Injuries in beach handball

INJURIES IN BEACH HANDBALL

Kostas Manavis1, Dimitris Hatzimanouil2, Eleftherios Stefas1, George S. Bebetsos3
1
Hellenic Handball Federation, Medical Commission, 2Aristotle University of
Thessaloniki, Dept. of Physical Education and Sport Science, 3Hellenic Handball
Federation, Beach Handball Commission

Keywords

Beach handball, injuries, severity, and environment

Summary

The purpose of the present study was to investigate the injuries in beach handball and
their correlation with those in indoor handball. The sample of the study was composed
of 96 beach handball players, all members of the men’s national teams that participated
in the 2007 European Beach Handball Championships that took place in Misano
Adriatico (Italy, 10-15 July 2007).

All the athletes were given a self-reported questionnaire related to the injuries
that the players had suffered during their involvement with the sport within the period of
the last 24 months. The results showed that 15.5% of the players suffered a serious
injury. Goalkeepers and backcourt players presented the most injuries (71%). Most
injuries were closed (85.7%), mainly ligamental (57%), concerning the lower limbs and
more specifically the torso (42.8%). The main reason for those injuries was the violent
contact with an opponent player (71.4%). Most injuries were reported to have occurred
during the match (57.1%) while in attack (71.4%). Regarding the severity of the injuries,
this was 71.4% of a serious form (resulting in a 2-4 weeks absence) and 14.2% of a
severe form (resulting in a more than 4-week absence). The injuries were diagnosed at
a hospital (42.8%), mainly by doctors (85.7%). The percentage of players who had to be
hospitalized was 57.1%.

Most players followed conservative treatment (57.1%). Finally, the majority of the
athletes (92.8%) had no relapse after they returned to athletic activity. Deductively this
game level demonstrates low frequency of injuries but of great severity mainly due to
the environment that the matches take place (sand, high temperatures, at least two
games per day), while obvious is the need of further research in larger sample of
handball players.

Import

Bigger probability of injury exists in contact sports as opposed to the non-contact sports
(American Association of Oral and Maxillofacial Surgeons, 1999 Kujala, Taimela, Antti-
poika, Orava, Tuominen and Myllynen, 1995). Both indoor and beach handball include
movements that produce stress to the myoskeletic system and consequently injuries
(Andren-Sandberg, 1994 Loes and Goldie, 1988 Tyrdal and Bahr, 1996 Werner and
Plancher, 1998). Therefore, the requirements and the particularities of the sport, as for
example the frequent and intense contact with the opponent players, lead quite often to
injuries (Andren-Sandberg, 1994 Asembo and Wekesa, 1998 Wolf et al. 1974).

Hoeberigs, van Galen, and Philipsen (1986) supported that each sport should
have its own model of injuries, which can be more or less specialized. The knowledge of
this model can be very important for planning the medical care that perhaps needs to be

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 Injuries in beach handball

given and is useful to define the most important causative factors of injuries in handball.
The necessity of knowledge of this model that concerns injuries in this particular sport,
appeared, also, in the study of Nielsen and Yde (1988) in which has been documented
that the knowledge of athletic injuries and their rehabilitation was poor for both athletes
and coaches.

This conclusion is reached by a number of scientific publications (Bak and Koch,

1991 Engebretsen, Gruntvedt, and Bredland, 1993 Fagerli, Lereim, and Sahlin, 1990
Hoeberigs et al., 1986 Yde and Nielsen, 1990 Backx, Beijer, Bol and Erich, 1991
Sorensen, Larsen and Rock, 1996). The above mentioned injuries lead -many times- the
individuals to the hospital with injuries of high severity that require medical care
(Hoeberigs et al., 1986 Jorgensen, 1984 Maehlum and Daljord, 1984 Menquy, Guillou
and Condamine, 1999). The sustained injuries appear to be of high severity because the
majority of athletes are absent from training sessions for more than a week (Lindblad,
Jensen, Terkelsen, Helleland, and Terkelsen, 1993 Lindblad, Hoy, Terkelsen, Helleland,
and Terkelsen, 1992 Nielsen, and Yde, 1988 Biener, and Pole, 1980). Asembo and
Wekesa (1998), support that injuries in handball are inevitable. They suggest that, for
these specific injuries, measures of prevention, treatment and rehabilitation should be
taken.

