Victorian Injury Surveillance Unit (VISU), Monash University, (accessed 2 June 2021). VISU has been analysing, interpreting and disseminating Victorian data on injury deaths, hospital admissions and emergency department presentations across the state, nationally and internationally for more than 25 years. This critical information is provided to around 250 organisations and agencies each year, including Commonwealth, state and local government departments and agencies, health and injury prevention organisations, media, business and industry, education institutes, research groups, and the community.

• e-Bulletins, fact sheets and other VISU reports. E-Bulletins summarise the analysis of the latest available year of death or unintentional hospital-treated injury data overall and by age group (children aged 0-14 years, adolescents and young adults aged 15-24 years, adults aged 25-64 years, and older adults aged 65 years and older). Analysis covers the frequency, rate, trends, causes, location, type of injury and body region injured.

• Australian-first study reveals gender differences in footy injuries, Deakin University, (26 March 2021). The study of more than 1600 Australian rules football players who attended emergency departments in Victoria between January and October 2019 found:
  • female players had a higher proportion of hand/ finger injuries (34.3% v 23.4%), neck injuries (6.6% v 2.5%) and patella dislocations (2.9% v 0.6%);
  • male players experienced a higher proportion of shoulder injuries (11.5% v 5.8%), skin lacerations (8.0% v 1.7%), and thorax/abdominal/pelvic injuries (5.7% v 2.1%);
  • concussion rates were similar between the genders and occurred in 14.1% of all patients;
  • anterior cruciate ligament (ACL) injuries were infrequent (1.0%) and not significantly different between genders (2.1% v 0.9%);
  • female players received more imaging investigations, such as x-rays and CT scans, (83.1% v 74.7%) and analgesia (62.4% v 48.5%);
  • a higher proportion of male players required admission to hospital (5.0% v 2.1%), usually for surgery.
• How children break their bones: a decade of data, Macquarie University, (10 August 2020). On average, more than 28,000 children each year end up in hospital somewhere in Australia with a broken bone from playing sport, a new study from Macquarie University shows. Piecing together data over a 10-year period on injuries suffered by children up to 16 years old, Macquarie researchers found broken bones to be the single biggest cause of hospitalisation accounting for 41 per cent of all paediatric trauma admissions. Of 686,409 children admitted to hospital over 10 years as a result of an injury, the largest number (287,646) were hospitalised for fractures. As well as the immediate pain and suffering to the child, the researchers discovered that fractures directly cost the Australian health system about $73.2 million a year.The five most common fractures were the forearm (48.1%), shoulder and upper arm (14.1%), lower leg including the ankle (11.3%), wrist and hand (10.4%), and the skull and face (9%). Twice as many boys as girls were hospitalised for fractures – around 820 hospitalisations per 100,000 boys – compared to girls with around 416 hospitalisations per 100,000, the AIHI study found.

