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A national study of the epidemiology of exercise related illness and injury

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With the approval of the appropriate administrative and ethical committees, a random sample of the population of England and Wales aged between 16 and 45 years was drawn from Family Practitioner Committee lists between July 1989 and June 1990. With the consent of their family doctors, we sent postal questionnaires to a sample of 28,857 people asking about participation in sports and leisure exercise, and injury experiences during the previous four weeks. The response rate was 68%.

There were 17,564 usable responses. Of the respondents 7,829 (45%) had taken part in vigorous exercise or sports in the previous 4 weeks. Of these, 1429 had been injured in the previous 4 weeks, and they reported 1803 separate injuries in 1705 incidents.

Three quarters of all injury incidents occurred in men, and a half occurred in the age group 16-25 years. Over one quarter (29%) of the incidents occurred in soccer, and no other activity was involved in more than 10% of the incidents. The majority (58%) of new injury incidents happened with the involvement of another person or object.

Two-thirds of the incidents resulted in new injuries and the remaining one third in recurrent injuries. Sprains and strains of the ankles, knees, legs and back and arms were the most common injuries and represented about one third of all injuries. Fractures (37, 2%) and dislocations (41, 2%) were uncommon, as were eye injuries (11, 0.6%), and mouth or teeth injuries (5, 0.4%).

Approximately half of all incidents result in substantive injuries - that is those that are potentially serious (fractures, dislocations, or any injury to the head, face, features),  or need treatment or restrict the activities of the injured participant. Excluding injuries that only restrict the injured from participating in their sports, leaves a group of significant injuries, representing about a third of all injuries.
After weighting, it was estimated that there are 29 million injury incidents of which nearly 10 million incidents result in new substantive injuries each year in England and Wales in persons aged 16-45. The new injuries result in 8 million days off work, and recurrent injuries may result in up to a further 3 million days off work.

The direct treatment costs of new injuries are approximately £240 million pounds per annum, and the estimated value of lost production due to time off work was £405 million pounds per annum. Recurrent injuries may cost up to another £350 million in total.

The activity with the highest risk is rugby, resulting in one significant injury incident every 18 playing occasions, the next most risky activities are soccer (1 in 50), martial arts (1 in 58), cricket (1 in 61) and hockey ( 1 in 68). The racquet sports have smaller injury risks which are similar to one another. The risk of significant injury in horse riding was low - about the same as for the racquet sports.

The risks per occasion of participation were the same for men and women, and for persons of different ages, but they were higher for persons playing frequently or for a club - indicating an increased risk in competitive sport, and they were higher for people in non-manual occupations.

With regard to prevention, it is suggested that participation in the less injurious activities could be encouraged; that the adequacy of shin-pads to prevent lower leg injuries in soccer players should be reviewed; and that there was little epidemiological evidence of a need in the majority of participants to wear mouthguards or eye protectors.

It is concluded that sports injuries are a substantial public health problem, costing the health service at least £250 million each year, the main burden of which falls on family doctors and hospital Accident and Emergency departments. and incurring other costs to the nation as a result of time lost from work.

However, it should be borne in mind that as a result of regular vigorous exercise there are probably greater health benefits than health costs, and, because of a reduced incidence of many medical condition, greater savings to the health service than there are increased costs, and, because of the wealth generated by the sports industry, greater benefits to the economy as a whole than losses due to time off work.



 editors comments   

Editor's comments - [  For a variety of reasons there has recently [1991] been an increase in the amount of recreational physical exercise being taken. Prominent amongst these reasons may be increased leisure time, and cultural pressures for health and fitness, or at least the appearance of fitness. Furthermore, there is now a large body of evidence showing that exercise results in health benefit, particularly with respect to coronary heart disease, hypertension, diabetes, osteoporosis. and depression. Whether or not this evidence has also played a part in the trend towards physical activity, it has certainly encouraged those involved in public health programmes to recommend less sedentary lives. However, the benefits of exercise must be considered in the light of the associated risks both for the individuals exercising and for the community as a whole, which may have to bear the costs of any resulting injury and illness which is sometimes regarded as unnecessary and self-inflicted.

This is the original research report which informed the Sports Council's 'Injuries in Sport & exercise' report of 1993.  ]  Reference this?Sasha, T. D. (2013). This page title in italics. Retrieved date, from In the text: Sasha (2013)


APA reference for this document


Reference :  Nicholl, J.P., Coleman, P. Williams, B.T. (1991). A national study of the epidemiology of exercise related illness and injury. Sheffield: University of Sheffield Medical Care Research Unit.


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Download this file (exrelatedinjury1991.pdf)exrelatedinjury1991.pdfNicholl, J.P., Coleman, P. Williams, B.T. (1991). A national study of the epidemiology of exercise related illness and injury. Sheffield: University of Sheffield Medical Care Research Unit
Last Updated on Saturday, 23 February 2013 15:14  

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