Sex differences in injury rates in team-sport athletes: A systematic review and meta-regression analysis

Zech, Astrid; Hollander, Karsten; Junge, Astrid; Steib, Simon; Groll, Andreas; Heiner, Jonas; Nowak, Florian; Pfeiffer, Daniel; Rahlf, Anna Lina

doi:10.1016/j.jshs.2021.04.003

Cited by 43 publications

(35 citation statements)

References 63 publications

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“…Biological sex is also considered a risk factor for ankle sprain. Although there are reports of comparable incidence rates between males and females [ 22 ], a 2014 systematic review concluded that females suffer from ankle sprains at higher rates than their male counterparts [ 23 ], which aligns with recent evidence indicating sex-specific general injury patterns in team sports [ 24 ] and running [ 25 ]. Sex-based differences in factors such as joint laxity and sensorimotor control may contribute to this injury rate discrepancy [ 26 , 27 ], and there is early evidence that ankle sprain injury history influences future ankle sprain risk in males but not females [ 15 ].…”

Section: Introductionsupporting

confidence: 55%

Intrinsic Risk Factors for Ankle Sprain Differ Between Male and Female Athletes: A Systematic Review and Meta-Analysis

et al. 2022

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Background Ankle sprains remain prevalent across most team sports. However, despite divergent ankle sprain injury rates in male and female athletes, little is known about potential sex-specific risk factors for ankle sprain. Objective To systematically investigate the sex-specific risk factors for ankle sprain. Methods Combinations of the key terms were entered into PubMed, Web of Science, Embase and Cochrane Library databases, and prospective studies reporting ankle sprain risk factors in males or females were included for meta-analysis. Results Sixteen studies were eligible for inclusion, for a total of 3636 athletes (735 female) and 576 ankle sprains (117 female). Out of 21 prognostic factors, previous ankle sprain injury (odds ratio = 2.74, P < .001), higher body mass index (SMD = 0.50, P < 0.001), higher weight (SMD = 0.24, P = 0.02), lower isometric hip abduction strength (SMD = − 0.52, P < 0.0001) and lower dynamic balance performance (SMD = − 0.48 to − 0.22, P < 0.001–0.04) were identified as risk factors in male athletes. In female athletes, out of 18 factors eligible for meta-analysis, only lower concentric dorsiflexion strength was identified as a risk factor (SMD = − 0.48, P = 0.005). Conclusion This meta-analysis provides novel evidence for different risk factor profiles for ankle sprain injuries between female and male athletes. Further studies, particularly in female athletes, are needed to strengthen the evidence.

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Section: Introductionsupporting

confidence: 55%

Intrinsic Risk Factors for Ankle Sprain Differ Between Male and Female Athletes: A Systematic Review and Meta-Analysis

et al. 2022

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“…ACL rupture is the most common knee ligament injury [ 36 ], and where individuals intend returning to sport, they are usually recommended for ACL reconstruction (ACLR) and rehabilitation [ 23 ]. After these, individuals are expected to be able to return to sport [ 33 ], but the time of return to sport varies between 6 months and 27 years [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…Long-term negative effects include reduced physical activity and quality of life (QOL) [ 7 ], and increased risk of osteoarthritis [ 34 ]. Women have a significantly higher risk of injury than men, and they experience worse patient-reported outcomes (PROs) [ 28 ] and lower return to sport rates [ 36 ].…”

Section: Introductionmentioning

confidence: 99%

“I don't opt out of things because I think I will get a sore knee, but I don't expose myself to stupid risks either”: patients’ experiences of a second ACL injury—an interview study

Heijne

Silbernagel

Lundberg

2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this qualitative study was to describe women’s experiences with anterior cruciate ligament reconstruction (ACLR) and a subsequent ACL rupture, and to identify potential facilitators and barriers for coping with rehabilitation after the second injury. Methods Eight women between 17 and 36 years (mean 26, SD 6.5) who had experienced ACLR, followed by another ACL rupture, participated in the study. Semi-structured interviews were conducted, and data were analyzed using qualitative content analysis. Results One overarching theme, “Rehabilitation after a second ACL injury—A lifelong adaptive coping process”, emerged from analyses. Undergoing a second rehabilitation is described as a process of adaptation, beginning with the first injury and still ongoing, more than 5 years later. Participants applied different coping strategies to adapt to these life-altering injuries, but the common denominator was of major life adjustments with no return to previous activity levels. Initially, after the reinjury, it was about coping with the catastrophe of the dreaded second injury. Over time, they accepted their “new” life and reset their recovery/rehabilitation goal not just as “return to sport” but rather as a “personal life goal”. Conclusion Undergoing a second ACL injury is a long process that challenges the patient’s coping skills. Given these results, rehabilitation programs need to be more person centred according to the patients-adjusted life goals. Level of evidence 3.

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“…This is consistent with previous research in military populations that showed higher injury rates in females may be more likely due to differences in fitness levels rather than sex [ 33 – 36 ]. In contrast, a systematic review on injury rates in sports found male athletes to have a significantly higher injury rate [ 37 ]. While tactical and athletic populations have differing occupational demands this does provide further context that fitness levels in female tactical personnel may be impacting injury rates more than physiological or biomechanical differences [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Profiling the injuries of law enforcement recruits during academy training: a retrospective cohort study

Maupin

Canetti

Schram

et al. 2022

BMC Sports Sci Med Rehabil

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Background Injuries within law enforcement are a significant issue as they increase organisational costs and workforce strain. As one of the biggest risk factors of future injury is previous injury, minimising injuries suffered during academy has multiple beneficial and long-term effects, including a healthier and fitter police force. The purpose of this study was to profile the injuries sustained at a law enforcement academy to inform future injury mitigation strategies. Methods Injury data were provided retrospectively (from May 2012 to September 2019) from the official insurance records of a law enforcement academy and included nature, location, and activity performed at time of injury. A total of 4340 (3288 males, 938 females, 114 sex not stated) recruits participated in academy training during this period. Inclusion criteria for the data were (a) injury record related to a recruit, and (b) the recruit was injured during academy training., with injury defined as tissue damage caused by acute or repetitive trauma, inclusive of musculoskeletal, neural, and/or integumentary systems but excluding general medical conditions such as cardiac (e.g. heart attacks) or respiratory (asthma) that was subsequently reported for worker’s compensation. Injury incidence rates and proportions were calculated and a Spearman’s correlation analysis was conducted between injury rates over successive classes. Results An injury incidence rate of 368.63 injuries per 1000 recruits per year was calculated in this population, with a moderate correlation coefficient (rs = 0.60) of increasing injury rates over chronologically occurring classes. Females also had higher injury rates than male recruits, even across various fitness levels. Trauma to joints and ligaments (49.30%) was the most common injury, and the knee the most common location (23.17%) of injury. Physical training (56.10%) was the most common activity being performed at the time of injury. Conclusions This research demonstrates a large number of lower limb, musculoskeletal injuries that often occur during physical training. Further research is needed to assess suitable injury mitigation programs.

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Sex differences in injury rates in team-sport athletes: A systematic review and meta-regression analysis

Cited by 43 publications

References 63 publications

Intrinsic Risk Factors for Ankle Sprain Differ Between Male and Female Athletes: A Systematic Review and Meta-Analysis

Intrinsic Risk Factors for Ankle Sprain Differ Between Male and Female Athletes: A Systematic Review and Meta-Analysis

“I don't opt out of things because I think I will get a sore knee, but I don't expose myself to stupid risks either”: patients’ experiences of a second ACL injury—an interview study

Profiling the injuries of law enforcement recruits during academy training: a retrospective cohort study

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