Original ResearchpISSN 2671-793X eISSN 2671-7948
J EMS Med 2024;3(1):11-18
https://doi.org/10.35616/jemsm.2023.00059

A retrospective analysis of injury
and illness incidence in four new
extreme sports debuting during theTokyo 2020 Summer Olympic
Games: surfing, BMX freestyle,sport climbing, and skateboarding
Shota Tanaka1, Hironori Inoue2,3, Shuji Sakanashi2,4, Tomoya Kinoshi1,2,4,
Koshi Nakagawa3, Hiroyuki Yokota2,5, Yasuhiro Otomo2,6, Takao Akama2,7,
Hideharu Tanaka1,2,3,4
1

Received: September 23, 2023
Accepted: October 23, 2023
Correspondence to:
Shota Tanaka
Research Institute of Disaster
Management and EMS, Kokushikan
University, 7-3-1, Nagayama, Tama,Tokyo 206-8515, Japan
E-mail: tanakamedical24@gmail.com© 2024 Korean Council of EMS PhysiciansThis is an Open Access article distributed
under the terms of the Creative Commons
Attribution Non-Commercial License(http://creativecommons.org/licenses/
by-nc/4.0/) which permits unrestricted
non-commercial use, distribution, andreproduction in any medium, provided theoriginal work is properly cited.

www.jemsmed.org

Research Institute of Disaster Management and EMS, Kokushikan University, Tokyo, Japan
Medical Services Department, The Tokyo Organizing Committee of the Olympic andParalympic Games, Tokyo, Japan
3
Graduate School of Emergency Medical System, Kokushikan University, Tokyo, Japan
4
Department of Sports Medicine, Kokushikan University, Tokyo, Japan
5
Graduate School of Health and Medical Science, Nippon Sport Science University, Tokyo,
Japan
6
National Hospital Organization Disaster Medical Center, Tokyo, Japan
7
Faculty of Sport Sciences, Waseda University, Saitama, Japan
2

Objective: Surfing, bicycle motocross (BMX) freestyle, sport climbing, and skateboarding
are four extreme sports that were introduced at the 2020 Tokyo Olympics. As such, there
are currently no reports available on the number of injuries or illnesses associated withthese sports. This study aimed to describe the characteristics, anatomical sites, and mechanisms of injuries.
Methods: In this retrospective descriptive study, 178 athletes were included, comprising
18 in BMX freestyle, 40 in surfing, 40 in sport climbing, and 80 in skateboarding. The injury and illness characteristics reported in the competition venue and the Olympic Village
were analyzed.
Results: The largest number of patients were in their 20s, in 61% of the cases. More than
three-quarters of new extreme sport athletes had either medical emergency or orthopedic
visits. The incidence rates of medical attention requirements were 16.7% for BMX freestyle, 20% for sport climbing, 20% for surfing, and 25% for skateboarding. Acute injuries
and illnesses were more frequently reported during the game period than in the pre-gameperiod.
Conclusion: Among the four sports, skateboarding had the highest rate of medical attention requirements. Fractures and bruises were frequently observed, indicating the urgent
need for preventive measures in the future.
Keywords: Incidence; Athletes; Contusions; Emergency service

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New extreme sports in Olympics

INTRODUCTION
The Tokyo 2020 Summer Olympic Games hosted 339 events,
the most in Olympic history [1], and the provision of medical
support for outdoor athletes faced significant challenges due tothe extremely hot conditions and the ongoing coronavirus disease 2019 (COVID-19) pandemic [2]. Nonetheless, a survey
conducted by the Internatio nal Olympic Committee (IOC) revealed a slightly lower incidence of both injuries and illnesses at
the Tokyo 2020 Summer Olympic Games compared to the Rio
2016 Summer Olympic Games [3].
Seven new sports were introduced at the Tokyo 2020 Summer
Olympics, four of which were classified as extreme sports: surfing, bicycle motocross (BMX), sport climbing, and skateboarding [4]. These sports were specifically chosen to appeal to the interests of the younger generation [4]. When examining the incidence of medical attention required across all sports, sport
climbing accounted for 15% of 40 cases, skateboarding for 12.5%of 80 cases, surfing for 10% of 40 cases, and BMX freestyle for4.2% of 48 cases [2]. Three out of these four sports ranked
among the top 10 for incidence rates. Out of the 74 patients who
were transported to the hospital, two were from these four new
extreme sports [2]. Tanaka et al. [2] focused their study solely on
medical care provided at the competition venue, excluding datafrom the Olympic Village.
Few studies have investigated the epidemiology of injuries sustained during extreme sports activities. The objective of thisstudy was to analyze the characteristics, anatomical locations,and mechanisms of injuries in surfing, BMX freestyle, sport
climbing, and skateboarding. These were the first extreme sports
to be introduced at the Olympics. The study also aimed to explore their epidemiology.

