Sports injury hospitalisations

There were almost 52,300 sports injury hospitalisations reported in Australia in 2019–20, 7,800 fewer than in the previous year.

The number of sports injury hospitalisations in 2019–20 was less than the two previous years, with males accounting for a larger proportion of the drop in injuries (Figure 1). The main cause of the drop appears to be the interruption of organised sports due to COVID-19 lockdowns in March of 2020, as discussed later.

Figure 1: Sports injury hospitalisations, by sex, 2017–18 to 2019–20

Line graph with 3 lines representing sports injury hospitalisations for persons, males and females over three financial years from 2017 18 to 2019 20

Source: AIHW National Hospital Morbidity Database.

For more detail, see data table A28.

Young males are more likely to be hospitalised

There were more than twice as many male cases of sports injury hospitalisation (36,400) than female (15,900) in 2019–20.

Males had a higher rate of hospitalisation than females in every age group. Rates rise during childhood and peak in the teenage years, with a taller peak for males. The highest rates were in:

  • the 15–19 age group for males (745 cases per 100,000)
  • the 10–14 age group for females (274 cases per 100,000) (Figure 2).

Figure 2: Sports injury hospitalisations, by age and sex, 2019–20

Dual axis graph repeated for males and females. The columns align with the left axis and represent hospitalisations by age group. The lines align with the right axis and represent the crude rate per 100,000 at each age.

Source: AIHW National Hospital Morbidity Database. 

For more detail, see data tables A1 and A20.

Place of occurrence

As you might expect, the largest proportion of these injuries occurred at dedicated sports areas. For sports injury hospitalisations in 2019–20, the place of occurrence was specified in two thirds of cases (66%). Of these specified cases:

  • over half occurred at a sports or athletic area (57% or 19,800), including
    • almost a third at an outdoor ground (30% or 10,300)
    • almost 1 in 10 at an indoor hall (8% or 2,700)
  • more than 1 in 10 occurred on a street or highway (13% or 4,400).

For more detail, see data table A7.

Types of injury sustained

A person can be hospitalised with multiple injuries, some of which will be more serious than others. This report only presents data about the main injury—known as the principal diagnosis—additional concurrent injuries are not included.

Fractures are the most common injury

In just over half of all sports injury hospitalisations in 2019–20, the main injury was a fracture (51% or 26,700). Soft–tissue injuries were the next most common (18% of cases or 9,400) (Figure 3).

Figure 3: Type of injury as a percentage of all sports injury hospitalisations, 2019–20

Bar graph showing the proportion of injury hospitalisations by main type of injury.

Note: Type of injury is derived from the principal diagnosis.
Source: AIHW NHMD.

The most common fractures were of the arm or shoulder (41% of fractures or 10,800 cases), followed by a fracture to a leg or hip (23% of fractures or 6,020 cases). 69% of soft tissue injuries were to the leg or hip (6,500 cases).

For more detail, see data tables A2–6.

Concussions

Most hospitalised intracranial injuries (injuries inside the skull) in sports (80%) were concussions in 2019–20. Concussions are usually caused by a knock to the head but can also be caused by a blow to the body (Concussion in Sport Australia, 2022).

There has been growing concern in Australia and internationally about the incidence of sport-related concussion and potential health ramifications for athletes (Concussion in Sport Australia, 2019). While short-term symptoms are reversible, a single knock to the head can have serious consequences in later life (Queensland Brain Institute, 2021).

There were over 2,300 cases of hospitalised concussion caused by sports in 2019–20. Of these:

  • around 1,600 were male, and 700 were female
  • about 730 occurred while playing some form of football
  • about 440 occurred while cycling.

For more detail, see data tables A15–18.

