SAFETY IN SPORT – DELIVERY OF SAFE TEAM SPORTS FOR CHILDREN · SAFETY IN SPORT – DELIVERY OF...

SAFETY IN SPORT – DELIVERY OF SAFE TEAM SPORTS FOR

CHILDREN

Professor Caroline FinchNHMRC Principal Research FellowAccident Research Centre, Monash [email protected]

JUNIOR SPORT SAFETY RESEARCH• Most community-level participation is

by children• Lack of data on junior sport

• Much derived from studies in adults or highly competitive athletes Source: Finch, Sport Health, 2007

Adult74%

Children12%

All ages14%

Australian studies 2001-2006

IMPLICATIONS FOR JUNIOR SPORTS INJURY STUDIES

• Reasons for participation

• Children are not “little” adults– physical– cognitive– social

• Nature of sport is very different

• Injury risk and rates are different

IMPLICATIONS FOR JUNIOR SPORTS SAFETY

• Delivery of sport very different

• Translation of safety information very different

• Major role of coaches/teachers and other significant others in sports and sports safety behaviours

COHORT STUDIES OF INJURY RISK IN

3 TEAM-BASED JUNIOR

COMMUNITY SPORTS

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AIM OF TALK

• To present latest evidence from 3 junior team sports in Australia

– Australian football– cricket– netball

• Implications of the findings for junior team sport

• Resources available

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THE JUNIOR AUSTRALIAN FOOTBALL SAFETY STUDY (JAFSS)

Source: Romiti, Finch & Gabbe; British Journal of Sports Medicine; 2008; 42:441-445

• Partnership with the AFL, Victorian FL, AFL Sydney

• Players from Eastern FL (Vic), Northside AFL (NSW)

• Injury risk/safety in relation to game development in relation to

• Assess the safety of junior game versions

• Specific recommendations for updated game development manuals for coaches

JUNIORS ENJOYING NETBALL SAFELY EVALUATION PROJECT

(JENSEP)

• Partnership with Netball Victoria and Netball Australia

• Funded by Dept Health & Ageing, SRV, SMA

• Important information about injury risk in relation to game development

• Context of junior community sport –players and coaches

• Cues to sustainability of a safety program in community sport

Source: Finch, Otago, Saunders, Romiti, White, Donaldson. 2008. UB HMSS Research Report

JUNIORS ENJOYING CRICKET SAFELY (JECS)

• Partnership with Cricket Victoria, Cricket Australia, Ballarat Cricket Association

• Funded by Dept Health & Ageing, SRV, SMA

• Context of junior community sport• Important information about injury risk

in relation to game development stages• Impact of ground conditions• Player risk perceptions and safety

attitudesSource: Finch, White, Dennis, Twomey, Hayen; Journal of Science and Medicine in Sport; 2010 13(5): 489-495

STANDARDISED METHODOLOGY


SAMPLING METHODOLOGY

• Prospective (group clustered) cohort studies– Clubs– Teams– Players

• JAFSS – 54 teams (12-20 players); 40,208 hours

• JENSEP – 510 players, 1,300 hours

• JECS - 410 players, 2,255 hours

• Games and training

Ballarat Cricket Association clubs

19 *

clubs with U12 teams nominated

7


13


10

U16 teams recruited13 out of 21

(62%)


(56%)


(50%)

U12 teams after drop outs

9

U14 teams afterdrop outs

19

U16 teams after drop outs

12

U12 players 118

U14 players 268

U16 players 156

consenting U12 players79

(67% of players)


(78% of players)


(78% of players)

Recruitment sampling plan

INJURY DEFINITION

• JECS/JENSEP– an event which requires the provision of medical

attention, either on or off the field, and/or results in missed participation during the match or training session

• JAFSS– any trauma causing disability and/or pain– JECS/JENSEP definition as subset

DATA COLLECTION

• On-field injuries of any severity– left field?– stayed-off field?– received treatment?– sent to hospital?– body region– nature and mechanism of injury

Severity Indicators

Leave field?

Receive treatment?

Return to field?

Advised to seek medical advice?

Taken to hospital?

