Extreme sports usually involve high-risk elements, such as high speed, height, real or perceived danger, a high level of physical exertion, spectacular stunts and, in a worst-case scenario, heightened risk of death. The popularity of such sports has been rising for the past two decades thanks to dedicated TV channels, the internet, high rating competitions and high-profile sponsors, attracting more and more participants.
The medical personnel of extreme sports athletes need to be aware of the numerous differences between traditional sports and this new area. These can relate to the temperament of the athletes themselves, the epidemiology of the injury, which procedures were taken after the injury, the options taken, and rehabilitation.
The management of injuries sustained by extreme sports athletes is very challenging. It’s a challenge for surgeons and sports physicians to assure the right management and the appropriate gear to protect from severe or fatal injuries.
A review published on BioMed Central tries to provide an epidemiologic overview of common injuries affecting mostly athletes who go through a few of the most popular extreme (and exciting) sports.
Extreme sports background
Even though the traditional sports epidemiology has suffered great evolution, extreme sports injuries are still less understood. Most injuries can be divided in two groups: those taken by new and inexperienced athletes who have just now started practicing, and those taken by experienced extremists. There is no specific data about the injury pattern but we do know that the number of injuries has been increasing during competitions rather than during training. It might be because athletes have been trying even more to push their limits for prizes, audience and fame.
Extreme sports and their injuries
Skydiving is a major sport which consists in someone parachuting from an aircraft. Approximately 5.5 million jumps were reported in 2009 by the International Parachuting Commission (IPC), a number that included jumpers from all over the world. The number of skydivers operating their own equipment added up to some 220,000 skydivers performing around 4.7 million skydives, with the majority of jumps being performed by a small number of skydivers.
During world free fall skydiving conventions in Illinois in 2000-2001, Barrows at al. documented several jumping incidents.
The data tells us that they followed 8976 skydivers making 117,000 jumps, in 20 days, with a total injury rate of 170 per 100,000 jumps, of which only 30% required medical attention. 66% of the injuries were considered minor, with 32% of these being abrasions and contusions and 22% lacerations. Of the jumpers who visited the emergency department for follow-up, half suffered from extremity trauma which was related to the lower extremity in 80% of patients, with a rate of 0.5 fractures per 10,000 jumps.
The most dangerous adventure sports in the world, this skydiving offshoot uses specially adapted parachutes to jump from fixed objects.
BASE jumping (“BASE” stands for Building, Antenna, Span — a bridge, arch, or dome, and Earth — a cliff or other natural formation often less than 500 ft above ground level) has around 300 active members.
“Soreide et al. determined that BASE jumping is associated with a five- to eightfold risk for fatality or injury when compared to regular skydiving . The fatality rate associated with BASE jumping was found to be 0.4 per 1000 jumps from a single site, although lacking information on demographic characteristics or jumpers’ experience level”.”
Climbing is an adventure sport that has developed from alpine mountaineering, and its popularity has vastly grown in the past three decades, with the introduction of indoor climbing gyms and climbing walls becoming globally spread. Climbing is also evolving to new categories, like ice climbing, bouldering, speed climbing and aid climbing, reaching an estimated two million participants in Europe and about nine million in the USA.
There are various disciplines encapsulated under the umbrella of climbing, some less risky than others, with sports climbing or free climbing among the safest. A cross-sectional survey on rock climbing showed a lower frequency injury rate compared to football and horse riding, but with more fatal consequences.
The incidence of overuse injuries is associated with climbing frequency and difficulty. A great part of the injuries are sustained by the lead climber, with fall being the most common mechanism of acute injuries.
Overall, most registered injuries in climbing studies are of minor severity. The fatality rate reported in climbing ranges from 0 to 28% climbers in various studies. This wide range could be explained by varying methodology and data collection techniques in different series.
Injuries on extreme sports are increasing because these sports are fun to participate and exciting to watch. These type of injuries can become a challenge to surgeons and sports physicians. Appropriate safety gear is essential for protection.