Despite the popularity of collegiate Gaelic football in Ireland and the recent expansion into the United Kingdom and United States, no previous study has examined injury incidence. A prospective epidemiological study was implemented to establish injury incidence in 217 male collegiate Gaelic footballers from two collegiate institutions in one season. An injury was defined as any injury sustained during training or competition resulting in time lost from play or athlete reported restricted performance. Athletic therapy and training students, alongside a certified athletic and rehabilitation therapist, attended all training/matches over one season, and injuries were recorded using a standardized injury report form. The match injury rate was 25.1 injuries per 1000 h, with a significantly higher match injury rate noted in fresher players (players in their 1st year of higher education) (41.6 injuries per 1000 h) than senior players (12.7 injuries per 1000 h). Lower limb injuries were predominant (71.1%), particularly in the hamstring (15.5%), knee (14.1%), and ankle (11.3%). Soft-tissue injuries predominated, particularly strains (32.4%) and sprains (27.5%). A scan and surgery was required in 31% and 12% of injuries, respectively. Thus, injuries are prevalent in male collegiate Gaelic football, and injury prevention programs are required.

Most research examining injury in Gaelic games has focused on elite adult men. Gaelic football and hurling are two of the most popular sports in Ireland, commonly played by teenagers. However, despite their popularity, only one previous study has looked at injuries in teenagers, and this focused on Gaelic footballers only and was published back in 1996. This study followed 292 male teenagers (15.7 +/-0.8 years) who played Gaelic football and hurling over 1 year. Any players who had an injury during training or matches that led to them not being able to play, or reduced their perceived performance when playing, were examined.One-third of all players sustained an injury during the year, with a quarter of those experiencing at least one other injury. Hurlers sustained more match injuries than Gaelic footballers, and match injuries were more common than training injuries. Overuse and recurrent injuries were quite frequent in players. Most of the injuries occurred to their lower limb, especially to the knee and ankle. Gaelic footballers suffered from more hamstring injuries, whereas hurlers experienced more lower back injuries. Hurlers reported more minor injuries leading to <7 days from sport, with Gaelic footballers experiencing injuries that kept them out of sport for 8 +/- 21 days and >21 days more commonly. One-fifth of all injuries were referred for a scan (X-ray, MRI and others) and 7% needed surgery. This led to significant costs to the players, their parents and the governing body for Gaelic games. The use of protective equipment by teenage players, outside of the mandatory mouth guards in Gaelic football and helmets in hurling, was very low

The aim of this study was to investigate potential moderators (i.e. lower body strength, repeated-sprint ability [RSA] and maximal velocity) of injury risk within a team-sport cohort.Forty male amateur hurling players were recruited. During a two-year period, workload (session RPExduration), injury and physical qualities were assessed. Specific physical qualities assessed were a three-repetition maximum Trapbar deadlift, 6x35-m repeated-sprint (RSA) and 5-, 10- and 20-m sprint time. All derived workload and physical quality measures were modelled against injury data using regression analysis. Odds ratios (OR) were reported against a reference group.Moderate weekly loads between 1400 AU and 1900 AU were protective against injury during both the pre-season and in-season periods compared to a low load reference group (<1200 AU). When strength was considered as a moderator of injury risk, stronger athletes were better able to tolerate the given workload at a reduced risk. Stronger athletes were also better able to tolerate larger week-to-week changes (>550-1000 AU) in workload than weaker athletes. Athletes who were slower over 5-m, 10-m and 20-m were at increased risk of injury compared to faster athletes. When repeated-sprint total time was considered as a moderator of injury risk at a given workload, athletes with better repeated-sprint total time were at reduced risk compared to those with poor repeated-sprint total time. These findings demonstrate that well-developed lower-body strength, repeat sprint ability and speed are associated with better tolerance to higher workloads and reduced risk of injury in team-sport athletes.

The aim of this study was to examine the pathogenesis and clinical presentation of sports-related femoroacetabular impingement (SRFAI) in a large consecutive series of symptomatic athletes. Between January 2009 and February 2017 prospectively collected data from competitive athletes within the Gaelic Athletic Association, and who subsequently underwent arthroscopic treatment for symptomatic FAI, were analysed. Data was collected using internationally validated health questionnaires (Harris Hip Score, UCLA, SF-36, WOMAC) and recognised clinical (ROM, symptom presentation, provocation tests) and radiological (AP pelvis, Dunn, False profile) indicators/measures of FAI. A total of 1021 consecutive cases were included. In every case, conservative treatment failed to resolve symptoms with athletes attending an average of 2.4 ± 1.1 health care professionals prior to referral. Symptoms developed gradually (78%) and consisted primarily of groin pain (76.1%) and hip stiffness (76.5%) following activity. An acetabular rim deformity (pincer) was present in all cases; a cam deformity in 72.1%. The prevalence and degree of cam deformity increased with progressing age groups; mean lateral centre-edge angle remained static. Increasing CEA, alpha angle and presence of rim fracture was associated with a reduction in all ranges of hip movement. Symptomatic SRFAI presented in this large series of GAA athletes failed to resolve with non-operative treatment. Increasing hip deformity resulted in poorer ROM. Abnormal acetabular morphology remains static with increasing athletic age while cam deformity is progressive and most likely a secondary pathology.

This study aimed to highlight the dangers of hurling helmet modification. This case study provides photographic evidence of a penetrating injury from helmet modifications. We recommend that rule changes to allow referees to inspect helmets before games take place.

The aim of this study was to assess the proportion of penoscrotal injuries arising from the sport of hurling and to assess work-up and management of each injury.Using Hospital In-Patient Enquiry data, all penoscrotal injuries occurring over a 10-year period between 2007 and 2017 were identified and assessed. Chart review, imaging reports, operative notes and discharge summaries were used to identify the aetiology of each injury and those occurring due to hurling were selected for analysis. Investigations and management of each case were reviewed.Seventy patients presented to our institution over a 10-year period with penoscrotal injuries and, of these, ten patients (14%) presented with injuries arising due to blunt scrotal trauma whilst playing hurling. The average age of these patients was 24.3 years, and the right testicle was injured six times, compared with the left testicle twice and isolated scrotal injuries twice also. One hundred percent of patients underwent diagnostic ultrasonography with Doppler flow assessment with 90% (9 patients) having positive findings. Three patients (33%) required operative management with only one patient (10%) requiring an orchidectomy. There were no delayed or interval procedures.The authors conclude that hurling is a physical sport with a notable proportion of blunt scrotal trauma arising due to the sport. Prompt physical examination and diagnostic ultrasonography are essential in investigations of injuries, and surgical exploration should be considered in all cases with concerns of testicular survival. Groin protection should be recommended to all players and in particular to those at high risk such as single testis or prior injury.

Hamstring injuries are a leading cause of injury in Gaelic games. Hamstring flexibility as a risk factor for hamstring injury has not yet been examined prospectively in Gaelic games.The aim of this study was to examine whether hamstring flexibility, using the modified active knee extension (AKE) test, and previous injury are risk factors for hamstring injury in Gaelic players and to generate population-specific AKE cut-off points.This study examined 570 players in School and colleges consisting of adolescent and collegiate Gaelic footballers and hurlers.The modified AKE test was completed at preseason, and hamstring injuries were assessed over the course of one season. Any previous hamstring injuries were noted in those who presented with a hamstring injury.Bilateral AKE scores and between-leg asymmetries were recorded. Receiver operating characteristic curves were implemented to generate cut-off points specific to Gaelic players. Univariate and backward stepwise logistic regression analyses were completed to predict hamstring injuries, hamstring injuries on the dominant leg, and hamstring injuries on the nondominant leg.Mean flexibility of 64.2 degrees and 64.1 degrees was noted on the dominant and nondominant leg, respectively. Receiver operating characteristic curves generated a cut-off point of?<?65 degrees in the AKE on the nondominant leg only. When controlled for age, AKE on the nondominant leg was the only predictor variable left in the multivariate model and significantly predicted hamstring injury. However, the sensitivity was 0% and predicted the same amount of cases as the null model. It was not possible to generate a significant model for hamstring injuries on the dominant leg, and no variables generated a P value <0.20 in the univariate analysis on the nondominant leg.Poor flexibility noted in the AKE test during preseason screening and previous injury were unable to predict those at risk of sustaining a hamstring strain in Gaelic games with adequate sensitivity.

Femoroacetabular impingement (FAI) is a commonly recognized condition in athletes characterized by activity-related hip pain and stiffness, which if left untreated can progress to hip osteoarthritis. The aim of the study was to determine the effect of symptomatic FAI on performance in young athletes based on the hypothesis that athletes with FAI would show deficits in performance compared with healthycontrols.The functional performance of a cohort of preoperative, competitive sportsmen with symptomatic FAI, was compared with that of a group of age, sex and activity-level matched controls. Participants performed functional tests including a 10-m sprint, a modified agility T-test, a maximal deep squat test and a single-leg drop jump (reactive strength index). Hip range of motion was assessed by measuring maximal hip flexion, abduction, and internal rotation (at 90 degree hip flexion). The FAI group was significantly slower during the 10-m sprint (3%) and agility T-test (8%); flexion, abduction, and internal rotation values for the FAI group were reduced compared with controls. No significant differences between groups were identified for squat depth or reactive strength index. The FAI group also reported higher levels of anterior groin pain during the 10-m sprint, modified agility T-test, and while squatting.

This study aimed to examine internal loads in male adolescent Gaelic footballers and their association with musculoskeletal injury. Written training diaries were completed by 97 male adolescent Gaelic footballers weekly and injuries, defined as any injury sustained during training or competition causing restricted performance or time lost from play, were assessed by a Certified Athletic Therapist. Daily load was determined for each player (session rating of perceived exertion by session duration) and summed to give weekly load. Univariate and multiple logistic regressions were conducted to determine the association with injury. Twenty-two injuries were recorded with match injuries significantly more common than training injuries. Periodic variations in weekly load and injuries were evident throughout the season. Univariate analysis identified weekly load, monotony and absolute change in load greater than the team average were significant injury risk factors. Multiple logistic regression with 2-weekly and 3-weekly cumulative loads, absolute change, monotony, strain, ACWR and age as independent variables identified internal load measures (monotony, strain and absolute change) were associated with injury with high specificity (96.0%) but low sensitivity (25.0%). The findings highlight the need to monitor team and individual loads to avoid sudden week-to-week changes or excessive weekly loads. Open communication between players, parents, coaches and sports medicine clinicians enables effective load monitoring that can reduce injury risk and may subsequently minimise dropout, improve team success and overall sport enjoyment and promote life-long sports participation.

