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The Orchard Sports Injury Classification System (OSICS) version 10

Authors:
Lluis Til Perez at Consorci Sanitari de Terrassa
Lluis Til Perez
John Orchard
John Orchard
John Orchard
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Katherine Louise Rae at The University of Sydney
Katherine Louise Rae
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EDITORIAL
109
APUNTS. MEDICINA DE L’ESPORT. 2008; 159: 109-12
The Orchard Sports
Injury Classification
System (OSICS)
Version 10
LLUÍS TILa,JOHN ORCHARDbAND KATHE R I N E RAEc
aSports Medicine Physician. FC Barcelona. Olympic Training Center.
Sant Cugat. Barcelona. Spain.
bTeam Physician. Sydney Roosters (NRL). Sydney. Australia.
cSports Physician. Sydney University Football Club. Sydney. Australia.
If you ignore the name of the things, what you know
of them disappears.
Carl Von Linné (1755)
Classifying and sorting knowledge about a matter are strategies
that will improve the ability to access it. Study of medical
conditions, in order to attain or broaden knowledge, is more
efficient when it is performed in an orderly and systematic
fashion, based on classifications. These medical classifications need
to use a concrete language, facilitating communication among
professionals, diminishing the ambivalence of indeterminate
concepts and eliminating the uncertainty that arises from the use
of equivalent words.
Taxonomy is derived from the Greek ταξις (taxis; “ordering”) and
νοµος (nomos; “rule”) meaning the science of the classification.
Carl Von Linné introduced it in 1753 when Species Plantarum was
published, a book that describes the bases of the system that is
used until today for classifying living species. He grouped the
species establishing hierarchical levels, which have since grown to
be more complex.
Following similar criteria, classifications have been designed in
different areas of the biosciences, intending to group different
entities at hierarchized levels. The categories need to have as clear
a foundation as possible, so that it will be accepted by those who
use the system.
The best classification in a
subject area is one with codes
generated from the professionals
working in that field. Ideally this
will be a system that attains
sufficient complexity, is valid and
is in constant revision, is flexible
enough to adapt and to introduce
new categories and concepts
without invalidating the previous
versions.
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Exhaustive classifications attempt to code all possible diagnoses in
maximum detail, including information on all variables such as
severity and mechanism. However, this extreme complexity lessens
the functionality for everyday use. On the other hand, a superficial
and schematic classification is simple and user friendly, but it can
also be insufficient to differentiate diagnoses for further study.
The International Classification of Diseases in its versions ICD-9
and ICD-10, is the gold standard system of classification and
coding for hospital medicine. This classification allows reporting
from different centers in a reliable fashion, making possible
comparison and pooling of different diagnoses and cases from the
different sources. This classification is relatively inaccessible,
because it is so big, and often specialist coders are required to
ensure coding with rigor and reliability. Some groups use their
own classification systems which are far more accessible, and easy
to use for creators but therefore not useful to communicate or to
compare with others.
The best classification in a subject area is one with codes generated
from the professionals working in that field. Ideally this will be a
system that attains sufficient complexity, is valid and is in constant
revision, is flexible enough to adapt and to introduce new
categories and concepts without invalidating the previous versions.
It must be broad enough in the main field but have simple and
accessible codes for major diagnostic groups in other areas of
medicine.
In Sports Medicine, we hope that the OSICS (Orchard Sports
Injury Classification System) version 10 has these requirements.
This was created originally as part of an injury surveillance system
in Australian football. Because it has been published and copyright
waived, it has commonly been used internationally, but always to
date in English, the original language. Among the groups have
been using are the epidemiological research groups of UEFA and
FIFA. It is subject to regular adaptations and updates, it accepts
open fields that will allow future versions to add extra categories
and diagnoses deemed necessary. The current version OSICS-10
has attained a sufficient level for classifying and coding the injuries
and conditions of athletes at all competitive levels. Also it has
incorporated new categories that allow to code structural
anomalies, pathologies specific to disabled sportsmen, pediatric
conditions, postsurgical situations, medical pathologies,
EDITORIAL
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APUNTS. MEDICINA DE L’ESPORT. 2008; 159: 109-12
John Orchard
Lluís Til
Katherine Rae
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administrative medical actuations and about non ill patients. All
these conditions are also typical of the practice in sports medicine
and it is necessary to register them and to code them. These added
categories penetrate specifically into the aspects that correlate with
the sport, for example among the gynaecological disorders related
to sport (MUGE) and in the different categories of screening of
healthy athletes (ZSXX).
