Inline skating

Abstract: Inline skating belongs like ice hockey, rugby, and boxing to sporting activities with high-risk of suffering tooth accidents. Because of high velocity and loss of balance, especially on uneven ground, the injury potential in inline skating is higher. The objective of this work was to conduct a comparative study between Switzerland and Germany. The questions focussed on the frequency of tooth accidents, their prevention by mouthguard and the level of information about emergency measures after dental trauma and the resulting consequences for athletes. Using a standardized questionnaire totally 612 individuals, 324 men and 288 women, in two countries belonging to three different divisions (fun, fitness and speed) were surveyed. Fifty-six (9.2%) of these 612 interviewees have already experienced a tooth injury while inline skating. More than half of all interviewed players (68.3%) were aware of the possibility of replanting avulsed teeth. Only 32.4% were familiar with the tooth rescue kit. Just 65.4% knew mouthguard and only 1.9% of those athletes (n ¼ 12) wore a mouthguard while inline skating. The results show that the area of inline skating requires more information about preventing dental trauma through sports associations and dentists.

Abstract: Dissection of the vertebral arteries following minor head and neck traumas due to sporting activities such as tennis, yoga and volley ball has been previously reported (1±3). We report on a case of a 41-year-old female patient who was admitted with increasing left-sided neck pain since 4 days. She did not report any fall or other trauma. However, she performed on the day of acute onset of symptoms inline skating for about 2 h. Neurological examination at admission was otherwise unremarkable. MRI of the brain showed no pathological ®ndings. Duplex scan revealed normal frequency spectra and a normal ̄ow velocity in the right vertebral artery and a high resistance ̄ow pro®le in the left vertebral artery. In addition to the clinical features these ®ndings were considered as highly suspicious for a dissection of the left vertebral artery. MR-angiography disclosed a small vessel lumen with severe narrowing proximal to and along the atlas slope of the left vertebral artery, but no evidence of a dissection. With respect to the clinically suggestive presentation conventional supraaortic angiography was performed and disclosed occlusion of the left vertebral artery cranial to the origin of the posterior inferior cerebellar artery. The distal parts of the vertebral artery were ®lled retrograde by the right vertebral artery, which showed no abnormalities. To prevent further thrombus formation treatment with intravenous heparin was established. Follow-up MRangiography 1 week later demonstrated concentric wall thickening of the left vertebral artery characteristic for a dissection of the vessel wall. On day 9 after admission the patient developed horizontal nystagmus and transient right sided homonymous hemianopsy. Five days later the patient complained of severe neck pain on the right side. Duplex scan demonstrated dissection of the right vertebral artery revealing an extending intimal ̄ap in the right vertebral artery. At this time MRI showed small bilateral medullar infarctions whereas an eccentric crescent high signal intensity representing intramural hemorrhage surrounded the left vertebral artery at the mastoid slope and con®rmed the diagnosis of dissection. MR-angiography disclosed patency of the left vertebral artery without residual lumen narrowing or thrombi. However, in the right vertebral artery an extensive dissection with subtotal lumen obstruction was detected. Therapy with intravenous heparin was proceeded. The patient recovered completely and was discharged without any neurological symptoms on oral anticoagulants. MRI performed 4 weeks after the primary event con®rmed persisting dissection of the right vertebral artery with subtotal stenosis and patency of the left vertebral artery without lumen narrowing. Clinical examination 6 months after discharge showed the patient free from neurological symptoms. In this case the ®rst dissection may have been caused by excessive tension of the neck muscles during inline skating. Any fall or macrotrauma as well as abrupt or uncontrolled head movements during skating were denied by the patient. The excessive tension of the neck muscles in the rather untrained woman may have resulted in a small intimal tear which consecutively led to a false lumen of blood within the media. However, the second dissection occurred 2 weeks later during bed rest. It may be speculated that a small tear in the vessel wall was increased by a microtrauma due to coughing or nose blowing and led to the delayed manifestation of the dissection of the right vertebral artery. The interval between the onset of neck pain indicating the initiation of dissection and the ischemic event was 14 days. This is in accordance with reports by Hinse et al. (4) and Mas et al. (5) that pain is preceding neurological symptoms of basilar ischemia for few minutes to 6 weeks. Duplex scan and clinical ®ndings established the diagnosis. The initial dissection was localized in the V3 segment of the left vertebral artery. Diagnosis by color-coded duplex scan was based on indirect signs in the midcervical course showing a high resistance ̄ow pro®le with an increased Acta Neurol Scand 2000: 101: 70±71 Printed in UK. All rights reserved Copyright # Munksgaard 2000

Abstract: Objectives: To evaluate differences in the way iceskaters and roller/inline skaters fall. Methods: Children’s falls related to skating were videotaped and categorised based on type of skating activity, child’s estimated age, direction of fall, whether the child attempted to break the fall, and whether the head struck the skating surface. Results: In total, 216 iceskating and 201 roller/inline skating falls were captured on videotape. In both iceskating and roller/inline skating, the majority of falls were forward in direction. The skaters attempted to break the falls with their arms or hands in over 90% of falls in both iceskating (93.1%) and roller/inline skating (94.5%). A greater proportion of falls in iceskating resulted in the head striking the skating surface (13.0%) than did those in roller/inline skating (3.0%) (odds ratio = 4.8; 95% confidence interval 1.9 to 13.3; p Conclusions: This study found that paediatric iceskaters and roller/inline skaters fall similarly and that both types of skaters try to break their falls with their arms or hands; however, because iceskating takes place on a low friction surface, attempts to break falls with the arms or hands are often unsuccessful, leading to head and face injuries. The development of a new type of protective gear, a wrist guard with a non-slip palm, should stop iceskaters from striking the head, protect against upper extremity fractures, and unlike a bulky helmet, should not discourage children from skating.

Abstract: In a field study the injury pattern as well as the active and passive injury prophylaxis of 1036 inline skaters were evaluated. Of them, 60% had already been injured. Every 124 h an injury occurred during inline skating. While 61% of the injuries affected only soft tissue, 31% were joint distorsions, and 8% were fractures. Altogether 37% of the 626 injured skaters required medical treatment. The upper extremities are especially at risk: 78% of the fractures and 48% of the distorsions affected the fingers, wrist, forearm or elbow. It is obvious that the inline skaters' passive prophylaxis measures are still unsatisfactory. Only 17% of the questioned used complete protection, whereas 16% were wearing no protective gear at all. Of the rest, 49% were skating with wrist guards, 66% were using knee pads, and 31% elbow pads. A high percentage of injuries is due to the lack of basic knowledge and techniques. The survey revealed that only 24% can stop immediately. While 51% had only slight problems with braking, 16% admitted having great difficulties, and 7% were not able to brake at all. These numbers reveal that there are still large deficits regarding braking techniques and education on the risks of injury. Therefore, athletes who use this equipment for the first time should learn the basic techniques of skating, braking and falling with the help of a qualified instructor. Most of all those questioned wanted to have more information, and half would be interested in special educational programmes.