Catastrophic Injuries in Sports and Recreation

Catastrophic Injuries in Sports and Recreation: Causes and Prevention - A Canadian Study

EDITED BY CHARLES H. TATOR
Copyright Date: 2008
https://www.jstor.org/stable/10.3138/9781442687561
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  • Book Info
    Catastrophic Injuries in Sports and Recreation
    Book Description:

    Catastrophic Injuries in Sport and Recreationis an essential reference guide to safe participation in a wide variety of sports and recreational activities.

    eISBN: 978-1-4426-8756-1
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-xii)
  3. Editor’s Acknowledgments
    (pp. xiii-xiv)
  4. Contributors
    (pp. xv-xvi)
  5. SECTION 1. INTRODUCTION AND OVERVIEW

    • 1 Description of the Study
      (pp. 3-20)
      CHARLES H. TATOR

      For any given population, injuries sustained in connection with sports and recreational activities account for a significant proportion of all injuries, and of these, the catastrophic ones – such as brain or spinal cord trauma and fatalities – comprise a significant proportion.1–7Catastrophic injuries can result in death or lifelong disability, with major effects of all kinds on the injured individuals and their families, and major financial costs to society for medical care, supports, and services, and for the replacement of lost earnings. The risk factors associated with injuries acquired in sports and recreational activities, and the particular causes of such...

    • 2 Overview of the Results of the Ontario Study, 1986–1995
      (pp. 21-57)
      CHARLES H. TATOR

      The total number of catastrophic injuries in the 4 survey years (1986, 1989, 1992, and 1995) used in this study was 2,154, consisting of 1,523 (70.7%) survivors and 631 (29.3%) fatalities (Table 2.1). Although the total number of injuries in each survey year was similar, there were fewer fatalities in the first survey year, most likely because of difficulties in the identification of relevant cases in the coroner’s office, a problem that was corrected in the following three years surveyed. In the first two surveys (1986 and 1989, as noted in Chapter 1 and Table 1.1), prospective questionnaires were mailed...

    • 3 Sports Injury Prevention: General Principles
      (pp. 58-78)
      CHRISTINE PROVVIDENZA and CHARLES H. TATOR

      More people today are participating in sports and recreational activities not only for enjoyment, but to improve their health and physical fitness. Others participate for leisure and competition, and for some, sports and recreation are professions. Unfortunately, these activities involve the risk of injury. An injury may arise when unintentional or intentional damage occurs to the body from activities involving physical effort, carried out for enjoyment or relaxation purposes.¹ For minor injuries, the severity is often measured by time lost from participation, whereas catastrophic injuries are usually classified as either fatal or non-fatal. Catastrophic injury is a serious problem in...

    • 4 Geographical Locations Where 2,154 Catastrophic Sports and Recreation Injuries Were Sustained
      (pp. 79-118)
      CHARLES H. TATOR

      This chapter focuses on the geographical locations where during the four survey periods (1986, 1989, 1992, and 1995) 2,154 individuals sustained catastrophic injuries while taking part in sports and recreational activities. Close examination of the relationship between location and injury events should be helpful to governments and organizations charged with the responsibility for planning, implementing, and monitoring injuries and injury prevention programs. Such knowledge should enable key individuals across Ontario to target the activities and age groups in their own locations who are particularly at risk for sustaining catastrophic injuries in sports and recreation. Thus, this chapter is directed especially...

    • 5 Anatomical Locations and Types of Ontarians’ Catastrophic Injuries
      (pp. 119-128)
      ALUN ACKERY and CHARLES H. TATOR

      In this study, the following classification of anatomical location of catastrophic injuries was used: sudden death, drowning, head, spine, eye, abdomen, chest, face, limb, and miscellaneous. It should be noted that often numerous injuries result from one traumatic event, and these are called multiple trauma cases. Our study documented all the catastrophic injuries in every event, and these ae summarized in Table 5.1 (fatalities) and Table 5.2 (survivors). Below are descriptions of each type of catastrophic injury, starting with outright deaths and then injuries that may have been fatal or not, presented in rank order according to total mentions for...

  6. SECTION 2. WATER SPORTS

    • 6 Canoeing
      (pp. 131-138)
      YUSRA AHMAD and CHARLES H. TATOR

      Canoeing traces its origins to the dawn of human culture with the earliest canoes dating from 6000 B.C. North America was a fertile ground for the development of canoes, with indigenous peoples building them from a frame of wooden ribs covered with the lightweight bark of birch trees, and sometimes elm or cedar. Canoes were meant to be light, streamlined, and easy to manoeuvre through the rapids in the rivers of the North American wilderness. European settlers and voyageurs adapted indigenous peoples’ canoes for their needs. With the building of transcontinental railways, however, the commercial role of the canoe eroded,...

    • 7 Sailing
      (pp. 139-147)
      PEMMA MUZUMDAR

      Sailing continues to increase in popularity as both a sport and recreational activity. Regions such as the Caribbean, Australia, the Mediterranean basin of Europe, and the North American coasts attract millions of sailors, especially during the summer months.¹ In Canada marine activities on the east and west coasts have shown steady growth. There is also a great deal of sailing activity in the country’s numerous inland lakes and rivers. In 2000 Canada was reported to have 3.5 million recreational boats, with almost 20% of them in British Columbia.²

      Sailing injuries result from a lack of proper safety equipment, alcohol consumption,...

