraceptives on physical exercise and performance in 1,086 athletes from 57 sports. Front Physiol 2022; 13: 954760
    CrossrefPubMedGoogle Scholar
  • 15 Somerson JS, Isby IJ, Hagen MS. et al. The menstrual cycle may affect anterior knee laxity and the rate of anterior cruciate ligament rupture: A systematic review and meta-analysis. JBJS Rev 2019; 7: e2
    CrossrefPubMedGoogle Scholar
  • 16 Herzberg SD, Motu’apuaka ML, Lambert W. et al. The effect of menstrual cycle and contraceptives on acl injuries and laxity: A systematic review and meta-analysis. Orthop J Sports Med 2017; 5: 2325967117718781
    CrossrefPubMedGoogle Scholar
  • 17 Brooks JHM, Fuller CW, Kemp SPT. et al. Epidemiology of injuries in English professional rugby union: part 1 match injuries. Br J Sports Med 2005; 39: 757-766
    CrossrefPubMedGoogle Scholar
  • 18 Hjelm N, Werner S, Renstrom P. Injury risk factors in junior tennis players: A prospective 2-year study. Scand J Med Sci Sports 2012; 22: 40-48
    CrossrefPubMedGoogle Scholar
  • 19 Arnason A, Sigurdsson SB, Gudmundsson A. et al. Risk factors for injuries in football. Am J Sports Med 2004; 32: 5S-16S
    CrossrefPubMedGoogle Scholar
  • 20 Bowen L, Gross AS, Gimpel M. et al. Accumulated workloads and the acute:chronic workload ratio relate to injury risk in elite youth football players. Br J Sports Med 2017; 51: 452-459
    CrossrefPubMedGoogle Scholar
  • 21 Eckard TG, Padua DA, Hearn DW. et al. The relationship between training load and injury in athletes: A systematic review. Sports Med Auckl NZ 2018; 48: 1929-1961
    CrossrefPubMedGoogle Scholar
  • 22 Dalen-Lorentsen T, Bjørneboe J, Clarsen B. et al. Does load management using the acute:chronic workload ratio prevent health problems? A cluster randomised trial of 482 elite youth footballers of both sexes. Br J Sports Med 2021; 55: 108-114
    CrossrefPubMedGoogle Scholar
  • 23 Raya-González J, Nakamura FY, Castillo D, Yanci J, Fanchini M. Determining the relationship between internal load markers and noncontact injuries in young elite soccer players. Int J Sports Physiol Perform 2019; 14: 421-425
    CrossrefPubMedGoogle Scholar
  • 24 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
  • 25 Clarsen B, Bahr R, Myklebust G. et al. Improved reporting of overuse injuries and health problems in sport: An update of the Oslo Sport Trauma Research Center questionnaires. Br J Sports Med 2020; 54: 390
    CrossrefPubMedGoogle Scholar
  • 26 Fulton J, Wright K, Kelly M. et al. Injury risk is altered by previous injury: A systematic review of the literature and presentation of causative neuromuscular factors. Int J Sports Phys Ther 2014; 9: 583-595
    PubMedGoogle Scholar
  • 27 van der Worp MP, ten Haaf DSM, van Cingel R. et al. Injuries in runners; a systematic review on risk factors and sex differences. PloS One 2015; 10: e0114937
    CrossrefPubMedGoogle Scholar
  • 28 Emery CA. Risk factors for injury in child and adolescent sport: A systematic review of the literature. Clin J Sport Med Off J Can Acad Sport Med 2003; 13: 256-268
    CrossrefPubMedGoogle Scholar
  • 29 Engebretsen AH, Myklebust G, Holme I. et al. Intrinsic risk factors for hamstring injuries among male soccer players: A prospective cohort study. Am J Sports Med 2010; 38: 1147-1153
    CrossrefPubMedGoogle Scholar
  • 30 Ivarsson A, Johnson U, Podlog L. Psychological predictors of injury occurrence: A prospective investigation of professional Swedish soccer players. J Sport Rehabil 2013; 22: 19-26
    CrossrefPubMedGoogle Scholar
  • 31 Watson A, Brickson S, Brooks A. et al. Subjective well-being and training load predict in-season injury and illness risk in female youth soccer players. Br J Sports Med 2017; 51: 194-199
    CrossrefPubMedGoogle Scholar
  • 32 Johnson U, Ivarsson A. Psychological predictors of sport injuries among junior soccer players. Scand J Med Sci Sports 2011; 21: 129-136
    CrossrefPubMedGoogle Scholar
  • 33 Lavallée L, Flint F. The relationship of stress, competitive anxiety, mood state, and social support to athletic injury. J Athl Train 1996; 31: 296-299
    PubMedGoogle Scholar
  • 34 Laux P, Krumm B, Diers M. et al. Recovery-stress balance and injury risk in professional football players: a prospective study. J Sports Sci 2015; 33: 2140-2148
    CrossrefPubMedGoogle Scholar
  • 35 Lefevre N, Bohu Y, Klouche S. et al. Anterior cruciate ligament tear during the menstrual cycle in female recreational skiers. Orthop Traumatol Surg Res OTSR 2013; 99: 571-575
    CrossrefPubMedGoogle Scholar
  • 36 Ruedl G, Ploner P, Linortner I. et al. Are oral contraceptive use and menstrual cycle phase related to anterior cruciate ligament injury risk in female recreational skiers?. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 2009; 17: 1065-1069
    CrossrefPubMedGoogle Scholar
  • 37 Gray AM, Gugala Z, Baillargeon JG. Effects of oral contraceptive use on anterior cruciate ligament injury epidemiology. Med Sci Sports Exerc 2016; 48: 648-654
    CrossrefPubMedGoogle Scholar
  • 38 von Rosen P, Heijne A, Frohm A. et al. High injury burden in elite adolescent athletes: A 52-week prospective study. J Athl Train 2018; 53: 262-270
    CrossrefPubMedGoogle Scholar