Femoral acetabular impingement and hook of hamate injuries are on the rise in NASCAR pit crews according to new research presented at the 2017 NASCAR Summit in Concord, North Carolina, on January 10, 2017.
NASCAR: Spike in Hip, Wrist Injuries
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William Heisel, PA-C, director of Motorsports at OrthoCarolina, and his team tracked the incidence rate of both of these injuries and found higher incidences of femoral acetabular impingement injuries (FAI) among rear tire changers and higher incidences of hook of hamate fractures among changers and carriers.
The data showed that over the past seven years, 14 out of 80 total Sprint Cup Series NASCAR rear tire changers were diagnosed with FAI.
“Rear changers are ‘chasing’ the car coming into the pit, and flexing and internally rotating while weight bearing in the beginning of changing the tire,” Walter B. Beaver, M.D. of the OrthoCarolina Hip and Knee Center in Charlotte, North Carolina, and head team physician for Hendrick Motorsports said in a press release. “After changing the right side, they post coming into extension and internally rotate and push off to get to the opposite side.”
R. Glenn Gaston, chief hand surgeon with OrthoCarolina Hand Center in Charlotte, North Carolina, and hand consultant to many NASCAR teams spearheaded the research on hook of hamate fractures. He reported that although this injury is pretty rare in the general population, over a 10 year period there was a 7% incidence rate among changers and a 12% incidence rate among carriers.
“In NASCAR, we generally see hook of hamate injuries that occur from a direct blow to the palm,” Gaston said in the release. “For pit crew members this can happen when carriers are placing tires on the car or when changers are adjusting the gun.”
OrthoCarolina has conducted previous studies on upper extremity injuries in NASCAR. Heisel explained in the release that “specific forces associated with each position in racing can cause distinctive injuries”.
He added, “When we better understand the position-associated risks and forces, we can implement preventative measures to help teams determine a course of care and when to return their athletes to the race.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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