    • 8 Personal Watercraft
      (pp. 148-157)
      DOUGLAS J. COOK and CHARLES H. TATOR

      The personal watercraft (PWC) industry began in the late 1960s with the first commercially available Seadoo® from Bombardier. This initial offering was not popular, and it was not until the 1970s when the Kawasaki Jet-Ski® was introduced that the PWC became a common public pastime. The Bombardier model required the passenger to sit while driving, whereas Kawasaki incorporated sitting and standing positions. The current PWC industry has several manufacturers with different models available, including sitting or standing models and single or multiple user models for up to four people.

      PWC are powered by a jet of water generated by the...

    • 9 Other Boating Activities
      (pp. 158-168)
      PEMMA MUZUMDAR and CHARLES H. TATOR

      This chapter includes boating activities other than canoeing, sailing, and the use of personal watercraft. Recreational boating is often enjoyed as a relaxing activity, but boating also entails considerable risk of injury. To ensure that boating remains pleasurable, precautions must be taken to avoid injury. Safety measures such as abstaining from alcohol use and wearing a personal floatation device (PFD) decrease the risk of fatality from drowning and hypothermia. Non-fatal catastrophic injuries, such as the loss of a limb because of a propeller strike, can also be prevented. This chapter discusses injuries associated with recreational boating, and offers prevention strategies....

    • 10 Fishing
      (pp. 169-179)
      YUSRA AHMAD and CHARLES H. TATOR

      In both Canada and the United States, fishing ranks as the second most popular water sport, surpassed only by recreational swimming.¹ Ontario, in particular, has the distinction of having the largest freshwater fishery in Canada, and indeed, one of the largest in the world. What distinguishes fishing from other sports is its appeal and accessibility to all ages, ethnoracial groups, and socioeconomic backgrounds.1,2School-aged youngsters who can swim can partake in the pleasures of fishing on an almost equal footing with seniors. Basic fishing does not require extravagant equipment, specialized training, or extra physical conditioning. In spite of factors that...

    • 11 Diving
      (pp. 180-191)
      SHEILA HEINICKE and CHARLES H. TATOR

      Whether from a diving board, the side of a swimming pool, or a rock on the edge of a lake, diving involves head-first entry into the water and subsequent risk of impact. Given the warm summers and the abundance of swimming pools, lakes, and rivers across Canada, many Canadians have attempted to dive at some time in their lives. According to the McLaren Report (see Appendix), only a small proportion, approximately 0.04%, of the Ontario population regularly engages in diving activities. However, the rate of catastrophic injuries among this population, and the severity of the injuries sustained from diving mishaps,...

    • 12 Scuba-Diving
      (pp. 192-200)
      SHEILA HEINICKE

      Recreational diving using a scuba, which is a self-contained underwater breathing apparatus, is defined as ‘pleasure diving without mandatory decompression to a maximum depth of 130 feet.’¹ Scubadiving is a sport with growing popularity in North America. Between 1996 and 2001 the number of certified divers in the United States rose from a reported two million to an estimated nine million.1–5Given the expanse of Canada’s coasts and vast inland waterways, it is reasonable to assume that scuba-diving has also gained in popularity in this country. In the present study, there were 10 catastrophic injuries over the 4 survey...

    • 13 Swimming
      (pp. 201-208)
      ALUN ACKERY

      Swimming is a sport enjoyed by many people in many regions of Ontario and elsewhere, and it can provide recreation and physical activity for the entire family. The high participation rates and popularity have been attributed to the leisure and cardiovascular benefits of this activity. Swimming is done in residential and community swimming pools, lakes, rivers, and oceans, and it is also a competitive Olympic sport. Competitive swimming involves people of all ages, from youths to seniors.

      In the 4 survey years there were 100 catastrophic swimming injuries (Table 13.1). The McLaren Report showed that 29% of the Ontario population...

    • 14 Waterskiing
      (pp. 209-220)
      PEMMA MUZUMDAR

      Waterskiing was first attempted in 1922, and has since become an increasingly popular activity. Recent surveys estimate that there are 2.5 million waterskiers in Canada,¹ and 11 million waterskiers in the United States.² Waterskiing is recognized as both a competitive sport and a recreational activity.

      There are different kinds of traditional waterskiing, and several activities that are related or similar to waterskiing. Traditional waterskiing includes slalom, trick, and jump skiing.² Slalom skiing involves a series of buoys that are typically set in a straight path and placed 8 feet apart. In slalom, the boat that tows the skier is challenged...

