Tug of war: Introduction to the sport and an epidemiological injury study among elite pullers

The objective of this study was to describe injury patterns among elite tug of war athletes, using a survey method. The setting was the World Tug of War (TOW) Championships in 1998. All 990 male and female athletes asked to participate. Demographic data, participation history, and injury history during TOW, including injury number and type, were collected. A total of 252 (187 males and 65 females) athletes completed the survey (25% response rate). Although males had been competing longer than females (9.3 ± 6.9 years vs. 6.5 ± 5.0 years, t-test, P < 0.005), the percentage of males (64/187 = 32%) and females (24165 = 37%) females reporting TOW injuries was similar. Strains and sprains comprised over half of all injuries, and the back (42%), shoulder-upper limb (23%), and knee (17%) were most commonly injured. Injury patterns were similar among males and females. Elite TOW athletes represent a diverse age range (15-55 years) of males and females who have competed for 5-10 years. About one-third will have suffered past TOW-related injuries, typically involving sprains or strains of the low back, shoulder girdle-upper extremity, and knee. The possibility of an increased injury rate among female TOW athletes warrants further study. Considerations for future research are discussed.