METHODSData

All athletes provided written consent for the use of their medical
records at the time of accreditation. The Tokyo Organizing Committee of the Olympic and Paralympic Games' Medical Services
Department officially granted permission for data collection, in
accordance with the IOC 2020 Consensus Statement on Injury
Definition. Furthermore, the Ethics Committee of Kokushikan
University approved data utilization (approval No. # 22001).
Injury data were entered and digitally stored by J-SPEED. The
collected data included: (1) information from the daily reportsof medical operation managers, which detailed the number of

12cases reported at each location [5]; (2) data from electronic
medical records, which included the treatment histories of athletes; (3) medical information sourced from the hospital; (4)data from the main operation center, specifically information obtained from the medical coordination office; and (5) information
concerning the final diagnosis from the treating hospital.
These reports were used to gather emergency medical information on injuries and illnesses that transpired at competition
venues. The data specifically extracted and consolidated into asingle database included: date, location, sport, continent of origin, sex, age, primary complaint, time of occurrence, injury or illness classification, acute or chronic classification, injury mechanism, visit reason, initial vital signs, treatment, diagnosis, anddestination medical facilities for transportation. Cases with insufficient data, missing data, duplicates, and data deficiencies met
the exclusion criteria and were therefore not extracted. However,if the same athlete required treatment for different diseases andinjury sites at various times, each incident was classified and added as a new case.

Participants

A total of 11,420 athletes competed in the Tokyo 2020 Summer
Olympics, which took place in 2021. This study focused on 178
of these athletes who participated in four extreme sports: 18 in
BMX freestyle, 40 in surfing, 40 in sport climbing, and 80 inskateboarding.

Data analysis

The background and characteristics of four new extreme sports
were examined, including factors such as the location of the medical facility where the patient was treated, the patient's age groupand sex, the continent where the incident occurred, the timing of
the injury or illness, the type of injury or illness, the departmentthat treated the patient, and the reason for the medical consultation. The period and location of the injury or illness occurrence,
the mechanism of the injury or illness, and the final diagnosis
were also analyzed. Tanaka et al. [2] discussed incidents of accidents, injuries, or illnesses, as well as emergency transport atcompetition venues, and reported their findings. In this report,
duplicate cases were excluded. However, in this study, incidents
that occurred at different times and involved different injuries orillnesses were considered separate events. The study also investigated both competition venues and the Olympic Village, and included both orthopedics and physical therapy. As a result, thenumber of reported cases may have varied.

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J EMS Med 2024;3(1):11-18

Definition

The game period was defined as the time span between the
opening and closing ceremonies, which took place from July 23
to August 8. The pre-game period refers to the time frame prior
to the commencement of the games.

Game period(1) Unknown refers to circumstances of injury that were seen at
the competition venue on game day, but it was not clear whether
it occurred during the game or training. (2) Others referred tocircumstances of injuries treated at the Olympic Village during
the game period.

RESULTS
Background

Out of 178 athletes, 39 required medical attention. This included
three from BMX freestyle, eight from sport climbing, eight fromsurfing, and 20 from skateboarding. There was no significant difference between the sexes, with males comprising 51.3% and females 38.5%. The majority of cases, 61.5%, involved patients intheir 20s, while teenagers accounted for 7.7% of all cases; thesefigures are attributable to the extreme nature of the sport.

