American Fencing 43(3):16-17,29 (1993)

 

What Hurts

and Why

Data from the 1992 USFA Fencing Injury Survey show some common culprits.

 

BY CYNTHIA CARTER, JOHN HEIL, & ERIC ZEMPER

 

The results are in. Sixteen hundred three (1603) fencers responded to the United States Fencing Association Injury Survey distributed last fall, representing 19% of the membership. Your support of this Survey provides the USFA with one of, if not the, most broadly based published report of fencing injuries available to any FIE nation.

The Survey is composed of 25 questions divided into five parts. Your responses to the survey are summarized in the sections that follow. At this time data analysis is ongoing. Upon completion, a technical report will be prepared with detailed statistical analysis and methodological information for use by the USFA Safety Committee, the USFA Sports Medicine Committee, and other USFA committees. This report will be available to all fencers upon request.

Part I-General Information

Responses to the first part of the survey tell us that the average respondent is 30 years old. Seventy-two percent of the respondents are male, 28% female. Fifteen percent trained less than 30 days; 58% trained between 30 and 120 days, 27% trained greater than 120 days. Of those who answered the survey, the average fencing career spanned five years -- 36% report less than three years of fencing experience; 23% report greater than 12 years. The majority of respondents were unclassified in at least one weapon: but 184 respondents reported A or B classifications.

Part II-A1l Injuries Within the Last Year

Part II includes questions 7-9 which pertain to number of injuries, lost time due to injury, and the effect of injuries on fencing success. A summary of the answers follows:

Injuries were reported by 842 fencers, slightly more than half of those who responded to the survey.

22% of injuries were not severe enough to cause any loss of time to training or competition.

15% reported injuries that were described as having a severe or extreme impact on fencing success; 61% of respondents reported that injury had little or no impact on their fencing in the year.

Part III- Worst Injury Within the Last Year

In Part III, questions 10-15 address the following injury issues: site of injury (e.g., knee, ankle), type of injury (e.g., strain, puncture wound), time lost from training or competition, effect of injury on fencing success, circumstances of injury, and the factors contributing to injury (equipment/facilities; personal behavior; behavior of others). Please keep in mind that this information refers only to injuries described as worst within the last year.

Selected results are noted below:

Knee (17%) and ankle (14.5%) injuries were most frequently reported by a substantial margin: as would be expected muscle strain (26.5%) and joint sprain (24%) were the most frequently reported injury.

Approximately 6% of injuries (i.e., puncture wounds and lacerations) resulted in bleeding.

Approximately 2/3 of injuries were sudden in onset, while 1/3 were of gradual onset.

Injuries are attributed to a wide variety of behavioral factors (61%) and problems with equipment or facilities (28%).

Inadequate warm-up and poor technique were the most commonly reported behavioral causes of injury.

Problems with strips and with inadequate footwear were the most commonly reported equipment problems.

______________________________________________________________________________________

Type of Worst Injury in Past Year and Worst Injury in Fencing Career

______________________________________________________________________________________

_____Type of Injury______

Worst in Last Year (%)

Worst in Career (%)

Strain (muscle)

26.0

22.0

Sprain (ligament)

23.9

21.8

Tendinitis

14.5

14.4

Cartilage tear

5.3

7.5

Puncture

3.3

4.9

Torn tendon

2.4

3.8

Fracture

2.1

3.6

Laceration

3.0

3.5

Other

18.9

18.5

______________________________________________________________________________________

Part IV - Most Serious Injury During Your Fencing Career

Part IV addresses similar questions to those presented in Part III but relative to the most serious injury ever received. Highlights of the responses follow:

1,246 fencers reported on worst career injury.

Knee (19%) and ankle (14%) problems were most common; again, as would be expected muscle strain (22%) and joint sprain (22%) were the most frequently reported type of injury (similar to report of worst injury within the last year).

61 fencers (approximately 1 in 20) listed a puncture wound as their most serious career injury; wounds were delivered to the face, neck, chest and abdomen as well as to the arms and legs.

Approximately 1/3 of most serious career injuries were rated as having a significant impact on fencing success.

The causes of injury were (again) attributed to a wide variety of behavioral factors (60%) and problems with equipment and facilities (28%).

Problems with strips and shoes, and with poor technique and inadequate warm-up were (again) noted.

Approximately 12% of most serious career injuries are attributed to the behavior of others (most notably dangerous tactics by opponent), similar results were obtained for most serious injury within the last year.

