Faculty of Health Sciences

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An investigation into the use of the Functional Movement Screen as a predictor of injury in CrossFit athletes in the eThekwini municipality
(2018) Richardson, Michelle; Haswell, Garrick David
Background: CrossFit is a popular and unique exercise training programme and competition. Despite the popularity of this training programme there is a high incidence of injury amongst the athletes. The Functional Movement Screen™ (FMS™) is a pre-participation assessment which grades seven tests which screen fundamental movement patterns of athletes to possibly predict future injury. No studies have successfully looked at the use of the FMS™ to predict injury in CrossFit athletes. Aims: The aim of this study is to establish the normative values of the FMS™, which have yet to be determined for CrossFit athletes, and to determine the use of these values as a predictor for future injury. Methods: The methodology included scoring 61 CrossFit athletes using the FMS™ one month prior the “United We Stand (UWS) Games 2017”. Additionally, the athletes were required to fill out a questionnaire which was used to assess for additional risk factors for injury. The athletes were thereafter tracked documenting CrossFit specific injury over the course of the one month training period that lead up to and included participation in the “UWS Games 2017” in order to compile a injury profile. The mean FMS™ was then compared to the injuries sustained. Results: The research sample revealed that the mean FMS™ score for CrossFit athletes was 17.73 out of 21. There was no significant link between the mean value when compared to the injury rates and this was therefore not a predictor of injury. There were significant findings that showed that using components of the FMS™ as a method of injury prediction in CrossFit athletes was possible; specifically, a low trunk stability push-up test score increased the likelihood of sustaining injury and previous injury negatively impacted the shoulder mobility test. Further findings suggested that Body Mass Index (BMI) negatively impacted the performance of the FMS™, and the boxes with which the athletes were affiliated, influenced the total FMS™ scores. The most common types of injuries recorded were joint dysfunction and muscle strain and the most common locations of injury were the shoulder, knee and lower back. Conclusions: Aspects of the FMS™ were a statistically significant predictor of injury in CrossFit athletes, specifically that of the shoulder mobility test and the trunk stability push-up test. Other findings concluded that factors such as the BMI and the box that athletes trained under influenced the FMS™ outcome. The normative value of 17.73 out of 21 for the FMS™ was provided as reference values for CrossFit athletes in order to assist with the interpretation of future scores when screening athletes.
An injury profile of ice hockey players in South Africa
(2017) Van Doesburgh, Donne Claire; Matkovich, Grant
Background: Ice hockey is a fast paced team sport, played on an ice surface in an enclosed arena. As a result of the high contact, aggressive nature of the sport, players are susceptible to injury. Ice hockey is not a popular sport in South Africa and the environment is unique in comparison to international ice hockey countries. The playing surfaces and ice rink arenas differ across South Africa, which may affect the risk of injury in this population. Protective equipment is not easily accessible to ice hockey players in South Africa and therefore they may be at a higher risk of injury. Participation in ice hockey is developing in South Africa; however there is a paucity in the literature relating to injuries in the South African context. This study aimed to determine a profile of ice hockey injuries in South African players. Methodology: This study was a quantitative, descriptive study that used a self-administered questionnaire. The questionnaire was administered to 187 ice hockey players (141 male and 46 female) who were registered with the South African Ice Hockey Association. Players were required to sign the letter of information and informed consent form, following which, questionnaires were distributed to the participants who met the study criteria. The researcher was present to supervise and collect all forms and completed questionnaires directly after completion. The questionnaire contained sections on demographics, injuries sustained over the previous season as well as the use of protective equipment. The results were analysed using SPSS version 24 and a p value of < 0.05 was considered statistically significant. Results: The response rate met the minimum requirement of 138 males and 45 females. Of the 187 participants, 110 (58.8%) of the participants sustained at least one injury due to ice hockey. Age was considered to be a risk factor in this study as those participants in the youngest age group of 18-27 were at a higher risk of all injuries (χ2 p-value < 0.0001). Although gender was not a risk factor for the total number of injuries, female players in this study were at a greater risk of head and knee injuries (χ2 p-value = 0.0196 and χ2 p-value = 0.0046 respectively). The most severe injury affected the head (10.2%, n = 19) and overall the knee was the most commonly affected area of injury (n = 30). The majority of the injuries were sustained during a game and resulted from contact with another player. The results of this study showed that the use of protective equipment does not prevent all injuries in ice hockey. The type of facial protection worn was a risk factor for facial injuries and the lack of a mouthguard was a risk factor for head injuries. Conclusion: The aim of this study was to determine a profile of ice hockey injuries in South African players. The South African demographic profile of ice hockey players showed similarities to international profiles with respect to age, gender, BMI and player position. The profile of injuries in this study was similar to international injury profiles in terms of site, type, severity, onset and mechanism of injury and regarding the majority of injuries being sustained during a game. Ice hockey players in the younger age groups were at a higher risk of injury both in South Africa and internationally. Females were at a higher risk of head injuries in comparison to males which is congruent with international literature. In South Africa, and internationally, the use of full facial protection and a mouthguard was shown to decrease the risk of facial and head injuries respectively. The South African demographic profile differed from international findings in terms of experience level, total hours of training per week and number of games played in a season. The injury profile of South African ice hockey players showed that this population is at a higher risk of muscular injuries than international players. Larger ice surfaces and flexible boards and glass did not reduce the risk of injury in South African ice hockey players in the same way as it has internationally.