Falls and transport accidents cause over half of all injuries

Falls and transport accidents caused over half (58%) of all sports injury hospitalisations in 2019–20. Falls include falls on the same level (13% or 6,700 cases), falls involving an object (12% or 6,400 cases) and falls involving another person (5.1% or 2,600 cases). Transport accidents include road transport (21% or 11,100 cases) such as bicycle crashes, and other land transport including horses (4.8% or 2,500 cases) (Figure 4).

Figure 4: Selected causes of injury as a proportion of sports injury hospitalisations, 2019–20

Bar graph representing the proportion of injury hospitalisations for each cause.

Source: AIHW NHMD.

For more detail, see data tables A11–12.

Emergency admissions are more common than elective

Hospitalisations are classed as emergency admissions if the patient requires admission within 24 hours. About two-thirds of sports injury hospitalisations in 2019–20 (67%) were emergencies. The proportion that was emergencies varied by sport, ranging from 91% of hospitalisations for equestrian activity injuries, to 32% for netball injuries.

For more detail, see data table A24.

COVID-19 interrupted the usual patterns

Month of admission data from 3 years of sports injuries suggests some patterns over the year. Male admissions in particular rise in the winter sport season and dip in the summer months.

In March 2020 the first lockdowns and social distancing measures associated with COVID-19 interrupted team sports participation. Male sports injury hospitalisations were 62% less and female hospitalisations were 39% less in April 2020 than in April 2019. (Figure 5).

Figure 5: Sports injury hospitalisations by sex, by month of admission, 2017–18 to 2019–20

Line graph split into two sections, one for male and one for female. Each section has 3 lines, one for each financial year showing hospitalisations by month of admission across a financial year. Each of the 3 lines for either sex follows a pattern until March of 2020, when the 2019 20 lines drop compared to the previous 2 years.

Notes
1. Months have been standardised to 31 days.
2. A scale up factor has been applied to June admissions to account for cases not yet separated.

Source: AIHW National Hospital Morbidity Database.

For more detail, see data table B1.

Looking at hospitalisations by sport, COVID-19 restrictions appear to have had the greatest impact on traditionally winter sports (such as football and skiing), compared with summer sports (such as cricket and swimming) and less seasonal sports (such as basketball and motor sports), as shown in Figure 6.

Figure 6: Sports injury hospitalisations by season category, by month of admission, 2017–18 to 2019–20

Line graph split into 3 sections, one for winter sports, summer sports and all others. Each section has 3 lines, one for each financial year showing hospitalisations by month of admission across a financial year. Each of the 3 lines generally follows a pattern until March of 2020, when the 2019 20 lines drop compared to the previous 2 year for winter sports especially, and slightly for the other 2 sections.

Notes
1. 'Winter sports' are all kinds of football (except touch), snow and ice sports, netball and hockey. 'Summer sports' are cricket, surfing, swimming and diving, water skiing, boating and fishing.
2. Months have been standardised to 31 days.
3. A scale up factor has been applied to June admissions to account for cases not yet separated.

Source: AIHW National Hospital Morbidity Database. 

For more detail, see data table B3.

Another interesting picture emerges when activities are grouped based on whether they would have been possible during lockdown: not only was there a drop in injury hospitalisations for the category of sports that would not have been possible, (including all winter team sports), but there was a rise in injuries from solo activities such as cycling and running (Figure 7). Cycling is examined in more detail in the featured sports section.

Figure 7: Sports injury hospitalisations by type of activity, by month of admission, 2017–18 to 2019–20

Line graph split into two sections, one for solo activities and one all others. Each section has 3 lines, one for each financial year showing hospitalisations by month of admission across a financial year. Each of the 3 lines for either category follows a pattern until March of 2020, when the 2019 20 line for solo activities rises compared to the previous 2 years, while for all others it falls.

Notes
1. 'Solo activities' are cycling, recreational walking, rollers sports, and running.
2. Months have been standardised to 31 days.
3. A scale up factor has been applied to June admissions to account for cases not yet separated.

Source: AIHW National Hospital Morbidity Database.

The next section examines participation and rates of injury in sports in Australia.