    • 15 Other Water Sports: Parasailing, Parachute-Skiing, Sailboarding, Sea-Biscuit Riding, Surfing, Water-Tubing, Water Polo, Watersliding, Water Play, and Windsurfing
      (pp. 221-226)
      MICHAEL DETSKY and MARK O. BAERLOCHER

      Water sports can be healthy, outdoor activities for fun and fitness. Indeed, many believe swimming to be one of the best forms of exercise, given its joint-protective, low-impact nature. Water sports are very popular activities for all age groups, especially in the summer, but with popularity comes a high incidence of injuries. Worldwide, there are many causes of injuries in this diverse group of water-play activities such as jellyfish stings and shark bites, although in Ontario the causes are more circumscribed.¹ This chapter focuses on catastrophic injuries in the following water sports which we classify as other water sports: parasailing,...

  7. SECTION 3. MOTOR SPORTS

    • 16 Snowmobiling
      (pp. 229-242)
      SHEILA HEINICKE and CHARLES H. TATOR

      Snowmobiles have been a part of the Canadian winter landscape for decades, and each year, many Canadians sustain serious injuries as a result of snowmobiling-related incidents (Table 16.1). According to the McLaren Report, many people enjoy this recreational activity, including an estimated 77,000 Ontarians, or about 0.8% of the population (Table 16.2). While the male:female ratio within the Ontario population as a whole is approximately 1, there were twice as many male participants (estimated at 51,744) than females (estimated at 26,509). In total, approximately 1% of the Ontario male population and 0.5% of the Ontario female population engage in recreational...

    • 17 All Terrain Vehicle Riding
      (pp. 243-256)
      SHEILA HEINICKE and CHARLES H. TATOR

      All-terrain vehicles (ATVs) are typically three-or four-wheeled motorized vehicles designed to traverse a variety of ‘off-road terrain.’1–3They generally have large tires, a high centre of gravity, a seat that is ‘straddled,’ are steered by handlebars similar to a motorcycle, and come in a variety of engine sizes.2–4ATVs do not provide the rider with the same protection as automobiles do because they are not encased by doors or a roof, nor do they have seatbelts or airbags.5,6These vehicles can weigh up to 500 lb (approximately 227 kg) and can travel at speeds of approximately 105 km/hour...

    • 18 Motorbiking
      (pp. 257-267)
      VANESSA I. PAESANI and CHARLES H. TATOR

      Motorbiking is both a highly utilized form of transportation and a popular pastime among people around the globe. Motorbikers often comprise distinct subsets of a population; males are the dominant users of motorbikes in most countries, constituting approximately 90% of all riders.1–2Young riders are common: in Taiwan, for example, more than 66% of motorbike users are under the age of 20 years.³ Motorbikes consume less fuel than automobiles, and overall vehicular costs are often relatively low. Expense-related factors make motorbikes a cost-effective mode of transportation and attractive for many youth.

      Although motorbikes are relatively inexpensive, they pose specific...

    • 19 Dirt-Biking (Off-Road Motorcycling)
      (pp. 268-278)
      DANIEL H. OVAKIM

      Motorcycle riding has a reputation for being a significant source of trauma and mortality.1–8Recent increases in the popularity of motorcycle riding due in part to a broadening of the age range of riders, and the use of motorcycles as a predominant mode of transportation in many countries, has resulted in an increase in the number and severity of motorcycle-related injuries.5,9In addition, beginning in the 1960s, large numbers of motorcycle enthusiasts and competitive racers moved away from streets and highways to more challenging terrain such as dirt roads, dirt tracks, and deserts.2,3,7,10–12The popularity of this type...

    • 20 Other Motor Sports: Mopedding, Motorcycling, Mini-biking, Trail-Biking, Stock Car Driving, Go-Carting
      (pp. 279-288)
      PEMMA MUZUMDAR

      This chapter will focus on catastrophic injuries that occur while riding a moped, motorcycle, mini-bike, trail bike, stock car, or go-cart, activities that have been grouped together as ‘motor sports – other.’ It should be noted that in our study, all of the injuries were sustained when these motor sports were being pursued as sports and recreational activities, and that traffic-related injuries were excluded. Injuries sustained while on motorbikes and dirt-bikes are included in separate chapters.

      In recent years motorcycle sales have increased in Canada; in 2003 the Canada Safety Council¹ reported that sales had more than tripled since 1996; however,...

  8. SECTION 4. WINTER SPORTS

    • 21 Ice Hockey
      (pp. 291-304)
      FADY SALEH and CHARLES H. TATOR

      Ice hockey was likely initiated by North American Indians from whom European explorers eventually learned the game.¹ In the mid-1800s, the modern form of ice hockey began, and the first recorded game was between two teams from McGill University in 1875. The sport gradually grew in popularity to become Canada’s national pastime, and only recently has it been overtaken by soccer as the country’s highest participation sport. Ice hockey is currently a very popular sport among Canadian males, and increasingly, among females as well. Ice hockey is played recreationally, as well as in organized leagues, and includes amateur, professional, and...

    • 22 Ice Skating
      (pp. 305-317)
      ADNAN JALAL and CHARLES H. TATOR

      Ice skating originated in Scandinavia more than 3,000 years ago and became increasingly popular through the middle ages. It was introduced to North America in the 1740s by British servicemen, with the first rink in Canada opened in Toronto in 1868. Ice skating remains popular in countries with natural ice resources, and with the introduction of ice tracks and skating rinks with artificially produced ice, it has spread rapidly to warmer countries as well.¹

      There are several major types of ice skating: recreational skating, figure skating, ice dancing, and speed skating. Another type of ice skating, particularly popular in the...