The of this study was to determine whether athletes undergoing surgical intervention for FAI completed more hours of structured training in adolescence than matched healthy athletes. Sixty-seven athletes (25.53 ± 4.8 years) undergoing surgical intervention for symptomatic FAI were asked to recall the number of hours engaged in structured training between the ages of 10-12 and 13-15 years old (FAI group). Resultswere compared to an age (24.56 ± 4.5 years), gender and activity level matched control group (n=71) with no history of chronic hip/groin pain or hip stiffness and who were currently engaged in similar levels of training and competition. The FAI group reported significantly more structured training hours between the ages of 10-12 years than controls (6.55 ± 3.1 versus 5.69 ± 3.7 hrs/week) but no differences were observed for training volume between the ages of 13-15 years (8.45 ± 3.4 vs 8.03 ± 3.7 hrs/week). The authors concluded that higher volumes of structured training in early adolescence are a potential risk factor for the development of symptomatic FAI later in the player pathway.

Gaelic games are some of the most popular sports played by Irish adolescents, and the Gaelic Athletic Association has undertaken educational initiatives to improve awareness of a sports-related concussion (SRC). However, SRC underreporting is common among adolescent athletes internationally, potentially due to poor knowledge or attitudes toward SRC. This study aimed to examine previous experiences with, knowledge of, and attitudes toward reporting SRCs, as well as views on future education in adolescent Gaelic games players and their parents. Adolescent male and female Gaelic games players (n = 113) and parents (n = 151) completed an anonymous questionnaire examining previous experiences with, knowledge of, and attitudes toward reporting SRCs, as well as views on future SRC education initiatives. Overall, 57.5% of adolescent Gaelic games players suspected they had suffered an SRC previously, and a greater number of suspected SRCs were reported than were medically diagnosed. Adolescent players (mean score, 11.4/14) and their parents (mean score, 11.8) displayed good knowledge of SRC signs and symptoms. However, adolescents were less likely to report an SRC during an important game or if an important game was coming up. Both adolescents and their parents would like more SRC education, particularly in the format of online videos or medical professional-led workshops. Underreporting of SRC occurs in adolescent players, despite good knowledge of SRC signs and symptoms. Education is required to highlight the importance of completing a return-to-play program after an SRC regardless of match importance. A multifaceted educational strategy that targets the wider Gaelic games community in the preferred formats identified by key stakeholders is required.

Shoulder instability following traumatic glenohumeral dislocation is a common injury sustained by athletes particularly in contact and collision sports. Overhead contact sports such as gaelic football and hurling pose a unique hazard to the glenohumeral joint, increasing the risk of dislocation.The aim of this study was to assess return to sport, level of play, recurrence and functional outcomes in gaelic football and hurling athletes in comparison with players of other sports.A retrospective cohort study was carried out from 2007 to 2016. Follow-up was conducted via telephone interview using the Western Ontario Shoulder Instability Index (WOSI) score used to assess functional outcomes as well as return to sport, level of return and recurrence.Ninety patients were included with follow-up which was obtained on 61 patients (68%) with a mean follow-up of 5.04 years. 91.8% played sport at the time of injury, 55.4% of those (31 patients) played a gaelic sport with 44.6% (25 patients) playing other sports. 76.8% returned to their sport, 80.4% of these able to return at their pre-injury level. Recurrence occurred in 10 patients (16.4%). WOSI scores were not significantly different between groups. No significance in recurrence between groups was noted.Favourable outcomes can be expected for overhead contact sport athletes undergoing anterior arthroscopic stabilisation for recurrent instability. Players from these groups returned to sport sooner than those from other sports and no difference in recurrence was noted. The level at which they can expect to return to is favourable with most athletes reaching their pre-injury level.

A teenage boy had a cardiac arrest following a blow to the chest from a hurling ball (sliotar). Prompt resuscitation and automated external defibrillation enabled a full recovery. This is the first reported case of commotio cordis caused by a sliotar although it is described in other sports. Primary prevention of commotio cordis (CC) and secondary prevention of cardiac death are discussed.

Ankle sprains are common injuries in sports, but it is unclear whether they are more likely to occur in a specific period of a sporting game.This study aimed to systematically review the literature investigating when in a match ankle sprains most likely occurred.Databases were searched up to August 2016, with no restriction of date or language. The search targeted studies that presented data on the time of occurrence of ankle sprains during sports matches. Data from included studies were analyzed as a percentage of ankle sprain occurrence by halftime and by quarters. Meta-analyses were run using a random effects model. The quality assessment tool for quantitative studies was used to assess the article's quality.The searches identified 1142 studies, and 8 were included in this review. A total of 500 ankle sprains were reported during follow-up time, which ranged from 1 to 15 years, in 5 different sports (soccer, rugby, futsal, American football, and Gaelic football). The meta-analyses, including all 8 studies, showed that the proportion of ankle sprains during the first half was smaller than the second half. For the analyses by quarters, the proportion of ankle sprains in the first quarter was considerably smaller than the second, third, and fourth quarters.The results of this review indicate that ankle sprains are more likely to occur later in the game during the second half or during the latter minutes of the first half.

The purpose of this observational analytical cohort study was to assess the effectiveness of an injury prevention program (IPP)-Gaelic Athletic Association 15 (GAA15)-on the incidence of injury in collegiate Gaelic games. One hundred and thirty-one Gaelic games players were used for analysis in this study. Participants completed preseason and postseason testing which involved performance of the Y-Balance Test. The GAA15 was used for the intervention group; coaches were instructed to implement the program before every training session and match throughout the collegiate Gaelic Athletic Association (GAA) season. The control group adopted their normal warm-up procedures for the season. The players' injuries were documented on a weekly basis by allied health care professionals working with the teams using an online database system. Results showed significant improvements in composite Y-Balance scores in favor of the intervention group. Injury rates in the intervention group (2.62 injuries per 1,000 hours) were reduced by 66% in comparison with an age-matched control group (7.62 per 1,000 hour). Training injuries, hamstring injuries, noncontact injuries, and severe injuries were also reduced as a result of the implementation of the GAA15. Implementation of an IPP such as the GAA15 can reduce the risk of injury in Gaelic games and influence players' neuromuscular performance assessed through the Y-Balance Test.

The aim of this study was to report eccentric knee flexor strength values of elite Gaelic football players from underage to adult level whilst examining the influence of body mass and previous hamstring injury.341 elite Gaelic football players from under 14 years to senior age-grades were recruited from twelve teams.The measurements examined were Absolute and relative eccentric hamstring strength as well as corresponding between-limb imbalances (%) were calculated for all players.Mean maximum force was 329.4N per limb. No statistically significant differences were observed in relative force values between age-groups. Body mass had moderate-to-large and weak associations with maximum force in youth and adult players, respectively. Overall 40% presented with a maximum strength between-limb imbalance >10%. Players with a hamstring injury had greater relative maximum force and a 28% higher prevalence of between-limb imbalances ?15% compared to their uninjured counterparts.Overlapping strength profiles across age-groups, combined with greater strength in previously injured players, suggests difficulties for establishing cut-off thresholds associated with hamstring injury risk.

Managing injury risk requires an understanding of how and when athletes sustain certain injuries. Such information guides organisations in establishing evidence-based priorities and expectations for managing injury risk. In order to minimise the impact of sports injuries, attention should be directed towards injuries that occur frequently, induce substantial time-loss, and elevate future risk. Thus, the current study aimed to investigate the rate at which elite Gaelic football players sustain different time-loss injuries during match-play and training activities. 38 datasets from 17 elite Gaelic football teams were received by the National Gaelic Athletic Association Injury Surveillance Database from 2008 to 2016. A total of 1,614 time-loss injuries were analysed. Each season teams sustained 24.0 (interquartile ranges) and 15.0 match-play and training injuries, respectively. When exposure was standardised to 1,000 h, greater rates of injury (12.9) and time-loss days (13.4) were sustained in match-play than in training. Acute injury rates were 3.1-times greater than chronic/overuse injuries. Similarly, non-contact injury rates were 2.8-times greater than contact injuries. A total of 71% of injuries in elite Gaelic football affected five lower limb sites. Four lower limb-related clinical entities accounted for 40% of all time-loss injuries (hamstring, 23%; ankle sprain, 7%; adductor-related, 6%; quadriceps strain, 5%). Thus, most risk management and rehabilitation strategies need to be centred around five lower limb sites-and just four clinical entities. Beyond these, it may be highly unlikely that reductions in injury susceptibility can be attributed to specific team interventions. Thus, compliance with national databases is necessary to monitor injury-related metrics and future endeavours to minimise injury risk.

Most soccer, rugby union, rugby league, American football, Australian football and Gaelic football competitions over the world are played on natural grass over seasons that commence in the early autumn (fall) and extend through winter. Injury surveillance in these competitions has usually reported high rates of injury to the lower limb and an increased incidence of injuries early in the season. This 'early-season' bias has not usually been reported in summer football competitions, or in sports played indoors, such as basketball. Although easily compared rates have not often been published there has also been a reported trend towards a greater injury incidence in football played in warmer and/or drier conditions. Injury incidence in American football played on artificial turf has often been reported to be higher than in games played on natural grass. This review concludes that the most plausible explanation for all of these reported findings involves variations in playing surface characteristics. Shoe-surface traction for the average player is the specific relevant variable that is most likely to correlate with injury incidence in a given game of football. Shoe-surface traction will usually have a positive correlation with ground hardness, dryness, grass cover and root density, length of cleats on player boots and relative speed of the game. It is possible that measures to reduce shoe-surface traction, such as, ground watering and softening, play during the winter months, use of natural grasses such as perennial ryegrass and player use of boots with shorter cleats, would all reduce the risk of football injuries. The most pronounced protective effect is likely to be on injuries to the lower limb of a noncontact nature, including anterior cruciate ligament injuries. Intervention studies should be performed, both using randomised and historical controls.

