Results: Out of 50 coaches, 94% were males and 6% were females with mean age of 38.74 years. 70% of the coaches found the frequency of injury in the range of 1-5, which included soft tissue injury (46%) followed by bruise and dental trauma. 66% of the coaches believed that boxing was the sports event most likely to cause injury, but boxing, football and rugby (38.5%) were the sports which actually caused injury. The mechanism of injury was mainly due to collision (42%). The protective devices most commonly used were helmet (61.4%) and mouth guards (47.7%). 70% of the coaches felt that nonuse of protective devices can cause injuries sometimes. 68% of the coaches found that protective devices enhance the efficiency of the players and 76% considered the use of protective devices based on the type of games.
Conclusions: The results show that there is an increasing acceptance to the use of protective devices among the coaches of Chennai, but its usage was mostly based on the type of game. Keywords: Coaches; Sports injuries; Protective devices
Contact sports are defined as those sports in which players physically interact with each other, trying to prevent the opposing team or person from winning [8]. There is seldom very high incidence of dental trauma compared with all accidents in contact sports varying from 2% to 33% [9,10,11]. Dental and soft tissue injuries are commonly associated with collision and contact sports such as football, ice hockey, soccer, baseball, bicycling, inline skating, gymnastics, basket ball, alpine skiing, softball, volleyball, karate, mountain biking and skateboarding [6,12,13,14,15,16].
Incidence of sports related oral injury vary widely based on the sport played, level of competition, the participant's age and sex [6,17]. Dental injuries are the most common type of orofacial injuries sustained during sports activities [18]. Dental trauma in sports differ from other dental trauma, as it is possible to easily prevent it and there is also a possibility to dramatically reduce the occurrence levels by the use of mouthguards that protect all dental and periodontal structures [19,20]. Dental professionals have long encouraged mouthguard use and dental consultation in organized sports [21]. The only professional sports that require a mouthguard is boxing [22]. In New Zealand, despite a high incidence of avulsive injuries, sports coaches generally had an inadequate knowledge for managing such conditions [23]. Injuries can counter the beneficial effects of sports participation at a young age if a child or adolescent is unable to participate because of the residual effects of injury [24,25].
Some sports medicine professionals pointed directly to poor coaching as a factor in injury [26]. Many young athletes are never taught the proper conditioning methods or technique for their sports [27], as the coaches simply do not have the proper knowledge base for instructing in correct sports techniques [28]. However Smith and Smoll and Smith et al proved the effectiveness of certain communication techniques used by coaches to interact with young athletes during their coaching [29,30,31]. The risks are always inherent risks in physical activity hence our goal should be to create a safe environment as possible in which our children can participate.
This present study was undertaken because a thorough search of the literature revealed sparse data of the perception of Indian coaches regarding oro-facial injuries and their prevention. This study evaluated the perception and attitudes of sports coaches in Chennai, India regarding various aspects of sports related oro-facial injuries as they have a direct influence on the trainees. The data collected from the coaches could be utilized to plan a sports injury preventive strategy by providing feedback to coaches, trainees and henceforth promote the use of oro-facial protective devices.
Name: Age: Qualification:
GamesExperience in years
Yes No Not sure
Yes No
(a) (b) (c)
(a)None (b)1-5 (c)6 or more
(a) (b) (c)
(a) Falls (b) Collision (c) Hit by a ball/hockey stick/hard object (d) Fights between players
(a) Bruise (b) Cut-lip, cheek, tongue (c) Broken tooth, Tooth lost (d) Fracture of facial bones (e) Others
(a) First aid done by me (b) First aid done by any associated medical officer (c) Referral to the hospital/dental office
Games Protective devices
(a) Always (b) Sometimes (c) Never
(a) Reduce efficiency? (b) Enhance efficiency? (c) Any other comment?
(a) Always required irrespective of the type of game (b) Required based on the type of game (c) Not required at all
(a)Mouthguard, helmet, facemask, knee cap (b)------------------ |
70% of the coaches found the frequency of injury in the range of 1-5 [Table 3]. 66% of the coaches believed that boxing was the sports event most likely to cause oro-facial injury (Table 1). Boxing again stood first among the sports events (38.5%) along with football and rugby which actually caused injury (Table 2). In majority of the injuries, the mechanism by which they were caused was due to collision (42%) (Table 3). The most common injury was a soft tissue injury (46%) like cut lip, cheek or tongue, followed by bruise and dental trauma (Table 4). 46.20% of the coaches gave first aid by themselves.