Characteristics
Overall
All relevant characteristics are presented in Table 1. Of the total,
59% received treatment at competition venues, while 41% weretreated at the Olympic Village. There was a tendency for moreacute injuries and illnesses to be reported during the game period
compared to the pre-game period. Furthermore, a higher numberof visits were made to emergency medical services (46.2%) andorthopedics (30.8%). The primary reason for these visits was injury treatment, which constituted 69.2% of all visits. Only 12.8%of the athletes sought medical treatment, and fewer than 15.4%
visited for physical therapy. A total of 35 injuries were reported
across four sports, with lower extremity injuries (51.4%) being
the most frequently reported anatomical site (Table 2). Contact
with an object was the most common injury mechanism (Fig. 1).
BMX freestyleThree patients sustained injuries while participating in BMX
freestyle. All these individuals were in their 20s at the time of thecompetition (Table 1). Two of the injuries (66.7%) involved theupper extremities, necessitating magnetic resonance imaging
and, in certain instances, specialist referrals (Table 2). In all cases,

https://doi.org/10.35616/jemsm.2023.00059

the injuries were either muscular or skeletal in nature (Fig. 2).

Sport climbing
Eight cases involving sport climbing were reported, including
seven injuries and one illness (Table 1). Three of the injuries
were skin lesions, and one was musculoskeletal (Fig. 2). Injuries
were evenly distributed between the upper (50.0%) and lower
extremities (50.0%) (Table 2). The most frequently reported injury resulted from collisions with objects (Fig. 1).
Surfing
All eight reported surfing-related cases involved injuries. The patients visited various departments: two sought help from emergency departments, two from internal medicine departments,
one from an orthopedic department, and three from physicaltherapy departments (Table 1). Among these cases, two were diagnosed with skin injuries caused by rocks, and one was identified as a ligament injury (Fig. 2). The mechanisms of these injuries ranged from chronic overuse and exercise-induced injury tocontact with objects (Fig. 1).
Skateboarding
Twenty athletes from various extreme sports, including skateboarding, sought treatment at the athlete clinic (Table 1). The
athletes represented a wide range of age groups, and injuries werereported across all genders and continents. Of these athletes,
45% required emergency care, while 40% needed orthopediccare. The majority of these visits were due to injuries. Six of theseinjuries were acute, occurring during practice in the game period,
while two occurred during practice in the pre-game period.
During the gaming period, 70% of the injuries or illnesses werereported. The majority of these were musculoskeletal injuries orskin lesions. Specifically, there were three cases of distal radius
fractures, one case of pelvic contusion, and the remaining cases
were reported as contusions or muscle sprains (Fig. 2).

DISCUSSION
During the Tokyo 2020 Summer Olympics, the incidence rateof medical clinic visits at competition venues and Olympic Villages by 178 new extreme sports athletes was found to be notably
high. Specifically, 16.7% of these visits were by BMX freestyleathletes, 20% by sport climbing athletes, 20% by surfing athletes,and 25% by skateboarding athletes. Over three-quarters of these
new extreme sports athletes required either emergency medicalor orthopedic care.

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New extreme sports in Olympics

Table 1. Background of athletes and characteristics of medical services
Characteristic
No. of athletes requiring medical attention
At the competition venue
At the Olympic Village
Age group
10s
20s
30s
40s
Unknown
Sex
Male
FemaleUnknown
Continent
Asia
AfricaAmerica
Oceania
EuropeUnknown
Injury and illness occurrence period
Pre-game periodGame period
Type of injuries or illnesses
Acute
Chronic
Relapsing
Unknown
Not injury: conditioning
Service
Emergency medicine
Internal medicine
Orthopedics
Physiotherapy
Reason for visit
Request for injury treatment
Request for medical treatment
Request for injury report
Physiotherapy

BMX freestyle(n = 18)
3 (16.7)
1 (33.3)
2 (66.7)

Sport climbing(n = 40)
8 (20.0)
6 (75.0)
2 (25.0)

Surfing(n = 40)
8 (20.0)
5 (62.5)
3 (37.5)

Skateboarding(n = 80)a)20 (25.0)
11 (55.0)
9 (45.0)

Overall(n = 178)
39 (21.9)
23 (59.0)
16 (41.0)0
3 (100)000

1 (12.5)
6 (75.0)
1 (12.5)000
6 (75.0)
2 (25.0)00

2 (10.0)9 (45.0)
3 (15.0)
2 (10.0)
4 (20.0)

3 (7.7)24 (61.5)
6 (15.4)
2 (5.1)4 (10.3)

2 (66.7)
1 (33.3)
05 (62.5)
3 (37.5)04 (50.0)
4 (50.0)09 (45.0)
7 (35.0)
4 (20.0)

20 (51.3)
15 (38.5)
4 (10.3)