An injury profile and management analysis of marathon runners at selected marathons in the great eThekwini and uMgungundlovu Municipalities during 2014
(2016) Van Niekerk, Giselle; Korporaal, Charmaine Maria; Gomes, Adrian Neil
Background: Running injuries are increasingly common as participation in this sport increases. Health care providers need to be better able to treat and manage these injuries and prevent their recurrence. Thus, there is a need for profiles of different population groups to enable the development of health promotion and injury prevention strategies. This research study profiled and tracked runners over seven marathons held in the eThekwini and uMgungundlovu Municipalities during the first quarter of 2014. Methods: This Durban University of Technology, Institutional Research and Ethics Committee approved retrospective Chiropractic Treatment Facility record analysis, analysed 741 recorded marathon visits. The records were based on a previously validated data collection tool (CSSA questionnaire) that allowed clinical data to be captured relating to patient demographics, anatomical site of the complaint, clinical impression, diagnosis and treatment. These fields were analysed for each visit, and then captured in SPSS version 22 with records only being excluded because they were unsigned. Descriptive and inferential statistics (McNemar’s tests) were compiled and a p-value of 0.05 was used. Results: The majority of the runners were Black males of approximately 40 years of age. A total of 95.6% of runners presented with overuse injuries, of which 73.6% and 89.3% had no history of previous injury or trauma respectively, and with 94.7% being able to continue participation. The shin and calf (21.7%), thigh (21.6%) and lumbar regions (16.1%) were most commonly affected by injuries which were predominantly muscle strains (23.2%) and SI syndrome (21.4%). These injuries were treated by manipulation (82.8%), massage (57.2%) and PNF stretching (33.6%). With runners that presented at subsequent marathons, a significant difference (McNemar’s p=0.013) in history of previous injury between the first and second marathon was found, with the runner being more likely to report a history of previous injury at their second marathon visit. Specific trends, although not significant, were found for specific subgroups (defined by age, gender, ethnicity, history of previous injury / trauma and chronicity of the diagnoses). Conclusion: The data is not dissimilar to the literature on running injuries, although specific trends in terms of sub categories were noted. These trends require further investigation through prospective, longitudinal studies.
