Eleanor Travis

This booklet has been put together to provide Clubs and players with advice that should help athletes get fitter, faster, stronger, more resilient and improve your on-pitch Flag Football performance. Even if you have been playing for years and already train regularly, we hope some of the information presented will help you achieve your goals.

Background: British American Football (BAF) is a developing sport in the United Kingdom, with keen growth in the British Universities and Colleges Sport (BUCS) league. Participation in BAF carries risks and so to facilitate safe participation medical care services must be evaluated. Aims: To evaluate medical provision in BUCS American Football in the 2019-2020 season. Methods: An online survey tool was used to collect data from BUCS BAF teams in the 2019-20 season. Thirty-one teams (from across England, Wales and Scotland) responded to questions on facilities, provision and procedures. Results: Almost 42% of teams had a regular team first aider who attended home games each week. Only 61.5% attended away games and 7.7% attended team training. Access to a first aider was not dependent upon division. Home games were more likely to be risk assessed and have an emergency action plan compared to away games. The majority of teams had access to Automated External Defibrillator (AED) within 100m of the pitch yet only 29% of staff were trained to use them. Almost 84% of teams reported carrying a designated fully charged phone (with signal). Prominent qualitative themes indicated were: cost/funding as barriers to hiring qualified medical staff, lack of institutional support, unreliability of medical provision and inadequate facilities/preparation for games. Conclusions: These findings provide key information on the status of medical provision, facilities, and protocols in BUCS BAF. Data reveals a lack of consistent medical personnel, particularly at training and away games, and training in emergency care.

The objective of this study was to examine concussion reporting and safeguarding policy in British American Football (BAF). Data were collected via an online survey tool. The data presented are part of a broader study that examined injury profiles, concussion reporting behaviors, and medical provision in BAF. Concussion-like symptoms were found in over half (58.8%) of the participants. Of those, 36.4% reported they had previously been formally diagnosed with a concussion while playing BAF. Just under half of the participants (44.7%) had suspected they had had a concussion, although it was not formally diagnosed, and 23.5% of the participants had previously hidden concussion symptoms. Fifty-eight percent of the teams reported they did not have a regular game-day medic, with a range of hired medical personnel who attended the games. Prominent barriers to hiring a medic included budget, institutional support shortfall, and lack of medic reliability and game knowledge. BAF is a developing sport with a clear vision for growth of participation. Yet, the current concussion and medical provision policies do not address the sport's welfare needs. Through discussion of these policies in the context of this study's findings, we highlight vital areas of concern in policy and practice that the British American Football Association needs to address in their medical and concussion policies.

Therapy Expo 2021.

Objectives: To examine concussion knowledge and concussion attitudes of players, coaches and support staff in British American Football (BAF). Methods: Data from players, coaches and support staff (n=236) were collected from across all leagues in BAF. An online survey tool was used which included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS), and questions examining concussion education and perceived risk of participating in football. Results: The mean score on the RoCKAS concussion knowledge was 21.0 ± 2.1 of a possible score of 25 reflecting good knowledge. Of a possible score of 65, the mean concussion attitude score was 55.6 ± 6.1 showing safe attitude. Whilst an overall safe attitude was seen, almost half of participants (45.3%) noted they would continue to play with a concussion. No relationship was found between CAI and prior concussion history. Fifty seven percent of participants agreed the benefits of playing football outweighed the risks. Forty eight percent reported that they had received no concussion-related education in the past 12 months. Conclusion: BAF participants have good concussion knowledge and safe attitudes. However, risky behaviour is demonstrated through unsafe likelihood to report and attitude to long term health risks. Access to the British American Football Association (BAFA) concussion policy and education was poor raising questions over what sources of information stakeholders are drawing their knowledge from. These findings can help form the foundation of educational interventions (e.g., coaching workshops) to challenge current misconceptions and improve likelihood to report concussion in BAF.

Internal LBU presentation. July 2023.

