Nutrition in Combat Sports

234 R.R. Wroble
13.5.2 Catastrophic Injury
Amateur wrestling at the high school and collegiate levels very rarely results in
fatality or paralysis. Understandably, most catastrophic injuries in wrestling occur
to the head and cervical spine. Mueller et al. (2002) described 46 catastrophic high
school injuries, two of which were fatal, and one catastrophic college injury. The
rate of direct catastrophic injury in high school was 0.97 per 100,000 and 0.72 per
100,000 wrestlers for college competition. Mueller et al. (1990) also documented
indirect (caused by systemic failure as a result of exertion while participating in a
sport) fatalities over that 20-year period, 14 in high school and 3 in college. The
rate of indirect fatality was 0.3 per 100,000 for high school wrestlers and 2.16 per
100,000 for college wrestlers. The deaths in college wrestling were of note because
they all occurred during a 3-month period in 1997 and all were related to hyperthermia,
dehydration, and weight loss.
Laudermilk and Boden analyzed NCCSIR data specific to wrestling. Laudermilk
(1988) reviewed 1982–1987 data from the NCCSIR. Fifty percent of the 24 injuries
were found to involve the cervical spine, spinal cord, or head. 42% of the injuries
occurred during takedown, and 71% during matches. Boden reviewed the NCCSIR
data from 1981 to 1989. He documented 35 cases of catastrophic injuries, 34 among
high school wrestlers and one among college wrestlers. He estimated the rate of catastrophic
injuries as being about 1 per 100,000 participants. Twenty-seven cases
involved the cervical spine. Of the 27 cervical spine injuries, 15 were permanent and
12 achieved full recovery. There were four cases of transient quadriplegia, three severe
head injuries, one herniated disk, and one death. They defined the at-risk settings: the
wrestler defending on a takedown, and matches as opposed to practice.
Clarke (1977 ) sent surveys to state high school associations and to individual
colleges. From 1973 to 1975, eight catastrophic injuries were found, all at the high
school level. All resulted in permanent spinal cord injury, none in death.
Bailes and Maroon (1989) reported on cervical spine injuries in athletes. Four
percent of the total admissions to their spinal cord unit were related to sports injury.
Wrestlers suffered accidents when they fell to the mat, with the usual mechanism of
injury being hyperflexion. They described the cervical spine being subjected to tremendous
forces, putting great stress on the intervertebral disks, ligaments, and facet
joints from rotational and horizontal vectors during certain maneuvers and holds.
In 1991, Bailes described a series of 3,200 spinal cord injuries at two centers
over a 12-year period from 1975 to 1987 (Bailes 1991). There were 13 wrestling
injuries. Of the 13 cervical injuries in wrestlers, 10 were spinal cord injuries and 3
were fractures or subluxations without neurologic injury. Five of the cervical cord
injuries were permanent and five achieved a full recovery.
Bruce et al. (1984) documented a very low incidence of major head and spine
trauma in children, but noted that the incidence increased in the 15- to 18-year-old
group. Wrestling injuries were produced by direct blows to the head or by falls in
which the head or neck was twisted. Other mechanisms include the twisting and
flexion activities and motions that are part of takedown maneuvers.