Analyses of routinely-collected injury hospitalisation data show that sport and leisure activities are a common setting for injury, despite limitations in the application current international classification of diseases (ICD) coding schemes (Finch & Boufous 2008).  Currently, routine data sources that rely on ICD-9 or ICD-10 coded data are unable to separately identify injuries that occur in formal (organised) sport, highly competitive professional sport, general fitness activities or recreational play.  This is an important limitation because the agencies that most directly govern safety across these various settings can be quite different.  For example, professional sports bodies have no direct influence on social play in their sport (e.g. kicking a football in the park).  Similarly, the practitioner workforce is different with professional sports medicine professionals being part of the support team for professional athletes and physical education (PE) teachers delivering programs in schools.

A new study by Verhagen et al. in the October 2011 issue of the British Journal of Sports Medicine, gives another compelling reason for why sports injury epidemiology studies need to report data for different settings.  As part of a prospective study of 996 Dutch primary school students over a school year, the direct and indirect costs of any sustained injuries were recorded in a cost diary.  The sports injury setting was categorised as organised (club) sport, leisure time or PE class.  The mean total costs per treated injury in each of these categories were €59, €293 and €164, respectively.  The higher costs for leisure time injuries was related to more fractures to the upper extremities sustained in that setting.

Whilst most population-wide studies generally talk about sports injury as a single category, there is a clear need to now broaden recommendations for, and action by, just sports bodies and clubs/associations. Yes, these agencies have a clear role to play in preventive efforst and can provide both sport-specific information and role model examples to organised sports participants across all levels of play.  But to fully tackle the sport and leisure (or sport and active recreation) injury problem, we also need to engage the other individuals (e.g. teachers, parents, etc.) and environments (e.g. schools, local government authorities, recreation parks and facilities, etc) that also are key for promoting and supporting all forms of physical activity in settings other than just organised sport.

Caroline Finch is an injury prevention researcher from the Monash Injury Research Centre, Monash University, Australia.  She specialises in implementation and dissemination science applications for sports injury prevention.  She is the Senior Associate Editor for Implementation & Dissemination for the British Journal of Sports Medicine and a member of the Editorial Board of Injury Prevention; both journals are published by the BMJ Group.  Caroline can be followed on Twitter @CarolineFinch