August 2020

Collegiate Twirlers Suffer High Rates of Lower Extremity Injuries

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Baton twirling, which has been around in some form since military groups first twirled torches and rifles, is evolving into a highly competitive sport, drawing ever larger numbers of youth athletes. Today’s twirling is a unique performance-based sport that emphasizes strength, athleticism, and artistry. It requires fine coordination of fingers, hands, arms, feet, and legs, as well as extraordinary control of the back, stomach, and torso—all so the twirler can control the baton.*

While epidemiology and health-related quality of life (HRQoL) has been examined in other collegiate-level sports, this was not the case in baton twirling. Until now.

Data presented at the recent 2020 NATA Virtual Clinical Symposia & AT Expo showed that the vast majority of collegiate baton twirlers have suffered some form of injury. Using a 4-part, online survey, the cross-sectional study measured training volume, number of time-loss injuries within the preceding 12-month period, current injury status, and HRQoL via the Short Form-36 (SF-36). Out of an estimated total population of 300 – 400 collegiate baton twirlers, 142 completed the survey for the study, Self-Reported Injury History and Health-Related Quality of Life in Competitive, Collegiate Baton Twirlers. Respondents recalled 295 twirling injuries, with a full 90% of participants experiencing a time-loss injury, according to lead author Breanna Dufour, MS, LAT, ATC. Injury prevalence in collegiate baton twirlers appears to be comparable to self-reported dance injuries. However, the injury characteristics (location, timing, and nature of injuries) are unique to this population.

Key among the findings was that nearly a third of injuries involved the hip and thigh—with knee and ankle ranking second and third. Twirlers reported injuries were more in the recurrent category than acute, yet reported onset was more sudden than gradual.

The burden that these injuries place on aspects of this population’s quality of life (bodily pain, vitality and physical function) is important for clinicians who work with baton twirlers to note. The authors conclude that baton twirlers need consistent access to trained healthcare providers.

In a follow-up conversation with LER, lead author Dufour said what was most surprising was the number of hip injuries. As a competitive twirler herself, she said, “I know there’s a lower extremity emphasis because of all the competitive emphasis on the illusion.” The move, carried over from dance and gymnastics, involves standing on a static leg and dipping the full torso toward the ground while the other leg is raised straight up in full rotation of the hip, somewhat like a windmill. “Everyone knows someone who has hurt a hip.”

The other surprising response was the number of individuals who had participation restrictions due acute hit to the head or face. “I do know people who have received concussions from baton twirling,” Dufour said. “A lot reported being hit in the head…a lot more than I thought. I’ve been hit and it hurts.”

Prevention—especially concussion awareness—would be helpful she acknowledged. Her team has initiated conditioning, but it’s not yet consistent. “We need access to trained healthcare providers to prevent these injuries,” she said.

The study abstract will be published in the Journal of Athletic Training, the scientific journal of the National Athletic Trainers’ Association, later this year.

*Today’s batons are hollow steel tubes with rubber ends. They weigh ~1/2 pound and run in length from 18-32 inches. They are sized to the length of the twirler’s arm from the shoulder to the tip of the fingers. 

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