• Sports injury hospitalisations in Australia, 2019–20, (23 March 2022). In 2019–20, about 52,300 sports injuries led to a hospital stay in Australia. This report describes the people hospitalised, the types of injuries they sustained, and the sports they were playing. The impact of COVID-19 restrictions on admissions after March 2020 is explored. Sports participation and rates of injury are discussed. The report does not cover emergency department presentations where a patient was treated without admission to hospital.
• Kidsafe WA Childhood Injury Bulletin: Annual Report 2019-2020, Posa, I., McKenna, J and Skarin, D., Kidsafe WA, (November 2020). This annual report provides a summary of all the Injury Surveillance System data collected at PCH ED between July 2019 and June 2020. While this data does not capture all Emergency Department presentations in Western Australia, it offers a representative snapshot of injury patterns.
  • 18,912 Children were seen in the Perth Children’s Hospital Emergency Department (PCH ED) due to injury during the 2019-20 financial year.
  • Just under half of all injuries had an associated injury factor (45.6%, n=8,619). Among injury factors, the most common is wheeled equipment (17.7%, n=1,527) and sports and recreational equipment such as, a sports ball (13.6%, n=1,176)
  • Sporting activities were related to just under a quarter of injury presentations to PCH ED (22.1%, n=4,171). The most common sporting activity associated with injury was cycling, accounting for 17.5 percent (n=728) of sports injuries. This was followed by trampoline (12.0%, n=500), Australian Rules Football (9.2%, n=384), basketball (8.9%, n=372) and scootering (7.8%, n=325)
• Sport and recreation deaths in Australia, National Coronial Information System, (August 2020). The data was extracted from the NCIS in April 2020. The data set contained every closed case reported to an Australian coroner between 1 January 2001 and 31 December 2017 where the death was due to unintentional external cause(s), and where the deceased was engaged in a sport or recreation activity. There were 3231 sport and recreation deaths reported to an Australian coroner between 2001 and 2017. In 62 of these deaths, the person was engaged in the activity in a professional capacity. Professional refers to instances in which the person’s activity at the time of the incident was coded as paid work or unpaid work. All other cases in the fact sheet refer to instances where the person’s activity was sport and exercise during leisure time. Over two thirds (67.0%) of sport and recreation deaths involved water and boating activities. There were 551 deaths in which the person was engaged in wheeled activities such as cycling, skate boarding or car racing. Of these, 241 involved motorcycling.
• Kidsafe WA Childhood Injury Bulletin Research Report: Sporting Injuries, Kays, A, McKenna, J, Skarin, D., Kidsafe WA, (April 2018). This research report provides a summary of the Injury Surveillance System data collected at Princess Margaret Hospital for Children (PMH) in Perth, Australia, between July 2007 and June 2017 relating to childhood sporting injuries. Over the 10 year period 39,541 children presented to the PMH emergency department with what was classified as a sports related injury. However, quite a few of these would appear to be related to general physical activity or active transport (e.g. cycling, trampolining, scootering) rather than organised sports activity. However, of the sport specific results:
  • Australian Rules Football accounted for the most sport-related injuries at 12.6% followed by: soccer 9%, basketball 6.8%, netball 4.6%, rugby 4.2%, cricket 1.4%, hockey 1.3%, and ice skating 1.2%
  • The percentage of injuries from other activities included: cycling 12.6%, trampoline 11.6%, scootering 6.8%, skate boarding 5.8%, swimming 3.7%, motocycling 2.1%
  • The most common location for a sporting injury to occur is ‘other place’ (52.1%, n=20,590) referring to an unspecified location or one that does not fit within another category. Following this is the home (11.6%), school or residential institution (10.9%), and sports area (10.2%) locations.
  • The data did not indicate whether or not sporting injury incidents occurred at organised (i.e. sports clubs) or unorganised/social (backyard cricket, swimming at the beach etc.) activities.
  • The majority of injuries were classified as semi-urgent (76.5%) or urgent (20.3%), with small numbers of injuries being classified as emergency (2.6%), requiring resuscitation (0.4%), or non-urgent (0.2%). It also did not indicate the principal nature, location, or severity of sporting activity related injuries.
• A 10-year review of the characteristics and health outcomes of injury-related hospitalisations of children in Australia, Rebecca Mitchell, Kate Curtis, Kim Foster, Macquarie University, University of Sydney, Australian Catholic University, (May 2017). The overall objective of this research is to describe the burden of hospitalised childhood injury in Australia during 1 July 2002 to 30 June 2012 and to determine the health outcomes and severity of the injuries experienced and factors influencing survival. Some key findings included:
  • Male children accounted for just less than two-thirds (63.6%) and female children accounted for 36.4% of injury hospitalisations. Forty-one percent of injury hospitalisations involved children aged 11-16 years, 30.9% involved children aged 1-5 years, 24.7% involved children aged 6-10 years and 3.5% involved children aged less than one year.
  • Where the activity at the time of the injurious incident was specified, sporting activities (19.0%) and leisure activities (6.6%) were the most common types of activities conducted. A higher proportion of males (22.9%) were injured during sporting activities than females (12.1%). The six most common sports where injuries occurred were team ball, bat and stick sports, during individual water sports or equestrian activities, and during wheeled motor and non-motor sports. Males had a higher proportion of hospitalised injuries following team ball sports (11.1% vs 3.0%), wheeled motor (1.8% vs 0.4%) and non-motor (5.3% vs 2.4%) sports than females. Females (1.6%) had a higher proportion of hospitalised injuries during equestrian activities than males (0.2%)
  • The estimated total hospital costs of child injury hospitalisations and any subsequent rehabilitation hospital treatment was $2.1 billion over the ten year period. Annually, hospital treatment cost an estimated $212 million, with a mean cost per injured child of $3,119 (median $1,262). The total hospital cost is likely to be an underestimate
• Rural v metro: geographical differences in sports injury hospital admissions across Victoria, Anna Wong Shee, Angela Claperton, Caroline Finch, Medical Journal of Australia, Volume 203(7), (October 2015). Analysis of International Classification of Diseases-coded hospitalisation data routinely collected from all Victorian public and private hospitals admissions over the financial years 2003–04 to 2011–12 was undertaken. They were classified according to the Local Government Area (LGA; 31 metropolitan, 49 rural/regional) of the patients’ usual residence. Population-adjusted sports injury hospital admission rates were based on annual LGA populations; trends were analysed by negative binomial regression. The overall annual number of sports injury-related hospital admissions increased by 34% (n = 8092 to n = 11 359). The regression model found a corresponding 15% increase in the annual population-adjusted sports injury-related hospital admissions rate from 166.0 to 205.01 per 100 000 population. For every year, the population-adjusted rate of sports injury hospital admissions was higher for people residing in rural/regional LGAs than in metropolitan LGAs. Our data demonstrate geographical differences in population-adjusted sports injury hospital admissions rates that have persisted over time. This epidemiological study is the first step to understanding how the burden of sports injuries varies by region in Victoria.
• Injury in Victoria: The hospital treatment costs of injury, 2012/13, Angela Clapperton, Victorian Injury Surveillance Unit, Monash University, (July 2015). This report describes the cost of hospital treatment (hospitalisations and non-admitted emergency department presentations) for injury in Victoria, Australia for the 2012/13 fiscal year in the context of injury settings and causes. Overall, it is estimated that the hospital treatment costs for injury cases (excluding medical injury) in Victoria in 2012/13 totalled $806.3 million, an average of $2,050 per hospital-treated injury. Includes data on injuries that occurred in sports and athletic areas.
  • Males accounted for a much higher number of incidents than females at all ages. The age pattern was similar for males and females with the exception that the peak age for males was 15-19 years while for females it was 10-14 years. Overall, males accounted for almost three-quarters of all hospitaltreated sports injury incidents (n=20,654).
  • Males accounted for 76.1% of all hospital-treated costs ($27.1m) and accounted for a much higher proportion of hospital costs than females at all ages except 70-74 years and 85+ years. Almost one-third of total hospital costs were concentrated among males aged 15-24 years ($11.2m, 31.5%)
  • Australian Rules football accounted for more than one-quarter of incidents occurring in sports and athletics areas and 28.3% of hospital costs associated with these incidents ($10.0m).
  • Despite accounting for just 1.2% (n=340) and 1.5% (n=432) of hospital-treated incidents respectively, snow sports and motorcycling accounted for around 5% of hospital treatment costs for injuries occurring in sports and athletics areas.
  • The mean cost per incident data likely reflects the severity of incidents for some sports activities (snow sports, motorcycling and equestrian related activities) and also the age profile of injured persons for others (golf and lawn bowls).
• Rural v metro: geographical differences in sports injury hospital admissions across VictoriaKidsafe WA Childhood Injury Bulletin Research Report: Playground Injuries, Kidsafe WA, (2015).This research report provides a summary of the Injury Surveillance System data collected at Princess Margaret Hospital for Children (PMH) in Perth, Australia, between July 2006 and June 2014 relating to childhood playground injuries. Over the eight year period from July 2006 to June 2014 there was a total of 132,424 presentations to the PMH ED for injury. During that same time period there were 6,852 injury presentations specifically relating to playgrounds, accounting for 5.2 percent of injury presentations.
  • Falls are the most common cause of playground related injury, accounting for 77 percent of presentations. Falls injuries from greater than one metre are often associated with more severe injuries with nearly a quarter (24.3%, n=234) requiring hospitalisation. Similarly 22.2 percent (n=756) of falls from less than a metre required hospitalisation, in comparison to only 11.7 percent of falls from the same level.
  • Trampolines were the most commonly associated piece of equipment relating to playground injuries, accounting for 47.3 percent (n=3238) of presentations, followed by monkey bars (17.9%, n=1,226), slides (15.1%, n=1,037) and swings (12.6%, n=862)
• Adult sports injury hospitalisations in 16 sports: the football codes, other team ball sports, team bat and stick sports and racquet sports,  Erin Cassell, Emily Kerr, Angela Clapperton, Victorian Injury Surveillance Unit, Hazard, Edition 74, (2012). In this issue the results of an investigation into the frequency, incidence, trend and pattern of adult sportsrelated injury hospitalisations in four groups of popular sports are reported. The 16 sports covered are: football codes (Australian football, combined rugby union & league and soccer), other team ball sports (basketball, netball and volleyball), team bat and stick sports (combined baseball & softball, cricket and hockey) and racquet sports (badminton, table tennis, combined squash & racquetball and tennis). Over the study period, 60% of injury hospitalisations recorded on the VAED did not have an activity code and a further 1.7% were coded to ‘activity: sport and recreation’ but the sport or recreational activity being engaged in at the time of injury was not specified. Hence, the number of injury hospitalisations in the 16 sports covered in this report may be grossly underestimated.
  • Over the 3-year study period 2007/8 to 2009/10 there were 12,460 adult hospitalisations for sports injury in the 16 sports: - Football codes: Australian football, rugby union and league (combined) and soccer (67%, n=8,357); -  Other team ball sports: basketball, netball and volleyball (18%, n=2,338); -  Team bat and stick sports: baseball & softball (combined), cricket and hockey (10%, n=1,234); and - Racquet sports: badminton, table tennis,squash&racquetball(combined) and tennis (4%, n=531). Cases included adults (aged 15 years and older) injured in indoor, outdoor, organised and unorganised participation.
  • The sport with the highest frequency of hospitalisations was Australian football (50%, n=6,275), followed by soccer (13%, n=1,662), basketball (11%, n=1,317), netball (8%, n=937) and cricket (7%, n=832).
  • Although the trend in the frequency of hospitalisations increased significantly over the 8-year period 2002/3 to 2009/10 for Australian football, soccer, basketball, netball, cricket and hockey, there was no significant increase in the hospitalisation rate per 100,000 participants in any of these sports. This indicates that the observed upward trend in frequency was related to increased participation.
  • Males comprised the majority of hospitalisations in 14 of the 16 sports studied (range 55% for tennis to 98% for Australian football). The exceptions were netball, where females comprised 85% of hospitalisations.
  • The total direct cost of injury hospitalisations in all 16 sports over the 3-year study period was $47.8million. Australian football hospitalisations accounted for the highest proportion VICTORIAN INJURY SURVEILLANCE UNIT HAZARD 74 page 3 of this cost (48%, $23.1m), followed by soccer (15%, $7.0m), basketball (11%, $5.0m) and netball (9%, $4.1m.). However, table tennis hospitalisations were the most costly on average ($6,816 per case), followed by tennis ($4,557), netball ($4,351) and soccer ($4,187) hospitalisations.
  • Attention should be paid to the information on the pattern and causes of injury in each sport from injury surveillance and research when VICTORIAN INJURY SURVEILLANCE UNIT HAZARD 74 page 17 devising prevention strategies and measures which should focus on reducing serious injuries and high frequency-lower severity injuries such as sprains and strains

• Gender differences in female and male Australian Football injuries - a prospective observational study of emergency department presentations, Stephen D. Gill, Julian Stella, Nicole Lowry, et.al., Journal of Science and Medicine in Sport, Volume 24(7), pp.670-676, (July 2021). All patients presenting to one of 10 EDs in Victoria, Australia, with an Australian Football injury were included in the study. Data were prospectively collected over a 10 month period, coinciding with a complete Australian Football season, including pre-season training and practice matches. 1635 patients were included, of whom 242 (14.8%) were female. Females had a higher proportion of hand/finger injuries (34.3% v 23.4%), neck injuries (6.6% v 2.5%) and patella dislocations (2.9% v 0.6%). Males had a higher proportion of shoulder injuries (11.5% v 5.8%), skin lacerations (8.0% v 1.7%), and thorax/abdominal/pelvic injuries (5.7% v 2.1%). Concussion rates were similar between the genders, occurring in 14.1% of all patients. Anterior cruciate ligament injuries were infrequent (1.0%) and not significantly different between genders. Females received more imaging investigations (83.1% v 74.7%) and analgesia (62.4% v 48.5%). A higher proportion of males required admission to hospital (5.0% v 2.1%), usually for surgery.
• Effects of Combination Movement Patterns Quality and Physical Performance on Injuries in Young Athletes, Dawid Koźlenia, Jarosław Domaradzki, International Journal of Environmental Research and Public Health, Volume 18(11), (May 2021). Identifying the factors associated with the injuries is crucial to prevention, enabling apply effective methods to reduce injuries frequency. This is especially important for young athletes for whom an injury may impair development or prematurely end a sports career. Therefore, the objective of this study is to examine if the movement patterns quality and physical performance simultaneously affected injury occurrence in young athletes. The participants were 176 athletes aged 22.44 ± 1.64. The injury data were collected from the 12 months retrospective period. The functional movement screen test was conducted to assess the quality of movement patterns, and the physical performance tests were done for assessing strength, power, flexibility, and balance. Results showed relationships between movement patterns quality and flexibility with injuries. The receiver operating characteristic curve demonstrated growing injury frequency for 14 ≥ FMS and 21 cm ≥ Sit-and-reach test. Rank Transform ANOVA revealed a simultaneous effect of movement quality and flexibility on an injury. Post-hoc tests indicated that the group with low-quality movement patterns combined with a low level of flexibility is the most frequently injured. It is recommended to include in training, routine exercises improving movement patterns and flexibility to prevent injuries.
• Epidemiology of Sports-Related Injuries and Associated Risk Factors in Adolescent Athletes: An Injury Surveillance, Pablo Prieto-González, Jose Luis Martínez-Castillo, Luis Miguel Fernández-Galván, et.al., International Journal of Environmental Research and Public Health, Volume 18(9), (May 2021). Four hundred ninety-eight athletes aged 14 to 21 voluntarily participated in this prospective injury surveillance, conducted from 1 January 2019 to 31 December 2019. Forty point four percent of the participants suffered an injury in 2019 (39% of them in a previously injured area). The average injury rate was 2.64 per 1000 h. Soccer presented the highest rate (7.21). The most common injuries were: lumbar muscle strains (12.24%), ankle sprains (11.98%), and bone fractures (9.31%). Ankles (36.12%), knees (19.32%), and shoulders (6.47%) concentrated the highest number of injuries. Fifty-nine point twenty-eight percent of the injuries occurred during practices, and 40.72% during competition or peri-competition. Higher injury rates were associated (in this order) with the following factors: (a) Greater number of hours of practice per week. (b) Not performing warm-ups. (c) Using inadequate sports facilities. (d) Being aged 14–17. (e) Not performing physical preparation. (f) Inappropriate training load. (g) Not performing injury-preventive activities. (h) Performing sports technique without the supervision of one sports coach. (i) Inadequate sports equipment. In conclusion, since most injury risk factors are modifiable, it is imperative to implement strategies to reduce amateur and professional adolescent athletes’ injury rates.
• Injury deaths in Australian sport and recreation: Identifying and assessing priorities for prevention, Lauren V. Fortington, Andrew S. McIntosh, Caroline F. Finch, PLOS One, (April 2021). This is a retrospective cohort study of injury deaths reported between 1 July 2000 to 31 December 2019 using data from the National Coronial Information System, Australia. Unintentional deaths with an external cause, where the activity was recorded as sport and exercise during leisure time were included. Drowning deaths were excluded. Presented are the number and % of cases by age, sex, sport, broad cause and annual crude death rate (population). There were 1192 deaths, averaging 63 per year. Deaths were mostly in males (84.4%), with the largest proportion in people aged 15–24 years (23.1%). Wheeled motor (26.9%) and non-motor (16.2%) sports accounted for the highest proportion of cases. The primary mechanism of death was most commonly blunt force (85.4%), followed by piercing/penetrating force (5.0%). The years 2001 and 2005 recorded the highest crude injury death rate (2001, n = 92, 0.47 per 100,000 population; 2005, n = 95, 0.47 per 100,000 population). On average, there is more than one injury death per week in a sport or recreation setting in Australia. Cases occurred in many sports and recreation activities, including those generally considered to be safe (e.g. individual athletic activities, team ball sports.) Detailed investigation of the coronial recommendations that are present within each case is now needed to understand and identify potential prevention opportunities.
• Anterior Cruciate Ligament Injuries in Australian Rules Football: Incidence, Prevention and Return to Play Outcomes, Kate Webster, Timothy Hewett, and Julian Feller, Open Access Journal of Sports Medicine, (31 March 2021). This review summarizes the incidence of ACL injury in both men’s and women’s Australian Rules football and reviews potential causative factors and risk reduction strategies. The final section takes an in depth look at return to sport outcomes after ACL reconstruction surgery in these populations. Whilst an ACL injury does not mean the end of a player’s career in Australian football, it certainly presents a significant challenge in terms of return to preinjury levels of form and high rates of secondary and tertiary ACL injury are also a significant concern.
• Injuries in Netball-A Systematic Review, Christopher Downs, Suzanne J. Snodgrass, Ishanka Weerasekara, et.al., Sports Medicine - Open, Volume 7, article 3, (January 2021). Netball is estimated to be played by more than 20 million people worldwide, but there is evidence of high injury incidence. A thorough understanding of the types and rates of netball injuries is essential for effective injury management and prevention strategies to be developed and implemented. This systematic review summarises the published findings with respect to injury types, participant characteristics and any identified risk factors for netball injuries. Forty-six studies (43.5% prospective, 37% hospital/insurance records, 19.5% retrospective) from 45 articles were included after screening. The majority of studies (74%) were conducted in Australia or New Zealand. There was little consistency in the definition of ‘injury’. Elite or sub-elite level players were included in 69% of studies where the level of competition was reported. The duration of injury surveillance was generally related to the format of competition from which data were collected. Self-report questionnaires were used in 48% of studies and only 26% of studies used qualified health professionals to collect data courtside. Injuries to the ankle and knee were the most common (in 19 studies) although the incidence varied considerably across the studies (ankle 13–84% and knee 8–50% of injuries). Prevention of ankle and knee injuries should be a priority. Children sustained more upper limb injuries (e.g. fractures) compared with adults who sustained more lower limb injuries (e.g. ankle and knee sprains/strains). A large number of potential risk factors for injury in netball have been investigated in small numbers of studies. The main circumstances of injury are landings, collisions and falls.
• A decade of head, neck and facial cricket injury hospitalisations in Victoria, Australia: From 2007/08 to 2016/17, Dulan Kodikara, Mandy S. Plumb, Dara M. Twomey, Journal of Science and Medicine in Sport, Volume 23(12), pp.1161-1165, (December 2020). This study provides a novel and current insight of the incidence and details of HNF injuries among cricket participants in Victoria over a decade. It is evident that males and younger participants, regardless of gender, have a higher risk of sustaining a HNF injury. This study provides a solid evidence base for stakeholders in developing strategies to minimise head, neck and facial injuries to make cricket a safe sport for all.
• Fracture-related hospitalisations and readmissions of Australian children ≤16 years: A 10-year population-based cohort study, Mona Faris, Reidar P. Lystad, Ian Harris, et.al., Injury, Volume 51(10), pp.2172-2178, (October 2020). There were 287,646 fracture-related hospital admissions in Australia for children ≤16 years. The five most common fracture regions were the forearm (48.1%), shoulder and upper arm (14.1%), lower leg including the ankle (11.3%), wrist and hand (10.4%), and the skull and face (9.0%). There was a decrease in hospitalisation rate for all fractures over the 10-year period. The hospitalisation rate for males was at least double that of females. Falls, particularly those from playground equipment, were the most common injury mechanism. Hospital readmissions within 28 days of hospitalisation were mostly due to further orthopaedic care or rehabilitation. Total treatment costs for fracture-related hospitalisations amounted to over AUD$732 million, with the median cost of readmissions being AUD$2,474. While there is a decline in the rate of hospitalised fractures in Australian children, continued efforts are required if the rate of fractures and their associated economic costs are to be reduced. The identification of the prevalence and causes of various fracture types provides policymakers with evidence to target preventive initiatives.
• Ten-year nationwide review of netball ankle and knee injuries in New Zealand, Suzanne Belcher, Chris Whatman, Matt Brughelli, et.al., Journal of Science and Medicine in Sport, Volume 23(10), pp.937-942, (October 2020). Data were divided into 5 equal year groups (2008/9, 2010/11, 2012/13, 2014/15, 2016/17), and 3 age groups (10 to 14 years, 15 to 19 years, 20 to 24 years old). Raw injury counts and injury rates per 1000 affiliated players were reported. Changes in injury rates over the 10-year period and differences between age groups were expressed as Incident rate ratios (IRRs). Ankle and Knee injuries have increased with the biggest increase in 10-19-year-olds. Injuries in 20-24-year-olds still represent the highest cost and continue at a higher rate than in younger players. Spikes in injury are likely associated with intense periods of trialling and tournament play.
• A prospective study of sport injuries in youth females, Lesley Sommerfield, Craig Harrison, Chris Whatman, et.al., Physical Therapy in Sport, Volume 44, pp.24-32, (July 2020). An online questionnaire was used to record training and competition exposure and self-reported injuries for 30-weeks. Participants were 103 PE students (12–15 years) from a girls’ secondary school. On average, girls trained 3.4 h/week and competed 1 h/week. During the study, 74 participants reported 595 injuries. The average weekly prevalence of all injuries was 20.7%, of which 8.6% were acute injuries and 12.0% were gradual onset/overuse injuries. The overall rate of sport and PE injuries was 10.4 injuries/1000 h of exposure. The most common acute injury involved the ankle (35%) while the most common gradual onset/overuse injury involved the knee (51%). There was no significant association between the stage of the menstrual cycle and the likelihood of injury (P = 0.18). The authors conclude that the high number of injuries in this population of girls suggests preventative measures, particularly targeting the lower extremity, are needed.
• Injury surveillance of an Australian community netball club, Melinda Franettovich Smith, M. Dilani Mendis, Alexander Parker, et.al., Physical Therapy in Sport, Volume 44, pp.41-46, (July 2020). In the preseason, risk factors were investigated using self-report questionnaires and physical measurements. During the season, injuries were reported using a standardised report, verified by follow-up phone calls. Player training and game hours were recorded. 169 injuries occurred with a rate of 13.8/1000 exposure hours, majority (60%) to the lower limb. The most frequent injury mechanisms were collisions (28%) and awkward landings (27%), nature was ‘Inflammation/swelling’ (32%) and consequence was ‘unable to continue playing/training’ (50%). Previous history of injury and age greater than 13.5 years were significant risk factors for a season lower limb injury. The authors conclude that injury rates in this community netball club were high. Results suggest that further research regarding the implementation and effectiveness of injury prevention programs for community netballers is required.
• Injury epidemiology in Australian male professional soccer, Donna Lu, Alan McCall, Mark Jones, et.al., Journal of Science and Medicine in Sport, Volume 23(6), pp.574-579, (June 2020). Match-loss injury data was collected from each A-League club (n = 10) for each competition match (n = 27/season) over 6 seasons (2012/13–2017/18). Injuries were collected weekly through a standardised protocol and were classified by setting, mechanism, severity, the type and location on the body. Analysis of the results suggests that injury rates, mechanisms, locations and types have remained relatively stable over recent seasons of the A-League. Current Australian professional soccer league medical practices may have contributed to the stability of injury rates.
• Medical-attention injuries in community cricket: a systematic review, McLeod G, O’Connor S, Morgan D, et.al., BMJ Open Sport & Exercise Medicine, Volume 6(1), (March 2020). Six studies were included: five reported hospital-treated data and one reported insurance claims data. Two had a low risk of bias. In hospital-based studies, fractures were the most frequent injury type. Upper and lower limb injuries (age ≥15 years) and injuries to the head (age <15 years) were the most common body region injured. Being struck by the ball was the most common mechanism for injury presenting to hospitals. Children were also commonly struck by equipment. One study using insurance claims data reported soft tissue injuries as the main of injury type.
• Infographic. Sports injury-related hospitalisations in Australian children: incidence, costs and trends, Lystad RP, Tran J, Curtis K, et al., British Journal of Sports Medicine, Volume 53(22), pp.1434-1435, (October 2019). Although the benefits of participation in sporting activities are undisputed, injury is a common adverse outcome. Despite the increasing recognition of the issue worldwide, there is very limited high-quality population-based data quantifying the burden of sports injuries in children and monitor changes over time. Such data are essential for decision-makers to prioritise and develop policy and for stakeholders and researchers to evaluate the impact of sports injury prevention efforts in the real-world setting.
• Incidence, costs, and temporal trends of sports injury-related hospitalisations in Australian children over a 10-year period: A nationwide population-based cohort study, Reidar P Lystad, Kate Curtis, Gary J Brown, et.al., Journal of Science and Medicine in Sport, Volume 22(2), pp.175-180, (February 2019). This study used linked hospitalisation and mortality data of children aged ≤16 years who were hospitalised for sports-related injury in Australia from 1 July 2002 to 30 June 2012. Age-standardised incidence rates were calculated with 95% confidence intervals (CI). There were 130,167 sports injury-related hospitalisations during the 10-year study period. The overall annual incidence rate was 281.0 (95%CI: 279.5, 282.6) per 100,000 population. Males and older children were more frequently hospitalised than their female and younger counterparts. The most common sports activities resulting in hospitalisation were team ball sports (43.1%) and wheeled non-motor sport (22.3%). There was no significant annual decline in the overall incidence rate during the 10-year study period (−1.0% [95%CI: −3.0%, 1.0%]). The estimated total hospital treatment cost was $396 million, with an estimated mean cost per injured child of $3058. There has been no significant decline in sports injury-related hospitalisation rates among Australian children during 2002–03 to 2011–12. This may suggest that sports injury prevention initiatives in Australia to date have been inadequate to produce population-level reduction in sports injury-related hospitalisations. It is recommended that a national injury prevention strategy to reduce the burden of sports injuries among Australian children is developed and implemented.
• Trends and incidence of sports injury-related hospitalisations in Australian children: A 10-year nationwide population-based cohort study, R. Lystad, K. Curtis, G. Browne, et.al., Journal of Science and Medicine in Sport, Volume 21, Supplement 1, (November 2018). There were 130,167 sports injury-related hospitalisations of Australian children aged ≤16 years during the 10-year study period. The overall incidence rate was 281.0 per 100,000 population. The incidence rate in male children (419.7 per 10,000 population) was more than three times that of female children (134.8 per 100,000 population). There was no significant annual decline in the overall incidence rate during the 10-year study period; however, differences in trends were observed between sexes and age groups. The most common sports activities resulting in injury-related hospitalisation were team ball sports (43.1%) and wheeled non-motor sport (22.3%). The estimated total hospital treatment costs of sports injury among Australian children was AUD$39.6 million per year, with an estimated mean cost per injured child of $3058. There has been no significant decline in sports injury-related hospitalisation rates among Australian children during 2002–03 to 2011–12. This suggests that child sports injury prevention initiatives in Australia to date have either been inadequate or ineffective. There is a clear need to develop and implement a national injury prevention strategy to reduce the burden of sports injuries among Australian children.
• Increasing rates of anterior cruciate ligament reconstruction in young Australians, 2000–2015, David Zbrojkiewicz, Christopher Vertullo and Jane E Grayson, Medical Journal of Australia, Volume 208(8), pp.354-358, (2018). Rupture of the anterior cruciate ligament (ACL) is a common and devastating injury that is largely preventable by neuromuscular agility training. The incidence of ACL reconstructions in Australia is the highest in the world, and is increasing. At greatest risk are men aged 20–24 years and women aged 15–19 years, but incidence is increasing most rapidly among 5–14-year-old children. The incidence of revision ACL is increasing more rapidly than that of primary ACL reconstructions. These findings justify establishing a national ACL injury prevention program and an ACL reconstruction registry to improve outcomes for active young Australians.
• Ten-Year Incidence of Sport and Recreation Injuries Resulting in Major Trauma or Death in Victoria, Australia, 2005-2015, Christina Ekegren, Ben Beck, Pamela Simpson, et.al., Orthpaedic Journal of Sports Medicine, Volume 6(3), (March 2018). The 10-year study period entailed 2847 nonfatal major trauma cases and 614 deaths (including 96 in-hospital deaths). The highest frequencies of major trauma cases and deaths were in cycling, motor sports, and equestrian activities. The participation-adjusted major trauma and death rate was 12.2 per 100,000 participants per year over the study period. An 8% increase was noted in the rate of nonfatal major trauma and a 7% decrease in the death rate. Significant increases were found in the rates of major trauma (including deaths) in equestrian activities, motor sports, and cycling. The authors suggest that study findings highlight the need to prioritize investments in the prevention of trauma in these activities.
• Injuries in Australian Rules Football: An Overview of Injury Rates, Patterns, and Mechanisms Across All Levels of Play, Richard Saw, Caroline F. Finch, David Samra, et.al., Sports Health, Volume 10(3), pp.208-216, (August 2017). The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play.
• Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015, Louise Shaw and Caroline F. Finch, International Journal of Environmental Research and Public Health, Volume 14(6), (June 2017).  Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of ACL injuries in children. This study utilizes the Victorian Admitted Episodes Dataset (VAED) to characterize epidemiologic trends of hospital-admitted ACL injuries in those aged 5 to 14 years over a period of 10 years from 2005 to 2015. There was a total of 320 cases and the overall annual rate of ACL injuries increased by 147.8% from 2.74 per 100,000 population in 2005/2006 to 6.79 per 100,000 in 2014/2015. The majority (96.9%) of these injuries were in 10- to 14-year-olds. The main in-hospital procedure provided to over 80% of the hospitalized cases involved ACL reconstruction. Sporting activities accounted for 56.6% of ACL injuries. For females, over half (52.4%) of ACL injuries occurred whilst playing ball sports, compared to 35.4% of males. The large increase in ACL injuries in 5- to 14-year-olds in the state of Victoria, Australia over a 10-year period indicates they are a significant and emerging health burden. Population-wide ACL prevention policies are required to halt these trends. Cost effective prevention programs that involve neuromuscular training must be implemented in schools and junior sports teams.
• Priorities for injury prevention in women's Australian football: a compilation of national data from different sources, Fortington LV, Finch CF., BMJ Open Sport and Exercise Medicine, Volume 2(1), (July 2016). This study aimed to provide a first injury profile from existing sources for female AF. Victorian hospital admissions and ED presentations (2008/09-2013/14) were dominated by upper limb injuries, representing 47% and 51% of all injuries, respectively, primarily to the wrist/hand at 32% and 40%. Most (65%) insurance claim injuries involved the lower limb, 27% of which were for knee ligament damage. A high proportion of concussions (33%) were reported in the club-collected data. The results provide the first compilation of existing data sets of women's AF injuries and highlight the need for a rigorous and systematic injury surveillance system to be instituted.
• Is physical activity, practiced as recommended for health benefit, a risk factor for osteoarthritis? Marie-Martine Lefèvre-Colau, Christelle Nguyen, Rebecca Haddad, et.al., Annals of Physical and Rehabilitation Medicine, Volume 59(3), pp.196-206, (June 2016). In this critical narrative review, we examine the role of physical activity (PA), recreational and elite sports in the development of knee/hip osteoarthritis (OA), taking into account the role of injury in this relationship. The process of article selection was unsystematic. Articles were selected on the basis of the authors’ expertise, self-knowledge, and reflective practice. In the general adult population, self-reported diagnosis of knee/hip OA was not associated with low, moderate or high levels of PA. For studies using radiographic knee/hip OA as a primary outcome, the incidence of asymptomatic radiographic OA was higher for subjects with the highest quartile of usual PA than the least active subjects. The risk of incident radiographic knee/hip OA features was increased for subjects with a history of regular sports participation (for osteophyte formation but not joint space narrowing). This risk depended on the type of sport (team and power sports but not endurance and running), and certain conditions (high level of practice) were closely related to the risk of injury. The prevalence of radiographic OA was significantly higher, especially the presence of osteophytes, in former elite athletes than controls. The risk of OA was higher with participation in mixed sports, especially soccer or power sports, than endurance sport. However, the prevalence of clinical OA between former elite athletes and controls was similar, with less hip/knee disability in former athletes. Moderate daily recreational or sport activities, whatever the type of sport, are not a consistent risk factor for clinical or radiographic knee/hip OA. Risk of injury in different sports may be the key factor to understanding the risk of OA related to sport.
• Self-reported worst injuries in women's Australian football identify lower limb injuries as a prevention priority, Fortington LV, Donaldson A, Finch CF, BMJ Open Sport and Exercise Medicine, Volume 2(1), (April 2016). Nationwide survey of women aged 17+ years who played in an AF competition was conducted following the 2014 playing season. The players' self-reported worst injury from the 2014 season is presented according to injury type, body part injured, treatment sought and games/training missed. Three-quarters of 553 respondents (n=431, 78%) reported at least 1 injury. Over half (n=235, 55%) of injuries were to the lower limb. Ankle ligament tears/sprains (n=50, 12% of all injuries) and knee ligament tears/sprains (n=45, 10%) were most frequent lower limb injuries reported. Two-thirds (65%) of all lower limb injuries led to at least 1 missed game. Of 111 (26% of all injuries) upper limb injuries reported, over half (n=57, 62%) were to the hand/fingers/thumb, including fractures (n=28, 6% of all injuries), ligament tears/sprains (n=18, 4%) and dislocations (n=11, 3%). Half of the upper limb injuries (51%) resulted in players missing matches/training.
• Injuries in community-level Australian football: Results from a club-based injury surveillance system, Christina L. Ekegren, Belinda J. Gabbe, Alex Donaldson, et.al., Journal of Science and Medicine in Sport, Volume 18(6), pp.651-655, (November 2015). Far fewer injury surveillance systems exist within community sport than elite sport. As a result, most epidemiological data on sports injuries have limited relevance to community-level sporting populations. There is potential for data from community club-based injury surveillance systems to provide a better understanding of community sports injuries. This study aimed to describe the incidence and profile of community-level Australian football injuries reported using a club-based injury surveillance system. Injury data for 1205 players were recorded in season one and for 823 players in season two. There was significant variability in injury incidence across clubs. However, aggregated data were consistent across football seasons, with an average of 0.7 injuries per player per season and 38–39 match injuries per 1000 h match exposure. A large proportion of injuries occurred during matches, involved the lower limb and resulted from contact.
• The incidence and burden of hospital-treated sports-related injury in people aged 15+ years in Victoria, Australia, 2004-2010: a future epidemic of osteoarthritis? C F Finch, J L Kemp, A J Clapperton, Osteoarthritis and Cartilage, Volume 23(7), pp.1138-1143, (July 2015). Previous sports injury is a known risk factor for subsequent osteoarthritis (OA), but population-based rates of sports injury are unknown. The aims of this study were to: (1) describe the trends in the population incidence and burden of all hospital-treated sports injury in Victoria, Australia in adults aged 15+ years; (2) determine the incidence of lower limb and knee injuries; and (3) quantify their population health burden as average direct hospital costs per injury and lengths of stay. The overall annual rate of hospital treated sports injuries increased by 24% (P = 0.001), and lower limb injuries by 26% (P = 0.001) over the 7 years. The associated accumulated economic burden was $265 million for all sports injuries and $110 million for lower limb injuries over the 7-years. The findings of this study show a significant increase in sports injuries in the state of Victoria, Australia over a 7-year period. As previous sports injury is a risk factor for the development of OA, the future incidence of OA will escalate, placing an even greater burden on health care systems. Population-wide preventative strategies that reduce the risk of sports injury are urgently required in order to reduce the future burden of OA.
• Medical-Attention Injuries in Community Australian Footbal: A Review of 30 Years of Surveillance Data From Treatment Sources, Ekegren, Christina, Gabbe, Belinda, Finch, Caroline, Clinical Journal of Sport Medicine, Volume 25(2), pp.162-172, (March 2015). A systematic search was carried out to identify peer-reviewed articles and reports presenting original data about Australian football injuries from treatment sources (hospitals, EDs, and health-care clinics). Data extracted included injury frequency and rate, body region, and nature and mechanism of injury. 12 publications were included. In most studies, Australian football contributed the greatest number of injuries out of any sport or recreation activity. Hospitals and EDs reported a higher proportion of upper limb than lower limb injuries, whereas the opposite was true for sports medicine clinics. In hospitals, fractures and dislocations were most prevalent out of all injuries. In EDs and clinics, sprains/strains were most common in adults and superficial injuries were predominant in children. Most injuries resulted from contact with other players or falling.
• Time to add a new priority target for child injury prevention? The case for an excess burden associated with sport and exercise injury: population-based study, Caroline Finch,  Anna Wong Shee, Angela Clapperton, BMJ Open, Volume 4(7), (July 2014). Analysis of routinely collected data relating to non-fatal hospital-treated sports injury and road traffic injury cases for children aged <15 years in Victoria, Australia, over 2004–2010, inclusive.
  • Over the 7-year period, 2004–2010, inclusive, in children aged <15 years the frequency of hospital-treated sports injury increased significantly (by 29%) whereas the frequency of hospital-treated road traffic injury cases among children decreased significantly (by 26%). Sports-related hospital-treated injuries were more than five times more common than road traffic injury.
  • Sports injury also accounted for a much larger healthcare burden than did road traffic injury, accounting for 3-fold the number of years living with disability (YLDs), 1.9-fold the number of bed-days and 2.6-fold the direct hospital costs.
  • Given the limitations in the routinely collected sports injury data, it was not possible to determine if the cases arose through highly competitive or high-intensity sport, informal sport or more recreational forms of these activities. To effectively target prevention strategies to groups at high risk for sports and recreational injuries without discouraging participation, participation rates and exposure data need to be collected.
  • This study clearly demonstrates that hospital-treated sports injuries accumulate an overall higher morbidity health burden than does hospital-treated road traffic injury for children aged <15 years. Currently road traffic injury prevention is a well-recognised and resourced public health issue, but sports injury prevention is not.
• Priorities for Investment in Injury Prevention in Community Australian Football, C.F. Finch, B. Gabbe, P. White, et.al, Clinical Journal of Sport Medicine, Volume 23(6), pp.430-438, (November 2013). Compilation of published prospectively collected injury data from 3 studies in junior community AF (1202 injuries in 1950+ players) and 3 studies in adult community AF (1765 injuries in 2265 players). This was supplemented with previously unpublished data from the most recent adult community AF injury cohort study conducted in 2007 to 2008. Injuries were ranked according to most common body regions, nature of injury, and mechanism. In all players, lower limb injuries were the most frequent injury in community AF and were generally muscle strains, joint sprains, and superficial injuries. These injuries most commonly resulted from incidental contact with other players, or from “overexertion.” Upper limb injuries were less common but included fractures, strains, and sprains that were generally caused by incidental contact between players and the result of players falling to the ground. Lower limb injuries are common in communityAF and could have an adverse impact on sustained participation in the game. Based on what is known about their mechanisms, it is likely that a high proportion of lower limb injuries could be prevented and they should therefore be a priority for injury prevention in community AF.
• Increasing incidence of hospitalisation for sport-related concussion in Victoria, Australia, Caroline Finch, Angela Clapperton, Paul McCrory, Medical Journal of Australia, Volume 198(8), pp.427-430, (May 2013). Analysis of routinely collected hospital admissions data from all Victorian hospitals (public and private) over the 2002–03 to 2010–11 financial years for patients aged ≥ 15 years with a diagnosis of concussion and an ICD-10-AM external cause activity code indicating sport. There were 4745 hospitalisations of people aged ≥ 15 years for sport-related concussion, with a total hospital treatment cost of $17 944 799. The frequency of hospitalisation increased by 60.5% (95% CI, 41.7%–77.3%) over the 9 years, but could only partially be explained by increases in sports participation, as the rate per 100 000 participants also increased significantly, by 38.9% (95% CI, 17.5%–61.7%). After adjustment for participation, rates were highest for motor sports, equestrian activities, Australian football, rugby and roller sports.
• Injury risk is different in team and individual youth sport, Daniel Theisen, Anne Frisch, Laurent Malisoux, et.al., Journal of Science and Medicine in Sport, Volume 16(3), pp.200-204, (May 2013). This study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries. Injury incidence was significantly higher in team compared with individual sports (6.16 versus 2.88 injuries/1000 h, respectively), as a result of a higher incidence of both traumatic, and overuse injuries. A Cox proportional hazards regression revealed that team sports participation had a hazard ratio of 2.00 compared to individual sports, with additionally previous injury being a risk and age a protective factor. The number of competitions per 100 days was significantly higher in team sports, whereas the number of intense training sessions per 100 days was significantly lower. In team sports, the number of competitions per 100 days was positively associated with injuries, while in individual sports the number of competitions per 100 days had a protective effect.

• Hospitalised Sports Injuries in Australia, Injury Matters, YouTube, (20 May 2020). Join Injury Matters with special guest Dr Sarah Harris from the Australian Centre for Research into Injury in Sport and its Prevention at Edith Cowan University as we discuss the findings from the Australian Institute Health and Welfare Report Hospitalised Sports Injury in Australia 2016-17.

• The surprise costs of common sports injuries, Bupa, (29 May 2017). Previous national research has shown that more than 36,000 Australians are hospitalised every year for sports related injuries, with thousands of others treated outside of hospital. Dr Dwayne Crombie, Managing Director of Bupa Health Insurance, said that while participation in sport delivered overwhelming health benefits, when injuries occurred costs could exceed as much as $5,000.

• Sports Injury Prevention Taskforce, Final report, Victorian Government, (2013). The Victorian Government established a Sports Injury Prevention Taskforce to examine the sports injury related barriers that prevent people from leading a more active lifestyle and to provide advice on improving risk management strategies and sports injury prevention. Some of the accumulative effects of sports injuries identified included:
  • 4x greater - the Victorian hospital related costs of sports injuries in children under 15 years, when compared with road traffic injury costs.
  • 6% per annum - the estimated annual growth in Victorian hospital emergency department presentations relating to sports injury (meanwhile road related injuries have stabilised).
  • 30% to 40% - the estimated percentage of participants experiencing a major sportsrelated injury that will discontinue playing sport and/or will significantly reduce their physical activity levels.
  • 20,000 – the estimated number of participants per year dropping out of sport in Victoria in 2020 due to a sports-related injury.
  • 545,000 the number of Australians reported to have a long-term health condition caused by a sport or exercise-related injury.
  • $1.65 billion and up to $2 billion – some recent estimates of the total burden each year of all sports injuries in Australia.
• Women's Injury Study (WIN), The Cooper Institute, (reserach published 2011-2013). We recruited 918 community-dwelling women to report their physical activity behaviors and any musculoskeletal injuries incurred weekly via a secure Internet webpage. Baseline testing included an orthopedic examination conducted by licensed physical therapists to identify impairments in muscle strength and flexibility and biomechanical/structural abnormalities. A complete orthopedic and musculoskeletal injury history was obtained at baseline and 909 women began reporting data. At the end of data collection (nearly 3 years later), 731 women were still actively reporting physical activity data. Numerous reports have been published in the peer-reviewed literature and presented at national scientific meetings. Importantly, this research provides nearly real-time assessment of physical activity behaviors and concurrent physical activity-related musculoskeletal injuries. Key findings are that the risk of musculoskeletal injury increases for those achieving the USDHHS Physical Activity Guidelines (=150 MVPA-minutes per week). However, the actual financial costs associated with these injuries are typically very small. The nature of the musculoskeletal injuries resulting from physical activity is generally consistent with those occurring as a result of non-physical activity behaviors. The best predictor of subsequent musculoskeletal injury is having a previous musculoskeletal injury. Biomechanical, muscular strength, and flexibility factors are generally unrelated to self-reported physical activity-related musculoskeletal injury. Healthcare providers can feel comfortable recommending physically active lifestyle behaviors to community-dwelling women, knowing that there is a modest increase in risk of musculoskeletal injury, the actual medical costs are minimal, and that injury is generally unrelated to any specific musculoskeletal abnormality. The actual physical and financial costs associated with being physically active are small compared to the increased quality of life and positive health outcomes associated with a physically active lifestyle.

• Playing sport injured is associated with osteoarthritis, joint pain and worse health-related quality of life: a cross-sectional study, Garrett Bullock, Gary Collins, Nick Peirce, et.al., BMC Musculoskeletal Disorders, Volume 21, article 111, (February 2020). Sports participants are faced with the decision to continue or cease play when injured. The implications of playing sport while injured on joint health and health-related quality of life (HRQoL) has not been investigated. The purpose of this study was to investigate the relationship between having played sport while injured and HRQoL, osteoarthritis, and persistent joint pain; and compare findings in elite and recreational cricketers. Of the 2233 current and former cricketers (mean age: 51.7 SD 14.7, played 30 IQR 24 cricket seasons, 60% were current cricketers, 62% played recreationally; median PCS: 51.4 IQR 9.0; MCS: 54.3 IQR 8.6) 1719 (77%) had played sport while injured. Cricketers that had played sport injured had impaired HRQoL, increased odds of osteoarthritis and persistent joint pain, compared to those who had not played sport injured. Playing sport injured was only related to impaired mental-components of HRQoL in elite cricketers. The long-term impact of playing while injured on musculoskeletal health, should be considered when advising athletes on their ability to compete following injury.
• Quantifying the likelihood and costs of hip replacement surgery after sports injury: A population-level analysis, Ilana Ackerman, Megan Bohensky, Joanne Kemp, et.al., Physical Therapy in Sport, Volume 41, pp.9-15, (January 2020). This research aimed to quantify the likelihood of hip replacement (HR) surgery at a population level up to 15 years after sports injury. The cohort was established by linking administrative datasets capturing all hospital admissions and emergency department (ED) presentations. All sports injury presentations from 2000 to 2005 and HR admissions from 2000 to 2015 were identified using ICD-10-AM codes. Over the study period there were 64,750 sports injuries (including 815 hip or thigh musculoskeletal injuries) that resulted in ED presentation or hospitalisation, and 368 HR procedures. Compared to all other sports injuries, having a hip or thigh injury tripled the hazard of subsequent HR in multivariate analysis. Of the main hip or thigh injury types, femoral fractures and hip dislocations were significantly associated with HR. The authors conclude that sports-related hip or thigh musculoskeletal injury is associated with a significantly higher likelihood of HR within 15 years, average time from sports-related hip injury to hip replacement was 5 years, and estimate that hip replacement costs for the sports-injured cohort exceeded $AUD 10 million. Effective injury prevention and appropriate post-injury management are needed to curtail this population burden.
• Sports Participation and Health Care Costs in Older Adults Aged 50 Years or Older, Jamile Codogno, Henrique Monteiro, Bruna Turi-Lynch, et.al., Journal of Aging and Physical Activity, Volume 28(4), pp.634-640, (2020). The objective of the study was to analyze the relationship between sports participation and health care costs in older adults. The sample was composed of 556 participants (145 men and 411 women) who were followed from 2010 to 2014. The engagement in sports considered three different components (intensity, volume, and previous time). Health care costs were assessed annually through medical records. Structural equation modeling (longitudinal relationship between sport and costs) and analysis of variance for repeated measures (comparisons over time) were used. Health care costs increased significantly from 2010 to 2014 . Higher baseline scores for intensity were related to lower health care costs. Similar results were found to volume and time of engagement. In conclusion, higher sports participation is related to lower health care costs in older adults.
• Infographic. Sports injury-related hospitalisations in Australian children: incidence, costs and trends, Lystad RP, Tran J, Curtis K, et al., British Journal of Sports Medicine, Volume 53(22), pp.1434-1435, (October 2019). Although the benefits of participation in sporting activities are undisputed, injury is a common adverse outcome. Despite the increasing recognition of the issue worldwide, there is very limited high-quality population-based data quantifying the burden of sports injuries in children and monitor changes over time. Such data are essential for decision-makers to prioritise and develop policy and for stakeholders and researchers to evaluate the impact of sports injury prevention efforts in the real-world setting.
• Likelihood of knee replacement surgery up to 15 years after sports injury: A population-level data linkage study, Ilana Ackerman, Megan Bohensky, Joanne Kemp, et.al., Journal of Science and Medicine in Sport, Volume 22(6), pp.629-634, (June 2019). This population-level study aimed to quantify the likelihood of KR surgery and direct healthcare costs 10–15 years after sports injury. The cohort was established by linking two key administrative datasets capturing all hospital admissions and emergency department (ED) presentations in Victoria, Australia from 2000-2015. Over the study period there were 64,038 sports injuries (including 7205 knee injuries) resulting in ED presentation or hospitalisation, and 326 KR procedures. Multivariate analysis showed that having a knee injury more than doubled the hazard of subsequent KR, compared to all other sports injuries. Direct healthcare costs for KR totaled $AUD7.93 million for the cohort, with 21% of costs attributable to the knee injury group. The authors conclude that sports-related knee injury manifests in a significantly greater likelihood of KR, at considerable cost to society. Targeted health policy and effective interventions are needed to prevent sports-related knee injuries and contain this substantial burden.
• Incidence, costs, and temporal trends of sports injury-related hospitalisations in Australian children over a 10-year period: A nationwide population-based cohort study, Reidar Lystad, Kate Curtis, Gary Browne, et.al., Journal of Science and Medicine in Sport, Volume 22(2), pp.175-180, (February 2019). This study used linked hospitalisation and mortality data of children aged ≤16 years who were hospitalised for sports-related injury in Australia from 1 July 2002 to 30 June 2012. There were 130,167 sports injury-related hospitalisations during the 10-year study period. The overall annual incidence rate was 281.0 per 100,000 population. Males and older children were more frequently hospitalised than their female and younger counterparts. The most common sports activities resulting in hospitalisation were team ball sports (43.1%) and wheeled non-motor sport (22.3%). There was no significant annual decline in the overall incidence rate during the 10-year study period. The estimated total hospital treatment cost was $396 million, with an estimated mean cost per injured child of $3058.
• The incidence and burden of hospital-treated sports-related injury in people aged 15+ years in Victoria, Australia, 2004-2010: a future epidemic of osteoarthritis? C F Finch, J L Kemp, A J Clapperton, Osteoarthritis and Cartilage, Volume 23(7), pp.1138-1143, (July 2015). Previous sports injury is a known risk factor for subsequent osteoarthritis (OA), but population-based rates of sports injury are unknown. The aims of this study were to: (1) describe the trends in the population incidence and burden of all hospital-treated sports injury in Victoria, Australia in adults aged 15+ years; (2) determine the incidence of lower limb and knee injuries; and (3) quantify their population health burden as average direct hospital costs per injury and lengths of stay. The overall annual rate of hospital treated sports injuries increased by 24% (P = 0.001), and lower limb injuries by 26% (P = 0.001) over the 7 years. The associated accumulated economic burden was $265 million for all sports injuries and $110 million for lower limb injuries over the 7-years. The findings of this study show a significant increase in sports injuries in the state of Victoria, Australia over a 7-year period. As previous sports injury is a risk factor for the development of OA, the future incidence of OA will escalate, placing an even greater burden on health care systems. Population-wide preventative strategies that reduce the risk of sports injury are urgently required in order to reduce the future burden of OA.
• Time to add a new priority target for child injury prevention? The case for an excess burden associated with sport and exercise injury: population-based study, Finch CF, Wong Shee A, Clapperton A, BMJ Open, Volume 4(7), (July 2014). Analysis of routinely collected data relating to non-fatal hospital-treated sports injury and road traffic injury cases for children aged <15 years in Victoria, Australia, over 2004–2010, inclusive. Over the 7-year period, the annual frequency of non-fatal hospital-treated sports injury increased significantly by 29% (from N=7405 to N=9923; p<0.001) but the frequency of non-fatal hospital-treated road traffic injury decreased by 26% (from N=1841 to N=1334; p<0.001). Sports injury accounted for a larger population health burden than did road traffic injury on all measures: 3-fold the number of YLDs (7324.8 vs 2453.9); 1.9-fold the number of bed-days (26 233 vs 13 886) and 2.6-fold the direct hospital costs ($A5.9 millions vs $A2.2 millions). The authors conclude that the significant 7-year increase in the frequency of hospital-treated sports injury and the substantially higher injury population-health burden (direct hospital costs, bed-day usage and YLD impacts) for sports injury compared with road traffic injury for children aged <15 years indicates an urgent need to prioritise sports injury prevention in this age group.
• The impact of sport and active recreation injuries on physical activity levels at 12 months post-injury, N. Andrew, R. Wolfe, P. Cameron,, Scandinavian Journal of Medicine and Science in Sports, Volume 24(2), pp.377-385, (April 2014). Adults admitted to hospital with sport and active recreation-related injuries, and captured by the Victorian Orthopaedic Trauma Outcomes Registry were recruited to the study. Changes between preinjury and 12 month post-injury physical activity was assessed using the short International Physical Activity Questionnaire (IPAQ). Independent demographic, injury, and hospital variables were assessed for associations with changes in physical activity levels, using multivariate linear regression. A total of 324 patients were recruited, of which 98% were followed up at 12 months. Mean short IPAQ scores decreased from 7650 METS preinjury to 3880 METS post-injury, independent of functional recovery. Education level and occupation group were the only variables independently associated with changes in physical activity levels post-injury. These results highlighted that sport and active recreation injuries lead to significant reductions in physical activity levels. Hence, the prevention of sport and active recreation injuries is important when considering promotion of activity at a population level.
• Costs Associated With Women’s Physical Activity Musculoskeletal Injuries: The Women’s Injury Study, Robert Kaplan, Alison Herrmann, James Morrison, et.al., Journal of Physical Activity and Health, Volume 11(6), pp.1149-1155, (2014).Despite benefits of physical activity (PA), exercise is also associated with risks. Musculoskeletal injury (MSI) risk increases with exercise frequency/intensity. MSI is associated with costs including medical care and time lost from work. Participants included 909 women in the Women’s Injury Study reporting PA behaviors and MSI incidence weekly via the Internet for up to 3 years (mean follow-up 1.89 years). Participants provided consent to obtain health records. Costs were estimated by medical records and self-reports of medical care. Components included physician visits, medical facility contacts, medication costs, and missed work.Of 909 participants, 243 reported 323 episodes of expenditure or contact with the health care system associated with PA. Total costs of episodes ranged from $0–$18,934. Modal cost was $0 (mean = $433 ± $1670). Costs were positively skewed with nearly all participants reporting no or very low costs. The authors conclude that about 1 in 4 community-dwelling women who are physically active experienced a PA-related MSI. The majority of injuries were minor, and large expenses associated with MSI were rare. The long-term health benefits and costs savings resulting from PA likely outweigh the minor costs associated with MSI from a physically-active lifestyle.