Using a cross-sectional survey concussion knowledge was evaluated among forty university-level athletes (20 rugby union players & 20 Gaelic football players) and eight experienced team. Levels of knowledge of concussion were high across all participants. Coaches had higher knowledge scores for almost all areas; however, there was evidence of important gaps even in this group. Knowledge was not sufficient in identifying concussion, and when it is safe to return to play following a concussion. Impaired knowledge of how to recognise a concussion, and misunderstanding the need for rest and rehabilitation before return to play presents a hazard to health from second impact and more catastrophic brain injury. We discuss reasons for these guideline misconceptions, and suggest that attitude issues on the significance of concussion may underlie a willingness to want to play with a concussion. This suggests the current education on sport-related concussion needs to be expanded for the appropriate management of university-level contact sports.

The 2017 Berlin Concussion in Sport Group Consensus Statement provides a global summary of best practice in concussion prevention, diagnosis and management, underpinned by systematic reviews and expert consensus.Due to their different settings and rules, individual sports need to adapt concussion guidelines according to their specific regulatory environment. At the same time, consistent application of the Berlin Consensus Statement's themes across sporting codes is likely to facilitate superior and uniform diagnosis and management, improve concussion education and highlight collaborative research opportunities. This document summarises the approaches discussed by medical representatives from the governing bodies of 10 different contact and collision sports in Dublin, Ireland in July 2017. Those sports are: American football, Australian football, basketball, cricket, equestrian sports, football/soccer, ice hockey, rugby league, rugby union and skiing. This document had been endorsed by 11 sport governing bodies/national federations at the time of being published.

Hand injuries are the most common injury observed in hurling although compliance in wearing protective gloves is reportedly low.The aim of this study was to devise a glove that offers comfort, protection and freedom of movement, using the bespoke capabilities of 3-dimensional (3D) printing.Each player's "catching" hand was imaged using a 3D scanner to produce a bespoke glove that they later trialed and provided feedback.Nine players provided feedback. On average, the players favorably rated the glove for the protection offered. The average response on comfort was poor, and no players reported that glove aided performance during play.This feasibility study explores the versatility of 3D printing as a potential avenue to improve player compliance in wearing protective sportswear. Feedback will help refine glove design for future prototypes.Hurling is the primary focus in this study, but knowledge gains should be transferable to other sports that have a high incidence of hand injury.

Hamstring injury is one of the most common injuries affecting gaelic footballers, similar to other field sports. Research in other sports on whether residual hamstring weakness is present after hamstring injury is inconsistent, and no study has examined this factor in irish gaelic footballers. The aim of this study was to examine whether significant knee muscle weakness is present in male Irish gaelic footballers who have returned to full activity after hamstring injury.The concentric isokinetic knee flexion and extension strength of 44 members of a university gaelic football team was assessed at 60, 180 and 300 degrees per second using a Contrex dynamometer.Fifteen players (34%) reported a history of hamstring strain, with 68% of injuries affecting the dominant (kicking) limb. The hamstrings were significantly stronger on the dominant limb in all uninjured subjects. The previously injured limbs had a significantly lower hamstrings to quadriceps (HQ) strength ratio than all other non-injured limbs, but neither their hamstrings nor quadriceps were significantly weaker using this comparison. The previously unilaterally injured hamstrings were significantly weaker than uninjured limbs however, when matched for dominance. The hamstring to opposite hamstring strength ratio of the previously injured players was also found to be significantly lower than that of the uninjured players.Hamstring muscle weakness was observed in male Irish gaelic footballers with a history of hamstring injury. This weakness is most evident when comparisons are made to multiple control populations, both within and between subjects. The increased strength of the dominant limb should be considered as a potential confounding variable in future trials. The study design does not allow interpretation of whether these changes in strength were present before or after injury.

The aim of this study was to prospectively investigate incidence and associated time-loss of lower limb injuries in elite Gaelic football. Additionally, to identify sub-groups of elite players at increased risk of sustaining a lower limb injury.Team physiotherapists provided exposure and injury on a weekly basis to the National Gaelic Athletic Association (GAA) Injury Surveillance Database. Injury was defined using a time-loss criterion. Fifteen different teams participated throughout the 8-year study providing 36 team datasets from 2008 to 2015.1239 Lower limb injuries accounted for 83.5% and 77.6% of training and match-play injuries, respectively. Injury incidence was 4.5 and 38.4 per 1000 training and match-play hours, respectively. One-in-four lower limb injuries were recurrent. Non-contact injuries accounted for 80.9% of cases. The median team rate was 30 lower limb injuries per season resulting in 840.8 time-loss days. Previously injured players had a 2.5-times greater risk of sustaining a lower limb injury. Overall, 56.8% of players with a previous lower limb injury sustained another. Incidence was higher for forward players and those aged >25years.Lower limb injuries are the most common injury among elite division one Gaelic football teams. Injury risk management should become an ongoing component of a player's development programme and consider injury history, age, and playing position.

Hamstring injuries occur frequently in field sports, yet longitudinal information to guide prevention programmes is missing.The aim of this study was to investigate longitudinal hamstring injury rates and associated time loss in elite Gaelic football, while identifying subgroups of players at increased risk.38 data sets from 15 elite male Gaelic football teams were received by the National Gaelic Athletic Association (GAA) Injury Surveillance Database between 2008 and 2015. Injury and exposure data were provided by the team's medical staff via an online platform.391 hamstring injuries were sustained accounting for 21% of all injuries. Prevalence was 21%. Incidences were 2.2 per 1000 exposure hours, and 7.0 times greater in match play than in training. Typically each team sustained 9.0 hamstring injuries per season affecting the: bicep femoris belly (44%) proximal musculotendinous junction (13%); distal musculotendinous junction (12%) and semimembranosis/semitendinosis belly (9%). ?36% were recurrent injuries. Mean time loss was 26.0 days, which varied with age, injury type and seasonal cycle. Hamstring injuries accounted for 31% of injury-related time loss. Previously injured players, players aged 18-20?years or >30?years, as well as defensive and midfield players, were most at risk of sustaining a hamstring injury. Comparisons of 2008-2011 with 2012-2015 seasons revealed a 2-fold increase in hamstring injury incidences. Between 2008 and 2015 training incidence increased 2.3-fold and match-play incidences increased 1.3-fold.Hamstring injuries are the most frequent injury in elite Gaelic football, with incidences increasing from 2008-2011 to 2012-2015. Tailoring risk management strategies to injury history, age and playing position may reduce the burden of hamstring injuries.

The aim of this study was to establish the incidence, nature and severity of injuries in elite camogie players.A prospective, observational cohort study was carried out during the Provincial Championships and extending into the All-Ireland Championship until a participating team was eliminated (11 weeks). A purposive sample of 62 players from 3 of the total 11 senior intercounty teams participated to generate geographical representation. Injury data were recorded and classified by team physiotherapists using a time loss definition, consistent with consensus statements. A concurrent measure of exposure to matches and training was recorded.Twenty-one incidents of injury were recorded with 14 players injured. Injury incidence rate was 26.4 per 1000 match hours and 4.2 per 1000 training hours. There were 11 contact and 10 non-contact injuries. The lower limb accounted for 71.4% , the upper limb 9.5% and the trunk and head 19.1% of injuries. The main tissues injured were both muscle and ligament, representing 57.2%. The mean duration time loss from sport per injury was 12.14 days.These results provide data on the incidence, nature and severity of camogie injuries using definitions that reflect international consensus statements. Further study of injury incidence over a full season or multiple seasons is recommended.

The purpose of this study was to examine the association between combined session rating of perceived exertion (RPE) workload measures and injury risk in elite Gaelic footballers.Thirty-seven elite Gaelic footballers from 1 elite squad were involved in a single-season study. Weekly workload (session RPE multiplied by duration) and all time-loss injuries (including subsequent-week injuries) were recorded during the period. Rolling weekly sums and week-week changes in workload were measured, enabling the calculation of the acute:chronic workload ratio by dividing acute workload (ie, 1-weekly workload) by chronic workload (ie, rolling-average 4-weekly workload). Workload measures were then modeled against data for all injuries sustained using a logistic-regression model. Odds ratios (ORs) were reported against a reference group.High 1-weekly workloads (?2770 arbitrary units [AU], were associated with significantly higher risk of injury than in a low-training-load reference group (<1250 AU). When exposed to spikes in workload (acute:chronic workload ratio >1.5), players with 1 y experience had a higher risk of injury and players with 2-3 and 4-6 y of experience had a lower risk of injury. Players with poorer aerobic fitness (estimated from a 1-km time trial) had a higher injury risk than those with higher aerobic fitness. An acute:chronic workload ratio of (?2.0) demonstrated the greatest risk of injury.These findings highlight an increased risk of injury for elite Gaelic football players with high (>2.0) acute:chronic workload ratios and high weekly workloads. A high aerobic capacity and playing experience appears to offer injury protection against rapid changes in workload and high acute:chronic workload ratios. Moderate workloads, coupled with moderate to high changes in the acute:chronic workload ratio, appear to be protective for Gaelic football players.

The aim of this study was to determine if pre-season adductor squeeze test and HAGOS function, sport and recreation subscale scores can identify Gaelic football players at risk of developing groin injury.Fifty-five male elite Gaelic football players from a single senior inter-county Gaelic football team were examined in this study with the main outcome measure being occurrence of groin injury during the season.Ten time-loss groin injuries were registered representing 13% of all injuries. The odds ratio for sustaining a groin injury if pre-season adductor squeeze test score was below 225 mmHg, was 7.78. The odds ratio for sustaining a groin injury if pre-season HAGOS function, sport and recreation subscale score was < 87.5 was 8.94. Furthermore, for each additional point on the numerical rating scale pain rating during performance of the adductor squeeze test, the odds of groin injury increased by 2.16.This study provides preliminary evidence that pre-season adductor squeeze test and HAGOS function, sport and recreation subscale scores can be used to identify Gaelic football players at risk of developing groin injury.

