title: Injury risk in Danish youth and senior elite handball using a new SMS text messages approach.
abstract: OBJECTIVE
  To assess the injury incidence in elite handball, and if gender and previous injuries are risk factors for new injuries.
  
  
  METHODS
  Cohort study of 517 male and female elite handball players (age groups under (u)16, u-18 and senior). Participants completed a web survey establishing injury history, demographic information and sports experience, and provided weekly reports of time-loss injuries and handball exposure for 31 weeks by short message service text messaging (SMS). Injuries were further classified by telephone interview.
  
  
  RESULTS
  The weekly response rate ranged from 85% to 90% illustrating the promise of the SMS system as a tool in injury surveillance. Of 448 reported injuries, 165 injuries (37%) were overuse injuries and 283 (63%) traumatic injuries. Knee (19%) and ankle (29%) were the most common traumatic injuries. The injury incidence during match play was 23.5 (95% CI 17.8 to 30.4), 15.1 (95% CI 9.7 to 22.2), 11.1 (95% CI 7.0 to 16.6) injuries per 1000 match hours among senior, u-18 and u-16 players, respectively. U-18 male players had an overall 1.76 (95% CI 1.10 to 2.80) times higher risk of injury compared to females. Having had two or more previous injuries causing absence from handball for more than 4 weeks increased the risk of new injury in the u-16 group (IRR: 1.79 (95% CI 1.03 to 3.11)-2.23 (95% CI 1.22 to 4.10)).
  
  
  CONCLUSIONS
  The incidence of time-loss injuries in elite handball was higher during match play than previously reported in recreational handball. Previous injuries were a risk factor for new injuries among u-16 players. Male players had a significant higher injury rate in the u-18 group.
authors.affiliation: Aarhus University, Department of Public Health, Bartholins Allé 2, 8000 Aarhus C, Denmark. MereteM@stofanet.dk
authors.forename: Merete
authors.initials: M
authors.lastname: Moller
authors.forename: Jorn
authors.initials: J
authors.lastname: Attermann
authors.forename: Grethe
authors.initials: G
authors.lastname: Myklebust
authors.forename: Niels
authors.initials: N
authors.lastname: Wedderkopp
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000453:epidemiology*; D001265:Athletic Injuries / Q000453:epidemiology*; D012090:Cumulative Trauma Disorders / Q000453:epidemiology*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007718:Knee Injuries / Q000453:epidemiology*; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D013180:Sprains and Strains / Q000453:epidemiology; D055815:Young Adult