The OSICS-10 is structured in codes of four letters, the first digit
relates to the anatomic location or to the condition, the second
relates to the injured anatomic structure and the third and fourth
digits broaden information about the diagnosis.
The code X refer to non concrete general situations of location (in
the first digit), of tissue injured (in the second digit), or of
diagnosis (in the third and fourth digit). The code Z is used for
referring to nonspecific situations or in situations of illness
absence. The system intends to bring the maximum information
of the situation in the diagnosis. The use of the classification is
free, people can access to original English version at
www.injuryupdate.com.au.
With the translation from the OSICS-10 into Catalan and
into the Spanish normative we want to encourage to the
professionals in sports medicine working in the Catalan and
Spanish languages to use it. You can access to the free versions
from the page http://www.apunts.org/ and from
http://www.injuryupdate.com.au/research/OSICS.htm In the
translated versions small corrections have been made, detailed in
the attached document. These clarifications do not modify any
category and only complete them, in order to facilitate the tasks of
coding.
Yo u ar e f re e t o u se th e tr a ns lat ed OS IC S- 10 ; pl ea se t ry it , fin d
faults and make proposals of improvement. It is a useful tool that
will facilitate the communication amongst ourselves and with our
colleagues of other latitudes, without the inconveniences typical of
the errors of translation. Also it will facilitate the research about
medicine of sport and it will be useful for avoiding imprecision in
the nomenclature.
We welcome the OSICS-10 in Catalan and Spanish.
EDITORIAL
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EDITORIAL
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APUNTS. MEDICINA DE L’ESPORT. 2008; 159: 109-12
General Bibliography
http://www.injuryupdate.com.au/research/OSICS.htm
Rae K, Orchard J. The Orchard Sports Classification System (OSICS) Version 10. Clin J
Sport Med. 2007;17:1-4.
Rae K, Britt H, Orchard J, Finch C. Classifying sports medicine diagnoses: a comparison
of the International Classification of Diseases 10-Australian modification (ICD-10-
AM) and the Orchard sports injury classification system (OSICS-8). Br J Sports Med.
2005;39;907-11.
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... Each injury was classified using the Orchard Sport Injury Classification System (OSICS 10) (20). Injury severity was defined as the number of days of training and match play missed due to the injury sustained. ...
... [1. [16][17][18][19][20][21][22].07]; p=0.03), and 6.07 times higher in phase 4 (6.07 [1.34-27.43]; ...
Injury incidence, severity and type across the menstrual cycle in elite female professional footballers: a prospective three season cohort study
Preprint
Full-text available
  • Jul 2023
Objectives: The aim of the study was to assess the influence of menstrual cycle phase on injury incidence, severity and type in elite female professional footballers over three seasons. Methods: Time-loss injuries and menstrual cycle data were prospectively recorded for 26 elite female football players across three seasons. The menstrual cycle was categorised into four phases using a standardised model: menstruation (phase 1; P1), remainder of follicular phase (phase 2; P2), early luteal (phase 3; P3), and pre-menstrual phase (phase 4; P4). Injury incidence rates (IRR) and ratios (IIRR) were calculated for overall injuries, injury type, contact vs non-contact, game/training and severity of injury. Results: 593 cycles across 13,390 days were tracked during the study and 74 injuries from 26 players were eligible for analysis. Muscle injuries were the most prevalent sub-type (n=41). When comparing IRR between phases (reference: P1), injury rates were highest in P4 for overall (IIRR: 2.30 [95% CI: 0.99-5.34; p=0.05]), muscle-specific (6.07 [1.34-27.43; p=0.02]), non-contact (3.05 [1.10-8.50; p=0.03]) and ≤7 days time-loss injuries (4.40 [0.93-20.76; p=0.06]). Muscle-specific (IIRR P3:P1: 5.07 [1.16-22.07; p=0.03]) and ≤7 days time-loss (4.47 [1.01-19.68; p=0.05]) injury risk were also significantly higher in P3. No anterior cruciate ligament injuries were recorded across the monitoring period. Conclusion: Injury risk was significantly elevated during the luteal phase of the menstrual cycle ( P3 and P4) among elite female professional footballers. Further research is urgently needed to better understand the influence of the menstrual cycle on injury risk and to develop interventions to mitigate risk.