Exercise-Induced Bronchoconstriction (EIB) is an acute, transient airway narrowing occurring after exercise which may impact athletic performance. Studies report 10% of the general population and up to 90% of asthmatics experience EIB. Ninety-two players from three elite hurling squads underwent a spirometric field-based provocation test with real-time heart rate monitoring and lactate measurements to ensure adequate exertion. Players with a new diagnosis of EIB and those with a negative field-test but with a previous label of EIB or asthma underwent further reversibility testing and if negative, methacholine challenge. Eight (8.7%) of players had EIB, with one further athlete having asthma with a negative field test. Interestingly, only three out of 12 players who had previously been physician-labelled with EIB or asthma had their diagnosis objectively confirmed. Our study highlights the role of objective testing in EIB.

The initial step in developing injury prevention strategies is to establish the epidemiology of injury. However there has been no published research on injury in Gaelic handball. This study describes the epidemiology of injury in 75 Gaelic handball players utilising a retrospective questionnaire. 88% of participants reported one or more injuries. Injuries to the upper limb were prevalent (52.9%), followed by the lower limb (30.3%). The shoulder (17.6%), finger (10.5%) and ankle (9.8%) were the primary sites of injury. Injuries occurred most frequently in December (9.7%), January (9.7%), February (9.7%) and November (8.7%). Injuries predominantly occurred during games (82.4%). Injuries were primarily severe (54.7%), with 14.6% of participants admitted to hospital due to injury. Given that this is the only study on Gaelic handball to date, prospective epidemiological studies and further research on injury prevention strategies are necessary.

The aim of this study was to examine the relationship between chronic training loads, number of exposures to maximal velocity, the distance covered at maximal velocity, percentage of maximal velocity in training and match-play and subsequent injury risk in elite Gaelic footballers.Thirty-seven elite Gaelic footballers from one elite squad were involved in a one-season study. Training and game loads (session-RPE multiplied by duration in min) were recorded in conjunction with external match and training loads (using global positioning system technology) to measure the distance covered at maximal velocity, relative maximal velocity and the number of player exposures to maximal velocity across weekly periods during the season. Lower limb injuries were also recorded. Training load and GPS data were modelled against injury data using logistic regression. Odds ratios (OR) were calculated based on chronic training load status, relative maximal velocity and number of exposures to maximal velocity with these reported against the lowest reference group for these variables.Players who produced over 95% maximal velocity on at least one occasion within training environments had lower risk of injury compared to the reference group of 85% maximal velocity on at least one occasion. Higher chronic training loads (>4750AU) allowed players to tolerate increased distances (between 90 to 120m) and exposures to maximal velocity (between 10 to 15 exposures), with these exposures having a protective effect compared to lower exposures and distance.The authors conclude that players who had higher chronic training loads (>4750AU) tolerated increased distances and exposures to maximal velocity when compared to players exposed to low chronic training loads (<4750AU). Under- and over-exposure of players to maximal velocity events (represented by a U-shaped curve) increased the risk of injury.

Finger injuries are common in the sport of hurling. Injury to the little finger distal interphalangeal joint (DIPJ) often occurs when a high dropping ball impacts on the outstretched finger. The little finger contributes to approximately 15% of grip strength. Injury therefore results in reduced grip strength and may impair the ability of players to grip or catch a ball.Six elite hurlers with post-traumatic arthritis of their non-dominant little finger DIPJ underwent arthrodesis in 30 degrees of flexion. Kirchner wires were inserted for up to 8 weeks to achieve fusion of the joint. Patients were evaluated after recovery using a dynamometer to assess grip strength, the DASH questionnaire and a sport specific questionnaire.All arthrodeses achieved bony union without complication. All patients reported a resolution of their pain and recovery in their ability to catch & retain a ball. Measurements of grip strengths were comparable between hands. DASH scores improved by up to 47 points. All scores were less than 5 at final follow-up.Grip strength decreases when fingers are immobilized in full extension. In sports that require catching or gripping a ball or a bat, arthrodesis of the DIP joint in flexion can improve grip strength and hand function. Fusion in 30 degrees of flexion for hurlers results in restoration of function and resolution of pain. Little finger DIPJ arthrodesis is a valid method of treating posttraumatic arthritis in ball and bat sports.

Gaelic games (Gaelic football and hurling) are indigenous Irish sports with increasing global participation in recent years. Limited information is available on longitudinal injury trends. Reviews of insurance claims can reveal the economic burden of injury and guide cost-effective injury-prevention programs.The aim of this study was to review Gaelic games injury claims from 2007-2014 for male players to identify the costs and frequencies of claims. Particular attention was devoted to lower limb injuries due to findings from previous epidemiologic investigations of Gaelic games.This study examined open-access Gaelic Athletic Association Annual Reports from 2007-2014 were reviewed to obtain annual injury-claim data.The authors examined player age (youth or adult) and relationships between lower limb injury-claim rates and claim values, Gaelic football claims, hurling claims, youth claims, and adult claims.Between 2007 and 2014, €64,733,597.00 was allocated to 58,038 claims. Registered teams had annual claim frequencies of 0.36 with average claim values of €1158.4 +/-192.81. Between 2007 and 2014, average adult claims were always greater than youth claims (6217.88 versus 1036.88), while Gaelic football claims were always greater than hurling claims (5395.38 versus 1859.38). Lower limb injuries represented 60% of all claims. The number of lower limb injury claims was significantly correlated with annual injury-claim expenses and adult claims but not with youth claims.Reducing lower limb injuries will likely reduce injury-claim expenses. Effective injury interventions have been validated in soccer, but whether such changes can be replicated in Gaelic games remains to be investigated. Injury-claim data should be integrated into current elite injury-surveillance databases to monitor the cost effectiveness of current programs.

Despite no previous research, it is anecdotally reported that hurling and camogie players modify their helmet and faceguard, which is against GAA regulations and can potentially increase injury risk. This study aimed to establish the prevalence and rationale behind modifications in hurling and camogie.An online questionnaire was completed by 304 players aged over 18 (62% hurlers, 38% camogie players) which consisted of 27 questions.Appearance (43%) was the primary reasons for helmet brand choice, with just 1.6% citing safety as a main reason for choice. Surprisingly, 8% of helmets were already modified when purchased and 31% of participants made further modifications, primarily switching faceguards and removal of bars. Restricted vision, comfort and perceived poor quality of the helmet/faceguard were the most common reasons for modification. Players predominantly (75.8%) agreed that further education on modifications is required.Future research on the relationship between helmet/faceguard modification and injury risk is required.

Hamstring injury is prevalent with persistently high reinjury rates. We aim to inform hamstring rehabilitation by exploring the electromyographic and kinematic characteristics of running in athletes with previous hamstring injury. Nine elite male Gaelic games athletes who had returned to sport after hamstring injury and eight closely matched controls sprinted while lower limb kinematics and muscle activity of the previously injured biceps femoris, bilateral gluteus maximus, lumbar erector spinae, rectus femoris, and external oblique were recorded. Intergroup comparisons of muscle activation ratios and kinematics were performed. Previously injured athletes demonstrated significantly reduced biceps femoris muscle activation ratios with respect to ipsilateral gluteus maximus, ipsilateral erector spinae, ipsilateral external oblique, and contralateral rectus femoris in the late swing phase. We also detected sagittal asymmetry in hip flexion, pelvic tilt, and medial rotation of the knee effectively putting the hamstrings in a lengthened position just before heel strike. Previous hamstring injury is associated with altered biceps femoris associated muscle activity and potentially injurious kinematics. These deficits should be considered and addressed during rehabilitation.

There is a lack of epidemiological research in adolescent Gaelic games, with previous research primarily focusing on elite adult males. This study aimed to prospectively capture the epidemiology of injury in male adolescent Gaelic games over one year.Two hundred and ninety-two (15.7 +/-0.8 years) male adolescent Gaelic footballers and hurlers took part in a one year prospective epidemiological study. Injuries were assessed weekly by a certified Athletic Rehabilitation Therapist and an injury was defined as any injury sustained during training or competition resulting in restricted performance or time lost from play. An injury report form was utilised to standardise injury information.Match injuries were more frequent in Gaelic footballers (9.26 per 1000h) and hurlers (11.11 per 1000h) than training injuries (2.69 and 3.01 per 1000h, respectively). Over a quarter of injuries in adolescent Gaelic footballers (26.7%) and hurlers (26.5%) were overuse in nature. Recurrent injuries were also frequent, particularly in adolescent Gaelic footballers (47.3%). Lower limb injuries predominated (football 74.7%, hurling 58%), particularly in the knee (18.7%, 20.0%) and ankle (12.0%, 10.0%). Hamstring injuries were more frequent in footballers (13.3%), with lower back injuries more common in hurlers (22.0%). Minor injuries were common in hurling (61.7%), with moderate (20.8%) and severe (37.5%) injuries predominant in Gaelic football.Injuries are frequent in adolescent Gaelic games and this study sets the scene for the establishment of injury prevention strategies for this at risk population.

Nasal bone fractures that require reduction are a common sequela of sports injuries. We conducted a survey to ascertain the outcomes of patients who had experienced a nasal bone fracture and who subsequently underwent manipulation under anesthesia. We reviewed data on 217 nasal bone fractures that had been seen at our institution over a 3-year period. Of these, 133 (61.3%) had occurred as a result of a sports activity. Thirty of the 133 patients (22.6%) had been managed conservatively, while the other 103 (77.4%) had undergone manipulation under anesthesia. We were able to contact 87 of the 103 patients (84.5%) by telephone, who served as the study population. The most common sports associated with these 87 injuries were hurling (26 patients; 29.9%), rugby (22 patients; 25.3%), Gaelic football (20 patients; 23.0%), and soccer (13 patients; 14.9%). Patients who had undergone treatment within 2 weeks were significantly more satisfied with their outcome than were those who had been treated later. Twenty-six patients (29.9%) reported that their injury had had a detrimental impact on their subsequent performance in their sport; 12 (13.8%) described a fear of reinjury when they returned to play, 7 (8.0%) experienced functional problems, 3 (3.4%) complained of diminished performance, and 4 others (4.6%) quit playing contact sports altogether. To the best of our knowledge, our study is the first to demonstrate that a fracture of the nasal bones may have a notable psychological impact on an athlete and that it can lead to diminished performance or a complete withdrawal from contact sports.