Conference: MSK Health and Rehab Research Group Symposium 2025

Purpose: This study aimed to estimate the incidence, prevalence, type, and mechanism of injuries among grappling athletes in the United Kingdom (UK) across the following disciplines: Brazilian Jiu-Jitsu (BJJ), Judo, Catch Wrestling, Sambo, and Mixed Martial Arts (MMA). Methods: A retrospective, self-reported survey, delivered via JISC online survey software, was used to record the following information for all injuries sustained over the previous 12-month period: mechanism of injury, environment, severity, recurrence and body region. Additionally, injury diagnosis was reported where possible. Injury incidence for training exposure was calculated based on hours trained per week, while competition exposure was based on the number of bouts participated in during the year. One variable chi-square tests (X2) were used to calculate if observed values were significantly different from expected values. Results: A total of 341 grappling athletes, 243 males and 97 females, with one participant preferring not to state gender  (32 ± 9.3 years), completed the study over a 3-month period. The competition incident rates (IR) (24.16/1000 AE) were significantly higher than training (2.97/1000 AE). The knee was the most frequently injured site (24.5%). Ligament sprains were the most commonly diagnosed injury (24.3%). Most injuries occurred during practice sparring (65.8%), with the leading mechanisms being submission attempts and takedowns. Major injuries (>28 days recovery) accounted for 49.5% of all cases. BJJ exhibited the highest injury rate (3.49/1000 AE); patterns varied by discipline and gender. Conclusion: Grappling sports pose a substantial risk of injury, particularly to the knee. Structured training, medical support, and tailored injury risk reduction programs should now be explored to enhance athlete safety.

Background and aim: American Football is a developing sport in the United Kingdom. Establishing injury rates is the first part of any injury prevention strategy. To date, medically reported injury rates amongst British American Football (AF) university athletes are limited. Therefore, this study aimed to estimate the prevalence, severity, mechanism and period of game related injury in a British university AF team over one season. Methods: Twenty-four male university AF players were observed. The consensus statement on injury definitions in rugby union (2007) and the Community Rugby Injury Surveillance and Prevention (CRISP) programme were followed. Several injury factors were measured (e.g., injury site, type, severity, mechanism etc.). One variable chi squared tests (x2) calculated if expected values were significantly different from observed values. Results: Thirty-two injuries were sustained across the 9-game season, a clinical incidence of 0.75. Contact injures accounted for 68.8% of all injuries. Common sites of injury were the knee (21.9%) and shoulder (15.6%), whilst ligament (25%), muscle (21.9%) and haematoma (21.9%) injuries were most frequent types. Forty percent (12/32) of injuries had moderate severity. Conclusion: This is the first prospective medically reported cohort study to estimate the prevalence, severity, mechanism and period of injury in a single British university AF team. Findings are comparable to studies from the United States, with injures due to contact being the most frequent. However further research is needed to determine whether these findings are representative of wider British university leagues. Practical Implications: The data generated from this study allows the multidisciplinary sports science team to focus injury risk reduction strategies by region and injury type.

Poster presentation at the WiSEAN conference 2025.

Background and Aim Britain has competed in Freestyle Wrestling since it first featured in the Olympic Games in 1904 and the Commonwealth Games in 1930. Despite Britain’s long history with the sport, there are currently no studies that have aimed to quantify injury incidence and prevalence. Therefore, the aim of this study was to estimate the injury incidence and prevalence in a sample of wrestlers based in Britain. Methods A self-reported, cross-sectional study design was used. All participants were registered British Wrestling Association Club members and had at least 12 months of prior wrestling experience. Data was collected via a questionnaire offered to participants in both online and paper format at the English Wrestling Championships 2022 and via coaches from each British wrestling club. Injury incidence was calculated by estimating injuries /1000 athletic exposures (AE). Injury site, type, mechanism and severity were measured. One variable chi-square tests (X2) were used to calculate if observed values were significantly different from expected values. Results One hundred and forty-six (n=146) wrestlers (30.1 ± 8.6 years, 85.4 ± 15.6 kg, 176.6 ±10.37cm) completed the injury survey. Over 12 months, the participants sustained one hundred and ninety-five (n= 195) injuries, equating to an average of 1.3 ± 1.2 per participant. The overall incidence rate was 3.40/1000 AE (95% CI 3.16 to 3.6). The competition injury incidence of 42.01/1000 AE (95% CI 26.97 to 57.05) and 2.92/1000 AE (95% CI 2.69 to 3.14) for wrestling training activities. The knee was the most common injury site, accounting for 26.1% of all injuries, whilst strains or sprains occurred most often (36.3%). Takedowns were the leading mechanism of injury (36.4%), and most injuries were categorised as slight (28.7%). Conclusions This is the first study to estimate the prevalence, severity, and mechanism of injury in Wrestlers based in Britain. Data is comparable to previous studies in American high school and college wrestlers. Future studies should consider a medically reported method to confirm these results further. Practical Implications The reported data from this study allows for the development of injury risk reduction strategies by region and injury type.

