Untangling risk factors for injuries in circus artists in the USA.

This prospective cohort study aimed to analyse injury patterns in preprofessional and professional circus artists based on their exposure to specific circus disciplines. The study enrolled 201 circus artists aged 13 to 69 years, with 172 female and 29 assigned male at birth. The participants were located in 10 cities across the USA and were followed for one year. They recorded their training activities weekly and underwent evaluations by physical therapists to identify and document injuries. The study utilised the circus-specific extension of the International Olympic Committee’s consensus on recording injury and illness in sports to analyse the injury patterns.

The completion rate of the study was 77% (155 participants). The data were analysed based on participant subgroups, including age, professional status, and assigned sex at birth. The highest injury rates were observed in males (5.69 injuries per 1000 exposures). Regarding specific disciplines, the highest injury rates were associated with aerial disciplines involving ground elements (5.93 injuries per 1000 exposures) and aerial disciplines alone (4.26 injuries per 1000 exposures). Adults experienced more injuries related to aerial disciplines, while adolescents had more injuries related to ground disciplines. Non-time loss injuries were also more common among adolescents. Females had a higher proportion of repetitive injuries compared to males. Females had a higher proportion of repetitive injuries (70% vs 55%) than males (χ2 (1) = 4.43, p=0.035). Participants with a history of eating disorders had a higher number of injuries compared to those without such a history.

This study on injury patterns among circus artists has some potential flaws that should be considered. Firstly, the generalisability of the findings is limited as the study was conducted in the USA with a small sample size from specific cities. Additionally, relying on self-reported training logs and injury reports introduces the possibility of recall bias and misreporting. The study also experienced selection bias, with a completion rate of 77%, potentially affecting the representativeness of the enrolled participants. Moreover, the lack of a control group hinders comparisons with non-circus artists. The study primarily focused on injury occurrence rather than severity, limiting the understanding of the true impact of these injuries. Furthermore, confounding factors, such as previous injury history or training intensity, were not extensively addressed. These limitations emphasise the need for further research to validate and expand upon these findings.

Despite the potential flaws in the study, several noteworthy aspects should be acknowledged. Firstly, a prospective cohort design provides a strong foundation for examining injury patterns over time. Additionally, the study’s adoption of the circus-specific extension of the International Olympic Committee’s consensus on recording injury and illness in sports demonstrates a tailored approach to analysing injuries in the context of circus arts. The inclusion of a diverse range of participants in terms of age, assigned sex at birth, and professional status enhances the study’s applicability and allows for insights across various subgroups. The longitudinal follow-up period of one year enables a comprehensive understanding of injury patterns among circus artists. Moreover, the study successfully identifies intrinsic and extrinsic risk factors, such as age, assigned sex at birth, and history of eating disorders, shedding light on important considerations for injury prevention strategies. Lastly, emphasising the intersectionality of these risk factors highlights the need for a nuanced approach to promoting safety and implementing effective training practices within the circus community.

In conclusion, this study demonstrated that various factors, including age, assigned sex at birth, history of eating disorders, and exposure to specific circus disciplines, influenced the risk of injuries in circus artists. To effectively manage these risks, it is crucial to consider the intersectionality of these factors at both individual and group levels.

Jane x