Allergic rhinoconjunctivitis (AR/C), has been shown to impact upon athletic performance. The championships of the unique, amateur Irish sports of hurling and Gaelic football take place during the prime pollen months of summer. Elite GAA players must perform optimally when most exposed to pollen. Elite GAA subjects (n=254) underwent skin prick testing to 6 aeroallergens and completed a validated questionnaire (AQUA), producing a score indicating likelihood of having allergy. The prevalence of allergy (positive to at least one aeroallergen on SPT and positive AQUA score) was 27.1% (69 players). Sixteen and a half percent (42 players) of the subjects tested had grass pollen AR/C while 22% (54 players) had house dust mite AR/C, though none were on standard medical therapies or had used allergen-specific immunotherapy. Grass pollen AR/C prevalence appears as common in elite Irish athletes as it is in other countries. It appears to be mild rather than well controlled in these subjects.

Sports-related maxillofacial injuries contribute a significant proportion of the workload in a maxillofacial unit. The aim of this study was to identify the incidence of maxillofacial sports-related injuries, treatments required, and assess the impact of the injury on future sport participation.A retrospective review was carried out on all maxillofacial trauma referrals from September 1, 2009 to August 31, 2010. Patient records were reviewed and the following variables were recorded: age, sex, sport involved, injury sustained, mechanism of injury, treatment, subsequent participation, and interval before return to sport.The study population included 162 patients with sports-related facial injuries. The most common sporting injuries were as follows: Gaelic football 35.3% (57 cases), soccer 22.3% (36 cases), rugby 12.4% (20 cases), and equine sports 12.4% (20 cases). The most common injury sustained was zygomatic complex fracture 36.4% (59 cases). Mandibular fracture occurred in 20% (33 cases), orbit fracture in 14.2% (23 cases), and nasal bone fracture in 12.3% (20 cases). The most common mechanism of injury was from a clash of heads (23.4%) followed by an elbow to the face (17.2%). The majority of patients (84%) resumed participation in their chosen sport at mean interval of 7.3 weeks (range 1-18 weeks).This study identified a significant number of sporting facial injuries, which presented over 1 year. In total, 113 patients underwent a surgical procedure for the management of their injuries. This study highlights the need to educate all players regarding use of personal protective equipment and adherence to the rules of sports.

Despite the compulsory use of faceguards in hurling, serious and sight-threatening eye injuries are still occurring.The purpose of this study is to highlight a number of key areas where there is still a high risk of serious ocular injury.Distinct patterns of injuries are being observed in both playing and non-playing staff in the following areas: in the pre-match 'warm up' period and during training drills, situations historically where faceguards or eye protection has not been worn. Moreover, significant injuries are being observed in matches due to either modification of or defective faceguards.It is incumbent upon the Gaelic Athletic Association to expand current safety regulations to eliminate injuries in these key areas. This should include mandatory checks of faceguards by match officials prior to the commencement of matches. Finally, there needs to be more robust data collection by the association to ascertain the true extent of long-term ocular morbidity following these types of injuries.

Chronic hip and groin pain offers a diagnostic challenge for the sports medicine practitioner. Recent consensus suggests diagnostic categorization based on 5 clinical entities: hip joint-, adductor-, pubic bone stress injury-, iliopsoas-, or abdominal wall-related pathology. However, their prevalence patterns and coexistence in an active population are unclear.This study presents a descriptive epidemiology based on a large sample of active individuals with long-standing pain in the hip and groin region. The objectives were to examine the prevalence of key clinical entities, document coexisting pathologies, and present prevalence patterns based on key demographics.A retrospective review was conducted of clinical records of all hip and groin injuries seen between January 2006 and December 2011 under the care of a single experienced sports medicine consultant. In all cases, imaging was undertaken by a team of specialist musculoskeletal radiologists. Diagnoses were categorized according to 5 clinical entities using contemporary diagnostic nomenclature. The chi-square test was used to compare observed and expected frequencies across each subgroup's prevalence figures based on sex, age, and sports participation.Full medical records were retrieved from 894 patients with chronic hip and groin pain. The majority of patients were male (73%), aged between 26 and 30 years, and participating in footballing codes (soccer, rugby, and Gaelic sports) or running. A total of 24 combinations of clinical entities were found. There were significant differences in prevalence patterns based on age, sex, and sports activity. Adductor-related pain or pubic bone stress injury rarely presented in isolation. Hip joint pathology was the most common clinical entity (55.98%) and was significantly more likely to present in isolation. The majority of hip joint pathologies related to femoroacetabular impingement (40%), labral tears (33%), and osteoarthritis (24%). These figures were significantly different across male and female patients, with a higher percentage of cases of femoroacetabular impingement and labral tears in male and female patients, respectively.Chronic hip and groin pain is often associated with multiple clinical entities. Hip joint pathology is the most common clinical entity and is most likely to relate to femoroacetabular impingement, labral tears, and osteoarthritis. These pathologies seem to be associated with secondary breakdown of surrounding structures; however, underpinning mechanisms are unclear.

We report on an unusual case of a penetrating injury from a bar from a metal grille from a hurling face protector. The bar impaled the patient's thumb after a collision with a patient. The bar was surgically removed in theatre with minimal injury. The authors highlight the need to ensure that helmets and face protectors are regularly checked, particularly ensuring that the bars have not become detached.

Hurling is a stick handling game which, although native to Ireland, has international reach and presence. The aim of this study was to report incidence and type of injuries incurred by elite male hurling players over five consecutive playing seasons.This study examined male intercounty elite sports teams participating in the National GAA Injury Database, 2007-2011.A total of 856 players in 25 county teams were enrolled.Incidence, nature and mechanism of injury were recorded by team physicians or physiotherapists to a secure online data collection portal. Time-loss injury rates per 1000 training and match play hours were calculated and injury proportions were expressed.In total 1030 injuries were registered, giving a rate of 1.2 injuries per player. These were sustained by 71% of players. Average injury incidence rate was 2.99 per 1000 training hours and 61.75 per 1000 match hours. Direct player-to-player contact was recorded in 38.6% injuries, with sprinting (24.5%) and landing (13.7%) the next most commonly reported injury mechanisms. Median duration of time absent from training or games, where the player was able to return in the same season, was 12?days (range 2-127?days). The majority (68.3%) of injuries occurred in the lower limbs, with 18.6% in the upper limbs. The trunk and head/neck regions accounted for 8.6% and 4.1% injuries, respectively. The distribution of injury type was significantly different between upper and lower extremities: fractures (upper 36.1%, lower 1.5%), muscle strain (upper 5.2%, lower 45.8%).These data provide stable, multiannual data on injury patterns in hurling, identifying the most common injury problems. This is the first step in applying a systematic, theory-driven injury prevention model in the sport.

One of the three national games of Ireland, hurling is a contact team sport (15 a side) played with a metre long ash stick and a small hard leather ball. Over a 12 month period, 413 players were treated for hurling-related injuries at Cork Regional Hospital. While hand and facial trauma predominate, the proportion between the two sites has changed substantially from previous reports with a reduction in the level of facial injuries. The wearing of a helmet, and optionally a supplementary faceguard, is seen to have contributed to this trend. Despite this welcome reduction of facial injuries, a certain resistance to the use of protective headgear is evident, particularly among older players.

The objective of the present study was to investigate whether differences exist in adductor squeeze test values and hip joint range of motion between athletes with longstanding groin pain and injury-free controls.Eighteen Gaelic football players with current longstanding groin pain and 18 matched injury-free controls were assessed on their performance of the adductor squeeze test. Adductor squeeze test values were quantified using a sphygmomanometer. A fluid-filled inclinometer was used to assess hip joint internal and external rotation range of motion. A bent knee fall-out test was also utilised to examine hip joint range of motion.A significant difference in adductor squeeze test values was observed between the control group (269 +/-25 mmHg) and longstanding groin pain group (202 +/-36 mmHg). Furthermore, the longstanding groin pain group had a decreased bent knee fall-out bilaterally, as well as decreased hip joint internal rotation and hip joint external rotation range of motion bilaterally when compared to the control group.Gaelic football players with longstanding groin pain exhibit decreased adductor squeeze test values and hip joint range of motion when compared to non-injured players. These findings have implications for assessment and rehabilitation practices, as well as return to play criteria.

A decrease in the proportion of head injury among emergency department (ED) presentations for hurling-related injury has coincided with voluntary use of helmet and face protection since 2003. A similar decrease in proportions has not occurred in hand injury. We aim to quantify hurling-related ED presentations and examine variables associated with injury. In particular, we were interested in comparing the occurrence of hand injury in those using head and face protection versus those who did not.This study utilised a retrospective cross-sectional study design.This study took place at a university hospital ED over a 3-month period.A follow-up telephone interview was performed with 163 players aged ?16 years to reflect voluntary versus obligatory helmet use.The hand was most often injured (85 cases, 52.1%). Hand injury most commonly occurred from a blow of a hurley (104 cases, 65%), and fracture was confirmed in 62% of cases. Two-thirds of players (66.3%) had multiple previous (1-5) hand injuries. Most patients 149 (91.4%) had tried commercially available hand protection, but only 4.9% used hand protection regularly. Univariate analysis showed a statistically significant association between wearing a helmet and faceguard and hand injury. On further analysis adjusting simultaneously for age, prior injury, foul play and being struck by a hurley, this relationship remained significant.We report that hurling-related hand injury is common. We noted the low uptake of hand protection. We found that hand injury was significantly associated with the use of helmet and faceguard protection, independent of the other factors studied. Further studies are warranted to develop strategies to minimise the occurrence of this injury.

