Research approaches to describe the mechanisms of injuries in sport: limitations and possibilities

Abstract

A number of different methodological approaches have been used to describe the inciting event for sports injuries. These include interviews of injured athletes, analysis of video recordings of actual injuries, clinical studies (clinical findings of joint damage are studied to understand the injury mechanism, mainly through plain radiography, magnetic resonance imaging, arthroscopy, and computed tomography scans), in vivo studies (ligament strain or forces are measured to understand ligament loading patterns), cadaver studies, mathematical modelling and simulation of injury situations, and measurement/estimation from “close to injury” situations. In rare cases, injuries have even occurred during biomechanical experiments. This review describes each research approach and assesses its strengths and weaknesses in contributing to the understanding and prevention of sports injuries.

ECSS Position Statement 2009: Prevention of acute sports injuries

“…However, even if these few details are known, we still lack vital knowledge about the injury mechanisms. A complete biomechanical description should quantify whole-body and knee kinematics, loading directions, magnitudes, and rates (Krosshaug, Andersen, Olsen, Myklebust, & Bahr, 2005).…”

Reliability and Precision of Hip Proprioception Methods in Healthy Individuals

“…Although interpretation of the results is worthy, it is difficult to predict to what extent the observed proprioception capacities of the subjects in a laboratory setting exposes the athlete to increased risk of injury on the field. 67 For example, for TTDPM and FS, the subjects were tested in a supine and side lying position. This is not the position at which hip injuries occur during practice or a game.…”

Recommendations for Defining and Classifying Anterior Cruciate Ligament Injuries in Epidemiologic Studies

“…As a result, the interpretation of differences in noncontact ACL injury rates, especially over time, is problematic. This limitation has also been discussed in a broader context by Krosshaug et al 7 Another example occurs when one attempts to compare results from different studies. In the area of ACL intervention studies, Gilchrist et al 12(p1478) conducted a randomized trial of an intervention program in 61 NCAA female soccer teams and found a positive effect.…”

“…Patient narratives are an imperfect source of injury-event data because they depend on accurate recall of events that occur rapidly. 7 We believe that the information obtained in the JUMP-ACL study is sufficiently accurate to permit development of the classification system outlined above. However, replication and refinement by other researchers is needed.…”

“…As a result, no clear definition or consensus about the meaning of the term noncontact exists. 7 Based on these articles, the typical scenario for noncontact ACL injury can be summarized as follows: No large external force was applied directly to knee (eg, no direct blow to the knee from an opponent or object, including the ground); the patient may have been cutting and planting while running or landing from a jump. The leg is often near full extension, and sometimes contact with another player appears to knock the patient off balance or otherwise disrupts the motor-control pattern (ie, a physical perturbation).…”