20th KOSSM-JSOA Combined Symposium of Orthpaedic Sports Medicine
Free paper presentation

Fencing Injuries which Required Medical
Time-out during Bout are Deferent
among Disciplines:
analysis of 25,976 fencers
1) Tokyo Fencing Association, 2) JR Tokyo General Hospital,
3) Ukima Central Hospital, 4) Japan Woman‘s College of Physical Education

Shuichi Nakayama1),2)
Yusuke Watanabe1),3)
2023/10/6

Itakura Hisako1),4)
1JR東京総合病院

Japan Sports Orthpeadic Association
COI disclosure
Auther: Shuichi Nakayama
The author have no financial conflicts of interest disclose concerning the study.

2023/10/6

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Introduction• Fencing–1 on 1 combat sports using sword (weapon)–On the linear ”Piste”–Wearing a distinctive bodysuit–Several bouts in the same day(preliminary rounds followed by final tournament )–3 different disciplines (Epee, Foil, Sabre)
FIE home page: https://fie.org/new-to-fencing/weapons
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Differences in Disciplines
 Weapon:
Epee; heaviest and hardest
Sabre; shortest

 Target area

Sabre
Epee
Foil

Foil;
Sabre;Epee;

Torso
Torso, Arm, Head
Whole body Priority for point: Foil and Sabre
FIE homepage:https://fie.org/new-to-fencing/weapons
2023/10/6 https://www.seiko.co.jp/magazine/article/00084.html

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Medical Time-out A 5-minute break for any injury or other medical reason
 By the end of break, medical staff (we) will decide that the fencer
should continue or retire (individual events) and/or be replaced (teamevents) .
 During the remainder of the same day, a fencer cannot be allowed afurther break for the same reason.
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Materials and Methods• Injury surveillance Between April 2019 and March 2023
 93 fencing competitions held in Tokyo 25,976 athletes (male 14,557, female 11,419) were included.
• Age, Sex, Discipline, Cause of Injury, Type of Injury, Body Part of Injury andOutcome were recorded1).
• Characteristics of injuries among the disciplines were statistically analyzed
using the multiple Chi-square test.
2023/10/6 1) Bahr R, et al. Br J Sports Med. 2020.

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Results
Of the 25,976 fencers in 93 competitions(134,638 AE)
 Athlete who needed medical care for any reason during thosecompetitions
1691 (6.51%, 12.56/1000AE)
 Medical Time-out during the bout

330 (1.27%, 2.45/1000AE ) Athletes who decided to Retire their bout

27 (0.10%,2023/10/60.20/1000AE)
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Medical Time-out (330 cases analysis)
Sex
Female
Male
total

Foil
5290
142

Epee
326395

Type
Foil
Epee
Sabre

contusion
32
1924

cramp
40
48
18

Sabre
1479
93

total
98 (0.67%)
232 (2.03%)
330 (1.27%)

laceration ligament
1615
5101029

multiple chi square test: p < 0.01, residual analysis: p <0.05
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Medical Time-out (330 cases analysis)
Contact- Contact- Contactathlete
moving stagnant
1626
7101511920
1CauseFoil
EpeeSabre

Noncontact
21727

Overuse- Overusegradual sudden
1256
172
2
29

head/shoulder Elbow Finger thumb thigh knee L-leg ankle footface
Foil
52
715
425
1426
189Part

Epee

8

122

327

725

53Sabre111111274

1423

4

multiple chi square test: p< 0.01, residual analysis: p <0.05
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Cause of Retirement (27 cases)
Foil: 13
Calf cramp (3)Strain (2)Ligament (2)Contusion (2)Dislocation (1)Heat illness (1)Other (2)2023/10/6

Epee: 4
Cramp (3)Strain (1)Sabre: 10
Ligament injury (5)Tendon rupture (1)Fracture (2)Dislocation (1)Strain (1)10JR東京総合病院

Discussion
 184 Time-Loss Iinjries (TLI) among 78,223 fencers over 5 years
 Overall TLI rate of 0.3/1,000AE
Harmer PA. 2)
This research; 27 TLI among 25,976 fencers

TLI rate was 0.20/1000AE

2023/10/6 2) Harmer PA. et al. Clin J Sport Med, 2008.

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Differences in Disciplines
Average time of single attack during bout
Foil 5 sec.

Epee 15 sec.

Sabre 3 sec.

Average moving distance per bout
Epee 250-1,000 m

Sabre ≤ 250 m

Epee needs more endurance. Sabre is more aggressive.
2023/10/6
3) Strength and Conditioning for Fencing.Strength & ConditioningJournal,2019

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Differences in Disciplines
Sabre injuries were Relatively high energy injuries like,

Ankle sprain and Thumb MPJ injury

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Differences in Disciplines
Epee injuries were
 Characteristics of endurance sports injuries like,Muscle Cramps and Overuse Injuries
 The distinctive whole body uniform condition makes body temperature risen easily
even in a normal WBGT condition.
IF the bout become longer, it might cause muscle cramps, as same as Heat Illness.
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Discussion
Therefore,
Prevention strategy should be different in each discipline, Sabre fencers should be aware of ankle sprain and thumb sprain.
e.g. Neuromuscular Training, Brace/Taping, Improving Initial Treatment…

 Epee fencers should manage their body temperature and hydration.
e.g. Icing, Change of Clothes, Hydration, Minerals and Citric Acid…

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Conclusion
In Fencing competition,
 TLI rate was 0.20/1000AE.
 The type, cause and part of injury which required medical timeout was significantly deferent among disciplines.
 We need deferent prevention strategy for each discipline.
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