    • 23 Alpine Skiing
      (pp. 318-332)
      HELEN SIMSON and CHARLES H. TATOR

      Alpine skiing, also known as downhill skiing, is a very popular recreational activity and competitive sport in Canada. Despite the recent emergence of new forms of snow sports such as snowboarding, alpine skiing remains the most popular form of snow sport, with approximately two-thirds of individuals on the slopes participating in this activity.¹ Alpine skiing usually takes place in formal facilities (ski resorts) that maintain groomed runs, whether with natural and artificial snow, although in recent years back-country settings have also become popular, some of which can only be reached by helicopter. Alpine skiing is also an Olympic sport. Telemark...

    • 24 Snowboarding
      (pp. 333-341)
      ALUN ACKERY

      Snowboarding has seen growing participation in the past decade. Thus, the catastrophic injury results found in the 4 survey years of our study, with the most recent being 1995, do not reflect the current incidence of injury among Ontario snowboarders (see Table 24.1). However, the data on age, gender, types of injuries sustained, and injury prevention tips will all be relevant for today’s snowboarders.

      The invention of snowboarding has been attributed to Sherman Poppen, when in 1965 he attached two skis together. A broader introduction of snowboarding began in the 1970s, but following its introduction at the 1998 Winter Olympics...

    • 25 Cross-Country Skiing
      (pp. 342-352)
      DANIEL R. RICCIUTO

      Cross-country (Nordic) skiing is a popular activity that has the reputation of being a relatively benign sport. Cross-country skiing trains both upper and lower body joints and muscles and is considered one of the most rigorous cardiovascular activities.1,2Although the risk of traumatic injury is small when compared with downhill (Alpine) skiing or snowboarding, the large numbers of participants render the overall number of injuries significant.2,3Most literature is based on studies of non-catastrophic injury in experienced skiers, predominantly in the Nordic countries. Relatively little is known about the incidence or types of injury to the recreational skier, especially in...

    • 26 Tobogganing and Sledding
      (pp. 353-362)
      MARK O. BAERLOCHER and CHARLES H. TATOR

      Tobogganing and sledding are very popular winter sports in Canada, primarily among children. It should be no surprise then that associated injury rates can be quite significant (see Table 26.1). Up to 1.5% of all injuries reported in the newsletter of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database¹ are associated with tobogganing and sledding. We examined the catastrophic and non-catastrophic injury rates among participants in these activities, in general, and have included all the various types of sleds, toboggans, GT or snow-racers, crazy or magic carpets, etc. (Table 26.1).

      McLaren² estimated that 0.4% of the population or...

    • 27 Other Winter Sports: Ringette, Curling, Boot Hockey, Broomball
      (pp. 363-368)
      PEMMA MUZUMDAR and CHARLES H. TATOR

      In our study, information was collected on injuries sustained in many different winter sports. Sports such as snowmobiling and ice hockey produced a large number of injuries, whereas other winter sports, such as ringette, broomball, boot hockey, and curling, produced fewer injuries. There was one injury sustained in ringette, one in curling, one in boot hockey, and two in broomball (Table 27.1). Although these particular winter sports are relatively safe, it is still useful to examine potential risk factors and prevention strategies for these activities.

      Ringette was originally developed for girls in North Bay, Ontario, in 1963. Although ringette is...

  9. SECTION 5. BICYCLING AND OTHER STREET ACTIVITIES

    • 28 Bicycling
      (pp. 371-381)
      FADY SALEH, HELEN SIMSON and CHARLES H. TATOR

      Bicycling is a very popular recreational and sporting activity for both males and females of all ages. It is estimated that 90% of children under 10 years of age own and ride a bicycle regularly in North America.¹ The McLaren Report indicated that about 30% of people in Ontario participate in bicycling at a recreational level. Due to its high participation rate and the potential risk features, bicycling causes a relatively high annual incidence of injuries, both catastrophic and noncatastrophic (see Table 28.1). Indeed, it is estimated that there are over half a million hospital emergency department visits as a...

    • 29 In-Line Skating
      (pp. 382-394)
      MARK O. BAERLOCHER, CYNTHIA KOCH and FADY SALEH

      In-line skating is an extremely popular recreational activity worldwide. In the United States alone the International In-Line Skating Association (IISA) reported that 26.6 million Americans over the age of 7 years participated in in-line skating in 1997.¹ The benefits of participation include aerobic fitness, independent transportation for those unable to drive, enjoyment from playing roller hockey games in the summer months, a fun way to train athletically, speed skating and other competitions, and the pure thrill and excitement of skating with friends.² Furthermore, the cost of in-line skates is now lower, with basic skates as low as Can $20.

      During...

    • 30 Skateboarding
      (pp. 395-404)
      BILAL BUTT and CHARLES H. TATOR

      Skateboarding has shown increasing popularity during the past 25 years, partly because of the improved design and manufacture of skateboards that have resulted in increased speed (even up to 90 km/hour) and manoeuvrability. Also, there has been a greater emphasis on vertical manoeuvres on rails and ramps and the development of skateboarding parks. It is highly likely that some of these changes have led to an increasing incidence of injuries in some countries. Indeed, countries such as Sweden and Norway have attempted to ban skateboards from public roads and sidewalks.¹ Fortunately, the majority of the injuries among skateboarders are non-catastrophic,...

