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Injuries

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Research into different aspects of martial arts competition.

Hands of karate experts

The hands of karate experts.
A. Crosby
British Journal of Sports Medicine, Vol 19, Issue 1 41-42

The hands and wrists of 22 karate instructors who had practiced the sport for a minimum of five years were reviewed. Radiological evidence of a total of ten fractures was found.

Conclusions. There was no evidence that practice of the sport predisposed to the early onset of chronic tenosynovitis or osteoarthritis.

Injuries in martiala rts

Injuries in martial arts: a comparison of five styles
M. Zetaruk, M. Violán, D. Zurakowski. and L. Micheli
British Journal of Sports Medicine 2005; 39:29-33

This study compared five martial arts with respect to injury outcomes.

A one-year retrospective cohort was studied using an injury survey. Data on 263 martial arts participants (114 from shotokan karate, 47 from aikido, 49 from taekwondo, 39 from kung fu, and 14 from tai chi) were analyzed using age, sex, training frequency, experience, and martial art style. Outcome measures were injuries requiring time off from training, major injuries, multiple injuries, the region of the body, and the type of injury.

The rate of injuries, expressed as a percentage of participants sustaining an injury that required time off training a year, varied according to style: 59% for taekwondo, 51% for aikido, 38% for kung fu, 30% for karate, and 14% for tai chi. There was a threefold increased risk of injury and multiple injuries in taekwondo than karate. Subjects ≥18 years of age were at greater risk of injury than younger ones.

Martial artists with at least three years of experience were twice as likely to sustain injury as less experienced students. Training >3 hours/week was also a significant predictor of injury. Compared with karate, the risks of head/neck injury, upper extremity injury, and soft tissue injury were all higher in aikido, and the risks of head/neck, groin, and upper and lower extremity injuries were higher in Taekwondo. No sex differences were found for any of the outcomes studied.

Conclusions. There is a higher rate of injury taekwondo than shotokan karate. Different martial arts have significantly different types and distribution of injuries. Martial arts appear to be safe for young athletes, particularly those at beginner or intermediate levels.

Injury in professional MMA

The incidence of injury in professional mixed martial arts competitions.
G. Bledsoe, E. Hsu, J. Grabowski, J. Brill, and G. Li

Journal of Sports Science and Medicine (2006) 5 (CSSI), 136 - 142

Mixed martial arts (MMA) competitions were introduced in the United States with the first Ultimate Fighting Championship (UFC) in 1993. In 2001, Nevada and New Jersey sanctioned MMA events after requiring a series of rule changes. The purpose of this study was to determine the incidence of injury in professional MMA fighters.

Data from all professional MMA events that took place between September 2001 and December 2004 in the state of Nevada were obtained from the Nevada Athletic Commission. Medical and outcome data from events were analyzed based on a pair-matched case-control design. A total of 171 MMA matches involving 220 different fighters occurred during the study period. There were a total of 96 injuries to 78 fighters.

Conclusions. Of the 171 matches fought, 69 (40.3%) ended with at least one injured fighter. The overall injury rate was 28.6 injuries per 100 fight participations or 12.5 injuries per 100 competitor rounds. Facial laceration was the most common injury accounting for 47.9% of all injuries, followed by hand injury (13.5%), nose injury (10.4%), and eye injury (8.3%). With adjustment for weight and match outcome, older age was associated with significantly increased risk of injury. The most common conclusion to an MMA fight was a technical knockout (TKO) followed by a tap out. The injury rate in MMA competitions is compatible with other combat sports involving striking. The lower knockout rates in MMA compared to boxing may help prevent brain injury in MMA events.

Injury in muay thai

Injury rates in muay thai kick boxing.
S. Gartland, M. Malik. and M. Lovell
British Journal of Sports Medicine 2001; 35:308-313

This study sought to determine the type and number of injuries that occur during the training and practice of muay thai kick boxing and to compare the data obtained with those from previous studies of karate and taekwondo.

A total of 152 people were questioned, 132 men and 20 women. There were 19 beginners, 82 amateurs, and 51 professionals.

Injuries to the lower extremities were the most common in all groups. Head injuries were the second most common in professionals and amateurs. Trunk injuries were the next most common for beginners. The difference in injury distribution among the three groups was significant. Soft tissue trauma was the most common type of injury in the three groups. Fractures were the second most common in professionals, and, in amateurs and beginners,t was sprains and strains.

Annual injury rates were: beginners, 13.5/1000 participants; amateurs, 2.43/1000 participants; professionals, 2.79/1000 participants. For beginners, 7% of injuries resulted in seven or more days off training; for amateurs and professionals, these values were 4% and 5.8% respectively.

Conclusions. The results are like those found for karate and taekwondo with regard to injury distribution, type, and rate. The percentage of injuries resulting in time off training is less.

Injury in shotokan

Injury rates in shotokan karate.
G. Critchley, S. Mannion, and C. Meredith
British Journal of Sports Medicine, Vol 33, Issue 3 174-177

This study documented the injury rate in three British shotokan karate championships in consecutive years. In these tournaments strict rules governed contact, with only "light" or "touch" contact allowed. Protective padding for the head, hands, or feet was prohibited.