______________________________________________________________________________________

Factors Contributing to Worst Injury in Past Year and Worst Injury During Fencing Career

______________________________________________________________________________________

 

Worst in Last Year (%)

Worst in Career (%)

Personal Factors

48.3

46.2

Poor technique

12.2

14.7

Inadequate warm-up

13.2

11.2

Fatigue

11.0

10.0

Dangerous tactics

2.4

2.5

Other

9.5

7.8

Behavior of Others

12.7

13.7

Dangerous tactics by opponent

8.5

9.0

Poor coaching

1.0

1.6

Poor officiating

1.6

1.4

Other

1.6

1.6

Equipment and Facilities

27.9

27.8

Strip

9.6

9.7

Shoes

9.5

8.3

Weapon

4.5

4.6

Jacket

0.8

1.3

Mask

0.4

0.5

Lighting

0.4

0.5

Other

2.7

2.9

No Identifiable Contributing Factors

11.1

12.4

______________________________________________________________________________________

Part V - Miscellaneous

Part V assesses: chronic minor injury, incidence of fencing strip related injury, type of fencing strip causing injury, and comments on injuries. Results are presented below:

4% (1 in 25) fencers indicated that chronic minor injury significantly impacted their fencing performance.

Approximately 1/3 of all fencers who responded to the survey reported at least one injury due to problems with the fencing strip; review of comments suggests that problems with strips are a major source of concern to USFA members.

Strip related injuries were attributed to surface hardness, inadequate anchoring, and raised strips.

A significant number of comments were provided by fencers who had received or delivered a puncture wound as well as by those who observed a puncture wound injury.

Summary

The results of the USFA Injury Survey lead to the following conclusions:

Although the general medical literature suggests that fencing injuries occur at a relatively low rate (in comparison to other directly competitive sports), fencing injuries have a negative impact on the success of a significant number of fencers and hence on the sport of fencing.

Greater than half of all injuries are to the lower extremities, most commonly knees and ankles.

A wide variety of problems with equipment and facilities plus behavioral factors contribute to injury.

Factors under personal control such as warm-up and technique significantly contribute to injury.

Strips appear to be a significant cause of injury.

Behavior of others (most typically dangerous tactics by opponent) are also reported as a significant cause of injury.

Conclusions

The results of the Injury Survey provide direction for reducing injury frequency and severity among fencers. Of primary concern is the interface of the fencer and the floor. This is reflected in the relatively high proportion of knee, ankle and other lower extremity injuries which appear to be due to problems with strips and shoes. A series of related recommendations follows:

Identify those strips in current use that are safest (resilient surface, adequate traction or friction; proper anchoring) and make these more widely available. NOTE: Concrete surfaces are assumed to exceed the limit of acceptable hardness, based on preliminary data.

Re-evaluate the design of elevated strips for increased safety.

Conduct research to improve the quality of strips while maintaining affordability.

Develop guidelines for materials, performance, and procedures for proper anchoring of strips.

Continue research already begun on footwear.

A separate article will follow in AMERICAN FENCING focusing on the characteristics of strips and their role in fencing injury. This article will include a more detailed report of results of the Injury Survey in conjunction with other research underway by the USFA Safety Committee.

Also of significant concern is the relatively large contribution of behavioral factors to injury. Inadequate warm-up, which is a leading cause of injury within this category, is relatively easily addressed. This requires more careful and systematic training of fencers and coaches in both warm-up and stretching techniques. For this purpose, proper regimens should be developed in consultation with sports medicine specialists. As is typically the case with personal behaviors, basic instruction would need to be supplemented by systematic efforts to encourage consistent compliance with warm-up and stretching procedures once learned.

The personal concern expressed by fencers regarding puncture wounds is noteworthy. This supports the value of continuing research already underway on personal equipment (masks and body padding) as well as on non-destructive evaluation of blades and new composite blade structures. The results of this survey along with previous research by Julie Moyer (see below for more information) are a good beginning to a better understanding of fencing injuries. Survey research in which fencers retrospectively report injuries have inherent limits. To continue to better serve the needs of fencers additional research is necessary including prospective research where the relationship between injuries and their causes is monitored on an ongoing basis.

For more information on fencing injuries, please see the following:

"Safer Fencing for Everyone" by Cynthia Carter and John Hell in AMERICAN FENCING, Vol. 42, No. 3, p. 13, 1992

"An Overview of Fencing Injuries" by Julie Moyer in AMERICAN FENCING, Vol. 42, No. 4, p. 25, 1992

"Competitions on Concrete Surfaces" by Paul Soter in AMERICAN FENCING, Vol. 42, No. 4, p. 30, 1992

 

Acknowledgement... The authors express their gratitude to the fencers who participated in the Injury Survey and to the members of the USFA Safety Committee and Sports Medicine Committee for their input on the development of this survey instrument. This work has been funded by the USFA. Additional support has been provided by Lewis-Gale Clinic, Roanoke Virginia, and Exercise Research Associates of 0regon.