Sports participation and injury prevalence among medical students in Mauritius: a cross-sectional pilot study

¹Department of Pharmacology, Sir Seewoosagur Ramgoolam Medical College, Belle Rive, Mauritius, ²Department of Surgery, Joe Morolong Memorial Hospital, Vryburg, South Africa

^&Corresponding author
Indrajit Banerjee, Department of Pharmacology, Sir Seewoosagur Ramgoolam Medical College, Belle Rive, Mauritius

Introduction    

Sport activities are a vital component in the lives of medical students; they enhance physical health, aid in stress management, and encourage the development of self-discipline whilst increasing self-confidence. However, the drawback when participating in sporting activities is that the risk of an injury is higher. Such injuries may lead to absences from classes and clinical rotations, and to disruptions in students´ studies, due to associated pain and medication use. The medical student population has been specifically selected for this study because, as future healthcare professionals, these students are expected to learn strategies for wellness and injury prevention. Understanding their personal experience with sports injuries so that they can counsel and manage their future patients. Helping them to bridge the gap between theoretical knowledge and practical experience of injury and recovery. In terms of Global data, an Indian teaching hospital found that 18.4% of the medical students who participated in sporting activities sustained musculoskeletal injuries after joining the medical school [1]. A medical school in Indonesia found a total injury rate of 99 per 1000 student exposure, with 76% of the students sustaining injuries [2]. Within the African context, specific data is scarce for medical students suffering from such sports-related injuries. Therefore, this study is crucial, as it is the first study to be conducted on undergraduate medical students in Mauritius, which can aid in providing the data necessary to create evidence-based health and curriculum policies on the island. The primary objective of the study was to determine the prevalence, distribution, and contributing factors of sports injuries and the subsequent medical treatment sought by medical students. There is a dearth of information and data related to sports injuries in Mauritius. To the best of our knowledge, this was the first study conducted to determine the pattern of sports injuries in Mauritius.

Methods     

Study design this is a cross-sectional pilot study conducted among undergraduate medical students who were injured while participating in sports activities at Sir Seewoosagur Ramgoolam Medical College, Mauritius. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed for this cross-sectional study.

Study setting and data collection: this study was conducted at Sir Seewoosagur Ramgoolam Medical College, Mauritius. The data was collected at the institute during the annual sports event that occurred from September to November 2025, involving 200 participants who were initially part of the study population. Of the 200 students, participants who sustained at least one musculoskeletal injury were further analysed. The data was collected from these participants via a structured self-administered questionnaire that was completed with the assistance of the team on-site. The team included two researchers, one medical officer and one first aid specialist.

Inclusion criteria: all the students who sustained musculoskeletal injuries during the sports event, completed the questionnaire and gave written informed consent were included in this study.

Exclusion criteria: students who sustained injuries during training sessions or during a different timeline from the sports event were excluded due to the presence of recall bias. Students who did not complete their questionnaire or refused to give informed consent were excluded from the study. Faculty members were excluded from the study as the population selected for the study was undergraduate students.

Outcome variable: the main outcome variables of the study were the type of sports, type of injury sustained, injured body part and the medical treatment sought on-site. These variables were used to study the injury patterns.

Outcome variable: the main outcome variables of the study were the type of sports, type of injury sustained, injured body part and the medical treatment sought on-site. These variables were used to study the injury patterns.

Questionnaire design: after a thorough review of the literature a structured questionnaire was designed. It was divided into 3 sections. Viz. A. demographic details (age, gender and academic year), b. sports activity (type of sports- indoor/outdoor), c. sports injury history (type of sports, injured body part, cause of injury and medical treatment availed on-site).

Questionnaire validity and reliability: the content and construct validity of the questionnaire was vetted and reviewed by five subject experts. All of the items was rated on a 4-point Likert scale and the average congruency percentage (ACP) was calculated according to Polit and Beck's method. Based on the feedback from the experts, the questionnaire was revised. The final ACP average congruency percentage was found to be 88%. Face validity was assessed by conducting a pilot study among five students for the readability of the questionnaire. Cronbach´s alpha was performed for reliability analysis, which was found to be 0.822.