• International Olympic Committee Consensus Statement: Methods for Recording and Reporting of Epidemiological Data on Injury and Illness in Sports 2020 (Including the STROBE Extension for Sports Injury and Illness Surveillance (STROBE-SIIS)), International Olympic Committee Injury and Illness Epidemiology Consensus Group, Roald Bahr, Ben Clarsen, Wayne Derman, et.al., Orthopaedic Journal of Sports Medicine, Volume 8(2), (February 2020). This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems, severity of health problems, capturing and reporting athlete exposure, expressing risk, burden of health problems, study population characteristics, and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE extension—the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS).
• Injury and illness definitions and data collection procedures for use in epidemiological studies in Athletics (track and field): Consensus statement, Timpka T, Alonso J, Jacobsson J, et.al., British Journal of Sports Medicine, Volume 48(7), pp.483-490, (March 2014). This consensus statement provides definitions and methodological guidance for epidemiological studies in Athletics. Consistent use of the definitions and methodological guidance would lead to more reliable and comparable evidence.

Sport injury data project, Australian Sports Commission/Australian Institute of Health and Welfare, (accessed 18 February 2022). The Australian Sports Commission, incorporating Sport Australia and the Australian Institute of Sport (AIS), have commissioned the Australian Institute of Health and Welfare (AIHW) to investigate the existing and potential data sources for sport injury, with a view to develop a national sports injury data collection. This project will also assess the economic impact of participation in sport and physical activity. This study will not only look at the costs to the health system of sport injuries, but also investigate the potential savings associated with better health outcomes attributed through increased sports participation and physical activity. The development of this collection will:

• provide insight into the types and causes of sports injury in the community
• help sport and their participants understand where injury prevention programs are needed
• provide ongoing surveillance to monitor trends and allow the impact of injury prevention programs to be evaluated.

Victorian Injury Surveillance Unit (VISU), Monash University, (accessed 2 June 2021). VISU has been analysing, interpreting and disseminating Victorian data on injury deaths, hospital admissions and emergency department presentations across the state, nationally and internationally for more than 25 years. This critical information is provided to around 250 organisations and agencies each year, including Commonwealth, state and local government departments and agencies, health and injury prevention organisations, media, business and industry, education institutes, research groups, and the community.

• e-Bulletins, fact sheets and other VISU reports. E-Bulletins summarise the analysis of the latest available year of death or unintentional hospital-treated injury data overall and by age group (children aged 0-14 years, adolescents and young adults aged 15-24 years, adults aged 25-64 years, and older adults aged 65 years and older). Analysis covers the frequency, rate, trends, causes, location, type of injury and body region injured.

• Guidance for sports injury surveillance: the 20-year influence of the Australian Sports Injury Data Dictionary, Finch CF, Staines C, Injury Prevention, Volume 24(5), pp.372-380, (September 2018). Injury prevention requires information about how, why, where and when injuries occur. The Australian Sports Injury Data Dictionary (ASIDD) was developed to guide sports injury data collection and reporting. Sports Medicine Australia (SMA) disseminated associated data collection forms and an online tool to practitioners and the sports community. This paper assesses the long-term value, usefulness and relevance of the ASIDD and SMA tools. The authors conclude that the ASIDD boasts a long history of use and relevance. Its ongoing use by practitioners has been facilitated by the ready availability of specific data collection forms by SMA for them to apply to directly their settings. Injury prevention practitioners can be strongly engaged in injury surveillance activities when formal guidance is supported by user-friendly tools directly relevant to their settings and practice.
• Injury surveillance in community sport: Can we obtain valid data from sports trainers? C. L. Ekegren, B. J. Gabbe, C. F. Finch, Scandinavian Journal of Medicine and Science in Sports, Volume 25(3), pp.315-322, (June 2015). A lack of available injury data on community sports participants has hampered the development of informed preventive strategies for the broad-base of sports participation. In community sports settings, sports trainers or first-aiders are well-placed to carry out injury surveillance, but few studies have evaluated their ability to do so. The aim of this study was to investigate the reporting rate and completeness of sports trainers' injury records and agreement between sports trainers' and players' reports of injury in community Australian football. Throughout the football season, one sports trainer from each of four clubs recorded players' injuries. To validate these data, we collected self-reported injury data from players via short message service (SMS). In total, 210 discrete injuries were recorded for 139 players, 21% by sports trainers only, 59% by players via SMS only, and 21% by both. Completeness of injury records ranged from 95% to 100%. Agreement between sports trainers and players ranged from K = 0.32 for date of return to football to K = 1.00 for activity when injured. Injury data collected by sports trainers may be of adequate quality for providing an understanding of the profile of injuries. However, data are likely to underestimate injury rates and should be interpreted with caution.
• Time to add a new priority target for child injury prevention? The case for an excess burden associated with sport and exercise injury: population-based study, Caroline Finch, Anna Wong Shee, Angela Clapperton, BMJ Open, Volume 4(7), (July 2014). Analysis of routinely collected data relating to non-fatal hospital-treated sports injury and road traffic injury cases for children aged <15 years in Victoria, Australia, over 2004–2010, inclusive. Over the 7-year period, 2004–2010, inclusive, in children aged <15 years the frequency of hospital-treated sports injury increased significantly (by 29%) whereas the frequency of hospital-treated road traffic injury cases among children decreased significantly (by 26%). Sports-related hospital-treated injuries were more than five times more common than road traffic injury.Sports injury also accounted for a much larger healthcare burden than did road traffic injury, accounting for 3-fold the number of years living with disability (YLDs), 1.9-fold the number of bed-days and 2.6-fold the direct hospital costs.Given the limitations in the routinely collected sports injury data, it was not possible to determine if the cases arose through highly competitive or high-intensity sport, informal sport or more recreational forms of these activities. To effectively target prevention strategies to groups at high risk for sports and recreational injuries without discouraging participation, participation rates and exposure data need to be collected.This study clearly demonstrates that hospital-treated sports injuries accumulate an overall higher morbidity health burden than does hospital-treated road traffic injury for children aged <15 years. Currently road traffic injury prevention is a well-recognised and resourced public health issue, but sports injury prevention is not
• Getting sports injury prevention on to public health agendas – addressing the shortfalls in current information sources, Caroline Finch, British Journal of Sports Medicine, Volume 46(1), pp.70-74, (2012). This paper argues that the major reason for a lack of sports injury policy by government departments for health or sport to date is a lack of relevant information available for policy makers to make their decisions. Key information gaps evident in Australia are used to highlight this problem. SIP policy does not yet rank highly because, relative to other health/injury issues, there is very little hard evidence to support: claims for its priority ranking, the existence of solutions that can be implemented and which will work, and potential cost-savings to government agencies. Moreover, policy action needs to be integrated across government portfolios, including sport, health and others. Until sports medicine research generates high-quality population-level information of direct relevance and importance to policy makers, especially intervention costing and implementation cost-benefit estimates, and fully engage in policy-informing partnerships, SIP will continue to be left off the public health agenda.

• Best Practice Guidelines: Injury Reporting, Australian Institute of Sport, (accessed 16 June 2021). The intent of this document is to deliver an update to Version 1 of the AIS Data Dictionary provided in 2014. It aims to combine a ‘gold standard’ of surveillance procedures and principles with operational efficiency for the clinician who is required to enter the data and maintain record accuracy. As a result of improving the reporting processes across Australian sports, the sporting system will be in a greater position to progress through the prevention process to optimise athlete health and improve the probability of achieving success.
  • Athlete Management System (AMS), Australian Institute of Sport, (accessed 16 June 2021). The AMS allows the Australian sporting network to combine resources while avoiding duplication to better provide data driven outcomes for sport. To date, the AMS has recorded over 1,500,000 training sessions and over 300,000 injury treatments from over 10,000 athletes across 42 sporting organisations. Using this data we have been able to reduce the risk of injury and increase awareness and education to data users.
• Australian Sports Injury Data Dictionary, Sports Medicine Australia, (accessed 16 June 2021). Developed to provide guidelines for injury data collection and classification for the prevention and control of injury in sport and recreation. The Dictionary has been written to assist sporting and recreation organisations, researchers, sports medicine professionals, first-aiders and individual clubs collect information on sports injury. The sporting organisation or researcher may customise a data collection form to suit their needs or choose to use the sport-specific form templates provided.
• Burden Calculator, (last update 2015). Burden Calculator is a simple and open analytical tool that can be used to estimate the burden of injuries in a population using data on the incidence of deaths and non-fatal injuries. The tool aims to simplify earlier methodology, while retaining the features most important for evidencebased estimation of the burden of injuries. The tool will evolve through contributions and collaborations of the injury statistics community. Users are encouraged to provide better input parameters, conduct validation studies, perform cross-country comparisons, and to contribute their results and modifications to the project website.

• Subsequent injury classifications and their role in injury prevention strategies, Prof. Caroline Finch, Director, Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University, AIS SmartTalk, (8 May 2014).