Purpose Primary aims of the study were to (i) assess the current equipment usage amongst American football (AF) players in the UK, (ii) evaluate the knowledge, adherence and practise to correct helmet fit guidelines, and (iii) explore AF player attitudes towards the use of protective safety equipment for injury prevention. Methods Cross-sectional study design. One hundred and sixty-eight British AF athletes participated in the online survey. Data were collected on current equipment usage, including practise related to reconditioning of equipment. Questions to assess knowledge, behaviour and perception of importance were designed using the 13-criteria checklist used for helmet fit assessment. Questions related to safety of helmet use and attitude towards equipment were asked on a 5-point scale. Results Knowledge of safe helmet fit was generally good. The most common knowledge question correctly identified by all participants was ‘The helmet should fit the head snugly on all sides’; however, attitude to use of equipment and long-term health was not reflective of this knowledge. Nineteen percent of athletes reported that wearing equipment allowed them to play, whilst injured and 31% of players felt fearless when wearing full AF equipment. Conclusion Despite good knowledge related to helmet safety, attitude to equipment and long-term health was poor. Research shows that the wearing of and choice of equipment is of upmost importance; however, our findings suggest that players attitude to its use could impact its effectiveness. The authors recommend that the national governing body seeks to educate players on equipment use and conditioning to ensure safe play.

Background Body composition strongly influences the performance of flag football (FF) players, which makes anthropometric measurements important. With the growing popularity of FF, understanding body composition requirements for both male and female players is essential to help optimize their performance. Purpose: This study aimed to characterize and compare anthropometric and body composition profiles between male and female FF players across different playing positions. The study was conducted during the European Flag Football Championship organized by the International Federation of American Football (IFAF). Methods A cross-sectional study design was used. Anthropometric measurements followed the International Society for the Advancement of Kinanthropometry (ISAK) full profile protocol. Data were collected from 91 male and 48 female players, and body composition was estimated using the five-way fractionation method. Comparisons between males and females were performed using analysis of variance (ANOVA), with statistical significance set at p < 0.05. Results Normative reference values and percentiles for anthropometric variables and body composition were established for male and female FF athletes. Male players had an average sum of eight skinfolds of 83.5 ± 30.5 mm, muscle mass of 36.0 ± 7.4 kg, and adipose mass of 19.8 ± 5.1 kg. Female players (27.4 ± 4.5 years) had an average sum of 8 skinfolds of 115.5 ± 40.9 mm, muscle mass of 27.8 ± 4.0 kg, and adipose mass of 20.5 ± 4.8 kg. Both sexes predominantly presented a mesomorphic somatotype. Conclusion This study provides valuable data on anthropometric characteristics of male and female FF players. These results can help create normative reference values and support strategies for performance optimization. Additionally, findings contribute to better understanding of body composition needs in FF athletes of both sexes.

Purpose: To (a) quantify the internal and external training load (TL) demands of professional ballet dancers; (b) explore the influence of session type, and sex on TL. Methods: Twenty-nine professional ballet dancers (men = 14; women = 15) were monitored over two weeks. Internal TL data was measured using heart rate-derived TRIMP, and external TL using PlayerLoad (PL). TL data from 303 sessions were categorised and analysed according to session type (rehearsal, class, and conditioning), and sex. Results: Dancers averaged ~4.62 per day (~ 26.1 hours/week) comprised of daily (PL: 539 AU; HR TRIMP: 314 arbitrary units (AU)) and weekly (PL: 2608 AU; HR TRIMP: 1503 AU) TL. Rehearsals had the longest duration (197 ± 66 min) but lowest load per minute. Conditioning produced the highest PL (140.1 AU, 95% CI: 120.2-160.0), while class elicited the greatest HR TRIMP (89.4 AU, 95% CI: 72.1-106.7). Session type significantly influenced TL (P = 0.004, η2 = 0.68) with small to moderate differences between rehearsal and conditioning (PL ES = 0.38; TRIMP ES = 0.49). No significant differences were observed by sex (PL, P = 0.57; TRIMP, P = 0.18). Conclusions: Conditioning sessions produced the greatest TL response and should play a key role in professional ballet dancer’s schedules. Although TL did not significantly differ by sex, the study suggests that a uniform training model may not meet individual dancer needs. These findings support the implementation of personalised monitoring and periodised scheduling strategies to optimise both artistic and physical performance in professional ballet.