Basketball and cycling rank highest in U.S. recreational injuries

Aug 3 2004

Basketball, cycling, football and soccer will be on the minds of millions of Americans as they watch the Summer Olympic games, but Loyola University Health System’s Dr. Pietro Tonino is cautioning the public that these sports are the ones that have the most injuries.

In 2003, more than 1.6 million injuries related to basketball were treated at hospitals, doctors’ offices, ambulatory surgery centers, clinics and hospital emergency rooms in the U.S., according to Tonino, assistant professor of orthopaedic surgery, Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago Stritch School of Medicine, Maywood, Ill.

“Bicycles ranked second highest with nearly 1.3 million injuries, followed by football with one million injuries,” said Tonino, co-director, division of Sports Medicine, Loyola University Health System, Maywood, Ill. “Soccer came in fourth at 456,320 injuries.”

Tonino analyzed new data from the U.S. Consumer Product Safety Commission (CPSC) and compiled a list of the 15 sports with the greatest number of medically treated injuries:

Recreational Activity Number of Injuries:

• Basketball 1,622,781
• Bicycles 1,299,987
• Football 1,035,450
• Soccer 456,320
• Baseball 417,479
• Swimming/Diving 364,116
• Softball 318,637
• Trampolines 244,564
• Skateboards 241,734
• Weightlifting 218,381
• Horseback 195,446
• Volleyball 161,240
• Golf 141,797
• In-line skating 114,574
• Roller-skating 114,338

“The Summer Olympic games may inspire people to try new a sport,” said Tonino. “But before they do, people need proper training and conditioning to reduce their injury risk. Athletes, youngsters and weekend warriors alike can wind up in hospital emergency rooms for injuries related to these sports.”

Many injuries can be prevented, according to Tonino, by knowing and playing by the rules of the game, being physically fit and wearing protective gear. “This applies to children as well as to adults,” he said.

Tonino noted that females are two- to eight times more likely than males to sustain one of the most common knee injuries in sports, a non-contact anterior cruciate ligament (ACL) injury. The ACL, a rope-like bundle of fibrous tissue in the center of the knee, connects the front of the lower leg (shinbone) with the back of the upper leg (thighbone) and helps a person bend their knee, jump and squat. Seventy percent of ACL injuries are non-contact; the other 30 percent result from collison with a person or an object.

“The ACL can be sprained or torn in sports where the athlete jumps, lands, twists, pivots or suddenly stops,” said Tonino. Such sports include basketball, soccer, football, volleyball, running and skiing.

“In contrast to males, females tend to land from a jump with their knees locked, which puts added pressure on the knee,” he said. “The result can be a sprain or tear of the ACL.”

Slightly bending the knees and hips when landing will reduce injury risk. “When playing basketball and volleyball, position the buttocks as if one was about to sit down in a chair, rather than standing upright,” he said. “Players also should land on their forefoot, not their heel.”

Uneven surfaces, such as sand, raise the risk of ACL injury. “Soccer is very unpredictable because people are sliding into each other,” said Tonino. “Players rarely stand still.” Tonino said that female athletes should strengthen their hamstrings, the muscles located in the back of the thigh.

Many ACL injuries occur in females ages 15 to 25 years. Research is underway to determine the reasons. “Injury prevention programs are being developed to improve females’ neuromuscular movement, build flexibility and increase awareness of at-risk positions,” said Tonino.

He said that the proper position to shoot a basketball, for example, is:

• Feet shoulder-width apart
• Knees slightly bent
• Buttocks sticking out as if one was about to sit down in a chair
• Chest up
• Look up
• Do not lean over and do not look at the floor

The proper position to pass a volleyball is:

• Feet positioned a little wider than shoulder-width apart
• One foot slightly in front of the other
• Avoid standing upright; bend hips and knees
• Arms below shoulder-height
• Keep on forefeet, not heels

An ACL injury can be surgically repaired, but recovery and rehabilitation takes the athlete out of the game for months. Non-surgical treatment is available for mild injuries. “Preventing ACL sprains and ruptures is worth the time required for training and exercise,” said Tonino.