Cross Fertilising Injury Prevention and the British Journal of Sports Medicine (BJSM)
After a hiatus of about a year, I am returning to writing my Injury Prevention to British Journal of Sports Medicine cross-fertilisation blogs. As I said in my first such item on the IP Blog, we need to break down injury research silos, and share collective knowledge so that we can truly prevent injuries from occurring in the first place. Many readers will know that my own interests are in using implementation science approaches to bring injury prevention knowledge together with sports medicine understanding of sports injury risks and causes.
It is timely with the completion of the recent Sochi Winter Olympic Games, and the most recent IP Blog, to now preview the contents of the first issue of the BJSM for 2014 (Volume 48, Issue 1). This issue pre-empted the games with discussions of injury rates, patterns and risk factors for injuries occurring in skiers, snowboarders and ice hockey.
There is no doubt that increased attention to rigorous injury surveillance in these sports has helped increased knowledge about the risks inherent in these high performance sports. Adoption of the International Ski Federations’ Injury Surveillance System in several studies now means that standardised injury data is collected and reported – e.g. injuries in general for elite snowboarders, and for specific injury types, such as head injuries in alpine and freestyle skiers and snowboarders. But just having a description of the injury problem and the outcomes of such injuries is not enough if we want to prevent future injuries. Unfortunately, much winter sport injury research remains at this injury description level, as two review articles relating to snowboarding and ice hockey injuries demonstrate.
In a previous IP-Blog, I discussed some emerging studies in previous issues of the BJSM into the specific mechanics of snow sports injuries, for elite performance forms of these activities. This first issue of the BJSM for 2014, continues to publish this type of valuable etiological research. One paper presents a video analysis of injury situations in freestyle ski cross that identifies features of four main incident scenarios that lead to injury. This paper brings us closer to prevention because knowledge of the how and why injuries occur (rather than just the fact that they do happen) is crucial for the development of potential injury countermeasure solutions.
Only one paper in the issue, evaluates a specific injury prevention measure, namely helmets for speed skating. Using standard helmet impact testing and biomechanical approaches, this study shows that such helmets do not adequately dissipate peak rotational accelerations, which could lead to injury in this sport.
The visual spectacle that was the Sochi Games introduced 12 new events, many of which would be considered as “extreme sports”. Longer. Faster. Higher. More spectacular. Like the more traditional snow sport events, these require athletes to take full command of a physical environment with inherent hazards, whilst also mastering control over their own bodies to execute the increasingly difficult physical manoeuvres needed to perform at the highest level and to avoid those hazards. The IOC’s Medical Commission conducted extensive injury surveillance during the Sochi Games, and so information about injuries in these new events will have been collected, but in some sense this will have been “after the event”. As sports evolve, there is increased need for more rapid understanding of the likely injury risks and hazards that may be present. This information needs to be understood before large sporting events are hosted, so that a range of risk and hazard mitigation measures are put into place before the athletes compete. When done properly, this will ensure that viewers get to see the right spectacular – stunning athletic performances, not painful dramatic injury events – and that the athletes themselves are able to participate at the level and frequency that they strive for.
It may be hard to pre-empt the exact nature of all injury issues that might occur during a major sporting event. But that does not mean that they were inevitable or could not have been prevented with adequate foresight. Surely we have enough knowledge from injury prevention science that could be used now to guide risk management and hazard mitigation planning for snow sports.
Now that sounds like a great way to link injury prevention and sports medicine research, to me.
Caroline Finch is an injury prevention researcher from the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP) within the Federation University Australia located in Ballarat, Victoria, Australia. She specialises in two areas: (1) sports injury surveillance and research methodologies and (2) 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 the Statistical Editor for Injury Prevention; both journals are published by the BMJ Group. Caroline can be followed on Twitter @CarolineFinch.