DATA COLLECTION

•––––––

• Participation attendance

PLAYER SURVEYS• Attitudes, knowledge, self-reported behaviours

• Injury risk perceptions

• Guided by– Theory of Planned Behaviour– specific game features– specific safety concerns

• Reliability, content validity, internal consistency demonstrated

Source: Siesmaa, Blitvich, White, Finch; Journal of Science and Medicine in Sport; 2010

CHILD INJURY RISK PERCEPTIONS

Source: Siesmaa, Blitvich, White, Finch; Journal of Science and Medicine in Sport; 2010

CHILD INJURY RISK PERCEPTIONS

Source: White, Dennis, Siesmaa, Finch; Journal of Science and Medicine in Sport; 2010

FACT 1CHILDREN ENJOY

THEIR SPORT, SKILLS AND

PERFORMANCE ARE SECONDARY


REASONS WHY CHILDREN CHOOSE TO PLAY CRICKET (N=279)

Source: Finch, Siesmaa, Blitvich, White, Telford; SKIDO report; UB HMSS; 2009

FACT 2

RELATIVESAFETY OF

JUNIOR SPORT


INJURY RATE COMPARISONS

0

5

10

15

20

25

rate

per

100

0 pl

ayer

hou

rs

Adults(WASIS)

Children(JAFSS)

Australian Football

0

5

10

15

20

25

Adults (WASIS)

Children (JENSEP)

rate

per

100

0 pl

ayer

hou

rs

Netball

Source: WASIS results: McManus, Stevenson, Finch; Journal of Science and Medicine in Sport; 2004 & 2006

FACT 3

INJURY RATES VARY BY AGE GROUP AND

GAME DEVELOPMENT


INJURY RATES IN JUNIOR AUSTRALIAN FOOTBALL PLAYERS

44.940.1

76.6

30.8

20.1 19.5

49.3

44.043.9

3.86.02.30.86.3

1.02.33.53.30

10

20

30

40

50

60

70

80

90

U9 U10 U11 U12 U13 U14 U15 U16 U18

Level of play

Inju

ry ra

te (p

er 1

000

hour

s of

exp

osur

e)

Game injury rate Training injury rate


RATES OF INJURY (PER 1000 PARTICIPATIONS) IN MATCHES ACCORDING

TO AGE LEVEL OF PLAY

MatchAge

groupBatting

IR 95% CIBowlingIR 95% CI

FieldingIR 95% CI

U12 0 - 0 - 3.0 0.0-8.9

U14 6.1 2.1-10.1 2.2 0.1-4.4 2.7 0.5-4.8

U16 1.4 0.0-4.2 3.2 0.0-7.7 8.0 2.1-13.6

Note: Rates are a function of the participations for each playing position separately

Source: Finch, White, Dennis, Twomey, Hayen; Journal of Science and Medicine in Sport; 2010 13(5): 489-495

FACT 4

INJURY PATTERNS AND CAUSES

DIFFERENT TO THOSE OF ADULTS


JUNIOR AUSTRALIAN FOOTBALL

• Adults– fast pace of game– overuse, running injuries– hamstring, groins, quads

• Children– incidental body contact– ball handling– introduction of tackling– knees and hands/fingers


JUNIOR NETBALL

• Adults– ankle/knee injuries– landing in sport– poor conditioning

• Children– ankle/knee/elbow– grazes/sprains– struck by ball/player– ball handling– landing problems for older children


JUNIOR CRICKET

• Adults– fast bowlers– overuse– backs/shoulders

• Children– batters, bowlers, fielders– ball handling– impacts from ball– thighs, hands/fingers– overuse only in oldest players


CRICKET INJURIES BY PLAYING POSITION

Children

• Batting 34%

• Bowling 33%

• Fielding 32%

Adults

• Bowling >>2X (batting + fielding combined)


