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      High Incidence of Hand Injuries From Blocking in Elite Taekwondo Despite the Use of Protective Gear: A 5-Year Descriptive Epidemiology Study

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          Abstract

          Background:

          Hand and wrist injuries are a common but underestimated issue in taekwondo. Detailed data on injury risk, patterns, and mechanism are missing.

          Purpose:

          To evaluate (1) the fight time exposure-adjusted injury incidence rate (IIR) and clinical incidence and (2) injury site, type, sport-specific mechanism, and time loss in taekwondo.

          Study Design:

          Descriptive epidemiology study.

          Methods:

          Athletes from a single national Olympic taekwondo training center were investigated prospectively for hand and wrist injuries during training and competition over 5 years. The Orchard Sports Injury Classification System Version 10 was used to classify injury type, and analysis of the anatomic injury site was performed. The mechanism of injury was classified as due to either striking or blocking techniques.

          Results:

          From a total of 107 athletes, 79 athletes (73.8%) with a total exposure time of 8495 hours were included in the final data set. During the study period, 75 injuries of the hand and wrist region were recorded despite the athletes using protective hand gear. The IIR was 13.9 (95% CI, 10.5-17.5) and was significantly higher during competition. The clinical incidence as an indicator for risk of injury was 60.7% (95% CI, 50.9-70.5). Finger rays were the most affected location (68%), and fractures (43%) and joint ligament injuries (35%) were the most common type of injury. Significantly more injuries were found on the dominant hand side ( P < .001). Comparison of injury mechanisms demonstrated significantly more injuries at the finger rays deriving from blocking techniques ( P = .0104). The mean time loss for all hand and wrist injuries was 15.7 ± 13.5 days (range, 3-45 days) and was highest for distal radial fractures, with a mean of 39.7 ± 4.8 days (range, 32-45 days).

          Conclusion:

          There was a significantly higher IIR for acute hand and wrist injuries in elite taekwondo athletes during competition, which resulted in considerable time loss, especially when fractures or dislocations occurred. Significantly more injuries to the finger rays were found during blocking despite the use of protective hand gear. Improvement of tactical skills and blocking techniques during training and improved protective gear appear to be essential for injury prevention.

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          Most cited references22

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          Injury surveillance in multi-sport events: the International Olympic Committee approach.

          The protection of athletes' health by preventing injuries is an important task for international sports federations. Standardised injury surveillance provides not only important epidemiological information, but also directions for injury prevention, and the opportunity for monitoring long-term changes in the frequency and circumstances of injury. Numerous studies have evaluated sports injuries during the season, but few have focused on injuries during major sport events such as World Championships, World Cups or the Olympic Games. To provide an injury surveillance system for multi-sports tournaments, using the 2008 Olympic Games in Beijing as an example. A group of experienced researchers reviewed existing injury report systems and developed a scientific sound and concise injury surveillance system for large multi-sport events. The injury report system for multi-sport events is based on an established system for team sports tournaments and has proved feasible for individual sports during the International Association of Athletics Federations World Championships in Athletics 2007. The most important principles and advantages of the system are comprehensive definition of injury, injury report by the physician responsible for the athlete, a single-page report of all injuries, and daily report irrespective of whether or not an injury occurred. Implementation of the injury surveillance system, all definitions, the report form, and the analysis of data are described in detail to enable other researchers to implement the injury surveillance system in any sports tournament. The injury surveillance system has been accepted by experienced team physicians and shown to be feasible for single-sport and multi-sport events. It can be modified depending on the specific objectives of a certain sport or research question; however, a standardised use of injury definition, report forms and methodology will ensure the comparability of results.
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            Sports injuries and illnesses during the London Summer Olympic Games 2012.