00
2 (66.7)
0
1 (33.3)02 (25.0)
1 (12.5)
2 (25.0)03 (37.5)0

1 (12.5)
1 (12.5)
3 (37.5)03 (37.5)
02 (10.0)
3 (15.0)
5 (25.0)
1 (5.0)5 (25.0)
4 (20.0)

5 (12.8)
5 (12.8)
12 (30.8)
1 (2.6)
12 (30.8)
4 (10.3)03 (100)08 (100)3 (37.5)5 (62.5)

6 (30.0)
14 (70.0)

9 (23.1)
30 (76.9)

2 (66.7)0001 (33.3)

6 (75.0)00
1 (12.5)
1 (12.5)

3 (37.5)
1 (12.5)
02 (25.0)
2 (25.0)

13 (65.0)
2 (10.0)
1 (5.0)04 (20.0)24 (61.5)
3 (7.7)
1 (2.6)3 (7.7)8 (20.5)

1 (33.3)
02 (66.7)
06 (75.0)0
1 (12.5)
1 (12.5)

2 (25.0)
2 (25.0)
1 (12.5)
3 (37.5)

9 (45.0)
1 (5.0)8 (40.0)
2 (10.0)

18 (46.2)
3 (7.7)
12 (30.8)
6 (15.4)

1 (33.3)
1 (33.3)
0
1 (33.3)

5 (62.5)
1 (12.5)
1 (12.5)
1 (12.5)

7 (87.5)
1 (12.5)
00

14 (70.0)
2 (10.0)04 (20.0)27 (69.2)
5 (12.8)
1 (2.6)6 (15.4)

Values are presented as number (%).
BMX, bicycle motocross.
a)
For skateboarding, background information (age, sex, continent) was missing in 4 cases.

The studies conducted by Soligard et al. [3], which analyzed
medical data from the National Olympic Committees and the
Olympic Village, and Tanaka et al. [2], which focused on acute14

injuries and illnesses at competition venues, both reported higher injury rates for newer sports. Soligard et al. [3] found that 22%of injuries occurred in BMX freestyle, 21% in skateboarding, 15%

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J EMS Med 2024;3(1):11-18

Table 2. Body locations of injuries by sports
Body
Head/face/neckHead/face
Neck
Trunk
Chest
Back
AbdomenPelvisUpper extremity
ShoulderScapulaHumerus
Elbow
Ulna/radius
Wrist
Hand
Lower extremity
Femur
Knee
Tibia/fibula
Ankle
Foot

BMX freestyle (n = 3)
0
0
0
0
0
0
0
0
2 (66.7)
0
1 (33.3)
1 (33.3)00001 (33.3)
1 (33.3)0000Sport climbing (n = 6)
0
0
0
0
0
0
0
0
3 (50.0)00
2 (33.3)0001 (16.7)
3 (50.0)0
1 (16.7)
2 (33.3)
00Surfing (n = 8)
1 (12.5)
1 (12.5)
0
0
0
0
0
0
1 (12.5)
1 (12.5)
0
0
0
0
0
0
6 (75.0)
1 (12.5)0
1 (12.5)04 (50.0)

Skateboarding (n = 18)
2 (11.1)
2 (11.1)0
3 (16.7)
1 (5.6)1 (5.6)0
1 (5.6)5 (27.8)
1 (5.6)0
1 (5.6)0
3 (16.7)008 (44.4)
4 (22.2)02 (11.1)
1 (5.6)1 (5.6)Overall (n = 35)
3 (8.6)3 (8.6)0
3 (8.6)
1 (2.9)1 (2.9)0
1 (2.9)11 (31.4)
2 (5.7)
1 (2.9)4 (11.4)03 (8.6)0
1 (2.9)18 (51.4)
6 (17.1)
1 (2.9)5 (14.3)
1 (2.9)5 (14.3)

Values are presented as number (%).
BMX, bicycle motocross.

5
4

Cases

3
2
1
0
Overuse(chronic)

Overuse (acute)

Exerciseinduced

Environmental

Contact(not moving)Non-contact

OthersUnknown■BMX freestyle ■Sport climbing ■Surfing ■Skateboarding

Fig. 1. Mechanism of injuries and illnesses among four sports. BMX, bicycle motocross.

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Tanaka S et al.