The prevalence and profile of musculoskeletal pain in elite wheelchair basketball players of different point classifications in South Africa
(2016) Mateus, Isabel Sita Maharaj; Pillay, Julian David; Padayachy, Keseri
Background There has been a remarkable increase in the participation of sport for athletes with disabilities. Consequently, there have been many international studies on injuries in athletes which have shown a high prevalence in wheelchair basketball, largely attributed to the fast-paced, high intensity nature of the sport. This sport has grown worldwide including South Africa, however, very little research has been published on South African wheelchair basketball players and more research is, therefore, needed. Aim To determine the prevalence and profile of musculoskeletal pain in elite wheelchair basketball players of different point classifications in South Africa. Hypothesis 1: Upper extremity (including neck and back) pain is experienced more commonly in lower point classified wheelchair basketball players than in higher point classified players. Hypothesis 2: Lower extremity pain is experienced more commonly in higher point classified players than in lower point classified players Method This study was a quantitative, cross-sectional, questionnaire-based study. The questionnaire comprised of sub-sections on demographics and disability characteristics; activity levels pertaining to wheelchair basketball and other sport/physical activity; the prevalence of pain and the impact thereof on wheelchair basketball and/or activities of daily living. This questionnaire was administered to 48 wheelchair basketball players who were competing in the 2015 Supersport League. A response rate of 70% was decided as the lower limit cut-off for statistical power. Results Fourty-three participants responded yielding an 89.58% response rate. The mean age of participants was 33.3 (SD:9.5) years and the majority of participants (n=35) were male and African (n=29). Out of the 43 participants, 79.1% (n=34) used mobility devices, the majority (n=20) used wheelchairs. Most of the participants (n=41) played wheelchair basketball for more than five years and 32 participants did not participate in other sport. Almost half of the participants (n=25) experienced musculoskeletal pain in the last twelve months or at present, 75% of whom (n=12) visited a Physiotherapist for the pain. More than half of these participants (n=15; 60%) reported that the pain negatively affected their basketball performance. It was established that arm pain occurred frequently in lower point classified players (1.0-2.5 point players) and that hand and wrist pain was also more prevalent in lower point players than in higher point players. The prevalence of lower extremity pain was low and there was no statistically significant difference between higher and lower point classified players. Conclusions and Recommendations The finding that upper extremity pain occurred more frequently in lower point classified players was in keeping with the first hypothesis (the null hypothesis was, therefore, rejected). The second hypothesis was, however, rejected (and the null hypothesis was, therefore, accepted) as lower extremity pain did not occur more frequently in higher point classified players than in lower point classified players. The Eta scores may have been higher and may have shown a much larger than typical relationship between point classification and the prevalence of musculoskeletal pain had there been a larger sample size. Notwithstanding this limitation, it is a challenge to obtain a significantly larger sample size due to the nature and limited number of participants in this sport. More studies are warranted on this group of individuals, as a large number experienced pain which affected more than half of the participants’ performance in wheelchair basketball. These studies are important for the future success of the South African players and the sport in South Africa.
A profile of injuries among participants at the 2013 CrossFit Games in Durban
(2015-05) Da Silva, Chantel; Gomes, Adrian Neil
Background CrossFit is a workout program developed in 2000 which involves high intensity interval training coupled with resistance training elements of powerlifting and gymnastics. CrossFit has grown to include competitive events and there are an ever increasing number of affiliate gyms internationally. CrossFit’s greatest criticism is related to safety. There is limited published data on the exercise program. Aims The aims of this study were: to determine a retrospective cohort analysis of the demographic, injury and treatment profiles of participants at the 2013 United We Stand CrossFit Games who presented to the Durban University of Technology’s sports treatment facility; to determine the association, if any, between demographics and injury types; and, to provide any recommendations regarding the clinical record form used. Methods This study was a retrospective, quantitative, descriptive study on the chiropractic Student Sports Association’s report form in order to produce a retrospective cohort analysis of the injury and treatment profiles. Persons who made use of the chiropractic treatment facility at the 2013 United We Stand CrossFit Games were required to complete an informed consent form. A sixth year chiropractic student then filled in a Chiropractic Student Sports Association report form to record participant, complaint and treatment information. The study was not limited to competitors, but all persons who had access to the chiropractic treatment facility. These forms were then collated and data captured on the complaints which presented and were treated at the chiropractic treatment facility. Results The data collected revealed that 137 participants presented to the chiropractic treatment facility in 162 visits, with 263 complaints treated. The age range of the sample was between 18 and 43 years, with a mean age of 27.49 years. The majority of participants who presented to the CTF were competing athletes and just under half of the study sample reported to not having a history of previous injury. The study found that the lumbar region (20.9%), wrist/hand (14.4%), shin/calf (11.0%) and knee (10.2%) were the most commonly presented regions of complaint. The highest presenting mechanism of injury was that of overuse (22.4%) followed by running (19.0%). Acute injuries accounted for 72.20% of all injuries. With regards to diagnoses, myofascial trigger points made up 21.6% of all injuries, followed by muscle strains (19.7%). Facet syndromes of the spinal column accounted for 13% of diagnoses.It was shown that kinesiotape, manipulation, massage and ischemic compression were the top treatment interventions utilised. It was also shown that rest, ice and referrals were types of treatment that were not utilised. Due to statistical inconsistencies no significance tests were possible between demographic and injury characteristics. Recommendations were proposed in order to maximise the quality of data captured. Conclusion: The results add insight into the injuries presented and the treatment they acquired at the chiropractic treatment facility at a national CrossFit event. The most common injuries require investigation in both training and competitive environments. Various recommendations have been proposed for the record form used at sporting events in order to facilitate the collection of high quality data.
