Sports, Sports, Sports – A Bit of Prevention Goes a Long Way to Beating Sports-Related Injuries

  Sport, sports, sports

The last month has been jam-packed with a lot of exciting play for sports fans. The Miami Heat clinched its second straight NBA title by beating the San Antonio Spurs on June 20 in Game 7, 95-88. The Chicago Blackhawks snagged its second Stanley Cup in three years in Game 6 of the NHL finals in Boston on June 24 in a rousing finish with back-to-back goals. There were injuries, naturally – such as a collision in Game 6 of the NBA Finals that caused Dwyane Wade’s left knee to swell very badly when he was already suffering with an injured right knee. Chicago Blackhawks Captain Jonathan Toews got hit in the head and sat out part of Game 5, while Andrew Shaw took a puck to the face in the first period of Game 6, but returned in the second period after receiving stitches.

For those that enjoy their spectator sports with a bit more starch and less blood, how about Wimbledon, which officially started on June 24 with fifth-ranked Rafael Nadal getting knocked out for the very first time in the first round of a Grand Slam! On June 20, Abby Wambach broke Mia Hamm’s record for international career goals by a soccer player, scoring four times in the first half against South Korea to increase her total to 160. While I was watching her the next day on Good Morning America with a recap of one of the goals she scored by heading the ball, I thought about the number of sports- and recreation-related injuries and concussions suffered every year by professional and amateur athletes alike.

On the recreational side, just yesterday on WBBM Newsradio, I heard a young man being interviewed. He was spotted riding a skateboard on busy Randolph Street in the Loop, one hand holding a cigarette, the other a can of soda, with headphones on. When asked incredulously by the interviewer if he had control of his wheels, he replied, yes, of course. Really? Well at least he wasn’t texting – an activity that has caused an ever-increasing number of serious injuries and fatalities – and not limited to vehicular accidents. Bicyclists, rollerbladers, and skateboarders are guilty of this activity as well, not to mention pedestrians – albeit strolling down the street is not considered a sport.

I have been tracking injuries utilizing the U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System (NEISS) going back to 2001 when I worked at Prevent Blindness America. Back then I analyzed eye injury statistics and translated this into compelling prevention pieces targeted to the consumer. Sports-related eye injuries occur most frequently in baseball, basketball and racquet sports. And while sports and recreational activities contribute to eye injuries, fireworks and occupational-related products cause very serious and often blinding eye injuries. When I worked at the American Association of Neurological Surgeons, I switched to analyzing head and neck injuries utilizing CPSC statistics as well as several other national surveillance databases. For nearly seven years, I translated these statistics into national media campaigns that garnered considerable coverage. I had the opportunity to publicize high-profile cases such as the tragic death of Natasha Richardson caused by an epidural hematoma suffered in a skiing accident on a bunny hill in Quebec. I also had the chance to talk to parents whose children incurred devastating head and spinal cord injuries from sports-related incidents and utilize these stories in prevention pieces.

One must keep in mind that NEISS statistics are limited to injuries treated at U.S. hospital emergency rooms. The actual incidence of head injuries may potentially be much higher for two primary reasons. 1). For the last few years, the CPSC has excluded estimates for product categories that yielded 1,200 injuries or less, those that had very small sample counts, or those that were limited to a small geographic area of the country; 2). Many less severe head injuries are treated at physician’s offices, immediate care centers, or self-treated. One of the intriguing things about this surveillance database is the short narrative provided of each incident. Some are quite flabbergasting – quite a few involve intoxication and far too many tell the sad tale of victims who chose to not wear a helmet. While I am no longer getting paid to perform these statistical analyses, injury prevention is a topic that I still feel very passionate about publicizing.

A number of sports and recreational activities posted increases in the number of injuries incurred and treated at U.S. hospital emergency rooms in 2012, with soccer posting the largest increase. Here is a short synopsis of a few sports that posted an increase in all injuries and/or an increase in head injuries:

Bicycling: All injuries in 2011: 555,432, head injuries: 84,359; All injuries in 2012: 547,499, head injuries: 84,483

Football: All injuries in 2011: 467,731, head injuries: 60,299; All injuries in 2012: 466,492, head injuries: 68,198

Basketball: All injuries in 2011: 536,840, head injuries: 41,573; All injuries in 2012: 569,746, head injuries: 48,523

Baseball & Softball: All injuries in 2011: 262,133, head injuries: 33,020; All injuries in 2012: 265,710, head injuries: 33,170

Soccer: All injuries in 2011: 214,053, head injuries: 26,726; All injuries in 2012: 231,447, head injuries: 32,008

Powered Recreational Vehicles (ATVs, Dune Buggies, Go-Carts, Mini Bikes): All injuries in 2011: 194,944, head injuries: 25,757; All injuries in 2012: 202,426, head injuries: 28,537

Skateboards & Scooters: All injuries in 2011: 165,957, head injuries: 20,125; All injuries in 2012: 174,219, head injuries: 20,869