    • 31 Running and Jogging
      (pp. 405-416)
      FATIMA BUTT and CHARLES H. TATOR

      With awareness of the link between physical activity and overall health, our collective consciousness has been raised, and more people are turning to running as an inexpensive, easily accessible sport. This chapter focuses on the catastrophic injuries sustained by participants in this sport, namely, the injuries resulting in permanent disability or death (Table 31.1). The majority of running and jogging injuries are non-catastrophic and are attributable to stress and overuse of the musculoskeletal system,¹ and most affect the feet, ankles, knees, hips, and lower vertebrae.² The primary source of stress in running stems from the fact that a runner’s foot...

  10. SECTION 6. AIR SPORTS

    • 32 Flying Small Aircraft
      (pp. 419-427)
      MEREDITH GIFFIN and MARK O. BAERLOCHER

      Although aviation mishaps receive a lot of publicity, they are relatively uncommon. In the United States, in 1992, there were 39.6 million flight departures and 2,075 crashes; in 78% of the crashes there were no deaths and in 68% there were no injuries.¹ In the past 40 years, there have been improvements in aviation safety. These have largely been limited to commercial air carriers, however, to the exclusion of smaller aircraft. For example, in 1996, the crash rate for general aviation flights, including all civil aviation flights such as recreational flying, aerial application, aerial survey, patrol, and search and rescue,...

    • 33 Other Air Sports: Ultralight Air Sports, Hang-Gliding, Para-gliding, Gliding
      (pp. 428-435)
      SANA RAHMAN and CHARLES H. TATOR

      Air sports, in this chapter, include ultralight aviation, hang-gliding, and paragliding, and these have gained much popularity since the advent of the hang glider in the 1960s, when NASA technician, Francis Rogallo, was designing landing mechanisms for Apollo astronauts on their return to Earth.¹ The technology used in the designs (i. e., the delta shaped and flexible Rogallo wing) was a catalyst for the rise of recreational hang-gliding.

      Hang-gliding requires the pilot of the device to be in a prone, facedown position strapped into a rigid, wing-shaped apparatus.² Typically, a hang glider weighs 50–70 lbs and its descending rate...

    • 34 Parachuting
      (pp. 436-446)
      MARK O. BAERLOCHER

      Parachuting is a popular sport both for individual enthusiasts and as a fundraiser for charities. It involves inherent danger, dropping from great heights, and relying on a parachute to prevent otherwise nearcertain death. Because of the injuries involved and the associated costs to health care, some have questioned the wisdom of parachuting for charity events,¹ since health care costs can vastly exceed the amount of money raised.² This chapter examines the demographics and characteristics of injuries sustained by parachutists (see Table 34.1), and in doing so utilizes some information derived from the military. Skydiving is recreational parachuting.

      According to the...

  11. SECTION 7. FIELD SPORTS

    • 35 Baseball
      (pp. 449-456)
      ALUN ACKERY

      Baseball was invented in the United States in the 1800s and is considered to be America’s national sport. Today, baseball is played throughout the world from North America to the Caribbean and all the way to Asia. It is a sport that uses a variety of skills that include running, pitching, hitting, and fielding. There are several versions of baseball, including teeball, softball, fastpitch, and hardball, which differ in the type of delivery, size of the ball, and distances between the bases. This chapter examines the catastrophic injuries associated with playing baseball (see Table 35.1).

      Baseball is played by both...

    • 36 Football
      (pp. 457-469)
      FADY SALEH

      American football has gained much popularity over the years, and there are now approximately 1.5 million participants in organized high school or college leagues in the United States.¹ The popularity of football in Canada has been high although much lower than in the United States. Football requires the utilization of skill, strength, agility, coordination, and conditioning, and presents risks because it involves fast pacing, risky plays, and hard hitting. It has always been viewed as a dangerous sport, and because of numerous deaths and cases of paraplegia in the early 1900s, Theodore Roosevelt demanded either the end of the violent...

    • 37 Soccer
      (pp. 470-482)
      FADY SALEH and ADNAN JALAL

      Soccer, called football in many countries, is the most popular team sport worldwide, and there are now more than 200 million participants registered with the Fédération International de Football Association (FIFA).¹ Its popularity in North America continues to grow. In the United States, the number of high school participants in soccer more than doubled between 1980 and 1995, and soccer is now the third most popular team sport in the 12–18 age group and second in the 6–11 age group.² As expected, the increase in the popularity of the sport has increased the number of injuries, a major...

    • 38 Rugby
      (pp. 483-495)
      FADY SALEH

      Rugby is a full body contact sport that uses minimal protective wear to shield its players from injury. In contrast, American football has placed great emphasis on equipment to protect players. It is interesting to note that football has its roots in rugby. It was U.S. President Theodore Roosevelt who insisted that the game of rugby be modified from its ‘brutal nature,’ thus opening the doors for football as it is played today.¹ Starting in the 1800s, rugby has spread the world over and is now played in more than 80 countries, having found a home in Britain, New Zealand,...