Facial injuries were common but have been significantly reduced by legislation enforcing compulsory helmet wearing. Current standard helmets worn by hurlers do not offer protection to the external ear. Here we describe an emerging pattern of ear injuries and demonstrate the risk of external ear injuries in hurlers complying with current helmet safety standards. A 6-month retrospective analysis was carried out of patients attending Cork University Hospital (CUH) with ear lacerations sustained while hurling. Patient notes were reviewed and helmet manufacturers were interviewed. Seven patients were identified, all of whom sustained complex through ear lacerations while wearing helmets complying with current safety standards. Current helmet design fails to protect the external ear placing it at an increased risk of injury, a potential solution is to include ear protection in the helmet design.

The aim of this study was to describe the incidence and nature of sport-related injuries in elite male Gaelic football players over 4 consecutive seasons.Over the period 2007 to 2010, a total of 851 Gaelic football players were tracked. Players were members of county-level teams who volunteered to be included in the study. Team injury, training, and match play data were submitted by the team physiotherapist on a weekly basis through a dedicated web portal to the National Gaelic Athletic Association (GAA) injury database. Injury was defined using a time loss criterion, in accordance with consensus statements in sports applicable to Gaelic games.A total of 1014 Gaelic football injuries were recorded. Incidence of injury was 4.05 per 1000 hours of football training. Match-play injury rates were 61.86 per 1000 hours. Muscle was the most frequently injured tissue (42.6%) and fractures accounted for 4.4% of Gaelic football injuries. Lower extremity injuries predominated (76.0%). Hamstring injuries were the single most common injury overall, representing almost one quarter (24%) of all injuries and over half of muscle injuries. Anterior cruciate ligament (ACL) injuries accounted for 13% of knee injuries. The majority of injuries were defined as new injuries (74.7%), with recurrent injuries constituting 23% of all injuries. The majority (59%) of match play injuries occurred in the second half of the match. Eighty six percent of injuries caused over one week's absence from play.These findings illustrate injury patterns in Gaelic football using a prospective methodology, over 4 consecutive seasons. Comparison with published literature suggests that Gaelic football match play injury risk is greater than soccer but less than rugby union.

The aim of this study was to determine the incidence, prevalence and nature of sports injuries in elite male hurling players.Four county teams during the 2007 season; January to September were evaluated in this study. A total of 127 male players were followed over 34 weeks. Data were collected on a median of 31 players per team per week. The mean age was 23.3 years.There were 204 injuries to 104 players. Injury incidence rate during match-play (102.5) was 19 times higher than for training (5.3). The mean weekly prevalence of injury was 13.9%. Most injuries were new, and acute. Muscle strain (86 cases) accounted for 42.2% of the total. 71% of injuries were to the lower limb (143 cases) with hamstring strain (33 cases) predominating. Fractures constituted 7.4% injuries (15 cases), 12 of which were to the upper limb. There were three eye injuries and one concussion injury.These results provide data on hurling injuries using definitions that reflect international consensus statements. Injury incidence from match-play in particular is high compared with other sports. These findings have relevance for clinicians and coaches.

Knowledge of normal muscle characteristics is crucial in planning rehabilitation programmes for injured athletes. There is a high incidence of ankle and anterior tibial symptoms in football players, however little is known about the effect of limb dominance on the anterior tibial muscle group. The purpose of this study was to assess the effect of limb dominance and sports-specific activity on anterior tibial muscle group thickness in Gaelic footballers and non-football playing controls using ultrasound measurements, and to compare results from transverse and longitudinal scans.Bilateral ultrasound scans were taken to assess the anterior tibial muscle group size in 10 Gaelic footballers and 10 sedentary controls (age range 18-25 yrs), using a previously published protocol. Both transverse and longitudinal images were taken. Muscle thickness measurements were carried out blind to group and side of dominance, using the Image-J programme.Muscle thickness on the dominant leg was significantly greater than the non-dominant leg in the footballers with a mean difference of 7.3%, while there was no significant dominance effect in the controls (p < 0.05). There was no significant difference between the measurements from transverse or longitudinal scans.A significant dominance effect exists in anterior tibial muscle group size in this group of Gaelic footballers, likely attributable to the kicking action involved in the sport. This should be taken into account when rehabilitating footballers with anterior tibial pathology. Ultrasound is a reliable tool to measure anterior tibial muscle group thickness, and measurement may be taken in transverse or longitudinal section.

The thigh adductor squeeze test is commonly used in the diagnosis of groin injuries. Currently no reports exist in the published literature which, detail the level of activation of the adductor musculature during the test as well as concomitant pressure values. Thus the aim of the present study was to investigate adductor muscle activity and concomitant pressure values during the performance of the thigh adductor squeeze test at 0 degrees, 45 degrees, and 90 degrees of hip flexion. Eighteen Gaelic games athletes without any history of groin injury participated. Each participant performed 3 repetitions of the thigh adductor squeeze test in the three positions of 0 degrees, 45 degrees, and 90 degrees of hip flexion. Adductor musculature surface electromyographic activity (bilateral) and pressure values quantified using a commercially available sphygmomanometer were recorded for each test. The greatest pressure values were observed in the 45 degrees of hip flexion test position. Similarly, the greatest amount of adductor muscle activity was observed in the 45 degrees of hip flexion test position. The combined results of the present study suggest that the 45 degrees of hip flexion test position is the optimal thigh adductor squeeze test position for eliciting adductor muscle activity and maximum pressure values.

Groin pain is commonly experienced by athletes involved in field-based sports and is particularly prevalent in Gaelic Games athletes. The adductor squeeze test is commonly used in the assessment of groin pain and injuries. To date, no evidence in the literature provides the reliability of the adductor squeeze test using a sphygmomanometer in assessing the adductor muscle integrity of Gaelic Games athletes. Given the high proportion of groin pain encountered in Gaelic Games athletes, establishing the reliability of the adductor squeeze test will allow clinicians to monitor injury responses and to assess return-to-play criteria.The aim of this study was to evaluate the intra-rater reliability of a commercially available sphygmomanometer for measuring adductor squeeze values in Gaelic Games athletes and to determine if different squeeze values are associated with the 3 commonly used test positions.Eighteen male Gaelic Games athletes without any previous or current history of groin or pelvic pain were used in this study.Each participant performed the adductor squeeze test in 3 positions of hip joint flexion (0 degrees, 45 degrees, and 90 degrees) on 2 test days separated by at least 1 week with the main outcome measures being the adductor squeeze test values (mm Hg) quantified by a commercially available sphygmomanometer. Intra-rater reliability intraclass correlation values ranged from 0.89 to 0.92.The highest squeeze values were recorded in the 45 degrees of hip flexion test position, and these values differed from those demonstrated in the 0 degrees and 90 degrees hip flexion test positions.This study concluded that a commercially available sphygmomanometer is a reliable device for measuring adductor squeeze test values.

The Ladies Gaelic Football Association has a playing population of 150,000 of which 33% are adults. A number of studies have been published on rates of injury among male athletes but none on female athletes in Gaelic football. A retrospective review of insurance claims, submitted under the Gaelic Athletic Association Player Insurance Injury Scheme. 405 injuries were recorded, 248 [107 (70%) male, 141 (58%) female] to the lower limb, 91 [33 (21%) male, 58 (23%) female] to the upper limb. The majority of lower limb injuries [56 (52%) male, 56 (40%) female] were to muscle. Almost a third of upper limb injuries were fractures [10 (30.3%) male, 33 (57%) female]. Injuries/1000 hours playing was 8.25 for men and 2.4 for women. The injury rate in ladies Gaelic football was found to be significantly lower than in men's Gaelic football. Lower limb injuries accounted for the majority of injuries in both sports.

The incidence of traumatic spinal cord injury varies in different countries from 2.5 to 57.8 per million per annum, with sport accounting for 8-12.7% of these injuries. Spinal injuries associated with recreational sport often result in long-term permanent disability in otherwise active individuals.The aetiology, pattern and mechanism of the 196 sports-related spinal injuries treated in the National Spinal Injuries unit in Ireland from 1993 to 2003 is reviewed in this article.Sports-related spinal injuries accounted for 11% of all spinal injury admissions. There were 145 (74%) males and 51 (26%) females, with an average age of 30.2 years. The most common sport responsible for a spinal injury was equestrian events (41.8%), rugby (16.3%), diving (15.3%), Gaelic football and hurling (9.6%), cycling (4.2%), and miscellaneous (12.7%). Injury distribution was cervical spine (118 patients, 60%), thoracic (41 patients, 21%), lumbar spine (37 patients, 19%). In 18 patients (9.25%) more than one region was affected. In 78 patients (40%) more than one vertebral level was affected. On admission 71 patients (36%) had a neurological deficit with 46 patients (65%) incomplete and 25 (35%) complete, of which 6 patients (23%) were paraplegic and 19 (77%) were tetraplegic.Sport is an important cause of spinal injury among young people in Ireland. This study contributes to our understanding of these injuries aetiology, pattern and mechanism of injury and allows constructive recommendations for injury prevention and management.

The incidence of facial injuries in hurling has decreased since the introduction of helmets with facial protection. The aim of this study was to identify the incidence of facial and dental injuries sustained in hurling training or matches and compliance with wearing helmets, with or without modified or unmodified faceguards. This prospective study included all patients who attended the Mid-Western Regional Hospital Limerick, with injuries sustained while playing hurling during 2007 and 2008 seasons. The study population included 70 patients. Forty-two (60%) injuries occurred during practice and 28(40%) during matches. Fifty-two players (75%) sustained facial injuries whilst no helmet was worn. Eighteen injuries (25%) were sustained by players wearing helmets. This study demonstrates that 60% of injuries occur during training when players do not wear helmets. We support the recent introduction by the GAA making it compulsory to wear helmets with faceguard protection from January 1st 2010.

We aimed to identify any pattern of injuries that impacted on the long-term physical wellbeing of players, sustained by Senior County Gaelic-football players during their playing career and the impact of those injuries on their quality of life. A questionnaire was sent to different Donegal-Panels looking for injuries and surgical procedures undergone in playing and post-playing career including chronic joint and musculoskeletal problems.

