# Analysis of Severe Spinal Injuries in Korean Elite Female Wrestlers
## 4 Discussion  
This study investigated severe spinal injury and post-injury management among Korean female freestyle wrestlers. Based on the current study results, nearly half (46.3%) of the participants experienced at least one spinal injury that resulted in a time loss of more than three weeks during their athletic career. More than half (52.0%) of these athletes were re-injured. Most severe spinal injuries occur during technical training in wrestling, particularly during tackling and standing attack maneuvers, primarily because of overuse  
Figure 3: Comparison of post-injury management (**A**) and return-to-play (RTP) time (**B**) according to injury timing. \begin{table}
\begin{tabular}{p{113.8 pt} p{56.9 pt} p{56.9 pt} p{56.9 pt} p{56.9 pt}} \hline \hline
**Variables** & \multicolumn{2}{c}{**Overall (\(n\) = 25) (\(n\), \%)**} & \multicolumn{2}{c}{**Student-Ahtle (\(n\) = 16) (\(n\), \%)**} & \multicolumn{2}{c}{**Professional (\(n\) = 9) (\(n\), \%)**} & \multicolumn{2}{c}{\(p\)-Value (\(\mathbf{v^{2}}\))**} \\ \hline Post-injury management & & & & \\ \hline \multirow{2}{*}{Surgery} & Yes & 9 (36.0) & 5 (31.3) & 4 (44.4) & 0.671 \\ \cline{2-6}  & No & 16 (64.0) & 11 (68.8) & 5 (55.6) & (0.435) \\ \hline \multirow{2}{*}{Rehabilitation} & Yes & 13 (52.0) & 5 (31.3) & 8 (88.9) & 0.011 \\ \cline{2-6}  & No & 12 (48.0) & 11 (68.8) & 1 (11.1) & (7.667) \\ \hline \multirow{2}{*}{Medical clearance for RTP} & Yes & 6 (24.0) & 3 (18.8) & 3 (33.3) & 0.630 \\ \cline{2-6}  & No & 19 (76.0) & 13 (81.3) & 6 (66.7) & (0.672) \\ \hline Post-injury psychological distress & & & & & \\ \hline Re-injury & & 12 (48.0) & 5 (31.3) & 7 (77.8) & \\ \hline Performance decline & 9 (36.0) & 7 (43.8) & 2 (22.2) & \textgreater{}0.999 \\ \hline Rehabilitation failure & 3 (12.0) & 3 (18.8) & 0 (0) & (0.071) \\ \hline Starting assignment & 1 (4.0) & 1 (6.3) & 0 (0) & \\ \hline RTP time (months) & & & & & \\ \hline Mean \(\pm\) SD & 2.7 \(\pm\) 1.7 & 2.4 \(\pm\) 1.9 & 3.3 \(\pm\) 0.9 & \(p\) = 0.131 \\ \hline Median (range) & 3.0 (1.0–7.0) & 1.0 (1.0–7.0) & 3.0 (2.0–5.0) & \\ \hline \hline \end{tabular}
\end{table} 
Table 5: Management, psychological distress, and characteristics based on time of injury. mechanisms. Lumbosacral disc herniation is the most commonly reported type of injury (Figure 4A,B). Finally, athletes who sustained injuries during their student-athlete years were significantly less likely to receive specialized rehabilitation than those who sustained injuries during their professional careers. This study found that Korean female wrestlers had a high incidence of severe spinal injuries throughout their athletic careers, regardless of weight class. This finding contradicts the previous study that reported different injury frequencies based on weight classes [9]. They analyzed spinal injuries in male wrestlers using NCAA ISP data from the 2009/2010 to 2013/2014 academic years; spinal injuries in NCAA wrestlers were more frequent in heavyweight wrestlers, particularly in the 75 kg and 89 kg weight classes [9]. In takewrondo sparring, another combat sport, heavyweights are more likely to be injured than lightweights because of their greater power. Several factors may explain the discrepancy between the results of the present study and previous studies. This discrepancy possibly arises because this study only included severe injuries that resulted in a time loss of more than three weeks. In addition, sex differences cannot be ruled out. In addition, approximately half of the female wrestlers who had experienced severe spinal injury reported at least one recurrence during their athletic careers. These observations are consistent with previous studies that have highlighted the high risk of lumbar spine injury recurrence [17]. For example, the recurrence rate of lumbar spine injuries was approximately 20.7% in a study by [PERSON] et al. [18], who examined the epidemiology of lumbar spine injuries in athletes from 25 NCAA sports teams between 2019/2020 and 2013/2014.