title: Safety recommendations in Shotokan karate.
abstract: OBJECTIVE
  To study risk factors for injury in karate and to establish safety recommendations.
  
  
  METHODS
  Cross-sectional survey of karate injuries.
  
  
  METHODS
  Shotokan karate clubs in Boston, Massachusetts, Dallas, Texas, and Winnipeg, Manitoba, Canada.
  
  
  METHODS
  All athletes training at each club received surveys. A total of 114 surveys were analyzed (74% response rate).
  
  
  METHODS
  Presence of injuries (requiring any time off from practice), major injuries (requiring at least 7 days off), and multiple injuries (3 or more injuries).
  
  
  RESULTS
  No statistically significant differences were found with respect to sex. For all outcomes, karateka younger than 18 years of age had fewer injuries. The number of karateka with injuries and with multiple injuries increased with belt rank until brown belt, then reached a plateau. Brown and black belts had a greater frequency of major injuries than the lower ranks. Training more than 3 hours per week correlated with an increase in injuries, major injuries, and multiple injuries.
  
  
  CONCLUSIONS
  Shotokan karate appears to be a safe sport, especially for those younger than 18 years of age. Risk of injury increases significantly when younger karateka of any rank or older karateka of lower ranks train more than 3 hours per week; therefore, to reduce the risk of injury to less than 50%, weekly training should be limited to a maximum of 3 hours in these groups.
authors.affiliation: Division of Sports Medicine, Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: M N
authors.initials: MN
authors.lastname: Zetaruk
authors.forename: D
authors.initials: D
authors.lastname: Zurakowski
authors.forename: M A
authors.initials: MA
authors.lastname: Violan
authors.forename: L J
authors.initials: LJ
authors.lastname: Micheli
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001265:Athletic Injuries / Q000453:epidemiology* / Q000517:prevention & control; D002170:Canada / Q000453:epidemiology; D002648:Child; D003625:Data Collection; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D016139:Martial Arts / Q000293:injuries*; D008875:Middle Aged; D012307:Risk Factors; D012449:Safety; D012737:Sex Factors; D014481:United States / Q000453:epidemiology