Page 138 - JSOM Summer 2022

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the two winter iterations. Finally, at least one study did not Table 3 shows that only two studies 23,24 provided data on lo-
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include what the authors considered “trivial injuries” such as cations of injuries. In the study by Hawley et al., 69% of
blisters, bruises, abrasions. As other studies have shown, 2,6,23,24 injuries occurred in the lower body, 31% in the upper body. In
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there can be a large number of these types of injuries and ig- the study by Rabb and Coleby, 81% of identifiable injuries
noring them can lead to an underestimation of their impact. occurred in the lower body and 19% in the upper body. The
Acknowledging these limitations, the two categories of inju- most commonly injured sites in the lower body were the ankle
ries that predominate in Table 3 are “musculoskeletal injuries” or “ankle/foot” and in the upper body, the hands, fingers, and
and abrasions/lacerations. wrist.

TABLE 3 Types of Medical Encounters and Anatomical Locations of Injuries during Obstacle Course Events
Medical Encounters Anatomic Locations (injuries)
Proportion of
All Encounters Proportion
Study Description N (%) Description n of Total (%)
Agar et al. 2009 Hypothermia a 84 33.5
Agar, 2009 Abrasion/laceration/blister 71 28.3
#7176 MSK (fracture, dislocation, sprain) 51 20.3 NR NR NR
Heat Injury 41 16.3
Missing 4 1.6
Coleby & MSK 98 59.4
Thibeault- Exertion 32 19.4
Rivard 2016 22 Laceration/burn 20 12.1
Cardiorespiratory 9 5.5 NR NR NR
Allergic Reaction 2 1.2
Gastrointestinal 2 1.2
Exposure 2 1.2
Pearkes et al. MSK (acute) 130 31.6
2016 6 Laceration/Graze 120 29.2
MSK (chronic) 31 7.5
Eye 27 6.6
Cold/Hypothermia 22 5.4
Bruising 15 3.6
Asthma 8 1.9 NR NR NR
Minor Head Injury 7 1.7
Allergic Reaction 5 1.2
Abdominal Pain 2 0.5
Hypoglycemia 1 0.0
Seizure 1 0.0
Other 42 10.2
Hawley et al. Abrasion/Laceration 223 36.6 Ankle 109 23.2
2017 23 Sprain/Strain 142 23.3 Knee 107 22.8
Soft Tissue Injury 50 8.2 Hand/Finger 60 12.8
Foreign Body 27 4.4 Lower Leg 44 9.4
Pre-Existing Injury 26 4.3 Feet/Toes 43 9.2
Possible Fracture 25 4.1 Eyes 25 5.3
Bite/Sting 15 2.5 Head/Neck 24 5.1
Preventative Measure 7 1.1 Forearm/Elbow/Arm 17 3.6
Nausea/Vomiting 7 1.1 Axial Skeleton 11 2.3
Shortness of Breath 7 1.1 Face 9 1.9
Altered Mental Status (syncope, confusion) 7 1.1 Hip/Thigh 8 1.7
Other Soft Tissue 7 1.1 Wrist 7 1.5
Other 39 6.4 Shoulder 5 1.1
Unknown 27 4.4
Rabb & Coleby Laceration 1051 59.0 Foot/Ankle 238 40.0
2018 24 MSK 595 33.3 Lower Leg 137 23.0
Exertion 56 3.1 Hand/Wrist 44 7.3
Environmental 52 2.9 Upper Arm 43 7.2
Cardiorespiratory 17 1.0 Back 23 3.7
Gastrointestinal 6 0.3 Lower Arm 18 3.0
Allergic Reaction 5 0.3 Hip 6 1.0
Upper Leg 3 0.5
Torso 3 0.5
Other 70 11.8
Unknown 10 1.7
Knapik et al. Blisters 14 46.7
2013 2 Abrasions/Lacerations 7 23.3
Pain NOS 6 20.0
Sprain 1 3.3 NR NR NR
Impingement 1 3.3
Contusion 1 3.3
a Oral or axillary temperature <95 F
o
Abbreviations: MSK = musculoskeletal; NR = not reported; NOS = not otherwise specified

134 | JSOM Volume 22, Edition 2 / Summer 2022