FACT 5

RISKPERCEPTIONS

ALSO VARYBY AGE


PERCEIVED RISK OF INJURY IN JUNIOR CRICKETERS

• Lower for self than others → optimistic bias

• Higher for batting and fielding

• Higher for facing fast bowler and fielding close to batter

• Higher for U12 and U14 except for bowling


PERCEIVED RISK ACROSS VARIOUS WICKET KEEPING SITUATIONS

Keeping to a Spin Bowler

0% 20% 40% 60% 80% 100%

U12

U14

U16

With Helmet

U12

U14

U16

No Helmet

Percent of players in each age group

Don't know No Chance Small Chance High Chance

Keeping to a Fast Bowler

0% 20% 40% 60% 80% 100%

U12

U14

U16

With Helmet

U12

U14

U16

No Helmet


Don't Know No Chance Small Chance High Chance


PERCEIVED RISK ACROSS DIFFERENT GROUND CONDITIONS

0% 20% 40% 60% 80% 100%

U12

U14

U16

Playing on grass

U12

U14

U16

Playing on hard ground

U12

U14

U16

Playing on bumpy ground


Don’t know No chance A small chance A high chance


FACT 5

HIGH DUTY OF CARE WITH

JUNIOR SPORT DELIVERY


JUNIOR AUSTRALIAN FOOTBALL


JUNIOR NETBALL

Severity of injuries reported (game and training combined) reported as rates per 1000 hrs/participation

8.7

6.7

3.72.8

0.6

0

2

4

6

8

10

12

all injuries left court did not return tocourt

advised to seekaid

advised to go tohospital

inju

ry r

ate

(per

100

0 h

rs)


JUNIOR CRICKET

3.7

2.1 2.0

0.6 0.50.2

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0in

jury

rat

e p

er 1

000

par

tici

pat

ion

s

All injuries

Left field

Received treatment

Remained off field

Advised to seek medical assistance

Taken to hospital


IMPLICATIONS FOR INJURY

PREVENTION


JUNIOR SPORT ADVANTAGES

• Provides opportunities for all to play• Much safer than adult versions• Perhaps use as a strategy to help prevent

other injury/health issues

• High level of duty of care • Graduated physical skills and contact

JUNIOR SPORT SAFETY

• Injuries related to– lack of skill/skill development– ball handling– little overuse

• Strategies for adult sport not always relevant because

– different injuries– different causes– different priorities

RESEARCH NEEDS

• Very little information about school sport– rate of injury not known– are the age and level of play effects the same?– best approaches for game development to maximise

safety?– are the risk perceptions, safety beliefs and sources of

information the same?

SPORTS SAFETY ADVICE


• Major role of teachers, coaches and other significant others in sports safety behaviours

• Continue to remind junior players of injury risk and correct technique for injury prevention

• Inform players that of how/why/where/when injuries can occur & include skills practice accordingly

– needs to be age specific and all positions

• Ensure information junior players receive is based on evidence and not just media hype

RECOMMENDATIONS

SMARTPLAY

• Smartplay Program• Delivered nationally since

2001• Sports Medicine Australia• Readily available

resources– fact sheets– guidelines– newsletters

NATIONAL SAFETY GUIDELINES

Source: http://www.smartplay.com.au/ImageLibraryAssets/resources/national/childrensafetyguidelines-fulldoc.pdf

PREVENTION STRATEGIES

• The environment

• Equipment

• Grounds and facilities


INJURY AND MEDICAL CONSIDERATIONS

• Pre-participation screening

• Medical record keeping• Illness and

participation• Medical conditions and

participation


PARTICIPATION CONSIDERATIONS

• Training sessions• Warm-up, cool-down,

stretch• Amount and intensity of

activity• Balanced competitions• Strength training• Recovery• Injury management and

return to play

RESPONSIBILITIES

• Clubs, schools other providers

• Safety personnel• Coaches and

teachers• Officials• Parents


THE SMARTPLAY PRINCIPLES (1)

• WARM UP• Be prepared for the

activity– facility– equipment– student– coach/teacher

Source: http://www.smartplay.com.au/Pub/pStart.asp


• GEAR UP• Use the appropriate

equipment– facilities– playing equipment– personal protective

equipment



• DRINK UP– drink plenty– avoid dehydration– avoid heat stress


www.smartplay.com.au

• Downloadable resources– safety fact sheets/guidelines– sport specific guidelines– media text for newsletters– teacher resources– others

• latest research, other initiatives

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