The epidemiology of injury and risk factors associated with injury in first league field hockey players

• Main Author: Ferguson, Kerry Jean
• Other Authors: Schwellnus, Martin P
• Format: Dissertation
• Language: English
• Published: University of Cape Town 2018
• Subjects: Sports Physiotherapy
• Online Access: http://hdl.handle.net/11427/26984

This study investigated the epidemiology of injury in a population of first league field hockey players during a playing season, establishing the true incidence (injuries/ 1000 hours) of injury, as well as the risk factors associated with field hockey injuries. Both the epidemiology of field hockey injuries, and associated risk factors, have not been well investigated on an international level, and no data on Southern African players have been published. A study population of 222 first league hockey players (males n= 111, females n= 111) from one particular region were followed over the duration of a hockey season (7 months). A preseason player profile questionnaire established player characteristics and training methods. A pre-season fitness assessment recorded the flexibility (sit and reach test), muscle power (standing broad jump), speed (40 m sprint) and endurance capacities (double winder) of all the players. Male players performed significantly better in the muscle power (p=0.0001), speed (p=0.0001) and muscle endurance (p=0.0001) tests compared to female players. However, female players recorded significantly better flexibility results (p=0.012) compared with male players. Player position influenced the results of the pre-season fitness assessment. Attacking players (strikers, midfielders) achieved significantly better results in the muscle power (p=0.0704), speed (p=0.0003) and muscle endurance (p=0.002) tests compared with defending players (defenders, goalkeepers). During the prospective study, an injury report form was completed for players that sustained injuries during the season. An injury was defined as physical damage that resulted in (i) a player being unable to complete the match or practise, (ii) a player missing a subsequent match or practise, or (iii) a player requiring medical attention. An overall incidence of injury of 10/1000 hours was reported for the playing population, with an injury risk of 0.59 injuries per player per season. No other study of hockey injuries has recorded the true incidence of injury. A number of factors were associated with field hockey injuries. The incidence of injury was significantly greater in matches compared to practices (p=0.003). The highest incidence of injury was recorded in the beginning of the season (month 2) (16 injuries/1000 hrs). Strikers reported the highest incidence of injury (11/1000 hrs). In certain instances, the player position could be associated with an injury to a specific anatomical area or mechanism of injury. For example, goalkeepers sustained significantly more upper limb injuries than players in outfield positions (p=0.001), which can be attributed to the nature of their play. The activities of a goalkeeper include diving, and fending off the ball with their hands. The most frequently injured anatomical areas were similar to those reported in other studies of field hockey injuries, namely the fingers (1.6/1000 hrs), knee (1.4/1000 hrs) and ankle (1.4/1000 hrs) joints, and hamstring muscle (0.8/1000 hrs). The type of injuries sustained were predominantly muscle strains (2.4/1000 hrs), ligament sprains (2/1000 hrs) and fractures (1.7/1000 hrs). The most frequent mechanism of injury was tackling (2.3/1000 hrs). There was a significantly higher incidence of injury reported on artificial turf (13/1000 hrs) compared with grass (4/1000 hrs) (p=0.015). Players who discontinued hockey due to injury missed an average of four subsequent matches or practices. There was no significant association between past injury history, pre-season training, stretching methods, equipment usage and pre-season fitness assessments and the incidence or epidemiology of injury in hockey players.