Injury Trends in Field Hockey: "Establishing the Extent of the Problem"

Establishing the extent of the injury problem in a sport is the primary step towards preventing injury in that sport. To date, few studies have been undertaken to investigate this injury problem in field hockey, particularly in male club level athletes. As such, injuries in the sport are poorly understood. Understanding the context of injuries is hugely important, as the responsibility for preventing injuries falls among a number of different stakeholders. Thus, the primary aim of this thesis was to investigate the injury problem in male field hockey athletes, using both quantitative and qualitative approaches. Following a systematic review of the literature, it was evident that good-quality epidemiological studies of injury in field hockey are lacking. Risk of bias was high, and there was significant heterogeneity. Injuries to the hamstring (18.6%), knee (12.1%), and hip/groin (11.8%) were the most frequently observed injuries in field hockey athletes, when using an all physical complaints definition. These particular injuries also incurred the most significant burden, with athletes suffering injury related symptoms for 22.6 days, 17.0 days, and 15.4 days per thousand exposure hours respectively. Overall, injuries had a total burden of 121.0/1000h (match=539.6/1000h; training=53.2/1000h), with 61.4 days/1000h being days lost through injury. Transient injuries accounted for roughly 54% of all injuries, highlighting the immense pressure that short-term injuries can have on a squad. Non-contact injury mechanisms were the most frequently reported, with injuries tending to occur in matches. Coaches generally had positive attitudes towards injury and injury prevention, but lacked the skills to implement such strategies in squads. Athletes, on the other hand, failed to demonstrate a good understanding of injury management. Athletes admitted to often failing to report injuries, particularly those more minor, to the coach, thereby hindering the coaches’ ability to protect the welfare of the athlete, a likely barrier to the implementation of future interventions. Fixture congestion and a poor structuring of the domestic calendar, as set out by the national governing body were considered to be leading barriers to injury prevention by both coaches and athletes. Potential considerations and implications of this thesis were proposed, targeting each of the stakeholders responsible for preventing injury in field hockey athletes with recommendations on how to improve future practice to reduce athlete’s risk of sustaining injury.