Investigating Injuries in Martial Arts
More than two million people in the United States participate in the martial arts. There are many benefits to participating in the martial arts, such as the development of discipline, respect, strength, coordination, balance, and flexibility (Violán, Small, Zetaruk,.et al., 1997; Fetto, 1994). However, it is not clear from literature what risks are involved with regular training. Although some research has been carried out to determine the risks of injury in martial arts, most studies have focused on tournaments (Oler, Tomson,& Pepe, 1991; Stricevic, Patel, Okazaki, et al,1983; McLatchie & Morris, 1977), as this appears to be the setting that poses the greatest risk of injury (Jaffe & Minkoff, 1988). Many martial artists never participate in competitions, therefore the data obtained from such studies cannot be extrapolated to all participants.
In addition, previous studies have often failed to identify either the specific style of martial arts, simply calling it "karate", or they have grouped several different styles together as one sport (Oler, Tomson,& Pepe, 1991; Birrer, 1996; Birrer & Halbrook, 1988). These studies have limited applicability to most martial artists, as injury rates and patterns in full contact styles are probably very different from non-contact ones (Birrer, Birrer, Son, et al., 1981; Zemper & Pieter, 1989) and the injuries sustained in styles that use joint locks and throws may be quite different from those that use kicks, punches, and blocking techniques.
Comparison of Injuries within Different Martial Art Styles
Compared with karate, the risks of head/neck injury, upper extremity injury, and soft tissue injury were all higher in aikido (p<0.005), and the risks of head/neck, groin, and upper and lower extremity injuries were higher in tae kwon do (p<0.001) (Zetaruk, Violan, Zurakowski & Micheli, 2005). There is a higher rate of injury in tae kwon do than Shotokan karate. Different martial arts have significantly different types and distribution of injuries. Martial arts appear to be safe for young athletes, particularly those at beginner or intermediate levels (Table 1 & Table 2).
Table 1 Injury rates by style (Zetaruk, Violan, Zurakowski, & Micheli, 2005).
|Style||No||Injury||Major injury||Multiple injuries|
|Karate||114||34 (29.8)||19 (16.7)||21 (18.4)|
|TKD||49||29 (59.2)*||13 (26.5)||22 (44.9)*|
|Aikido||47||24 (51.1)||13 (27.7)||15 (31.9)|
|Kung fu||39||15 (38.5)||7 (17.9)||9 (23.1)|
|Tai chi||14||2 (14.3)||1 (7.1)||0 (0.0)|
|Total||263||104 (39.5)||53 (20.2)||67 (25.5)|
Values are number of participants with outcome (%).
*p<0.001 compared with Shotokan karate, TKD, tae kwon do
Table 2 Region of injury (Zetaruk, Violan, Zurakowski & Micheli, 2005).
|Style||No||Upper extremity||Lower extremity||Groin||Trunk||Head/neck|
|Karate||114||19 (16.7)||26 (22.8)||1 (0.9)||17 (14.9)||11 (9.6)|
|TKD||49||20 (40.8)*||28 (57.1)*||9 (18.4)*||12 (24.5)||15 (30.6)*|
|Aikido||47||20 (42.6)*||16 (34.0)||3 (6.4)||12 (25.5)||15 (31.9)*|
|Kung fu||39||8 (20.5)||14 (35.9)||2 (5.1)||5 (12.8)||4 (10.3)|
|Tai chi||14||1 (7.1)||1 (7.1)||0 (0.0)||1 (7.1)||1 (7.1)|
|Total||263||68 (25.9)||85 (32.3)||15 (5.7)||47 (17.9)||46 (17.5)|
Values are number of participants with outcome (%).
*p<0.001 compared with Shotokan karate. TKD, tae kwon do.
Most martial arts have few rules and safeguards to protect players during training and sparring. Most rules of safety are considered only during competitive tournaments and these safety rules change from style to style. Thus, there may be differences in injury risk, depending on the style and whether or not rules of safety are closely adhered to (Zetaruk, Violan, Zurakowski, & Micheli, 2005).
Birrer (1996) found a much lower risk of injury in tae kwon do tournaments than had previously been reported (McLatchie & Morris,1977). They concluded that the lower risk was due to implementation of protective measures including strictly enforced rules of engagement that did not permit blows to the face, and only light contact to the other target areas. Further research is needed across the board – to include injuries sustained due to training and sparring along with injuries due to competitive tournaments. This all inclusive research will help to increase the safety of the players by understanding the causes of the injuries and how to prevent them in the future.
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