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... Para la elaboración de la encuesta de prevalencias de lesiones y dolencias deportivas, se realizó una revisión bibliográfica de diferentes estudios que aplicaron encuestas similares (16)(17)(18) , las cuales sirvieron de guía para la creación de esta herramienta. Para la categorización y definición de lesiones se siguieron los criterios establecidos según OSICS (Orchard Sport Injury Classification System) (19) . ...
Estudio retrospectivo de lesiones y dolencias, en deportistas seleccionados, menores de 18 años
Article
Full-text available
  • Jun 2018
Introducción: El conocimiento de la incidencia lesional y dolencias deportivas, permite dar cuenta de sus características, para establecer planes atingente de prevención en cada deporte. Objetivo: Determinar el historial de lesiones y dolencias deportivas que han presentado retrospectivamente en los últimos 5 años, los deportistas seleccionados de la Región de Magallanes y Antártica Chilena. Material-Método: Estudio retrospectivotransversal, con una muestra no probabilística intencionada de 86 deportistas seleccionados de la Región de Magallanes y Antártica Chilena, pertenecientes a las disciplinas de fútbol (15), atletismo (3), vóleibol (34), judo (11), ciclismo (4), básquetbol (6) y natación (13). Para la recolección de la información, se confeccionó y aplicó un cuestionario de historial de lesiones y dolencias deportivas en los seleccionados, el cual completaron posterior a la firma del consentimiento informado. Resultados: Se registró un total de 118 lesiones, categorizadas como leves 51 (43,2%), moderadas 32 (27,1%) y graves 35 (29,6%); 55,1% ocurrieron en competición y 44,9% en entrenamiento. Las zonas corporales más afectadas fueron tobillo (29,6%) y rodilla (21,1%). En el mecanismo lesional, destaca el mal apoyo (23%) y el sobreentrenamiento (18%). Se registraron un total de 57 dolencias en espalda (37,5%), rodilla (16%) y hombro (16%). Conclusión: Este primer estudio retrospectivo realizado en esta Región, integró múltiples disciplinas deportivas, permitiendo obtener la incidencia y características de lesiones y dolencias deportivas, destacando la zona corporal, gravedad y mecanismo lesional. Estos resultados, serán la base para establecer futuros planes de prevención.
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... Para la elaboración de la encuesta de prevalencias de lesiones y dolencias deportivas, se realizó una revisión bibliográfica de diferentes estudios que aplicaron encuestas similares (16)(17)(18) , las cuales sirvieron de guía para la creación de esta herramienta. Para la categorización y definición de lesiones se siguieron los criterios establecidos según OSICS (Orchard Sport Injury Classification System) (19) . ...
Estudio retrospectivo de lesiones y dolencias, en deportistas seleccionados, menores de 18 años
Article
Full-text available
  • Jun 2018
Introducción: El conocimiento de la incidencia lesional y dolencias deportivas, permite dar cuenta de sus características, para establecer planes atingente de prevención en cada deporte. Objetivo: Determinar el historial de lesiones y dolencias deportivas que han presentado retrospectivamente en los últimos 5 años, los deportistas seleccionados de la Región de Magallanes y Antártica Chilena. Material-Método: Estudio retrospectivotransversal, con una muestra no probabilística intencionada de 86 deportistas seleccionados de la Región de Magallanes y Antártica Chilena, pertenecientes a las disciplinas de fútbol (15), atletismo (3), vóleibol (34), judo (11), ciclismo (4), básquetbol (6) y natación (13). Para la recolección de la información, se confeccionó y aplicó un cuestionario de historial de lesiones y dolencias deportivas en los seleccionados, el cual completaron posterior a la firma del consentimiento informado. Resultados: Se registró un total de 118 lesiones, categorizadas como leves 51 (43,2%), moderadas 32 (27,1%) y graves 35 (29,6%); 55,1% ocurrieron en competición y 44,9% en entrenamiento. Las zonas corporales más afectadas fueron tobillo (29,6%) y rodilla (21,1%). En el mecanismo lesional, destaca el mal apoyo (23%) y el sobreentrenamiento (18%). Se registraron un total de 57 dolencias en espalda (37,5%), rodilla (16%) y hombro (16%). Conclusión: Este primer estudio retrospectivo realizado en esta Región, integró múltiples disciplinas deportivas, permitiendo obtener la incidencia y características de lesiones y dolencias deportivas, destacando la zona corporal, gravedad y mecanismo lesional. Estos resultados, serán la base para establecer futuros planes de prevención.