Sample size calculation: the sample size was calculated to achieve adequate statistical power. The following formula was used:

n represents the sample size, z represents the value of the standard normal distribution corresponding to 95% confidence interval, p is the expected proportion in the population, d: absolute precision. Where, z=1.96 for 95% Confidence interval, p=0.5, d=0.14.

The required sample size was found to be 48.98= 49. We have achieved an adequate sample size of 52 for a cross-sectional pilot study.

Data management and statistical analysis: before the analysis, the data was cleaned by imputing missing values, removing outliners based on standard deviation limits, and addressing inconsistencies by validation checks. The IBM SPSS Statistics (SPSS, version 31; IBM SPSS Statistics for Windows, Armonk, NY) software was used for analyzing the data. Chi-square test and Binary logistic regression were performed to assess associations among the variables. A p-value of <0.05 was considered to be statistically significant.

Ethical clearance: approval from the Institutional Research and Ethics Committee, Sir Seewoosagur Ramgoolam Medical College, Mauritius, was obtained for this study on September 15, 2025. (Approval number SSRMC/IERB/2025/004). Informed consent from the participants was obtained before data collection. The study was conducted according to the latest version of the Declaration of Helsinki - Ethical Principles for Medical Research involving Human Subjects guidelines.

Results     

A total of 200 undergraduate medical students participated in the annual sports event. Out of which 52 participants sustained musculoskeletal injuries and met the inclusion criteria for the study. The remaining 148 participants did not sustain any injury and were therefore not included in this analysis. An injury prevalence of 26% was calculated among the participants in the sports event. Table 1 depicts that out of the 200 participants, 52 students were injured while playing different categories of sports, and revealed an injury prevalence of 26%. The mean age observed was 21.54 (SD=±1.686). This study shows that males sustained more injuries than females, with 80.8% and 19.2%, respectively. It was noted that students who were more senior and studying clinically were injured more often at 63.4% as compared to those students in their preclinical years of study. Individuals of Indian nationality sustained the majority of the injuries (76.9%). Injuries were commonly sustained in high-contact sports such as football (28.8%) followed by cricket (21.2%) and basketball (15.4%). The association between the type of sport and the sports injury sustained is not statistically significant (P = 0.073). Abrasions (87.5%) were the most frequently reported injuries in basketball, while strain (33.3%) and sprains (26.7%) were commonly observed in football. Cricket was predominated by bruises (36.4%) and strain-type injuries (36.4%). Bruises were the leading injury in volleyball (50%). Strains were mostly seen in Throwball (100%) and athletics (50%). A significant association was found between the type of sport and cause of injury (P <0.001). It was noted that overuse and sudden impact were the most common causes of injury reported in football and cricket, accounting for 46.7% and 45.5%, respectively. Basketball injuries were frequently sustained due to falls (87.5%). Overuse is the most common cause of injury in athletics (50%) and volleyball (50%) (Table 2).

The association between the type of sports injuries and the medical treatment is statistically significant (P = 0.001). It is observed that most students refrained from seeking on-site medical treatment for their injuries. Strains (42.1%) and abrasions (38.5%) were the injuries for which students availed frequent medical attention. The association between the injured body part and the medical treatment received was not statistically significant (P = 0.637). The majority of students with injured body parts did not require any medical treatment. The ankle, thigh and knee were the most affected sites that received medical treatment, in which topical analgesics were used for the ankle (50%) and thigh (37.5%) whereas bandages were used for knee injuries (30%) (Table 3). The association between gender and the type of sport injury is statistically significant (P = 0.001). The vast majority of sports, such as football (100%), cricket (100%), basketball (87.5%), running (66.7%) and volleyball (66.7%), were male-dominated. While throwball (100%) and long jump (100%) were female-dominated. There was no significant association found between the gender and the injured body part (P = 0.894). The most affected site in male competitors was the lower limbs, in which the ankle (87.5%), the thigh (87.5%) and the knee (80) were the most frequently injured body parts. In females, it is seen that the upper limb and the trunk were the affected sites, including the wrist (50%), back (33.3%) and hand (28.6%). There was a significant association between the gender and the cause of injury (P = 0.023). Overuse (75%) and sudden impact (100%) were the leading causes of injury in males, while poor technique (60%) was the major cause of injury in females. The association between academic year and the type of sports injury is not statistically significant (P = 0.661), nor is the associated injured body part (P = 0.559), or the cause of the injury (P = 0.856). