By Dr Dylan Powell

Physical activity and exercise are important components of a healthy lifestyle, with a central role in prevention and improving health. However certain sporting and physical activities also involve an inherent injury risk. While there is limited data on the extent and long-term effects of these risks, estimates suggest that in the UK around 1.5 million people present to emergency departments every year due to sports related injury and one third of people injured playing sport report having long-term effects.^1,2 Research shows that injuries of a severe nature can incur substantial costs, such as the cost of assessment, treatment, and on-going care costs. Consequently, the optimisation and management of sports injuries has implications for healthcare more widely. A wide body of research is devoted to understanding and investigating ways of mitigating the negative effects of sports injury.³ This week’s blog explores what we know about the extent and costs of sports injury and how digital technology and concepts such as the ‘digital athlete’ can improve monitoring and recovery.⁴

Estimating the cost of sports injury

Injuries have and always will be a risk of participating in sport. In professional football alone it has been estimated that an average English Premier League (EPL) team loses approximately £45 million per season due to injury related reductions in performance.⁵ However quantifying the exact cost is extremely difficult due to the wide disparity in injury burden which varies across different sports and populations. For example, although the overall rate of Anterior Cruciate Ligament (ACL) injury is higher in males, primarily due to greater participation in contact sports, the relative risk of ACL injury in women is thought to be three to eight times greater than males.⁶ Emerging research in other complex injuries, such as sports related concussion, also suggests females may be at an increased risk of injury. As such significant attention has been given to developing a better understanding of the reasons for this and identifying opportunities to try and reduce this risk in different sports and populations.

How can technology and innovation help?

There is limited evidence to accurately or reliably predict injuries. Advances have been made in stratifying those at potentially higher risk and identifying opportunities to deploy preventative strategies to minimise their risk. But, as shown in the ACL injury example, the causes of injury are complex and can encompass biomechanics, physiology, and disparities in access to training.

AI and digital technology can be used to collect a vast amount of data about athletes and consumers, including their activity levels, movement patterns, heart rate. More sophisticated technologies now capture vital signs including blood pressure, oxygen saturation and physiological data.  This data is being used be used to identify those at an increased risk of injuries before they occur, and to develop personalised training plans to aid in recovery and rehabilitation.  

Computer vision and real time video analysis

For example, computer vision is being used to analyse video footage of athletes to identify subtle changes in movement that may indicate an injury risk. Equally, identifying quickly those who have suffered injury can support faster triage and identification of injuries such as concussion. This information can then be used to quantify training load, adjust training programmes or recommend additional rehabilitation exercises.

Using wearables for more holistic health monitoring on field monitoring

Wearables can be readily used to track athletes' heart rate, muscle fatigue, and other physiological data in real time over longer periods. This data can then be used to monitor performance and identify signs of fatigue or injury. More broadly, routine use of wearables enables prolonged and remote data capture that may offer more insight on overall wellbeing.

Virtual and augmented reality

Virtual reality (VR) is another potential solution that can enable players to practice in a realistic and controlled environment, while avoiding high risk collisions or repeated impacts to the head. This can be extended to the whole sports team.⁷  VR can also be used in clinician training. While real world or authentic clinical training is important, using VR may provide a reliable, convenient and auditable solution to train new clinicians, and enable more experienced clinicians to maintain or improve clinical skillsets through immersive learning and simulation.

Multimodal data integration and advanced analytics

Several research labs across the globe are investing in new technologies and testing both the technical and clinical validity of these products. An emerging area that seeks to supplement ‘traditional’ assessment biomarkers used to monitor sports related concussion, is the use of novel technologies, such as biomarkers and wearables to help individuals to recover more quickly after injury.

Looking ahead to the future

As highlighted in a recent  report The Future of Sport by the Deloitte Sports Business Group, a number of forces of change are shaping the future of sport and changing the status quo of sport in countries and communities around the world. These include diversity, equity and inclusion, climate change and sustainability. There are a number of common themes specific to sports injury.

Sustainable use of technology, including wearables

Within the field of technology and innovation, sustainability is often overlooked in comparison to the technical, economic and user experience.  Sports can embrace new formats that reward sustainable practices and as a consequence sustainable ‘norms’ including consideration of the materials or carbon footprint of the hardware deployed, from the materials used, durability, energy charging capacity and efficiency.⁸

Invest and focus on female and para sport research

Technology and digital has primarily focussed on male athletes or sports. Moving forward more focus needs to be given to female athletes and parasports.⁹ For example, recent research found that up to 82 per cent of female football players experience discomfort with their football boots, illustrating the  need for more resources and research relevant to and appropriate for female athletes.¹⁰

Deloitte’s recent report Super-charging the virtuous circle of women’s sport argues that women’s sport is well positioned to be a pioneer and leader in the adoption of digital technology and innovation. The report highlights collecting novel data is as an opportunity to achieve unrealised potential in sport. More specifically by centralising and creating an ecosystem for data, the knowledge gap and awareness on health and sport performance can be minimised. This may provide the conditions for players and the public alike be more informed on nutrition, training load, and rehabilitation.

Embracing the ‘digital athlete’

The use of AI and digital technology in athlete monitoring and injury reduction is still in its early stages, but the benefits are clear. By collecting and analysing large amounts of data, AI and digital technology may have the potential to identify those at higher risk of injuries before they occur, develop more personalised training plans to promote prevention and recovery during return to play. Moreover, they have the potential to revolutionise the way that athletes prepare, respond and recover from injury. By also focusing on diversity, sustainability and equity the benefits can be more equally distributed.

Dylan Powell, Research Analyst, UK Centre for Health Solutions

Dylan is a Research Analyst at the Centre for Health Solutions. He is excited by the value of technology, data and innovation in healthcare and life sciences to optimise care and wellbeing for patients and society. Prior to joining the centre, Dylan’s professional background as a Physiotherapist has spanned the NHS, professional sport, and the armed forces. His doctoral work in Computer Science explores the use of wearables in remote monitoring & objective healthcare assessment with collaborators across the USA and Australia. Dylan holds a Bachelor of Science degree in Human Biosciences (University of Exeter) and a Master of Science degree in Physiotherapy.

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¹ https://www.scienceforsport.com/virtual-reality-for-sports-training/

² https://doi.org/10.1038/s41746-023-00820-z

³ https://en.wikipedia.org/wiki/Parasports

⁴ https://www.stmarys.ac.uk/news/2022/11/female-football-tech

⁵ https://emj.bmj.com/content/21/6/704

⁶ https://www.theguardian.com/sport/2022/nov/10/survey-injury-long-term-effects-podium-yougov

⁷ https://injepijournal.biomedcentral.com/articles/10.1186/s40621-020-00243-4

⁸ https://www.nature.com/articles/s41746-021-00538-w

⁹ https://bmjopensem.bmj.com/content/6/1/e000675

¹⁰ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329328/