Health problems and injury management in adolescent handball: the Safeplay one-season cohort study of 679 players.

Abstract

To assess (1) the 1-year prevalence of previous shoulder, knee and ankle injuries; (2) the in-season prevalence proportion (prevalence) of injuries and illnesses, injury incidence rate (ir) and injury burden (product of ir and weeks with injuries); (3) initial injury management strategies. We conducted a cohort study of 679 highest-division Danish handball players aged 14-18. Players self-reported past-year shoulder, knee and ankle injuries at baseline, and weekly information on any handball-related injuries (irrespective of time loss and medical attention), illnesses, exposure hours and injury management over 31 weeks. At baseline, 46% (95% CI 42% to 49%) of the players reported a past-year shoulder, knee or ankle injury. The weekly average injury and illness prevalence was 21% (95% CI 19% to 23%) and 2% (95% CI 1.7% to 2.3%), respectively, and the ir was 9.4 (95% CI 8.7 to 10.2)/1000 hours. Females experienced the highest injury burden from knee injuries (ir: 1.7 (95% CI 1.3 to 2.2) × 6.7 (95% CI 4.7 to 8.7) weeks with injury/1000 hours), while males experienced the highest injury burden from shoulder injuries (ir: 1.3 (95% CI 1.0 to 1.7) × 5.7 (95% CI 3.6 to 7.8) weeks with injury/1000 hours). Health professionals were consulted in 58% (95% CI 54% to 62%) of injuries, players independently made the return to sport decision in 44% (95% CI 37% to 51%) of injury recurrences, and used analgesics, mainly (91% (95% CI 85% to 95%)) sourced from home, in 24% (95% CI 21% to 28%) of injuries. Almost half of highest-division adolescent Danish handball players reported a previous past-year shoulder, knee or ankle injury. Any time during the season, 21% reported an injury and 2% an illness. The highest injury burdens were from knee injuries in females and shoulder injuries in males. Health professionals often managed injuries, but players frequently made return to sport decisions independently and commonly used analgesics sourced from home.