    • 39 Other Field Sports: Track and Field, Field Hockey, Lacrosse
      (pp. 496-502)
      PEMMA MUZUMDAR

      This chapter will focus on the seven catastrophic injuries in our study that occurred during participation in track and field, field hockey, and lacrosse, and for the purposes of this book, these specific activities have been grouped together as ‘field sports’ (see Table 39.1).

      Field hockey refers to a form of hockey that is played on an outdoor field, and it is popular in many countries. According to Field Hockey Canada,¹ 15,000 Canadians play the sport, whether competitively or recreationally. Although field hockey is a popular sport, there is limited research on injury rates and patterns. One Canadian study² examined...

  12. SECTION 8. RACQUET SPORTS

    • 40 Badminton
      (pp. 505-514)
      SANA RAHMAN and CHARLES H. TATOR

      Badminton has often been perceived as a harmless sport with a negligible risk of injury. The lightweight racquet and shuttlecock and relatively low contact may explain such a perception. In fact, badminton involves arduous physical activity, where in a given 30-minute game, the average duration of physical activity lasts 10–15 minutes compared with 5 minutes in tennis.¹ Heart rates often reach 80%–85% of a player’s predicted maximum in badminton, while tennis players often reach only 68%–70% of their maximum heart rate. Thus, badminton players, especially those who perform at higher levels of play, must have a high...

    • 41 Racquetball
      (pp. 515-520)
      KASHIF PIRZADA

      Initially invented in the 1940s, in Connecticut, racquetball is a fastpaced sport derived from the much older game of squash. Its popularity spread in subsequent years, peaking in the mid-1980s, after which participation levelled to a reported figure of 5 million participants in the United States. Racquetball is included in the summer Olympic games, and world championships are held on a biennial basis.

      There is some confusion about distinguishing squash from racquetball. The racquetball racquet is shorter, the ball larger, and the court narrower and longer than in squash.¹ For this chapter, studies confined to racquetball will be emphasized, but...

    • 42 Squash
      (pp. 521-530)
      ISHTIAQ AHMED

      Tennis, badminton, and squash are three of the most widely played racquet sports around the globe, and much of the research on injuries in racquet sports has focused on these three. This chapter will highlight the catastrophic injuries sustained by participants in squash (see Table 42.1). What sets squash apart from the other racquet games is its fast pace that demands quickness, agility, control, and awareness in a confined setting. Unlike the other racquet sports, squash players share the same enclosed area and are not separated by a net. Given the level of vigorous activity, high-speed projectiles, and enclosed setting,...

    • 43 Tennis
      (pp. 531-544)
      ADNAN JALAL

      Tennis is a popular international racquet sport. It has a large following in North America, with 20 million Americans playing at least once a year and 5 million playing at least twice a month.¹ There are two versions of the game: singles (with two players) and doubles (with four players). While generally played outdoors, tennis is also played indoors. Tennis is a physically demanding game characterized by periods of intense exercise interspersed with periods of rest. It demands speed, balance, and strength.Studies1,2show that tennis improves both aerobic endurance and cardiovascular fitness. Tennis can be played by both genders...

  13. SECTION 9. EQUESTRIAN SPORTS

    • 44 Horseback Riding
      (pp. 547-560)
      CHRISTINE PROVVIDENZA

      Horseback riding and equestrian-related sports are popular recreational activities in Canada, particularly in rural areas. In 1988, there were 67,798 riders nationwide, according to the Canadian Equestrian Federation.¹ Participating in these activities, however, does involve a degree of risk. Close proximity to horses poses serious risk of injury because of the speed and power of the animals. Horses can reach speeds up to 60 km/hour, resulting in more injuries per hour in the saddle than during motorcycling or auto racing.² Other risk factors associated with horseback riding and equestrian activities include failure to wear and use the appropriate equipment, improper...

  14. SECTION 10. FLOOR SPORTS

    • 45 Basketball
      (pp. 563-572)
      MARIUM FATIMA and CHARLES H. TATOR

      Basketball has become one of the most popular sports in Canada and elsewhere and is played by millions of athletes around the world. It has also become one of the leading causes of sports injuries because of the increasing number of participants and the intensity of the game. Until 1906 the pace of the game was slow, as the baskets were closed at the bottom, requiring players to retrieve the ball after each basket was made. Then, in 1910, basketball players were allowed to dribble the ball but not to shoot after dribbling. Fouls were given if an offensive player...

    • 46 Floor Hockey
      (pp. 573-579)
      BILAL BUTT, PRAKASH MOTWANI and CHARLES H. TATOR

      Floor hockey has been played in schools and other organizations for many years in Canada. Fortunately, the majority of the injuries in floor hockey are non-catastrophic in nature, but nonetheless there are instances of catastrophic injuries, especially when protective equipment is not worn.¹ Developed as a mixture of ice hockey and ringette, floor hockey has become a recognized sport in the Special Olympics, the only team sport in their official winter sports. The rules of this version of floor hockey were conceived by the Special Olympics, which developed the game to enable warmer countries without snow and ice rinks to...