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... 14 In addition, the recovery after DOMS is more defined compared to an actual injury. 15,16 The psychological response will be different when comparing DOMS to an injury and this will also contribute to a wider experience of pain. 13,14 During a musculoskeletal injury, the symptomology begins at the time of the mechanism or during continued exercise. ...
Efficacy of topical versus oral analgesic medication compared to a placebo in injured athletes: A systematic review with meta‐analysis
Article
Full-text available
  • Jun 2023
  • SCAND J MED SCI SPOR
Background Athletes are injured frequently and often take analgesic medication. Moreover, athletes commonly use non‐prescription topical and oral medications with little guidance. Despite wide use, relatively few studies exist on the efficacy of pain medication in injured athletes compared to a placebo. Objective To determine efficacy of topical or oral medications in pain reduction compared to a placebo in injured athletes. Study Design A systematic review and meta‐analysis. Methods We conducted an electronic search using Medline/Pubmed, Web of Science, Ovid, and SportDiscus for all literature relating to topical or oral medications in athletes for pain management post‐injury. Two reviewers screened the studies and measured their quality. To determine efficacy, we calculated the Hedges' g value. We created forest plots with 95% CI to graphically summarize the meta‐analyses. Results There was a significant pooled effect size reflecting a reduction in pain outcomes for the topical treatment versus placebo (g = −0.64; 95% CI [−0.89, −0.39]; p < 0.001). There was not a significant reduction in pain outcomes for the oral treatment versus placebo (g = −0.26; 95% CI [−0.60, 0.17]; p = 0.272). Conclusion Topical medications were significantly better at reducing pain compared to oral medications versus a placebo in injured athletes. These results are different when compared to other studies that used experimentally induced pain versus musculoskeletal injuries. The results from our study suggest that athletes should use topical medications for pain reduction, as it is more effective, and there are less reported adverse effects compared to oral medication.
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... Descriptive data were obtained using a Microsoft Excel spreadsheet that removed any personal information. The injury data were classified into eight body regions based on the Major League Baseball's Health and Injury Tracking System [29] and Orchard Sports Injury Classification System [30]. Statistical analysis was carried out using SPSS 26.0 (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, USA). ...
Injury Prevalence among Young Elite Baseball Players
Preprint
Full-text available
  • May 2023
This study aimed to describe the injury profiles of young Korean baseball players according to position and age as the proportion and distribution of injuries based on playing position and age remains unclear. A total of 271 elite youth baseball players aged 8 to 16 years were divided into two groups: elementary school (ES) (n=135) and middle school (MS) (n=136). The participants' basic, baseball practice, and injury information were collected. Injuries in the MS group were not limited to the elbow and shoulder, and the injury prevalence varied by age group and baseball position. The most injured body region in the ES group was the elbow joint, regardless of the position. In contrast, the most injured body region in the MS group was the lower back, except for infielders whose elbows were the most injured. Additionally, the MS group was more likely to experience injuries of the lower back (OR=4.27, 95% CI=2.47–7.40), shoulder (OR=1.93, 95% CI=1.08–3.43; P=0.024), and knee (OR=2.15, 95% CI=1.17–3.94; P=0.012). Our findings indicate that excessive practice and lack of rest during MS (growth spurt period) can significantly increase the risk of lower back problems in young baseball players.