The study recorded injuries resulting from 1770 bouts in three national competitions of 1996, 1997, and 1998. The study found 160 injuries were sustained in 1770 bouts. The overall rate of injury was 0.09 per bout and 0.13 per competitor. 91 (57%) injuries were to the head. The average age of those injured was 22 years, with an average of nine years of experience in karate.

Conclusions. The absence of protective padding does not result in higher injury rates than in most other series of Shotokan karate injuries. Strict refereeing is essential, however, to maintain control and minimize contact.

Escin used for impact injuries

Escin/diethylammonium salicylate/heparin combination gels for the topical treatment of acute impact injuries: a randomized, double-blind, placebo controlled, multi-center study.
D. Wetzel, W. Menke, R. Dieter, V. Smasal, B. Giannetti, and M. Bulitta
British Journal of Sports Medicine 2002; 36:183-188

This study investigated the clinical efficacy and safety of escin-containing gels in the topical treatment of blunt impact injuries. Competitors in soccer, handball, or karate competitions were enrolled within two hours of sustaining a strain, sprain, or contusion and treated three times with the trial gel within a period of eight hours. Patients were randomized to three parallel groups consisting of two active treatment gels, containing escin (1% or 2%), 5% diethylammonium salicylate, and 5000 IU heparin, or placebo gel. Tenderness produced by pressure was measured at 0 (baseline), 1, 2, 3, 4, 6, and 24 hours after enrolment (within two hours of the injury). Tenderness was defined as the amount of pressure (measured by a calibrated caliper at the center of the injury) that first produced a pain reaction as reported by the patient.

A total of 158 patients were enrolled; 156 were evaluated with the intention to treat. The primary efficacy variable was the area under the curve for tenderness over a six-hour period. The gel preparations containing 1% and 2% escin were significantly more effective than placebo. The time to reach the resolution of pain at the injured site was shorter in the treatment groups than in the placebo group. Both active gel preparations produced more rapid pain relief than the placebo gel. No relevant differences were detected between the two active gels. The safety and tolerability of the escin-containing gels were excellent.

Conclusions. Escin/diethylammonium salicylate/heparin combination gel preparations are effective and safe for the treatment of blunt impact injuries.

Study of injuries in boxing

A prospective cohort study of injury in amateur and professional boxing
T. Zazryn, P. Cameron, and P. McCrory
British Journal of Sports Medicine 2006; 40:670-674

There is concern over the potential for a high incidence of injury in boxing. This is despite a lack of prospective data evaluating the risk for modern-day participants. Updated, reliable data with a focus on potential exposure to injury for both amateur and, especially, professional boxers is required.

This study sought to determine the epidemiology of injury and exposure of amateur and professional boxers in Victoria, Australia. A prospective cohort study with one year follow up was carried out over 2004–2005; 33 amateur and 14 active professional boxers volunteered. Exposure at training and competition was measured, and any injuries sustained during this participation were recorded.

Twenty-one injuries were sustained by the cohort during the follow-up period. Most were in the head region (71%), with concussion being the most common (33%). An overall injury rate of 2.0 injuries per 1000 hours of boxing was calculated.

Conclusions. The high exposure experienced by the boxers (because of considerable training time) indicated that boxing has acute injury rates comparable to, and often lower than, those found in other contact and non-contact sports. Further, acute injuries during training appear to be less common and severe than those sustained in bouts.

Prevention of injuries in karate

Prevention of injury in karate.
H. Johannsen and F. Noerregaar
British Journal of Sports Medicine, Vol 22, Issue 3 113-115

This study analyzed the effect of knuckle protection on the type and incidence of injuries in traditional karate matches.

Knuckle protection was mandatory at the Danish karate championships 1983 and 1986 (290 matches, 0.26 injuries per match), and prohibited at the championships 1984 and 1985 (620 matches, 0.25 injuries per match). Head injuries were more common in the tournaments where fist pads were used. The incidences of transitory psychomotor disturbances following blows to the head were comparable. The severity of head injuries, however, decreased; minor head injuries dominated when fist pads were used (66%, compared with 44% without fist pads, p less than 0.01) and there were fewer lacerations and fractures. Injuries to the fingers or hands were also fewer--1.3% compared with 11% without protection (p less than 0.01). The use of fist pads reduced considerably the number of injuries requiring treatment (from 42% to 16%, p less than 0.01).

Conclusions. Fist pads offer some protection against injuries, especially to the hands, but additional measures are needed.

Cervical injuries in MMA

Risk of cervical injuries in mixed martial arts.
T. Kochhar, D. Back, B. Mann, and J. Skinner
British Journal of Sports Medicine 2005; 39:444-447

Mixed martial arts have rapidly succeeded boxing as the world’s most popular full-contact sport, and the incidence of injury is recognized to be high. This study assessed qualitatively and quantitatively the potential risk for participants to sustain cervical spine and associated soft tissue injuries.

Four commonly performed maneuvers with possible risks to the cervical spine were analyzed with respect to their kinematics, and biomechanical models were constructed.
Motion analysis of two maneuvers revealed strong correlations with rear end motor vehicle impact injuries, and kinematics of the remaining two suggested a strong risk of injury. Mathematical models of the biomechanics showed that the forces involved are of the same order as those involved in whiplash injuries and of the same magnitude as compression injuries of the cervical spine.

Conclusions. This study shows that there is a significant risk of whiplash injuries in this sport, and there are no safety regulations to address these concerns.

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