SPORTS MEDICINE HYPERMOBILITY

hypermobile. Figure 1 illustrates the distribution of each Beighton score for each gender.

Beighton score versus self-score Correlation between the measured BS and the self-scored hypermobility test using a Spearman rho test was satisfactory (rs

= 0.468, p≥0.001).

Hypermobility compared with playing position Comparing playing positions (for boys and girls combined) with hypermobility scores showed excessive hypermobility in 30% of goalkeepers, in 25% of defenders, in 16% of midfielders and in 18% of forwards. Hypermobility and playing position for the separate genders is illustrated in Figure 2.

Training diaries and reported injuries

A total of 57 injuries were recorded in 32 individuals. Of these, 7 were contact (2 girls, 5 boys) and 40 were non- contact (16 girls, 16 boys) injuries and 10 were from sports other than hockey (6 girls, 4 boys). Training diaries completed by the players showed similar weekly training regimens for both genders. Both had an average of two hockey training sessions per week, one or two hockey matches, one endurance running and one sprint endurance session. Girls reported more frequent core stability sessions each week (two per week) while the boys undertook additional speed endurance work.

Site of injury

Injuries to the groin or hip (4 girls, 7 boys), the lower back (6 girls, 1 boy) and ankle (4 girls, 3 boys) were the most prevalent hockey-related injuries. Injuries sustained in other sports included ankle fracture–dislocation, rib fracture and strains to the acromioclavicular joint, groin, quadriceps and shoulder. Lumbar spine and pelvic pathologies, when considered together, accounted for 21% of all injuries. Figure 3 illustrates injuries by body part in each hypermobility group for both boys and girls.

Injury and playing position The players in the forwards position were the most commonly injured in this study, accounting for 34% of all individuals injured and 31% of all injuries. Defenders were next, followed by

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25 20 15 10 5 0

0 1 2 3 4 5 6 7 8 9 Beighton scores (BS)

Group 5–9 Group 3–4

14 12 10 8 6 4 2 0

Group 0–2 (a) Boys

3 1

4 8 2

1 1

Goalkeeper

16 14 12 10 8 6 4 2 0

2 1

Defender Midfielder 5 Forward (b) Girls

1 1

Figure 2: Player position and hypermobility (BS) scores for (a) boys and (b) girls

2 3

Boys Girls

Figure 1:

Distribution of Beighton scores (BS) of hypermobility by gender across 69 under-18 England hockey players

1

1 1

4 Goalkeeper Defender Midfielder 12 8 6 Forward

ACCEPTED FOR THE GROUP AS WHOLE, BUT THERE MAY BE AN ASSOCIATION BETWEEN THEM IN GIRLS THAT IS WORTHY OF FUTURE INVESTIGATION

THAT HYPERMOBILITY IS LINKED WITH AN INCREASED RISK OF INJURY MAY NOT BE

1

19

No. of girls

No. of boys

Number of athletes