The epidemiology of musculoskeletal injuries in competitive lifesavers in KwaZulu-Natal

Abstract

Lifesaving is a multidimensional sport which can lead to injury and a high likelihood of overuse-related injuries. The environment within which lifesaving occurs is unique, with the soft beach sand and unpredictable nature of the ocean. It is difficult to assess the effects that injuries may have on the training and competitive performance of lifesavers as the incidence and severity of these injuries have not previously been studied in South Africa. Thus, this study investigated the epidemiology of lifesaving induced musculoskeletal (MSK) injuries in competitive lifesavers in KwaZulu-Natal. Lifesavers are under-investigated, yet the growth and development of the sport requires that athletes are assessed for injury. This study could aid in educating federations, coaches and athletes regarding MSK injuries sustained by lifesavers, thereby assisting athletes to be more competitive at national and international competition levels. Method: A quantitative, descriptive, cross-sectional epidemiological survey was used to collect data from 100 competitive lifesavers in KwaZulu-Natal. The questionnaire was pre-validated and hand delivered to the lifesaving clubs that agreed to participate, where the lifesavers selfselected to participate. Informed consent was obtained. The survey contained questions related to demographics, activity participation, psychosocial factors and the occurrence of lifesaving related musculoskeletal pain. Results: The respondents were male (65%, n=65) and had a mean age of 28.6 years (±SD 14, range 16-73). The lifetime prevalence of MSK injury from lifesaving was 72% (n=72), with a total of 177 injuries being reported with shoulder pain being the most prevalent (38%). The 12- month prevalence showed 133 injuries were sustained whereas for current prevalence there were 86 injuries. Lower back pain was most frequently reported over these periods (26% and 22% respectively). The board race was the most popular event participated in at 76% (n=76), followed by surf ski 69% (n=69) and thirdly surf swim 67% (n=67). Seventy-four percent (74%) of board paddlers, 68% of surf ski paddlers and 67% of beach sprint and flags participants had experienced MSK pain related to lifesaving. Of the 72 competitors that experienced lifesaving MSK injuries more than half reported that it negatively affected them psychologically either in training, competition or overall. Injuries cause athletes to miss training sessions, which result in loss of fitness and falling behind the other athletes, this could cause a lack of confidence, lack of self-belief and lack of motivation to continue training and competing. The worst injury that the respondents had sustained occur mostly due to running (44%), was overuse related (43%), occurring in season (70%) and was described as a sharp, shooting severe pain with a constant and recurrent nature. It affected the athlete’s participation in the sport (75%) and required them to seek medical attention (89%). The only factor found to be related to MSK injuries was the number of rest days, which was significantly lower in those who suffered injuries (p=0.04). All other demographic, health, lifestyle and lifesaving activity participation factors were not associated with MSK lifesaving injuries (p < 0.05). Conclusion: This is the first study to document MSK injuries in lifesaving athletes in South Africa. The high prevalence of injuries necessitates that mechanisms are put in place to prevent injury. In addition, the mechanics of running on sand requires further investigation to understand its impact on injury