On comparing the games and protective devices used, 31.4% of the coaches opted mouthguard as the most preferred protective device for boxing. Helmet was the most preferred protective device for cricket (49%) and hockey (40%). In games like football, rugby and others, the most preferred protective
Games for which now coaching is provided |
Frequency |
Percentage |
Athletics |
4 |
8% |
Basket ball |
5 |
10% |
Boxing |
3 |
6% |
Cricket |
8 |
16% |
Foot ball |
10 |
20% |
Hockey |
5 |
10% |
Kabbadi |
3 |
6% |
Kho-kho |
3 |
6% |
Rugby |
4 |
8% |
Volleyball |
5 |
10% |
Total |
50 |
100% |
Frequency of sustaining an injury |
Frequency |
Percentage |
None |
11 |
22% |
1-5 |
35 |
70% |
6 or more |
4 |
8% |
Total |
50 |
100% |
Frequency of injury |
Frequency |
Percentage |
Always |
14 |
28% |
Sometimes |
35 |
70% |
Never |
1 |
2% |
Total |
50 |
100% |
The frequency of injuries when not using protective devices is shown in (Table 4). Of which 70% of the coaches felt that non-use of protective devices can cause injuries sometimes and 28% of the coaches felt that non-use of protective devices can
Other Protective devices |
Responses |
|
---|---|---|
N |
Percent |
|
Shinguard |
9 |
37.5 |
Head Gear |
2 |
8.3 |
Abdomen guards |
1 |
4.2 |
Armguards |
2 |
8.3 |
Elbow cap |
3 |
12.5 |
Kneecap |
1 |
4.2 |
Crap bandage |
3 |
12.5 |
Boot / spikes |
3 |
12.5 |
Total |
24 |
100.0 |
Coaches have witnessed 1-5 numbers of oro-facial or dental injuries during their coaching.
Sports that caused orofacial injuries were boxing, football and rugby.
Mechanism of injury was collision by players.
Type of injury witnessed was soft tissue injuries.
Games - Protective devices used
Boxing - Mouthguards
Cricket and hockey - Helmet
Most of the coaches felt non use of protective devices to cause injury was sometimes not always.
Even though most of the coaches agreed that protective devices enhance the efficiency of the players, it was used or they advocated its usage based on the game they played.
Though 66% of the coaches in the present study believed that boxing most likely caused injury, the sports events that actually caused injury along with boxing (39%) were also football (39%) and rugby (39%). This may be because probably higher percentage of coaches were having football as their main sport (20%).Similar results were also found by Mc Nutt, et al. and Garon MW, et al. who found the highest oro-facial injuries with football [33,34]. According to Fos, et al. the high velocity and intensity of football, hockey and rugby place them in a high risk category for oro-facial injuries whereas Kujala, et al. observed that injury rates were higher in those sports involving more frequent and powerful body contact like ice hockey and karate [36,37].
In the present study, majority of the injuries occurred due to collision (42%) followed by hit by an object (32%). The most common type of injury were soft tissue injuries (46%) followed by bruising (24%) and dental trauma (16%). In a similar study, Blinkhorn FA found that falls and collision were the main cause of injury (38). Rob Berg, et al. found in his study that the most common injury was a cut lip, tongue or cheek (82.4%). He also suggested that this type of injury should be a cause for great concern, as they may represent a tooth-object impact in which significant tooth damage was avoided only fortuitously [35].
The protective devices most often preferred by the coaches in the present study were helmet and mouthguards similar to the results by Lehl G [32]. Ranalli DN observed that appropriate and properly fitted protective mouthguards, headgear and helmets prevent oro-facial trauma [39]. Helmets and facemasks when used properly enhance player safety and reduce morbidity [22,40]. It is a promising finding that 80% of the coaches had interacted with medical or dental experts regarding injury prevention and 68% of the coaches found that protective devices enhance the efficiency of the players.
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