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Characterizing Health Events That Prevent Return To Play In Elite Collegiate Swimmers

Characterizing Health Events That Prevent Return To Play In Elite Collegiate Swimmers

Rishi Trikha, MD, UNITED STATES Danielle Greig, MD, UNITED STATES Grant Schroeder, BA, UNITED STATES Thomas J. Kremen, MD, UNITED STATES

University of California, Los Angeles, Santa Monica, CA, UNITED STATES


2021 Congress   ePoster Presentation     rating (1)

 

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Summary: Shoulder injuries, in particular shoulder impingement symptoms, were the most commonly diagnosed musculoskeletal injury in collegiate swimmers, however, they are not associated with high rates of early termination of athletic career when compared to other musculoskeletal injuries or concussions.


Introduction

There is limited available data regarding the incidence, type and extent of injuries and illnesses that affect competitive swimming athletes, particularly among elite swimmers. This study aimed to identify the most common health events observed among elite competitive swimmers as well as to characterize how these types of health events can affect return to play.

Methods

Retrospective data was acquired from a deidentified injury and illness database of swimming athletes who participated in NCAA Division I intercollegiate competitions within the United States Pac-12 conference between 2016 and 2020. Analysis of recorded health events was performed including musculoskeletal injuries stratified by body location, concussion injuries, medical illnesses and mental health conditions. Health events were recorded regardless of whether they occurred during swimming or non-swimming activities. Return to play (RTP) data was characterized as either RTP during the same season, season-ending, or career-ending. Fisher’s exact test was used to evaluate categorical variables with a p-value of < 0.05 being significant.

Results

A total of 1030 health events were observed in our dataset and were included in our analysis. There were 635 (61.7%) health events among females and 395 (38.3%) among males. Of the 1030 health events, 550 (53.4%) were musculoskeletal injuries, 415 (40.3%) were medical illnesses, 56 (5.4%) were concussions and 9 (0.9%) were mental health conditions. The most common specific injuries were concussions (56; 5.4%), shoulder impingement (35; 3.4%), lumbar strain (34; 3.3%), lateral ankle sprains (25; 2.4%) and groin/hip strains (24; 2.3%).

Of the 550 reported musculoskeletal health events there were 126 shoulder injuries (22.9%), 102 spine injuries (18.5%), 81 injuries below the knee (14.7%), 79 face/head injuries (14.4%), and 69 knee/thigh injuries (12.5%).

Of the 56 documented concussions, 26 (46.4%) were season-ending with 14 of those 26 (53.8%) concussions being career-ending injuries. Eighteen of the 415 (4.3%) medical illnesses were career-ending and 2 of the 9 (22.2%) mental health conditions were career-ending. Four of the 69 knee injuries (5.8%) were career-ending as compared to 3 of the 57 (5.3%) wrist/hand injuries. Only 1 out of 126 (0.8%) shoulder injuries, with none of the 35 shoulder injuries characterized as impingement, were career-ending. Concussions were significantly more likely (p<0.01) to be career-ending than knee injuries. Knee injuries were significantly more likely (p=0.05) to be career-ending than shoulder injuries.

Discussion/Conclusion:
This retrospective study identifies the most common health events as well as the most common season or career-ending injuries and health events observed in a population of elite collegiate competitive swimmers. Although shoulder injuries, in particular shoulder impingement symptoms, were the most commonly diagnosed musculoskeletal injury in this patient population, they were not associated with high rates of early termination of athletic career when compared to other musculoskeletal injuries or concussions. Although many current injury prevention strategies among competitive swimmers focus on shoulder injuries, an increased awareness of the incidence of other musculoskeletal injuries and concussions in this population may allow for more targeted injury prevention approaches that may ultimately serve to further prolong the career of elite competitive swimming athletes.