An analysis of injury profiles and management strategies utilised by chiropractic students at the 2015 Durban 'Rugby Rush Tournament'
(2015-07-28) McAlery, Caryn; Haswell, Garrick
Background Rugby union is one of South Africa’s most popular sports; it requires high levels of skill and fitness and is played at a high intensity and speed which allows for a greater risk of injury. The high risk of injury is said to be due to the nature of the physicality of rugby. It is because of this high risk of injury that several adaptations of rugby have since developed which rely more on speed and agility than physicality. These adaptations include tens or ten-a-side rugby, sevens or seven-a-side rugby and finally touch rugby, which is played with six players a-side. Each adaptation has its own set of rules and is played differently to the traditional rugby union or fifteen-a-side rugby. Hence, in these adaptations the physicality is said to decrease with a resultant increase in demand for speed and agility. The reduction of physicality and increase in the need for speed and agility would imply that the nature of injuries sustained will be different to those sustained in traditional rugby union. Objectives To develop a profile of injuries that describe the type, anatomical location and mechanism of injuries sustained in tens, sevens and touch rugby; to compare the injuries sustained between the three groups; and, to analyse management strategies utilised by chiropractic students at the 2014 Durban ‘Rugby Rush Tournament’. Additionally this study aimed to provide recommendations to the injury reporting form utilised. Method This study was a retrospective, quantitative, descriptive study based on the Chiropractic Student Sports Association’s report form in order to produce a retrospective cohort analysis of injury and treatment profiles. Participants who made use of the chiropractic treatment facility were required to complete the informed consent section of the injury reporting form. The chiropractic intern was required to complete the remainder of the form pertaining to the participant, complaint and treatment information. This study was limited to event participants to allow for subgroup analysis. The forms were then captured and analysed. Results The data collected consisted of a total of 345 individual patient forms which indicated 626 visits for a total of 733 complaints. The average participant age was 24 ± 5.58. The study found muscle strains (41.5%), SI Syndrome (17.6%) and Joint sprains (15.0%) to be the most frequent diagnoses. A history or previous injury or trauma was reported in 18.7% and 7.40% respectively. Acute injuries accounted for 64.3% and 35.7% were recorded as chronic in nature. The most frequent mechanism of injury was that of overuse (81.9%) and trauma accounted for 17.2% of injuries. The lumbar region (26.1%), thigh (20.7%) and shin/calf (15.6%) were the most commonly reported regions of complaint. Manipulation (58.8%), massage (32.0%) and stretch PNF (27.9%) were the most frequently used treatment protocols. Strapping was utilised in 21.1% of injuries of which 5.20% was applied to the muscle and 13.6% was applied to the joint. No comparison was made using the sevens subgroup as there were insufficient records, thus only tens and touch players were compared. A borderline non-significant difference (p = 0.057) was noted between the type of player and the history of previous trauma. Tens players were more likely to have a history of trauma compared to touch players. A significant difference (p = 0.001) was found between the type of athlete and mechanism of injury. Overuse was more common in touch players whereas trauma was more common in tens players. Due to statistical inconsistencies no significance tests were applicable to compare the type of player and region of complaint. Recommendations were proposed in order to avoid this in future research. Conclusion This study provides a base of knowledge regarding the injuries that were presented to the chiropractic treatment facility at the 2014 Durban ‘Rugby Rush Tournament’ and the management strategies utilised by the chiropractic interns at the event. This research provides insight into injury profiling of tens, sevens and touch rugby players. There were several recommendations proposed for future researchers in order to expand on this field of knowledge.
An investigation into the risk factors and management of rugby injuries in the greater Durban area
(2010) Tuck, Andrew Murray; Haswell, Garrick
Objective: Majority of studies to date have focused on injury profiles and types of injuries in rugby, without looking at the risk factors associated and the management of these injuries. It was thus the aim of this study to determine the risk factors and management of rugby injuries in the greater Durban area. Methods: This was a prospective, cross-sectional based study, using a self-administered questionnaire, developed specifically for this research utilizing a focus group and pilot study. The questionnaire details a patient injury history, rugby history, resources, management, coaching and training parameters. Letters of informed consent and the questionnaire were distributed to 300 players / coaches for completion and data was analysed using Pearson’s correlation and t-tests. Results: A response rate of 70% (n=210) was achieved. Selected risk factors were found to be significantly related to current and / or previous injury. New risk factors which did significantly impact injury, were also determined. Conclusion: It is advised that coaches and players take note of significant injury risk factors and management protocols in order to improve player health and decrease injury risk. Further research may look into the factors identified in order to set up better structures in order to prevent further injuries.
