Foot and Ankle Injuries in Elite Taekwondo Athletes: A 4-Year Descriptive Analysis

Maximilian Willauschus; Johannes Rüther; Michael Millrose; Matthias Walcher; Christophe Lambert; Hermann Josef Bail; Markus Geßlein

doi:10.1177/23259671211061112

Foot and Ankle Injuries in Elite Taekwondo Athletes: A 4-Year Descriptive Analysis

Orthop J Sports Med. 2021 Dec 15;9(12):23259671211061112. doi: 10.1177/23259671211061112. eCollection 2021 Dec.

Authors

Maximilian Willauschus¹, Johannes Rüther¹, Michael Millrose^{1

2}, Matthias Walcher^{1

3}, Christophe Lambert⁴, Hermann Josef Bail¹, Markus Geßlein¹

Affiliations

¹ Department of Orthopaedics and Traumatology, Paracelsus Medical University, Nuremberg, Germany.
² Department of Trauma Surgery and Sports Medicine, Garmisch-Partenkirchen Medical Center, Garmisch-Partenkirchen, Germany.
³ OCW, Wuerzburg, Germany.
⁴ Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne Merheim Medical Centre, Cologne, Germany.

Abstract

Background: Foot and ankle injuries are a common but underestimated problem in taekwondo. Detailed data on injury incidence rates (IIRs), patterns, and injury mechanism are missing.

Purpose: The primary aims were to evaluate the prevalence of foot and ankle injuries and the exposure-adjusted IIR of elite taekwondo athletes during matches while training (ie, sparring) and in competitions. The secondary aims were to evaluate injury site, type, sport-specific mechanism, and time loss.

Study design: Descriptive epidemiology study.

Methods: Athletes from a single national Olympic taekwondo training center were assessed prospectively for foot and ankle injuries over 4 years (between January 1, 2016, and December 31, 2019). Data were collected regarding number and type of injuries, anatomic location, and total exposure time during training and competition for each athlete. Injury mechanism and dominant foot were assessed via personal interview. Time loss from sport was analyzed retrospectively. The injury prevalence and IIR were calculated. Correlation between mechanism and injury type, location, and dominant foot was evaluated. Time loss according to location and injury type was assessed. The chi-square test and Fisher exact test were used to test for differences in sex, age, and taekwondo experience and for comparison of injury location and type, injury mechanism, and side dominance, respectively. Training and competition IIRs and prevalence were calculated with 95% CIs (for Poisson rates).

Results: From an initial 107 athletes, 79 (73.8%) were included in the final data set. Of these athletes, 38 were injured (n = 112 injuries) for a prevalence of 48.1% (95% CI, 43%-52%). The overall IIR of the ankle joint was 13.14 injuries per 1000 athletes (95% CI, 1.5-25.9) and was significantly higher during competition versus training (P < .001). Ankle joint injuries were most common (n = 71; 63%). Significantly more noncontact versus contact ankle ligament injuries (n = 46; 83%) occurred (P < .001). The forefoot (n = 18; 66%) was mainly affected by contact injuries (P < .001). Time loss was the highest for midfoot fractures (mean ± SD, 23.0 ± 0.6 days; range, 23-24 days).

Conclusion: Noncontact ligamentous ankle injuries were most common, with a higher incidence during competition. Improvement of strength, endurance, and postural stability under strain is recommended for prevention.

Keywords: ankle sprain; combat sports; foot; injury incidence rate; sports injuries; taekwondo.