    • 47 Gymnastics
      (pp. 580-592)
      ADNAN JALAL

      Gymnastics is a demanding sport in which participants exhibit control over a variety of acrobatic exercises and other movements, and to perform effectively, gymnasts have to develop balance, endurance, flexibility, and strength.¹ The vast majority of gymnasts participate in the sport for recreational or educational purposes, with elite gymnasts constituting but a small minority of participants. Gymnastics has been a part of the summer Olympic games since 1896. Currently, three types of gymnastics – artistic gymnastics, rhythmic gymnastics, and trampoline – are part of the summer games. Participants compete separately in individual and team events. In artistic gymnastics, men perform in six...

    • 48 Wrestling
      (pp. 593-603)
      FADY SALEH

      Wrestling dates back to ancient times, as indicated by the hieroglyphics lining the walls of the tomb of the ancient Egyptian dynasty Bani Hasan. On these walls are drawn pictures of two men engaged in wrestling, depicting many of the moves known today. Wrestling took on many different forms throughout the ages, influenced by the civilizations that engaged in the sport. However, it was the Greeks who had most influence on the development of wrestling, and after whom modern Greco-Roman wrestling is modelled. The other common form is free style, which, along with Greco-Roman, is practised today in the Olympics....

    • 49 Martial Arts: Karate and Tae Kwon Do
      (pp. 604-614)
      MARK O. BAERLOCHER

      Various forms of martial arts are popular in many countries. Martial arts originated in India and were subsequently passed on to mainland China, Korea, Okinawa, and then to Japan, Indonesia, and the Philippines. During and since the Second World War, the discipline spread worldwide.¹ Today, there are thousands of different forms and systems of martial arts. In Ontario in 1995, over 174,000 people participated in the activity,² with US estimates of participation varying between 1.5 to 2 million³ and 8 million.¹

      Martial arts encompasses many defensive and offensive techniques. Participation in martial arts can have many benefits, including exercise, flexibility,...

    • 50 Other Floor Sports: Weightlifting, Volleyball, Handball, Gym, Boxing, Kick-Boxing
      (pp. 615-620)
      SANA RAHMAN

      This chapter will discuss catastrophic injuries in the following floor sports: weightlifting, volleyball, indoor handball, gym, kick boxing, and boxing. Each of these floor sports is distinct, and all carry the risk of injury, and specifically catastrophic injury. Weightlifting involves high pressure and muscle exertion, while volleyball requires frequent, repetitive, and agile movements of jumping, twisting, and arm rotation. Handball involves quick movements and a high-speed ball. Injuries in gymnasiums can encompass a variety of activities: the sport of gymnastics is covered in Chapter 47.

      The participation in floor sports as a proportion of Ontario’s population is relatively high for...

  15. SECTION 11. PLAYGROUNDS AND PLAY

    • 51 Playgrounds and Play: Tree Climbing, Slides, Monkey Bars
      (pp. 623-634)
      CHRISTINE PROVVIDENZA and CHARLES H. TATOR

      Play is an essential component of healthy living and the development of children. During the nineteenth century, playgrounds were created to provide play opportunities for children growing up in urban and increasingly industrialized areas.1,2Playgrounds offer children a controlled, protective, and potentially supervised environment that is not only challenging, but stimulating.³ By engaging in creative play, children have the opportunity to develop their cognitive, motor, and social skills.³ Safety in play and playgrounds is of great importance for children and their families.¹ An awareness and concern about safety are essential ingredients in play and playgrounds because the activities in these...

  16. SECTION 12. MISSILE SPORTS AND RECREATIONAL ACTIVITIES

    • 52 Hunting
      (pp. 637-650)
      FADY SALEH and ADNAN JALAL

      Hunting is a sport involving the search, pursuit, and killing of wild animals and birds, and before the development of agriculture, hunting was a necessity. The quarry provided not only food, but also materials for tools from bones, horns, and hooves. With the introduction of agriculture, hunting became less essential for survival. Nevertheless, hunting retained its social value by maintaining group activity and preserving tradition. Records of hunting exist in almost all civilizations, but until recently, hunting was primarily restricted to rulers and their nobles – those with the most leisure and wealth. Nowadays, hunting is available to almost anyone, but...

    • 53 War Games (Paintball)
      (pp. 651-657)
      ALUN ACKERY

      The first war games, as we know them today, were played in 1981 in Henniker, New Hampshire.¹ War games, also called paintball, use CO2handguns and rifles powered by carbon dioxide to fire a ‘paintball,’ a gelatinous thin-skin coated capsule filled with coloured liquid. Paintballs released by these guns travel at speeds up to approximately 250–300 feet per second.1,2The paintball breaks on contact, releasing a non-permanent (washes away with soap and water), non-corrosive, biodegradable, water-soluble marker that tags an object. The main objective is to tag opponents with a paintball, thus eliminating them from the game.¹

      War games...

