Prevention of catastrophic injuries in sports.

Catastrophic sports injuries are rare but severely debilitating events. Catastrophic injuries are divided into two etiologic categories: direct and indirect. Direct injuries are those resulting directly from participation in a sport, such as a collision in football. Football is associated with the greatest number of direct catastrophic injuries for all major team sports in the United States, whereas ice hockey, pole vaulting, gymnastics, and football have the highest incidence of direct catastrophic injuries per 100,000 male participants. Cheerleading is associated with the highest number of direct catastrophic injuries for all sports in which females participate. Indirect or nontraumatic injuries are caused by systemic failure resulting from exertion while participating in a sport and include cardiovascular conditions, heat illness, exertional hyponatremia, and dehydration. Indirect deaths in athletes are predominantly caused by cardiovascular conditions such as hypertrophic cardiomyopathy and coronary artery disease.