Ultimate Frisbee injuries mostly in lower limbs, mainly major injuries

Ultimate Frisbee, a fast-paced, non-contact team sport played with a flying disc that is rapidly gaining popularity in Hong Kong, is associated with an injury prevalence of 62.7 percent, with most injuries occurring in lower limbs and a majority being major injuries, researchers from the Chinese University of Hong Kong (CUHK) have reported.

Results of the study also showed a higher risk of injuries in tournaments than during training, with laying out (ie, diving with an outstretched hand) and jumping or landing from jump associated with higher injury risks. [Asia Pac J Sports Med Arthrosc Rehabil Technol 2021;26:27-31]

In the retrospective cross-sectional study, online self-reported surveys were collected from Ultimate Frisbee players who had participated in at least one tournament in 2019 and/or members of Hong Kong-based teams in a professional, club, college, high-school or recreational league through the Hong Kong Flying Disc Federation. Among 119 active players invited to participate in the study, 90 responded, and 59 responses (age range, 18–55 years; male, 66.1 percent; mean height, 172 cm; mean body weight, 67.6 kg; mean body mass index, 22.6 kg/m²) were eligible for analysis. All study participants were of Chinese ethnicity.

The injury incidence rate (IR) was 5.74 per 1,000 hours of athlete-exposures, with 54 injuries reported over a total of 9,412 athlete-exposures. The prevalence of injuries was 62.7 percent. More participants suffered a single injury (59.5 percent) than multiple injuries (40.5 percent).

A majority of injuries occurred in the lower limbs (61.1 percent), most commonly at the feet and ankles (27.8 percent), followed by knees (24.1 percent). Most of the injuries arose from joints and ligaments (44.4 percent), followed by muscles and tendons (33.3 percent).

Cutting was the most commonly reported mechanism of injury (23.7 percent), followed by jumping (19.6 percent), pivoting (11.3 percent), stepping on uneven surface (11.3 percent), and laying out (10.5 percent).

No significant differences were observed in injury incidence between men and women (incidence rate ratio [IRR], 1.16; 95 percent confidence interval [CI], 0.63 to 2.14), and in the mechanisms of injuries between younger and older age groups.

Most of the injuries were major (72.2 percent), requiring on-site medical attention and/or resulting in time loss. The risk of injury during training was 3 times lower than that during tournament (IRR, 0.33; 95 percent CI, 0.18 to 0.60; p<0.01).

“There was a higher risk of injuries in tournaments from laying out [IRR, 0.04; 95 percent CI, 0.01 to 0.30; p<0.01] and jumping/landing from jump [IRR, 0.30; 95 percent CI, 0.11 to 0.86; p=0.02],” the researchers reported.

Most (57.4 percent) of the recorded injuries were new, while 29.6 percent and 13 percent were recurrence and exacerbation of previous injuries, respectively.

“A significant proportion of the injuries was indirectly associated with collision, such as improper landing from laying out [17.5 percent] and collision with another athlete [15.8 percent],” the researchers wrote.

With a lack of epidemiological study on injuries among Asian Ultimate Frisbee players, these findings can facilitate better injury rehabilitation and prevention of recurrence or exacerbation for players in Hong Kong.

“Individual injury mechanisms can be addressed with tailored intervention to decrease the occurrence and risk of injuries,” the researchers suggested.