sportEX comment We can’t get enough on injury

INJURIES TO JUNIOR CLUB CRICKETERS: THE EFFECT OF HELMET REGULATIONS. Shaw L, Finch C F. British Journal of Sports Medicine 2008;42:437-440

This study describes the epidemiology of cricket injuries in junior club cricket (age U8-U18) in New South Wales across three playing seasons (2002- 2005). It aimed to identify priorities for prevention including pre and post observational evaluation of mandatory helmet which was introduced before the 2004–05 season. Data examined was frequency of injury according to age level, grade of play and playing position, and injury rates per 100 registered players.

Results: 155 injuries were reported. No U8 player sustained an injury, and injury frequency increased with age. Traditional cricket was associated with more injuries than modified cricket. At each age level, the most skilled players had the lowest frequency of injury. Overall, batting accounted for 49% of all injuries, 29% when fielding; contact with a moving ball was responsible for 55% of injuries. The most commonly injured body region was the face (20%), followed by the hand (14%). In batters, the frequency of head/neck/facial injuries fell from 62% in 2002/03 to 35% in 2003–04 to just 4% in 2004–05 after headgear use was compulsory. Injury rates in junior players are low, but increase with age and level of play. Use of protective headgear, particularly by batters, leads to a significant reduction in injuries.

FAST AND SLOW MYOSINS AS MARKERS OF MUSCLE INJURY. Guerrero M. Guiu-Comadevall M, et al. British Journal of Sports Medicine 2008;42:581-584

The diagnosis of muscular lesions suffered by athletes is usually made by clinical criteria combined with imaging of the lesion (ultrasonography and/or magnetic resonance) and blood tests to detect the presence of non-specific muscle markers. This study was undertaken to evaluate injury to fast and slow-twitch fibres using specific muscle markers. Blood samples were obtained from 51 non-sports people and 38 sportsmen with skeletal muscle injury. Western blood analysis was performed to determine fast and slow myosin and creatine kinase (CK) levels. Skeletal muscle damage was diagnosed by physical examination, ultrasonography and magnetic resonance and biochemical markers. The imaging tests were found to be excellent for detecting and confirming grade II and III lesions. However, grade I lesions were often unconfirmed by these techniques. Grade I lesions have higher levels of fast myosin than slow myosin with a very small increase in CK levels. Grade II and III lesions have high values of both fast and slow myosin.

sportEX comment The correct diagnosis of grade I lesions can prevent progression to more serious conditions. This is a useful test if you have access to the methodology.

INTERIM EVALUATION OF THE EFFECT OF A NEW SCRUM LAW ON NECK AND BACK INJURIES IN RUGBY UNION. Gianotti S, Hume PA et al, British Journal of Sports Medicine 2008;42:427-430

In January 2007 the International Rugby Board implemented a new law for scrum engagement aimed at improving player welfare by reducing impact force and scrum collapses. This study examined insurance claims in new Zealand for one year post- implementation to assess the effectiveness of the new laws. Results revealed that the numbers of claims over the study period were reduced suggesting that the new laws are working.

prevention. The expansion of van Mechelen’s model adds an extra dimension of putting risk assessment into the context of the sport so that clinicians, coaches and managers can decide whether to implement a preventive measure programme. All sports and performance activities create a risk and it is in everyone’s interest to minimise them without compromising the activity. Note that the cricket study suggests that a modified form of the game reduces injury. It is ‘modified’, but it’s still cricket. The change in rugby laws and the compulsory use of safety equipment in other sports have had their critics especially from former players who were lucky enough to survive without serious injury, but the two studies examining the effects of such changes prove that the changes are beneficial. In the cricket study one sentence lights up like a flashing neon sign, “the most skilled players had the lowest frequency of injury”. The message can’t be stronger – skills make sport safe.

ENERGY EXPENDITURE IN

ADOLESCENTS PLAYING NEW GENERATION COMPUTER GAMES. Graves L, Stratton G et al. British Journal of Sports Medicine

2008;42:561-566

Six boys and 5 girls aged 13–15 years were fitted with a monitoring device validated to predict energy expenditure. They played four computer games for 15 minutes each. One of the games was sedentary (XBOX 360) and the other three were active (Wii Sports). The aim was to compare the energy expenditure of adolescents when playing sedentary and new generation active computer games. Unsuprisingly redicted energy expenditure when playing Wii Sports bowling, tennis, and boxing was significantly greater than when playing sedentary games

sportEX comment Is there hope for the ‘couch potato

computer game playing generation’? Not at the moment because the energy levels are not as high as playing the sport itself or indeed enough to contribute towards the recommended daily amount of exercise in children but active games are relatively new and will improve. The big question is can they be realistic enough to teach ‘real’ skill and so contribute to injury prevention in the real thing.

4 sportEX medicine 2008;38(Oct):4-6