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      Prevalence and burden of overuse injuries in elite junior handball

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          Abstract

          Aim

          To record overuse injuries among male junior handball players throughout a handball season.

          Design

          Prospective cohort study.

          Methods

          Ten Norwegian junior male handball teams (145 players aged 16–18 years) were followed for one 10-month season. All players were sent the Oslo Sports Trauma Research Center Overuse Injury Questionaire every second week to record overuse injuries located in the shoulder, elbow, lower back and knee. The relative burden of overuse injuries was calculated in each anatomical area represented, defined as the proportion of the total cumulative severity score.

          Results

          The average prevalence of all overuse injury problems was 39% (95% CI 29% to 49%) across all anatomical areas. The average prevalence of substantial overuse injury problems, defined as those leading to moderate or large reductions in training volume or sports performance, or to complete inability to participate, was 15% (95% CI 13% to 17%). Over the duration of the study, the cumulative incidence of overuse injury problems was 91% (133 players). Shoulder problems were the most prevalent (average prevalence 17%, 95% CI 16% to 19%), whereas knee problems had the greatest relative burden.

          Conclusion

          Overuse injuries, particularly in the shoulder and knee, have a substantial impact on junior handball players’ training participation and performance. Interventions to prevent overuse injuries among male junior handball players should focus on these areas.

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          Most cited references15

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          No injuries, but plenty of pain? On the methodology for recording overuse symptoms in sports.

          R Bahr (2009)
          Overuse injuries may represent as much of a problem as do acute injuries in many sports. This paper reviews key concepts related to the methodology for recording overuse symptoms. Results from the FIVB Volleyball Injury Study were used to compare two different recording methods. The aim of this paper was to provide recommendations on how standardised methodology can be developed to quantify overuse injuries in surveillance studies. Using beach volleyball data, a "traditional" cohort study approach using a time-loss injury definition suggested that injury risk was very low. In contrast, the data from a survey of past and present pain problems in the shoulder, knees and low back demonstrated that these were prevalent. The following recommendations are made: (1) studies should be prospective, with continuous or serial measurements of symptoms; (2) valid and sensitive scoring instruments need to be developed to measure pain and other relevant symptoms; (3) prevalence and not incidence should be used to report injury risk; (4) severity should be measured based on functional level and not time loss from sports. In conclusion, new approaches are needed to develop more appropriate methodology to quantify overuse injuries in studies.
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            Sports injuries during the Summer Olympic Games 2008.

            Standardized assessment of sports injuries provides important epidemiological information and also directions for injury prevention. To analyze the frequency, characteristics, and causes of injuries incurred during the Summer Olympic Games 2008. Descriptive epidemiology study. The chief physicians and/or chief medical officers of the national teams were asked to report daily all injuries newly incurred during the Olympic Games on a standardized injury report form. In addition, injuries were reported daily by the physicians at the medical stations at the different Olympic venues and at the polyclinic in the Olympic Village. Physicians and/or therapists of 92 national teams covering 88% of the 10,977 registered athletes took part in the study. In total, 1055 injuries were reported, resulting in an incidence of 96.1 injuries per 1000 registered athletes. Half of the injuries (49.6%) were expected to prevent the athlete from participating in competition or training. The most prevalent diagnoses were ankle sprains and thigh strains. The majority (72.5%) of injuries were incurred in competition. One third of the injuries were caused by contact with another athlete, followed by overuse (22%) and noncontact incidences (20%). Injuries were reported from all sports, but their incidence and characteristics varied substantially. In relation to the number of registered athletes, the risk of incurring an injury was highest in soccer, taekwondo, hockey, handball, weightlifting, and boxing (all >or=15% of the athletes) and lowest for sailing, canoeing/kayaking, rowing, synchronized swimming, diving, fencing, and swimming. The data indicate that the injury surveillance system covered almost all of the participating athletes, and the results highlight areas of high risk for sport injury such as the in-competition period, the ankle and thigh, and specific sports. The identification of these factors should stimulate future research and subsequent policy change to prevent injury in elite athletes.
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              Why we should focus on the burden of injuries and illnesses, not just their incidence

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                Author and article information

                Journal
                BMJ Open Sport Exerc Med
                BMJ Open Sport Exerc Med
                bmjosem
                bmjosem
                BMJ Open Sport — Exercise Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2055-7647
                2018
                26 June 2018
                : 4
                : 1
                : e000391
                Affiliations
                [1 ] departmentDepartment of Orthopaedics (ORTHO), Faculty of Medicine , University of Oslo , Oslo, Norway
                [2 ] departmentOslo Sports Trauma Research Center, Department of Sports Medicine , Norwegian School of Sport Sciences , Oslo, Norway
                Author notes
                [Correspondence to ] ChristerAasheim; christer_aasheim@ 123456hotmail.com

                CA and HS are joint first authors.

                Article
                bmjsem-2018-000391
                10.1136/bmjsem-2018-000391
                6045727
                30018791
                94180201-7b65-437f-b480-c66b8c0e1ebb
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 31 May 2018
                Categories
                Original Article
                1506
                Custom metadata
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                throwing athletes,handball,overuse injuries,epidemiology,junior

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