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... Each team's injuries were recorded according to the Orchard classification system (Rae & Orchard, 2007) by the ISO using an online data collection form created specifically for that team. Time-loss injuries only were recorded and was defined as the date of onset of absence from sports participation to when the medical staff deemed the participant was able to return fully to all RL activities. ...
The associations between unilateral leg strength, asymmetry and injury in sub-elite Rugby League players
Article
  • May 2023
Objectives: The aim of this study was to analyse the relationship between unilateral leg strength, associated asymmetries and the injuries suffered by sub-elite Rugby League (RL) players in one competitive season. Design: A prospective cohort design was used. Method: Unilateral leg strength was measured using the rear foot elevated split squat five repetition maximum test. Injuries were recorded using the Orchard classification system and were used to quantify relative risk (RR), mean severity, burden, player availability and survival time. Results: No measures of leg strength were related to RR, relative leg strength was found to have a significant, but not meaningful correlation with total time lost to lower body injury, lower body injury burden and lower body injury survival time. Conclusions: The data from the current study indicates a possible positive effect of increasing relative leg strength for injury outcomes in sub-elite RL players. This supports a heuristic that multi-joint lower body strength training for RL players has a potential dual effect of enhancing physical performance and reducing injury time loss, with minimal risk of harm.
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... Fusion Sport). Injury diagnosis was recorded using Version 10 of the Orchard Sports Injury Classification System (OSICS) 31 and entered by the physical therapist who assessed the injury. The mechanism of each injury and the type of footwear were also recorded. ...
Epidemiological Characteristics of Foot and Ankle Injuries in 2 Professional Ballet Companies: A 3-Season Cohort Study of 588 Medical Attention Injuries and 255 Time-Loss Injuries
Article
Full-text available
  • Feb 2023
Background The foot and ankle are often reported as the most common sites of injury in professional ballet dancers; however, epidemiological research focusing on foot and ankle injuries in isolation and investigating specific diagnoses is limited. Purpose To investigate the incidence rate, severity, burden, and mechanisms of foot and ankle injuries that (1) required visiting a medical team (medical attention foot and ankle injuries; MA-FAIs) and (2) prevented a dancer from fully participating in all dance-related activities for at least 24 hours after the injury (time-loss foot and ankle injuries; TL-FAIs) in 2 professional ballet companies. Study Design Descriptive epidemiological study. Methods Foot and ankle injury data across 3 seasons (2016-2017 to 2018-2019) were extracted from the medical databases of 2 professional ballet companies. Injury-incidence rate (per dancer-season), severity, and burden were calculated and reported with reference to the mechanism of injury. Results A total of 588 MA-FAIs and 255 TL-FAIs were observed across 455 dancer-seasons. The incidence rates of MA-FAIs and TL-FAIs were significantly higher in women (1.20 MA-FAIs and 0.55 TL-FAIs per dancer-season) than in men (0.83 MA-FAIs and 0.35 TL-FAIs per dancer-season) (MA-FAIs, P = .002; TL-FAIs, P = .008). The highest incidence rates for any specific injury pathology were ankle impingement syndrome and synovitis for MA-FAIs (women 0.27 and men 0.25 MA-FAIs per dancer-season) and ankle sprain for TL-FAIs (women 0.15 and men 0.08 TL-FAIs per dancer-season). Pointe work and jumping actions in women and jumping actions in men were the most common mechanisms of injury. The primary mechanism of injury of ankle sprains was jumping activities, but the primary mechanisms of ankle synovitis and impingement in women were related to dancing en pointe. Conclusion The results of this study highlight the importance of further investigation of injury prevention strategies targeting pointe work and jumping actions in ballet dancers. Further research for injury prevention and rehabilitation strategies targeting posterior ankle impingement syndromes and ankle sprains are warranted.
