Sports Medicine: Just the Facts

CHAPTER 6 • CATASTROPHIC SPORTS INJURIES 27

• There is no evidence that an isolated episode of head-
  ing a soccer ball can cause any head injury; however,
  there is controversy over whether repetitive soccer
  heading over a prolonged career can lead to neu-
  ropsychologic deficits.

PREVENTION

• Children should never be allowed to climb on the net
  or goal framework. Soccer goalposts should be
  secured at all times. During the off-season, goals
  should either be disassembled or placed in a safe stor-
  age area. Goals should be moved only by trained per-
  sonnel, and should be used only on flat fields
  (www.cpsc.gov). The use of padded goalposts may
  also reduce the incidence of impact injuries with the
  goalposts (Janda et al, 1995).


• Children should use smaller soccer balls to reduce the
  risks of repetitive heading. Leather or water-soaked
  soccer balls should never be used. Proper heading
  techniques should be employed: contact on the fore-
  head with the neck muscles contracted. Soccer play-
  ers should be trained to hit the ball, not to be hit by the
  ball. A long-term prospective study on the cumulative
  effects of heading a soccer ball is currently underway.

WRESTLING

EPIDEMIOLOGY

• Indirect catastrophic wrestling injuries are often the
  result of rapid weight loss which causes dehydration
  and potential cardiovascular compromise (Kiningham
  and Gorenflo, 2001; Oppliger et al, 1996).


• There are approximately 2.11 direct catastrophic
  wrestling injuries per year at the high school and col-
  lege levels (Boden et al, 2002). The direct catastrophic
  injury rate in high school and college wrestlers is
  approximately 1 per 100,000 participants. The major-
  ity of injuries occur in match competitions, where
  intense, competitive situations place wrestlers at a
  higher risk (Boden et al, 2002; Jarrett et al, 1998;
  Pasque and Hewett, 2000).


• There is a trend toward more direct injuries in the low-
  and middle-weight classes.


• Cervical fractures or major cervical ligament injuries
  constitute the majority of direct catastrophic wrestling
  injuries (Boden et al, 2002).

MECHANISM

• The position most frequently associated with injury is
  the defensive posture during the takedown maneuver,
  followed by the down position (kneeling), and the
  lying position (Boden et al, 2002). There is no clear

predominance of any one type of takedown hold that

contributes to wrestling injuries.

• The athlete is typically injured by one of three scenar-
  ios: (1) The wrestler’s arms are in a hold such that he
  or she is unable to keep from landing on his or her
  head when thrown to the mat. (2) The wrestler
  attempts a roll but is landed on by the full weight of his
  opponent, causing a twisting, usually hyperflexion,
  neck injury. (3) The wrestler lands on the top of his
  head, sustaining an axial compression force to the cer-
  vical spine.

PREVENTION

•A minimum body fat for high school and college

wrestlers has been established to reduce weight loss

injuries. The NFHS also instituted a rule that com-

petitors cannot lose more than 1.5% body weight per

week. Both the NCAA and NFHS have banned the

use of laxatives, diuretics, and other rapid weight loss

techniques such as rubber suits.

• Referees should strictly enforce penalties for slams
  and gain more awareness of dangerous holds (Boden
  et al, 2002). There is particular vulnerability for the
  defensive wrestler who may be off balance, have one
  or both arms held, and then have his opponent land on
  top of him. Stringent penalties for intentional slams or
  throws are encouraged. The referee should have a low
  threshold of tolerance to stop the match during poten-
  tially dangerous situations.


• Coaches can prevent serious injuries by emphasizing
  safe, legal wrestling techniques (Boden et al, 2002).
  Coaches should teach wrestlers to keep their head up
  during any takedown maneuver to prevent axial com-
  pression injuries to the cervical spine. Proper rolling
  techniques, with avoidance of landing on the head,
  need to be emphasized in practice sessions.

CHEERLEADING

EPIDEMIOLOGY

•Over the past 20 years cheerleading has evolved into

an activity demanding high levels of skill, athleticism,

and complex gymnastics maneuvers (www.aacca.org).

• In 2002 cheerleading was one of the four most popu-
  lar organized sports activities for women in high
  school.


• Cheerleaders in college and high school account for
  more than half of the catastrophic injuries that occur
  in female athletes (Mueller and Cantu, 2000).


• There are approximately 1.95 direct catastrophic
  cheerleading injuries per year. The catastrophic injury
  rate is 0.4 per 100,000 in high school cheerleaders,