This case report describes the occurrence of bilateral myositis ossificans in the rectus femoris muscles of a young Gaelic football player with a long history of recurrent bilateral thigh strain. In each case, clinical diagnosis was followed up with biochemical profiling and sonographic investigations. Management consisted of rest from elite level competition and intense rehabilitation to address any potential risk factors for rectus femoris strain. A 4-week course of acetic acid iontophoresis was administered to the first myositis ossificans lesion on the left thigh; however, as this did not result in any significant changes to the lesion's dimensions, it was not used on the contralateral lesion. The athlete returned to full sporting capacity 4 months after the first lesion was diagnosed. A 13-month follow-up showed that the athlete continued to play to full capacity with no recurrence of injury.

Children presenting with sport related injuries as a result of soccer, rugby and gaelic football are frequently seen in an emergency medicine (EM) setting in Ireland. A comparison of the demographics of injuries in these three sports has however not previously been performed. The purpose of this study was to provide up-to-date data on the nature of these SRIs.Data was collected retrospectively on all children (<17 years of age), injured in these three sports, presenting to an emergency medicine department over 6 months, and was entered into a database for analysis.Retrospective analysis was performed on 23,000 charts, and 409 sport related injuries were identified over a 6-month period. None of the children reported using any form of protective gear, and 27% reported a previous presentation to the emergency department with a sport related injury. Most injuries were as a result of soccer (56%), with 24% occurring in gaelic football, and 20% occurring in rugby. The predominant mechanism of injury was different in each sport, in soccer-falls (38%), in gaelic football-collisions with objects (balls) (37%), and in rugby-collision with persons (55%). Although the predominant type of injury in soccer and gaelic football was a fracture, accounting for 50% and 42% of injuries, respectively, in rugby however, skin/soft tissue injuries presented more commonly, accounting for 44% of injuries. When the general site of injury was investigated, the upper limb accounted for the majority of sport related injuries in each sport. In the management of sport related injuries, oral analgesics were prescribed in 50%, however, it was observed that no use was made of topical, intramuscular or rectal analgesic routes of administration. In addition it was observed that RICE/general injury advice was given in only 27%, physiotherapy was requested in 2%, and no injury prevention advice was given to any child. Overall, 8% required admission.The data provided from this study may raise awareness of the nature of sport related injuries affecting children in each of these three sports, and may be useful in formulating much needed injury prevention strategies.

The aim of this study was to prospectively evaluate, and compare, the incidence of hurling-related eye injuries in the South East of Ireland before and after implementation of new rules rendering the use of protective head gear and face masks compulsory for players aged 18 years or under.This study examined details relating to patients attending the regional ophthalmic department with injuries sustained during hurling were prospectively recorded between 1 October 2003 and 31 March 2006.Sixty players attended with hurling-related ocular injuries during the study period. Of these, 43 (71.6%) and 17 (28.3%) sustained the ocular injuries during the 15-month period before, and after implementation of the new rules (1 January 2005), respectively. Restricting our analysis to players aged 18 years or under, and, for statistical validity, to the 12-month period immediately before and immediately after implementation of the new rules, a statistically significant reduction in the number of hurling-related injuries was seen (1 January 2004 to 31 December 2004: 11; 1 January 2005 to 31 December 2005) in this age group. A permanent visual deficit was seen in 11 (18.3%) patients. Of these, one (9%) was aged 18 years or under, and this injury was sustained before the new regulations.New rules rendering the use of protective eye wear compulsory for players aged 18 years or under have resulted in a significant reduction in the incidence and severity of hurling-related eye injuries in this age group.

Gaelic football participation provides a wealth of benefits but a risk of musculoskeletal injury also exists. Injury is associated with physical consequences, including pain, discomfort, loss of function, time absent from school/sport, considerable medical expenses along with placing undue pressure on emergency services and hospital staff. Concurrent psychological consequences, such as fear-avoidance, can also occur causing psychological distress. There is a current dearth of available research examining the psychology of injury in male adolescent Gaelic footballers.The aim of this study was to examine fear-avoidance post-injury in male adolescent Gaelic footballers, the effect of pain, time-loss, injury severity and previous injury on the extent of fear-avoidance and the usefulness of a modified Athlete Fear Avoidance Questionnaire (mAFAQ) as a screening tool for predicting injury.This study examined 97 male adolescent club Gaelic footballers with an average age of 13.4 +/-1.1 years.The study looked at musculoskeletal injuries sustained during Gaelic football participation, defined as any injury sustained during training or competition causing restricted performance or time lost from play, and these were assessed and recorded weekly by a Certified Athletic and Rehabilitation Therapist. Injuries requiring time loss from participation were classed as time-loss injuries. Injury characteristics that included type, nature, location, severity and pain were recorded.Injured players completed the Athlete Fear Avoidance Questionnaire (AFAQ), a measure of injury-related fear-avoidance following injury assessment (AFAQ1). With time-loss injuries, the AFAQ was completed again (AFAQ2) prior to return to play. mAFAQ was completed at baseline.Twenty-two injuries were recorded during the season with fear-avoidance evident post-injury that significantly decreased before returning to play. Fear-avoidance post-injury was higher in those with greater pain but time-loss, injury severity and previous injury did not significantly affect the extent of fear-avoidance. Baseline fear-avoidance did not predict injury.Psychological rehabilitation is recommended for managing post-injury psychological distress in male adolescent Gaelic footballers.

The aim of this study was to describe the injury incidence in Gaelic football.A total of 83 players from three counties were interviewed monthly about their injury experience, during the 6 months of the playing season.The injury rate was 13.5/1000 h exposure to Gaelic football. There were nearly twice as many injuries during matches as in training. The ankle was found to be the most commonly injured site (13.3%). The musculotendinous unit accounted for nearly 1/3 of all injuries (31.1%). The tackle accounted for 27.8% of the injuries sustained (tackler 10; player being tackled 17.9%). Of total match injuries, 56.9% were experienced in the second half as opposed to 39.7% (95% CI, 29.8 to 50.5) in the first half.Gaelic footballers are under considerable risk of injury. Greater efforts must be made to reduce this risk so that players miss less time from sport due to injury. Risk factors for injury in Gaelic football must now be investigated so that specific interventions may be established to reduce them.

Head and facial injury is a major cause of morbidity associated with the game of hurling. Yet, little is known about either players' experience of these injuries and their prevention with safety devices.This study aimed to survey the attitude of some of the country's senior intercounty players towards the use of protective head and facial devices and their experience of injuries relating to the head and face.Forty-five players completed the survey. Thirty-two (71%) players currently wear helmets with 28 (87.5%) of these also wearing faceguards. Twenty-four (75%) players have been injured despite wearing a helmet and/or faceguard. Thirteen (40.6%) players expressed frustration with helmet performance.The authors concluded that injury is an unavoidable feature of hurling. To this end perhaps more should be done to involve players in overall apparatus design and safety.

The purpose of this study was to undertake a comprehensive prospective epidemiological study of injuries sustained by elite Gaelic Football players over one season. The pattern of injury is strikingly similar across all teams with 47% of all injuries occurring in the final quarter of games and training. Injuries to the lower limb, particularly the hamstrings muscles accounted for the majority of injuries. 65% of players were unable to participate fully in Gaelic Football activity for between one and three weeks as a result of injury. The high incidence of injury especially hamstrings injuries in the latter stages of training and games warrants further investigation.

The aim of this study was to describe the clinical characteristics of ocular injuries sustained in hurling in the south of Ireland and to investigate reasons for non-use of protective headgear and eye wear.The authors conducted a retrospective review of the case notes of 310 patients who attended Cork University Hospital or Waterford Regional Hospital between 1 January 1994 and 31 December 2002 with ocular injuries sustained during a hurling match. A confidential questionnaire on reasons for non-use of protective headgear and eye wear was completed by 130 players.Hurling related eye injuries occurred most commonly in young men. Fifty two patients (17%) required hospital admission, with hyphaema accounting for 71% of admissions. Ten injuries required intraocular surgicalThe injuries resulted in the following interventions:retinal detachment repair (5);macular hole surgery (1);repair of partial thickness corneal laceration (1); repair of globe perforation (1); enucleation (1); trabeculectomy for post-traumatic glaucoma (1).Fourteen eyes (4.5%) had a final best corrected visual acuity (BCVA) of <6/12 and six (2%) had BCVA <3/60. In the survey, 63 players (48.5%) reported wearing no protective facemask while playing hurling. Impairment of vision was the most common reason cited for non-use.The authors concluded that hurling related injury is a significant, and preventable, cause of ocular morbidity in young men in Ireland. The routine use of appropriate protective headgear and faceguards would result in a dramatic reduction in the incidence and severity of these injuries, and should be mandatory.

Reports of traumatic injury to the anterior lower leg muscles are scarce, with only a handful of reports of traumatic injury to the tibialis anterior. A database search of Medline, Cinhal, and Sports Discus only revealed three such cases, and they did not result from a direct sporting injury. This report documents the case of a traumatic rupture of tibialis anterior muscle in a young female Gaelic football player. It details the surgical repair and management of tibialis anterior muscle and the physiotherapy rehabilitation to full function.

Hurling is a contact sport, associated with significant morbidity. We have identified specific hand injuries sustained by participants and quantified the functional and financial implications of these injuries. Over a 3-month period, all hand injuries seen in the fracture clinic of our regional trauma unit were studied prospectively. Of the 123 consecutive injuries, 41 (33%) were sustained during hurling matches. Metacarpal (47%) and proximal phalangeal (37%) fractures were the most frequent. Eight hurlers (20%) required surgical intervention. Only four (10%) of the injured players were wearing hand protection. The mean cost of injury to the player was pound 615. We suggest the introduction of the mandatory use of hand protection for hurling.

To quantify injuries in elite gaelic footballers and to determine the nature, sites, and outcome of injuries and the possible risk factors involved.Information on injuries was collected from six elite gaelic football teams by a questionnaire. The footballers were asked to recall injuries over the preceding six-month period.A total of 88 out of 107 subjects sustained injuries over the study period. Ninety-five injuries were recorded, giving an incidence rate of 1.78 injuries per subject per year, of which 35% were recurring. It was found that 35% of injuries were sustained during training sessions. Lower body injuries predominated (77%), the ankle being the most commonly injured anatomic site. Most injuries were soft tissue in nature: muscle, 33%; ligament, 32%; tendon, 16%. The most common situations giving rise to injuries were collision (22%) and twist/turn (19%). Foul play only accounted for about 6% of injuries. Mean time off play as a result of injury was 17.3 days, and hospital admission was necessary for 15% of the injuries.Despite the limitations of a retrospective of this nature, the study provides useful and important information on injuries in gaelic footballers.