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Psychosomatic intelligence of young soccer players. Relationship with sports injuries prevention and self-regulation
Article
Full-text available
  • Jun 2024
The athlete’s perception of internal and external information seems to be crucial for the prevention of sports injuries and the self-regulation of healthy states. The goal of this cross-sectional study was to explore the relationship of athlete’s psychosomatic intelligence with injuries and mind-body practices. After obtaining the ethical approval, 217 young soccer players responded to a Psychosomatic Competence questionnaire assessing six dimensions: stress experience and stress regulation (SER), body-related health literacy (BHL), body-related cognitive congruence (BCC), mentalization (M), interoceptive awareness (IA) and general self-regulation (GSR). Mann–Whitney analysis was performed to detect potential differences of the items of these dimensions with three factors: (i) previous serious injuries, (ii) current injuries and (iii) mind-body practices. The main findings showed higher item-rating of: (a) IA by those previously and currently injured, (b) M by those currently injured and (c) SER, BHL, BCC and M by those engaged in mind-body practices. In conclusion, previous and current injuries appear to act as protective mechanisms linked to heightened IA, while mind-body practices seem effective educational strategies to promote self-regulation, detection and communication of health-related symptoms. Future research is warranted to focus on strategies for developing psychosomatic intelligence to prevent sports injuries in young players.
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Classifying sports medicine diagnoses: A comparison of the International classification of diseases 10-Australian modification (ICD-10-AM) and the Orchard sports injury classification system (OSICS-8)
Article
  • Jan 2006
  • BRIT J SPORT MED
The International classification of diseases 10-Australian modification (ICD-10-AM) and the Orchard sports injury classification system (OSICS-8) are two classifications currently being used in sports injury research. To compare these two systems to determine which was the more reliable and easier to apply in the classification of injury diagnoses of patients who presented to sports physicians in private sports medicine practice. Ten sports physicians/sports physician registrars each coded one of 10 different lists of 30 sports medicine diagnoses according to both ICD-10-AM and OSICS-8 in random order. The coders noted the time taken to apply each classification system, and allocated an ease of fit score for individual diagnoses into the systems. The 300 diagnoses were each coded twice more by "expert" coders from each system, and these results compared with those of the 10 volunteers. Overall, there was a higher level of agreement between the different coders for OSICS-8 than for ICD-10-AM. On average, it was 23.5 minutes quicker to complete the task with OSICS-8 than with ICD-10-AM. Furthermore, there was also higher concordance between the three coders with OSICS-8. Subjective analysis of the codes assigned indicated reasons for disagreement and showed that, in some instances, even the "expert" coders had difficulties in assigning the most appropriate codes. Based on the results of this study, OSICS-8 appears to be the preferred system for use by inexperienced coders in sports medicine research. The agreement between coders was, however, lower than expected. It is recommended that changes be made to both OSICS-8 and ICD-10-AM to improve their reliability for use in sports medicine research.
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The Orchard Sports Injury Classification System (OSICS) version 10
Article
  • Jun 2007
  • CLIN J SPORT MED
Injury classification systems are generally used in sports medicine (1) to accurately classify diagnoses for summary studies, permitting easy grouping into parent categories for tabulation and (2) to create a database from which cases can be extracted for research on specific injuries. Clarity is most important for the first purpose, whereas diagnostic detail is particularly important for the second. An ideal classification system is versatile and appropriate for all sports and all data collection scenarios. The Orchard Sports Injury Classification System (OSICS) was developed in 1992 primarily for the first purpose, a specific study examining the incidence of injury at the elite level of football in Australia. As usage of the OSICS expanded into different sports, limitations were noted and therefore many revisions have been made. A recent study found the OSICS-8, whilst superior to the International Classification of Diseases Australian Modification (ICD-10-AM) in both speed of use and 3-coder agreement, still achieved a lower level of agreement than expected. The study also revealed weaknesses in the OSICS-8 that needed to be addressed. A recent major revision resulted in the development of the new 4-character OSICS-10. This revision attempts to improve interuser agreement, partly by including more diagnoses encountered in a sports medicine setting. The OSICS-10 should provide far greater depth in classifications for the benefit of those looking to maintain diagnostic information. It is also structured to easily collapse down into parent classifications for those wanting to preserve basic information only. For those researchers wanting information collected under broader injury headings, particularly those not using fully computerized systems, the simplicity of the OSICS-8 system may still suffice.
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