A special characteristic of beach handball is the environment in which the games

take place: Sand, high temperatures and many matches during the same day.The cause
of injuries in each sport and its versions can differ between different subgroups of the
athletes’ population. Different subgroups of athletes' population in each sport, need,
also, different prevention programmes, so that the highest frequency and severity
reduction of particular injuries is achieved.

Therefore, the scientific research should be specialized, so that the groups of

high risk are ascertained and independent variables for forecasting injuries are defined
for each subgroup separately. The results of such studies can provide effective
precautionary measures and prevention programmes. It is desirable such research to
include similar subgroups for the determination of injuries and should be based on
epidemiologic and methodological principles (Inklaar, 1994).

Method

The total sample of the study consisted of 96 beach handball players all members of the
men’s national teams that participated in the 2007 European Beach Handball
Championships that took place in Misano Adriatico (Italy, 10-15 July 2007). All the
athletes were given a self-reported questionnaire developed specifically for this
research.

The questionnaire was related to the injuries the players had suffered during their
involvement with the sport within the period of the last 24 months. An injury was defined
as an accident sustained, during practice or competition, which led to a medical problem
(e.g. pain, disability) and prevented participation in training sessions or games for at
least one day beyond the date of occurrence (Gibbs, 1993; Hodgson, Standen and Batt,
1998). More specifically, at the beginning of the questionnaire each player was required
to give information and data on personal characteristics such as age, weight, height and
his history of athletic activity and participation.

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 Injuries in beach handball

In the main part of the questionnaire, information was required on injuries which
the players had sustained during the last two years. For instance, the incidence, severity
(injuries were graded into four categories of severity): mild (absence from practice less
than 1 week), moderate (1-2 week absence), serious (2-4 week absence), and severe
(more than 4 weeks absence) (Seil, Rupp, Tempelhof and Kohn, 1998), the percentage
of players who had to be hospitalized, localization, type and mechanism of injury, time
(that is during training or at a match), type of treatment and relapse of the injury. Finally,
information was asked about various environmental factors, such as the surface of the
field, the soles of the player’s shoes as well as the place where the injuries occurred.

Results
From the statistical analysis of the results concerning the players’ personal
characteristics the average age was 25.4 years. The average weight was estimated at
88.84 kg and height at 187.75 cm. The average training age was at 3.7 years, with 2.4
average training sessions per week. The findings revealed that 15.5% of the players had
treatment for at least one injury during the previous two years.

From the athletes with injuries, 14.2% had suffered two injuries in a 2-year
period. Goalkeepers and backs reported the most injuries (71%). The environment that
the matches were played was sand and high temperatures, while each player had at
least two games per day. Most injuries were closed (85.7%), mainly ligamental (57%),
concerning the lower limbs and more specifically the torso (42.8%). This result is similar
to the one found by Karras, Stergioulas, Tsolakis and Bebetsos (2002). The main
reason of injuries was the violent contact with an opponent player (71.4%). Most injuries
were reported to have occurred during the match (57.1%) while attacking (71.4%). The
severity of the injuries is described at the following table.

Table 1 Severity of injury

Severe form 14.2%

Serious form 71.4%
Moderate form 0.0%
Soft form 14.2%
Total 100%

Diagnosis was made at a hospital (42.8%), mainly by doctors (85.7%), the next few
hours after the injury (42.8%). The percentage of players who had to be hospitalized
was 57.1%. Most players followed conservative treatment (57.1%). The conservative
treatment that most athletes followed was physiotherapy (ice and ultrasounds) and
drugs (mainly NSAIDs).

The majority of the athletes followed the doctor’s advice (87.5%) for complete
rehabilitation of the injury. Twenty-seven percent of the athletes suffering a severe injury
had complications as pain, stiffness and difficulty while walking. Most athletes (57.1%)
continued to play after their severe injury. The majority of the athletes returned to
athletic activity healthy after three weeks. Finally, the majority of the athletes (92.8%)
had no relapse after they returned to athletic activity.

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 Injuries in beach handball

Conclusions

Deductively, it is obvious that while the public, media and sponsor interest for the sport
of beach handball is steadily increasing, there is absence of research via which we
would generate precious information and reliable inquiring data on factors that
determine the reduction of injuries at national team level.

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Contact

Kostas Manavis, MD, leocm64@yahoo.com

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