            The Olympic Movement Medical Code encourages all stakeholders to ensure that sport is practised without danger to the health of the athletes. Systematic surveillance of injuries and illnesses is the foundation for developing preventive measures in sport. To analyse the injuries and illnesses that occurred during the Games of the XXX Olympiad, held in London in 2012. We recorded the daily occurrence (or non-occurrence) of injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the London Organising Committee of the Olympic and Paralympic Games' (LOCOG) medical staff. In total, 10 568 athletes (4676 women and 5892 men) from 204 NOCs participated in the study. NOC and LOCOG medical staff reported 1361 injuries and 758 illnesses, equalling incidences of 128.8 injuries and 71.7 illnesses per 1000 athletes. Altogether, 11% and 7% of the athletes incurred at least one injury or illness, respectively. The risk of an athlete being injured was the highest in taekwondo, football, BMX, handball, mountain bike, athletics, weightlifting, hockey and badminton, and the lowest in archery, canoe slalom and sprint, track cycling, rowing, shooting and equestrian. 35% of the injuries were expected to prevent the athlete from participating during competition or training. Women suffered 60% more illnesses than men (86.0 vs 53.3 illnesses per 1000 athletes). The rate of illness was the highest in athletics, beach volleyball, football, sailing, synchronised swimming and taekwondo. A total of 310 illnesses (41%) affected the respiratory system and the most common cause of illness was infection (n=347, 46%). At least 11% of the athletes incurred an injury during the games and 7% of the athletes' an illness. The incidence of injuries and illnesses varied substantially among sports. Future initiatives should include the development of preventive measures tailored for each specific sport and the continued focus among sport bodies to institute and further develop scientific injury and illness surveillance systems.
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              • Article: not found

              Physical and physiological profiles of taekwondo athletes.

              Taekwondo has evolved into a modern-day Olympic combat sport. The physical and physiological demands of modern-day taekwondo competition require athletes to be competent in several aspects of fitness. This review critically explores the physical and physiological characteristics of taekwondo athletes and presents implications for training and research. International taekwondo athletes possess low levels of body fat and a somatotype that characterises a blend of moderate musculoskeletal tissue and relative body linearity. While there is some variation in the maximum oxygen uptake of taekwondo athletes, moderate to high levels of cardio-respiratory fitness are necessary to support the metabolic demands of fighting and to facilitate recovery between consecutive matches. Taekwondo athletes demonstrate high peak anaerobic power characteristics of the lower limbs and this attribute appears to be conducive to achieving success in international competition. The ability to generate and sustain power output using both concentric and 'stretch-shortening cycle' muscle actions of the lower limbs may be important to support the technical and tactical actions in combat. Taekwondo competitors also display moderate to high maximum dynamic strength characteristics of the lower and upper extremities, and moderate endurance properties of the trunk and hip flexor musculature. The dynamic nature of the technical and tactical actions in the sport demand high flexibility of the lower limbs. More extensive research is required into the physical and physiological characteristics of taekwondo athletes to extend existing knowledge and to permit specialised conditioning for different populations within the sport.
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                Author and article information

                Journal
                Orthop J Sports Med
                Orthop J Sports Med
                OJS
                spojs
                Orthopaedic Journal of Sports Medicine
                SAGE Publications (Sage CA: Los Angeles, CA )
                2325-9671
                25 January 2021
                January 2021
                : 9
                : 1
                : 2325967120973996
                Affiliations
                []Department of Orthopaedics and Traumatology, Paracelsus Medical University, Nuremberg, Germany.
                []Department of Hand Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau am Staffelsee, Germany.
                [§ ]Department of Orthopaedics and Traumatolgy, Lausanne University Hospital, Lausanne, Switzerland.
                [|| ]Center of Arthroscopy and Sports Medicine, Orthopedic Hospital Markgroeningen, Markgroeningen, Germany.
                [5-2325967120973996] Investigation performed at the Department of Orthopaedics and Traumatology, Paracelsus Medical University, Nuremberg, Germany
                Author notes
                [*] [* ]Markus Geßlein, MD, Department of Orthopaedics and Traumatology, Paracelsus Medical University, Breslauer Straße 201, 90471 Nuremberg, Germany (email: markus.gesslein@ 123456klinikum-nuernberg.de ).
                Article
                10.1177_2325967120973996
                10.1177/2325967120973996
                7841679
                87fa1c6d-fc30-4c64-9745-72ad11057d42
                © The Author(s) 2021

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License ( https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 18 June 2020
                : 28 July 2020
                Categories
                Article
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                injury incidence rate,taekwondo,hand injury,wrist injury,injury mechanism

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