    • 54 Air Guns
      (pp. 658-666)
      FADY SALEH and ISHTIAQ AHMED

      Air guns, also referred to as BB guns or pellet guns, are a form of nonpowdered firearms. In Ontario the potential danger of these weapons received great attention in the media after a series of injuries and violence related to their improper usage.² Air guns are intended for recreational and competitive sport use, and are popular for hunting, war games, and target training.³ Air guns are preferred over powdered firearms mainly because of their relative ease of maintenance, lower cost, and safer profile; nevertheless, they can cause catastrophic injury and even death. The risks of misusing air guns are grossly...

    • 55 Other Missile Sports: Darts, Archery, Target Practice, Slingshot
      (pp. 667-674)
      SANA RAHMAN

      Missile sports in this chapter are defined as activities in which the objective is to aim and launch a projectile towards a specific target, and these include darts, archery, target practice with a firearm, and use of a slingshot. There are two types of dart games: the first is the common game where 5 inch darts are thrown at a dartboard hung on a wall; and the second is lawn darts, with darts constructed of heavy metal 12 inches long and with larger wings and launched in an open area towards specific targets.

      Participation rates in Ontario are only available...

  17. SECTION 13. SUMMER SPORTS

    • 56 Golf
      (pp. 677-683)
      ALUN ACKERY

      Golf is a game played throughout the world by males and females of all ages. At the beginning of the twenty-first century, there were 33,000 golf courses and over 55 million golfers throughout the world.¹ Golf is one of North America’s most popular sports perhaps because it allows players of different skills and abilities to play the game for recreation and exercise, as well as to compete. It is a sport that is encouraged in all age groups, especially in older people, because of its minimal impact on the body, while supplying sufficient amounts of exercise. This chapter will focus...

    • 57 Ball Hockey
      (pp. 684-692)
      PRAKASH MOTWANI, BILAL BUTT and CHARLES H. TATOR

      Ball hockey is a game played in Canada and numerous other countries primarily during the summer when the ice skating surface has been removed from the arenas. The game is much like ice hockey, except that it is played with running shoes on a cement floor (sometimes on the street with in-line skates), rather than with skates on an ice surface.¹ Slightly less equipment is worn in ball hockey compared with ice hockey. Epidemiological studies have consistently shown that injuries in ball hockey are numerous and can be serious. Most serious injuries result from being struck by the stick or...

    • 58 Camping and Hiking
      (pp. 693-700)
      ALUN ACKERY

      Camping and hiking are recreational activities enjoyed by families and individuals of various ages and skill levels. In Ontario camping and hiking are predominantly undertaken in the warmer spring and summer months, but at times also in the winter. The province has four national parks, more than 270 provincial parks, and more than 200 conservation areas.¹ All of the parks and many of the conservation areas provide trails for hiking and cleared areas for camping during certain times of the year.

      Camping is an activity engaged in by individuals who have a range of skill levels, and so it can...

    • 59 Mountain Climbing
      (pp. 701-710)
      MAIA VON MALTZAHN, MARK O. BAERLOCHER and CHARLES H. TATOR

      Mountain climbing, also referred to as rock climbing, has expanded over the years to become both an indoor and outdoor sport. The faces of rocky cliffs are the more traditional outdoor locations, although sports centres boasting climbing walls provide an appropriate venue for indoor climbing. The number of injuries in mountain climbing increases as dedication to the sport grows. The climbers most at risk are those with the greatest level of skill.¹ The demands of mountain climbing can induce overuse injuries which prevail among the more avid climbers. There is great reliance on the hands as the tools for ascent,...

    • 60 Other Summer Sports: Roller Skating, Walking, Billiards, Tree Climbing, Kite Flying, Steer Wrestling, Fairgrounds
      (pp. 711-718)
      SANA RAHMAN

      In this chapter, catastrophic injuries sustained in various sports and recreational activities will be discussed including, roller skating, walking, tree climbing, billiards, kite flying, steer wrestling in rodeos, and injuries sustained at fairgrounds (Table 60.1). In general, these activities are mainly summer activities, and are therefore included in this category. None of these activities had a sufficient number of injuries in our study to merit a separate chapter, but each caused at least one catastrophic injury, and therefore these activities are included in this book.

      The participation rates according to the McLaren Report vary widely in these summer activities. Although...

    • 61 Conclusions
      (pp. 719-724)
      CHARLES H. TATOR

      This book presents the epidemiology of catastrophic injuries in sports and recreational activities in Ontario with the purpose of developing strategies for their prevention. Epidemiology and prevention are two sides of the same coin. It is impossible to develop effective prevention strategies without a thorough knowledge of how they occur. The book analyses all the catastrophic injuries that occurred in more than 100 sports and recreational activities in four periods of 12 months each within a 10-year period from 1986 to 1995. During this time, there were 2,154 individuals who sustained catastrophic injuries in sports and recreation – an incidence of...

  18. APPENDIXES

    • APPENDIX 1: Survey Questionnaire
      (pp. 726-727)
    • APPENDIX 2: Participation and Injury Rates – Males, Females, and by Sport, from the McLaren Report
      (pp. 728-729)
    • APPENDIX 3: Population of Ontario in 1986, 1989, 1992, and 1995
      (pp. 730-730)
  19. Index
    (pp. 731-761)