New extreme sports in Olympics

Lacerations, abrasions or other skin lesions
Muscle: others
Muscle contusions, bruises or hematomas
Bone contusion
Bone fracture
Muscle strain
Ligament sprain or rupture
Heat-related illness
Muscle cramp
Non-infectious stomach pain
Others
0

2

4

6

8

10

12

■BMX freestyle ■Sport climbing ■Surfing ■Skateboarding

Fig. 2. Diagnosis among four sports. BMX, bicycle motocross.

in sport climbing, and 13% in surfing. In contrast, Tanaka et al.
[2] reported that 15.0% of injuries in sport climbing and 12.5%
in skateboarding required emergency care at the competition
venue only, even though the subjects were the same. Soligard etal. [3] reported the total number of athletes who received emergency medical care, orthopedics, physical therapy, otolaryngology, dermatology, ophthalmology, and other departments in boththe stadium and Olympic Village. This could potentially explain
the difference in findings. The results from both studies suggestthat the four extreme sports introduced as new sports at the Tokyo Olympics have relatively high injury and illness rates compared to other Olympic sports.
The overall risk of injury is relatively low for sport climbing[6,7]. Modern sports climbers now compete on walls that are
not only steeper but also more three-dimensional than the vertical walls used in the past [8]. Thus, sport climbing is a physicallydemanding sport that puts significant stress on the arms, legs,
hands, and feet. Recent years have seen the emergence of new injuries in sport climbing, including fractures related to heel hookmaneuvers [8-10]. In line with previous studies, arm and hand
injuries were found to be common in this study. Interestingly,
only 2% of athletes in sport climbing reported injuries at the Buenos Aires 2018 Youth Olympic Games [11], in contrast to the
20% injury rate among sport climbers at the Tokyo 2020 Summer Olympic Games.

16

Surfing, while recognized as a relatively safe sport among extreme sports [12], is not without its risks due to its oceanic nature. Drowning is an inherent risk, and catastrophic injuries tothe neck and head can occur due to impact with the seafloor[13]. Fortunately, the athletes participating in the 2020 Tokyo
Olympics experienced many minor injuries but were overall safe.
Despite the safe conduct reported at the Tokyo 2020 Summer
Games, previous studies have indicated that the most common
cause of injury is the impact between the surfboard and the seafloor, with a rate of 6.6 injuries per 1,000 hours [13]. Lacerations
accounted for approximately 40% of these injuries, followed bysprains/strains, contusions, fractures, and dislocations [13].
Skateboarding is a sport where trauma to long bones and traumatic brain injuries (TBIs) are relatively common [14]. However, during the Olympics, only three fractures were reported, withno instances of TBIs. O'Connor et al. [15] highlighted the inconsistency in the Olympic guidelines, suggesting that the current
helmet requirement for those under 18 years of age should also
be extended to include those over 18 years.
Research on BMX athletes has predominantly focused on contusions and other skin injuries [16]. Furthermore, fractures anddislocations are relatively uncommon, accounting for only about
10% of all injuries. This suggests that while BMX may appear to
be a high-risk sport, it often results in minor injuries [16]. However, a study by Soligard et al. [3] reported a high incidence of in-

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J EMS Med 2024;3(1):11-18

juries during the Tokyo Olympics. In our research, we identified
only three cases, two of which were contusions.
The following are some limitations of the study. First, due tothe study’s design, we were unable to establish any causal relationships. Second, since this study was confined to Japan, thenumber of injuries at the Olympic Games in other countries mayvary. Third, the administrative and emergency medical systems
may have differed significantly from those of previous Games,
given that the Olympics took place amidst the ongoing pandemic. Fourth, the methods and perspectives of the National Olympic Committee medical teams vary from country to country, andnot all athletes receive the same level of medical care, which
could potentially affect the medical records. Lastly, the medical
and physiotherapy data from the National Olympic Committee
team statistics were not incorporated into these records.
In this study, we analyzed athletes in four extreme sports thatwere introduced to the Tokyo Olympics. These athletes were examined at both the Olympic Village and competition venues. Of
the four sports represented, skateboarding had the highest incidence of medical attention needs. Frequent occurrences of fractures and bruises were observed, underscoring an urgent needfor future preventive measures.

FUNNING
None.

CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.