Volleyball: All injuries in 2011: 58,803, head injuries: 4,185; All injuries in 2012: 61,945, head injuries: 4,619

Ice Hockey: All injuries in 2011: 54,639, head injuries: 10,357; All injuries in 2012: 55,328, head injuries: 11,701


Play it safe - prevent sports-related injuries

In 2012, nearly 550,000 people visited emergency rooms with bicycle-related injuries, and of these, 84,483 were head injuries. There were 677 bicycle-related deaths in 2011, with two-thirds being attributed to traumatic brain injury. Wearing a properly fitted bicycle helmet can reduce the risk of a brain and head injury by as much as 85 percent. A little bit of prevention goes a long way.

  • Buy and use a helmet approved by the American Society for Testing and Materials (ASTM) or Snell 100 percent of the time. The helmet must fit correctly and be worn properly to be effective.
  • Obey all traffic signals and be aware of drivers.
  • Do not text or talk on your cell phone while biking.
  • Avoid uneven or unpaved surfaces.
  • Wear bright colors when riding. If you must ride at dusk or night, wear clothing that reflects light. Install reflectors on the front and rear of your bike, and use a headlight.


Since 1990, the number of youth soccer players in the U.S. has doubled to 4.04 million players, according to the United States Soccer Federation. Protection against head injuries in soccer is complicated by the fact that heading is an established part of the game, and any attempt to protect against head injuries must allow the game to be played without modification. Several head guards have been developed to reduce the risk of head injuries in soccer. One independent research study found that none of the products on the market provided substantial benefits against minor impacts, such as heading with a soccer ball.

According to CPSC statistics, 40 percent of soccer concussions are attributed to head to player contact; 10.3 percent are head to ground, goal post, wall, etc.; 12.6 percent are head to soccer ball, including accidents; and 37 percent are not specified.

Ice Hockey

Although I didn’t watch every minute of the NHL finals, I watched enough to see several players lose their helmets during play. The cumulative and long-lasting effects of sports concussions have received heightened attention, including Congressional hearings. A concussion study conducted by the NHL in 2010/2011 uncovered the following trends:

  • Of the 80 reported concussions sustained by NHL players in the 2010/2011 season, 44 percent resulted from legal checks.
  • Twenty-six percent of the concussions occurred when players were struck accidentally, either colliding with another player, being struck by the puck or tripping or falling and making head contact with the ice surface or boards.
  • Seventeen percent of the concussions were the result of either illegal hits to the head or illegal body checks.
  • Eight percent of the concussions were caused by fighting.
  • Five percent of the concussions were not defined because the incidents were not taped.

The NHL concussion protocol includes the following:

  • Players are no longer allowed to be evaluated by the trainer on the bench after showing signs of a possible concussion. It will be mandatory that the player in question be moved to a quiet place and be evaluated by a team physician before he can return to action.
  • Before the 2011/2012 season began, a thorough examination of ways to modify player equipment to make it safer, including the removal of any seamless glass surrounding all NHL rinks.

Prevention Tips

  • In addition to head gear, protective gear should include a face shield, mouth guard, shoulder and elbow pads, shin guards, cup/supporter, and gloves. Goalies require additional protective gear.
  • Play outdoor hockey only in rinks designated for the sport, and be sure to check the ice for cracks and debris.
  • Avoid overly aggressive behavior. Boarding, butt-ending, charging, clipping, contact to the head, cross-checking, elbowing, head-butting, high sticks, holding, kneeing, roughing, slashing, and spearing are all “illegal” moves that incur penalties in hockey.

Helmet Usage

Buy and use helmets or protective headgear approved by the ASTM for specific sports 100 percent of the time. The ASTM has vigorous standards for testing helmets for many sports; helmets approved by the ASTM bear a sticker stating this. Helmets and headgear come in many sizes and styles for many sports and must properly fit to provide maximum protection against head injuries. In addition to other safety apparel or gear, helmets or headgear should be worn at all times for:

Baseball and Softball (when batting)
Horseback Riding
Powered Recreational Vehicles

Many sports safety experts recommend helmets for:

Bull riding
Martial Arts
Pole Vaulting

General Sports Injury Prevention Tips

  • Supervise younger children at all times, and do not let them use sporting equipment or play sports unsuitable for their age.
  • Wear appropriate clothing for the sport.
  • Do not wear any clothing that can interfere with your vision.
  • Do not participate in sports when you are ill or very tired.
  • Do not text or talk on your cell phone while engaging in sports or recreational activities.
  • Obey all traffic signals, and be aware of drivers when cycling, skateboarding, or rollerblading.
  • Avoid uneven or unpaved surfaces when cycling, skateboarding, or rollerblading.
  • Perform regular safety checks of sports fields, playgrounds and equipment.
  • Discard and replace sporting equipment or protective gear that is damaged.

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