Research Strengths

Only a moderate proportion of individuals return to pre-injury level of sport within one year of a significant sport or recreation injury. Sport and recreation injuries are associated with short and long-term consequences including obesity, physical inactivity, physical disability and other negative health outcomes (e.g., depression, osteoarthritis).

Given the global burden of OA and obesity, as well as functional deficits and negative psychological responses, which may interfere with return to sport and recommended levels of physical activity in the post-injury period, it is important to understand the impact of failure to return to sport and physical activity (as well as the reasons for this) to inform the development prevention strategies that can be used to shift focus from chronic disease management to disease prevention, which is vital for population health and healthcare sustainability.

Osteoarthritis is a disease that results in joint degeneration. It most commonly affects the knee joint and is the fastest growing major health condition in the world. In 2010, osteoarthritis affected over 4.4 million Canadians. It is projected that this number will double by 2040.

The forces driving the increasing burden of osteoarthritis include an aging population, earlier age of onset, and lack of a cure or method to reverse the disease. For instance, there is an increasing number of individuals who develop osteoarthritis at a young age (<30 years) as a result of a sport-related knee joint injury in their youth. Youth who experience a knee injury have a greater than 50 per cent chance of developing osteoarthritis 10-15 years following the injury and four times the risk of developing osteoarthritis than youth who do not have a knee injury. Sport and recreation is the leading cause of injury in adolescents with one in three Alberta youth between the ages of 11 and 18 seeking medical attention for a sport and recreation-related injury every year (of which knee injuries are the most common).

Given that there is no cure or way to reverse osteoarthritis, the only way to solve this problem is to prevent it. This requires a fundamental shift in the current approaches taken to manage osteoarthritis away from end stage treatment (joint replacement) towards preventing and/or delaying its onset by improving the joint health of young Canadians, particularly if they have experienced a joint injury.

The GSSMC will prioritize research on primary prevention strategies (e.g., injury prevention programs), which can reduce the burden of knee soft tissue injury in sport and recreation by 40-80 per cent. Research will focus on the development and evaluation of surgical selection and rehabilitation strategies to promote return to active living following injury, and prevent long term consequences of injury. This includes interventions targeting promotion of physical activity participation, reducing adiposity, improving functional outcomes, and reducing osteoarthritis in children, adolescent and adult populations following soft tissue knee injury.

The increasing attention given to sports concussions has led to improved identification, assessment and management. Four international consensus meetings have been held since 2001, with published guidelines being widely supported and adopted by medical specialties, healthcare organizations and sports organizations.

Baseline cognitive testing has become standard practice for a majority of high school, collegiate, semi-professional and professional sports organizations in high-collision sports. These advances have brought important changes to the management of sports concussions; however, several challenges remain (e.g., education of athletes, parents, coaches, athletic allied healthcare professionals, identifying the best injury outcomes for sport concussion, prognostic factors for prolonged recovery after concussion and biomechanical forces of concussion). The GSSMC will prioritize research focused on addressing these remaining challenges.