AUTHORS’ CONTRIBUTIONS
Conceptualization: ST; Data curation: HI, SS, TK; Formal analysis: ST, HI, KN; Investigation: HI, SS, TK, HY, YO, TA, HT;
Methodology: ST; Project administration: ST, HT; Resources: ;Software: ; Supervision: HY, YO, TA, HT; Validation: HI; Visualization: ST; Writing–original draft: ST; Writing–review & editing: ST, HT.

ORCID
Shota Tanaka, https://orcid.org/0000-0002-3191-9808
Hironori Inoue, https://orcid.org/0000-0002-2198-071X
Shuji Sakanashi, https://orcid.org/0000-0001-7915-8385

https://doi.org/10.35616/jemsm.2023.00059

Tomoya Kinoshi, https://orcid.org/0000-0003-2629-5452
Koshi Nakagawa, https://orcid.org/0000-0001-8738-1261
Yasuhiro Otomo, https://orcid.org/0000-0002-9674-1369
Takao Akama, https://orcid.org/0000-0002-3937-2448
Hideharu Tanaka, https://orcid.org/0000-0003-4565-0026

REFERENCES
1. Tokyo 2022. Chapter 2 event [Internet]. Tokyo Metropolitan
Government; 2022 [cited 2023 May 14]. Available from:https://www.2020games.metro.tokyo.lg.jp/c23c8b5cd5a9f719a1042a6ecd58c8d6.pdf
2. Tanaka H, Tanaka S, Yokota H, et al. Acute in-competition
medical care at the Tokyo 2020 Olympics: a retrospective analysis. Br J Sports Med 2023;57:1361–70.
3. Soligard T, Palmer D, Steffen K, et al. New sports, COVID-19
and the heat: sports injuries and illnesses in the Tokyo 2020
Summer Olympics. Br J Sports Med 2023;57:46-54.
4. Wheaton B, Thorpe H. Action sports and the Olympic Games:
past, present, future. Routledge; 2023.
5. Tokyo 2022. Chapter 8 convention management summary [Internet]. Tokyo Metropolitan Government; 2022 [cited 2022
Sep 30]. Available from: https://www.2020games.metro.tokyo.
lg.jp/73327c10d0404c285fc0e7cb1614bb9e.pdf?fbclid = IwAR2TwrhnL-wOQHubJEjOHudNnYBgONc-IlgG0h8dFzmOtpxYIJtnqT8zFss
6. Neuhof A, Hennig FF, Schoffl I, Schoffl V. Injury risk evaluationin sport climbing. Int J Sports Med 2011;32:794–800.
7. Schoffl VR, Hoffmann G, Kupper T. Acute injury risk and severity in indoor climbing-a prospective analysis of 515,337 indoor climbing wall visits in 5 years. Wilderness Environ Med
2013;24:187–94.
8. Schoffl V, Lutter C, Popp D. The "Heel Hook": a climbing-specific technique to injure the leg. Wilderness Environ Med
2016;27:294–301.
9. Hochholzer T, Bayer T, Straub G, Schoffl V. Overuse bone marrow edema of the hands in sport climbers. Sports Orthop Traumatol 2013;29:219–24.
10. Lutter C, El-Sheikh Y, Schoffl I, Schoffl V. Sport climbing: medical considerations for this new Olympic discipline. Br J Sports
Med 2017;51:2–3.
11. Steffen K, Soligard T, Mountjoy M, et al. How do the new
Olympic sports compare with the traditional Olympic sports?
Injury and illness at the 2018 Youth Olympic Summer Gamesin Buenos Aires, Argentina. Br J Sports Med 2020;54:168–75.
12. Laver L, Pengas IP, Mei-Dan O. Injuries in extreme sports. J Or-

17

Tanaka S et al.

New extreme sports in Olympics

thop Surg Res 2017;12:59.
13. Nathanson A. Injury prevention in the sport of surfing: an update. Muscles Ligaments Tendons J 2020;10:171–8.
14. Lustenberger T, Talving P, Barmparas G, et al. Skateboard-related injuries: not to be taken lightly: a national trauma databank
analysis. J Trauma 2010;69:924–7.

18

15. O'Connor M, Mehta S, Milanaik R. The lack of helmets in
Olympic skateboarding-skating into dangerous territory. JAMA
Pediatr 2022;176:224–5.
16. Rabanus A, Goost H, Burger C, Wirtz DC. Injuries in BMX
freestyle. Sports Orthop Traumatol 2013;29:225–8.

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