One-hundred-and-two high-level players of the field-games soccer, Gaelic football and hurling began a two-year investigation into the intrinsic causes of sports-injuries; 86 completed the study. During the first year all injuries, and the time affected by injury, were recorded. The subjects then underwent flexibility tests, an accurate photogrammetric assessment of posture, measures of speed and acceleration, and a clinical assessment of anatomical and physiological factors thought to be associated with the risk of sports injury. Time affected by injury was then recorded for a further 12-month period. Stepwise multiple-regression analysis revealed that the number of days of injury during the second 12-month period could be predicted from (1) the days of injury during the first 12-month period, (2) posture, (3) acceleration over 10m from a standing start, and (4) the number of musculo-skeletal clinical defects. Flexibility scores were not found to be significant predictors of injury. It is suggested that injury prevention programmes should concentrate on improving posture and the rehabilitation from previous injury rather than flexibility; and that research should be undertaken into the effectiveness of such interventions.

A survey was undertaken of all patients attending the Eye Casualty Department at Waterford Regional Hospital with sports injuries in the twelve-month period 1st January 1995 to 31st December 1995. Ninety-eight patients had problems associated with sport. Hurling was responsible for the largest group (30%) and football of different codes accounted for 29%. The next largest group was the racquet sports (13%). The most common injuries were to the anterior chamber (hyphaema and microhyphaema: 36%). There were three orbital fractures. 26 patients (27%) were admitted. 83 patients (85%) were male. The median age was 20 years. Sport is a significant cause of eye injury, which is often serious, and affects mostly young healthy males.

A prospective study of hurling injuries was conducted over the 8 months of one season on 74 players. These athletes averaged 4.30 hours per week of training and 1.15 hours per week of matches. Mean time of injury was 1.20 days in the hospital, 20.34 days off sport, and 13.34 days of restricted activity. Together this injury time amounts to 14.3% of the season. There were 92 match- and 43 training-related injuries, giving 342.47 injuries per 10,000 hours of matches and 43.83 injuries per 10,000 hours of training. Overall, there were 369.9 days of injury per 1000 hours of participation. The most common type of injury was muscle strain (24.4% of the 135 total injuries). The hamstrings was the most common site of strain, accounting for 41% of these injuries. Contusions comprised 16.3% of the injuries and sprains comprised 15.6%. The most frequently injured sites were the finger (13%), hamstrings (12%), back (11%), head (9%), and knee and ankle (9%). Forty-one percent of the injuries were attributed to foul play. The results of the study suggest that the incidence of injuries in hurling is high and may be attributed to poor conditioning, poor protection, and lack of enforcement of the rules.

School football injuries were studied over the seven months of one season on 150 males with an average age of 16.94 years. Training averaged 4.13 hours per week and matches 1.84 hours per week. Mean time injured was: 0.51 days in hospital, 34.27 days off sport and 13.98 days of restricted activity. There were 136 match and 63 training injuries giving 175.98 injuries per 10000 hours of matches and 31.06 injuries per 10000 hours of training. Injuries were treated as follows: hospital 83, general practitioners 51, physiotherapists 28, no treatment 38. The most common injuries were: ankle sprain (11.6% of the total), hamstring strain (6.5%), contusion (6.5%) back strain (6%) knee sprain (5.0%), finger sprain (5.0%), other muscle strains (5.0%), fracture of the wrist (5.0%), dislocation of the finger (4.5%), overuse injury of the back (4.0%), tenosynovitis (3.5%), fracture of the ankle (3.0%). Thirteen injuries were to goal-keepers, 85 to backs, 31 to mid-field players and 70 to forwards. In 34.83% of the injuries foul play was given as the major cause. This was followed by "Lack of fitness", "Poor kit or boots" and "Previous injury" (all 11.24%). The most common minor cause was "Poor state of the pitch" (17.42% of injuries).

A one year, retrospective, epidemiological study of all facial fractures, sustained whilst playing the GAA sports of football and hurling, treated in the Cork Regional Hospital was undertaken. The results have been analysed and compared to a similar study performed in this unit in 1975. Of 332 patients treated for facial fractures, 110 (33%) were injured whilst playing sport and 47% of these occurred when playing Gaelic football or hurling (52 injuries in all). Eighty per cent of Gaelic football and hurling patients required operative treatment. All surgery was performed under general anaesthetic. The numbers of hurling fractures have more than halved since 1975-76. This coincides with an increase in the numbers hurling, an increase in the use of protective headgear and vastly improved coaching. This study demonstrates that improved safety can be achieved without diluting sporting enjoyment.

Major head injuries are not uncommon in the Irish national game of hurling. Historically, helmets were not worn.We report a multistage campaign to facilitate and encourage the use of appropriate headgear among the estimated 100 000 hurling players in Ireland. This campaign lasted for 27 years between 1985 and 2012, and involved a number of different stages including: (1) facilitating the establishment of a business dedicated to developing head protection equipment suitable for hurling, (2) placing a particular emphasis on continual product enhancement to the highest industrial standards, (3) engaging continually with the game's controlling body, the Gaelic Athletic Association (GAA), with the ultimate objective of securing a mandatory usage policy for protective helmets and faceguards, (4) longitudinal research to monitor hurling injury, equipment usage and players' attitudes and(5) widely communicating key research findings to GAA leaders and members, as well as to 1000 clubs and schools.One of our three relevant studies included 798 patients and identified a dramatic association between the type of head protection used by a player, if any, and the site of the injury requiring treatment. While 51% of the injured players without head protection suffered head trauma, this rate was only 35% among the players wearing helmets and 5% among players who were wearing full head protection (both a helmet and faceguard).The GAA responded in three stages to the accumulating evidence: (1) they introduced a mandatory regulation for those aged less than 18 years in 2005; (2) this ruling was extended to all players under 21 years in 2007 and (3) finally extended to all players irrespective of age, gender or grade from January 2010. The latter ruling applied to both games and organised training sessions.

The objectives of the study were to determine the most common injuries in Gaelic football and hurling and to quantify contributory factors.The hypothesis tested was "Ankle sprains are a common injury in Gaelic football and hurling and their incidence can be linked to physical characteristics of the players".This was a prospective study over four years.The subjects were eighty male players of Gaelic football, and hurling, aged 18-27 years.The measures examined were the injuries sustained over a four-year period. Physical fitness tests and examination at the start of the study which included assessment of: anthropometric variables, lower-limb proprioception, lung function, six aspects of flexibility, 15 aspects of posture and body mechanics.962 significant sports injuries which included: 218 strains and 184 sprains. 122 were ankle sprains; 79 to the left ankle and 43 to the right. 104 ankle sprains represented a recurrence of this injury in a particular individual. In 26 out of 34 of these subjects both ankles were involved. This suggests that recurrence is not primarily due to previous injury but to intrinsic factors in the subjects that predispose them to ankle sprain. The subjects who sustained ankle sprains had (1) greater height, (2) lower body mass index (3) a higher incidence of posture defects of the ankle and knee, (4) more clinical defects (5) a higher incidence of defective lower-limb proprioception.Ankle sprains are a common injury. Their incidence is linked to the five intrinsic factors listed above.

In a 1 year period (1993) 332 facial fractures were treated in Cork Regional Hospital. Of these 110 (33%) were sports related.Males accounted for 94.5% of patients and 77% of patients were aged below 30 years. Nasal fractures were the most common fractures seen (56%). Almost half (49%) of sports related facial fractures occurred while playing Gaelic games. The incidence of hurling fractures has been more than halved over the last 20 years. Seventy eight percent of patients required operative treatment.

A year-long survey of sports injuries in the accident and emergency department of St. Luke's Hospital, Kilkenny revealed 864 injuries, with hurling and soccer accounting for 41% and 23% respectively. In hurling, lacerations to face and scalp, and fractures of the wrist and hand, accounted for a large number of the injuries seen, while in soccer bruising and sprains of the lower limbs accounted for the majority of the injuries. We make some recommendations for avoidance of these injuries. We show clearly that non-accidental or deliberately inflicted injury forms a significant proportion of sport injuries and recommended steps to curb non-accidental injuries.

The reported incidence of head and neck injuries in hurling is 0.12 per 1000 hours, but no previous research has quantified head impact characteristics in this sport. Here, a wireless accelerometer and gyroscope captured head impacts, in 20 senior club level hurling players. Peak linear and rotational acceleration and impact location were recorded during three hurling training sessions, each player participating once. A mean of 27.9 impacts (linear acceleration >10g) per player, per session were recorded; 1314 impacts during a total exposure time of 247 minutes. Only 2.6% impacts had peak linear acceleration of >70g and 6.2% had peak rotational acceleration >7900 rad/s2. There were significant differences in the number and magnitude of impacts, quantified by the accelerometer, between three training sessions of differing intensity. This study represents a first step in quantifying head impacts during hurling, demonstrating the feasibility of this technology in the field. The sensors were able to discriminate between sessions of varying intensity. These data can be used to develop athlete monitoring protocols and may be useful in developing innovative helmet-testing standards for hurling. The potential for this technology to provide feedback has clinical utility for team medical personnel.

In 1984, 4500 people with sport injuries attended the Cork Regional Hospital. Of these, 817 were injured in the national game of hurling and camogie. Hand injuries were the most frequent occurring in approximately one third of injured players (33 per cent) and of these, just half had a closed metacarpal fracture. Facial injuries were the second most frequent category (28 per cent). Almost one third of these were nasal fractures, while forehead and eyebrow lacerations, fractured zygoma, loss of teeth are also common. Sport eye injuries referred to the Eye, Ear and Throat Hospital in Cork during the same period amounted to 107, of which 26 occurred in hurling. It is believed that a properly designed protective head gear would largely eliminate such facial and eye injuries.