This cross-sectional survey was conducted at the 1^st All India Inter-University Kabaddi Tournament (2014-2015) held in Punjabi University, Patiala. An informed consent was taken from all the athletes. Common injuries related to this sport were identified with the help of a questionnaire from present and previous injury records. Five players were not related to the Kabaddi game, so excluded from the study. Thus, finally the study was conducted on 80 male national-level Kabaddi players, selected by a convenient random sampling technique.

Inclusion and Exclusion criteria: Indian Kabaddi players with national level experience of playing within the age 20-25 years that participated in the tournament were included in the study. Recreational players and those with below national-level experience were excluded from the study.

After an extensive review of literature, an interview schedule was developed. The initial draft of questionnaire consisting of 48 questions was shown to a Kabaddi coach and a senior physiotherapy expert to validate the content. As per their suggestions, 15 questions were deleted. Thereafter, the questionnaire containing 33 questions was field tested on 20 kabaddi players. It was found that 5 questions were difficult to comprehend, therefore, deleted. The questionnaire was in English version. The final interview schedule consisted of 28 questions which were further divided into three following sections:

Informed consent was taken from all the players who were present in the tournament. Coaches were taken into confidence by explaining them in detail about the importance and details about the purpose and significance of the study. Instructor was present to clarify any doubts and players were interviewed during the competition and practice schedule. The study focused on the present and the past injury status of two years of the Kabaddi players. This study documented the prevalence of total injury in terms of various body regions (upper limb, lower limb and other body parts) among Kabaddi players. The injury scenario specifically related to tournament or practice time injury was documented. It also recorded the awareness level and importance of physiotherapy among players, whether athletes have taken physiotherapy as management for injuries or not. It was explained to all participants that the information taken from them would be used only for research purposes and it was assured that no information about the individual player would be revealed to anybody during and after the study. No incentives or awards were given to the participants. Physiotherapy was advised to those players with musculoskeletal injuries during competition.

Data was entered into MS excel and analysed using the SPSS software version 20. Descriptive statistics (mean, percentage) were calculated.

The mean recorded age at presentation was 21.65 years (range: 20-25 years). It included 80 national-level male Kabaddi athletes. Seventy nine athletes were professional national-level Kabaddi players and this group included one player who represented India on International platform also. The study had only male players.

[Table/Fig-1a,b] showed that 62.5% (n=50) of athletes were injured in the past two years and 42.5% (n=34) of athletes were injured presently i.e., at the time of data collection. It was also found that out of 50 players that were injured in the past, 12 were injured in the present too (at the time of data collection).

[Table/Fig-2] showed the prevalence of upper limb injuries and found that in the upper limb, the shoulder is the most commonly injured joint followed by arm, forearm, elbow, wrist, hand, and fingers. Total 21.25% present injuries of shoulder and 25% in the past two years were recorded. It also showed that in the lower limb, knee and ankle and thigh were mostly injured in present injury status which represented 21.25%, 13.75%, and 6.25%, respectively. Lower back contributed to 13.75% of present injury whereas 22.5% in the past two years.

From [Table/Fig-3], it can be observed that only 53.75% of players had awareness about physiotherapy.

[Table/Fig-4] showed that out of 50 injured players in the past, only 15 (30%) athletes had taken physiotherapy in the past. But at the time of data collection, 23 (67.65%) players out of 34 players have chosen physiotherapy as treatment.

Limited research has been conducted on epidemiology of sports injury, particularly in Indian Kabaddi players [5,7,9,10]. The present study found that among 80 national-level Indian Kabaddi players 62.5% (n=50) players were injured in the past two years and 42.5% (n=34) represented present injury status. In present study, the knee (21.25%) represented the highest injury incidence in the lower limb. This result is consistent with a study by Dhillon MS et al., a cross-sectional study on knee injuries in 76 Indian Kabaddi players [5]. It was found that the most common injury was ACL tear (89.47%) which were noted in 68.42% of the players. A study by Mondal A and Ghosh MC found that knee ligament (sprain) was 25.71% in female Indian kabaddi players and for males it was 25.93% [9]. The main reason for sustained ACL injuries was faulty moves in kabaddi [11].

Similarly, another study by Moeini SM et al., investigated the range, incidence, location, and mechanism of injury in 73 elite male Iranian Kabaddi players using a questionnaire [12]. The majority of injuries were recorded in the upper limb (41.55%), lower limb (32.77%), head and face (15.28%), and trunk and neck (10.3%). But in the present study, the lower limb constituted most of the injuries among kabaddi players followed by upper limb and trunk similar to the studies by Prabhu A and Kumar KC and Indira NC et al., [10,13]. They reported that the majority of the injuries occurred on lower body parts (67%) than the upper body parts (33%). On the contrary, Sen J concluded that upper extremities (51%) are more vulnerable than lower extremities (46%) in Indian female Kabaddi players [7]. Knee (19%) and ankle (14%) were more prone to get injury. This finding was consistent with the present study result which showed knee injuries (20.25%) and ankle (13.75%) injuries.

As sports industry is growing up in India, sports injury rehabilitation is a crucial aspect and has to be lead by a trained sports physiotherapist to ensure full recovery and to prevent re-injury [14]. A recent study by Maan FS showed the efficiency of rehabilitation in the treatment of knee injuries in kabaddi athletes [15]. It was found that taping, massage, stretching and strengthening exercises showed reduction in pain and improvement in the range of motion of knee joint. In the present study, there was no dedicated physiotherapist with the team. Therefore, trainers and coaches with a sports physiotherapist should focus on the importance of biomechanics with a blend of characteristics such as balance, coordination, speed and strength in preventing sports injuries related to the Kabaddi technique [6] and plan an exercise program to make an athlete ready for the competition [16]. The present study highlighted the prevalence of injuries in terms of body parts, awareness of physiotherapy and access to physiotherapy in kabaddi players. More epidemiological studies are needed to understand the causes, biomechanics and risk factors of injury in kabaddi players. More studies are needed to design prevention programs for an athlete.

There were several limitations to the present study. Low sample size was the first limitation of this study. The second limitation was specific injuries were not determined by this study as diagnosis for specific injuries requires radiological (X-ray, MRI scan) examination, clinical examination and other laboratory investigations. Third, the present study was conducted only on male Kabaddi players.

Kabaddi is a high intensity, competitive sport, so the prevalence of injury is high. In the upper limb, shoulder constituted most of the injury whereas in lower limb, knee constituted most of the injuries. The present study concluded that in today’s modernise healthcare system physiotherapy and a sports physiotherapist should be included in the rehabilitation service for Kabaddi players also. Hence, it is suggested by the present author in the future to undertake more studies to find out the injury prevention strategies and management of injuries in kabaddi players.