A profile of horse riding injuries in adult horse riders registered with the Kwa Zulu Natal Horse Society
(2010) Catlin, Jo-Anne Carrie; Haswell, Garrick
Introduction: Equestrian sport as a competitive sport first began in 1868 at the Royal Dublin Horse Show 1. Injuries, especially minor injuries, are seldom reported, and there are no regulatory requirements anywhere that compel formal injury notification of this sport 2. Objectives: The objectives were to describe a profile of horse riding injuries, to determine the association between the type of equestrian activity and location and mechanism of injury, the association between use and type of equipment and location of injury and to determine anthropometric and history variables associated with location of horse riding injuries. As well as determining if non riding related injuries were associated with riding related injuries in the same sites. Therefore, for the purpose of this study, the following information was gathered in order to build up an injury profile: Anthropometric values (age, height, weight, gender, ethnicity, dominant hand and medical aid) of competitive horse riders in KwaZulu-Natal, South Africa, The participants horse riding history, Their record of any past or current injuries, Factors associated with previous and current injuries were also investigated, Equipment and facilities used Methods: This study was a quantitative descriptive design, which was questionnaire based and was administered by the researcher at various competitions in KwaZulu Natal or sent via email to those not present at the competitions. The study was limited to adult members of the KwaZulu Natal Horse Society that competed in on the Olympic disciplines of dressage, show jumping and eventing. iv Results: There were 176 respondents to the study. The average age was 36.3 years. The vast majority of participants were White (99.4%) females (81%). The overall prevalence of injury was 90.3%. Muscle strains were the most common type of injury. The head was the most commonly injured site (46.4%), the lower back was the site most likely to be injured many times. Forceful falls were ranked as the most severe type of injury mechanism. Most injuries occurred whilst jumping (63.8%). Use of protective equipment was associated with injury prevention and protection. Muscle strains due to riding were significantly less common in those who presently did regular exercise. Having no medical problems was associated with not having any riding injuries. There was no significant association between riding and non riding related injuries.
A retrospective cohort analysis of the injury profile of internationally competitive surfers
(2009) Murgatroyd, Taryn Lyn; Korporaal, Charmaine Maria
Modern surfing dates as far back as the 1960’s when the first amateur and professional surfing competitions were held (1). Since these humble beginnings, surfing has enjoyed a sustained growth over the last half a century, principally through increased commercialization of surfing apparel and an increased positive association with the lifestyle of surfers. Objectives: The aim of this study was to determine a retrospective cohort analysis of the injury profile of internationally competitive surfers and provide information on chronic, repetitive strain injuries suffered by them. Therefore, for the purpose of this study, the following information was gathered in order to create an injury profile: • Demographics of internationally competitive surfers competing in the Mr. Price Pro, Durban, South Africa, • Prevalence of surfing injuries, • Treatment received for injuries. Methods: This study was a retrospective, quantitative, epidemiological study (9), on the Chiropractic Student Sports Association’s (CSSA) questionnaire in order to produce a retrospective cohort analysis of the injury profile of internationally. On entry into the Chiropractic treatment facility, the surfer is requested to complete their portion of the CSSA questionnaire. Thereafter the senior intern then takes a brief case history, elaborating on the information provided by the surfer, followed by a standard clinical assessment related to the anatomical region or list of differential diagnoses based on the history. iv The study was limited to any surfer, male or female, who was competing on the World Championship Tour or the World Qualifying Series and registered to compete in the Mr. Price Pro. Results: Chronic injuries made up for 52.7% of surfing injuries, with the spine and surrounding musculature being the most commonly affected regions. Factors associated with injury were the repetitive nature of certain aspects of surfing and the age of the surfer. The findings in this study concurred with previous literature with the respect to sustaining of an injury related to surfing. However, many of the findings in this study differed to that of previous literature with respect to the common site of injury. The spine was the most common site of injury, as opposed to lower extremities as had been previously reported. The factors associated with injury also differed somewhat from previous literature. Therefore, this warrants further investigation with due consideration to the recommendations from this study.

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