Pediatric and Adolescent Figure Skating Injuries: A 15-Year Retrospective Review

Abstract

Objective: To analyze the characteristics of injuries sustained by young figure skaters who were evaluated at regional pediatric sports medicine clinics. Design: Retrospective chart review (2003-2017). Setting: Sports medicine clinics at a tertiary-level pediatric medical center. Patients: Two hundred ninety-four figure skaters (271 female and 23 male). Age rage: 9 to 19 years. Mean age: 14.2 ± 2.3 years. Interventions: None. Main Outcome Measures: Mechanism of injury (acute vs overuse), injured body areas, diagnoses for most commonly injured body areas, and distribution of bone stress injuries. Results: Eight hundred sixty-four figure skating–related injuries were identified. Approximately 68.9% were overuse and 31.1% were acute. In female figure skaters, the most frequently injured body areas were foot/ankle (29.6%), knee (19.3%), and back (15.8%). In male figure skaters, they were foot/ankle (25.4%), hip (16.4%), and knee (14.9%). Most common diagnoses at these body areas were tendinopathy (foot/ankle), extensor mechanism (knee), and posterior column bone stress injuries (back). All injuries to anterior knee structures, excluding bone contusions, were categorized as extensor mechanism injuries. About 11.8% of all injuries were bone stress reactions/fractures with the majority occurring at the back (42.2%), foot/ankle (32.4%), and lower leg (15.7%). Conclusion: Most injuries sustained by figure skaters were overuse and occurred most commonly at the foot/ankle (29.6%), knee (19.3%), and back (15.8%). Approximately 1 in 10 injuries were bone stress reactions/fractures, and nearly 1 in every 3 skaters who presented with back pain was diagnosed with a posterior column bone stress injury. Health care providers who take care of young figure skaters need to maintain a high index of suspicion for overuse injuries, especially bone stress reactions/fractures.

Determinants of Sports Injury in Young Female Swedish Competitive Figure Skaters

“…A recent retrospective study on figure-skating related injuries among 294 American figure skaters between 9 and 19 years of age found that 69% of the injuries were due to overuse and 31% were traumatic (Kowalczyk et al, 2019), similar to the results in this study. An overuse injury may negatively affect future sports participation and result in long-term health consequences (DiFiori et al, 2014) and is recognized to affect those exposed to repetitive loading combined with inadequate rest.…”

“…As in previous studies about figure skating (Han et al, 2018;Kowalczyk et al, 2019), the lower limbs seem to be more affected by an injury. This reflects figure skating's biomechanics, where the elements performed require work mainly in the foot/ankle, knee, and hip joints.…”

“…Also, skates restrict plantar flexion when jumping, which have been proposed to redistribute the energy produced by the knee extensors to the hip and the ankle joints, leading to an increased risk of injury (Haguenauer et al, 2006). The skating boot might also cause tendon-and ligament injuries in the foot/ankle (Kowalczyk et al, 2019). Moreover, asymmetrical loading in the joints of the same leg during repeated high impact landings might further increase the injury risk.…”

“…This is an international research project, that since 1985/1986, has been conducted by the World Health Organization, every fourth year in 50 countries and regions across Europe, Asia and North America (Public Health Agency of Sweden, 2014). The use of self-report questionnaires may be limited by athletes' tendency to underreport eating pathology and associated physiological features, leading to false negatives and underestimating the findings (Johnson et al, 1999). There is a possibility that athletes with injuries and worse health were overrepresented among the respondents; being more motivated to contribute to further research on these issues among figure skaters.…”

Effect of Sports and Growth on Hamstrings and Quadriceps Development in Young Female Athletes: Cross-Sectional Study

“…On the other hand, it has been theorized that skating athletes have a lower risk for sustaining acute injuries, such as anterior cruciate ligament (ACL) tears, when compared to other competitive female athletes [9]. Female soccer players, for instance, were known as a group of competitive athletes who have a relatively high incidence of ACL tears [10,11,12].…”