Epidemiology, injury and illness prevention in Olympic combat sports

Background: Olympic combat sports are commonly considered dangerous, however injury rates for these sports are not well understood. Isolated studies in combat sports have investigated injury, however these are mainly during competition, and therefore are unlikely to include significant or persistent injury which prevents athletes competing and participating in data collection. This thesis was undertaken as a series of linked studies, to provide further detail into the types, mechanisms and aetiology of injuries in combat sports. Methods: Study 1 was a systematic review that utilised the PRISMA guidelines to investigate the current evidence. Study 2 was a repeated measures study to examine the reliability of training load measures. Study 3 employed a longitudinal study design to assess the feasibility of injury, illness and training load monitoring. Finally, Study 4 was a cross-sectional cohort study that gathered perspectives of combat sport coaches and managers before and after an injury and illness prevention workshop. Results: Study 1 found one high-quality epidemiological study with low risk of bias in Judo. Variation in injury and illness definitions prevented cross-sport comparisons, however the injury incidence was comparable to other sports. In Study 2, rating of perceived exertion (RPE) was shown to have good stability across sessions (ICC=0.84), and no significant differences were found between coach (observed) and athlete (experienced) RPE (ordered logistic regression coefficient = 0.47 [1.51–0.57 95%CI]). Study 3 found that athlete engagement with the monitoring system was low, with only 13% of athletes entering data across a 12-week period. Irrespective of low engagement, 62 injuries and illnesses were recorded. In Study 4, combat sport coaches and managers were found to be generally well informed of the risk and seriousness of injury and illness, however, illness risk perceptions changed after the workshop (p=0.048). Discussion and Conclusion: Currently, cross-sport comparisons are not possible due to varying data methodology and study quality. Based upon the results presented in this thesis, RPE can be used as a tool to quantify training load in the sport of judo. Longitudinal surveillance of training load, injury and illness in combat sport is not currently feasible within the Australian system, due to low uptake and engagement. However, the collection of data on a large number of injuries and illnesses indicates that athletes are experiencing multiple, repeated health problems. Coaches and managers are well informed about injury and illness risk and seriousness, indicating that injury and illness prevention education alone may not translate to a decrease in injury and illness incidence in combat sport.Doctor of Philosoph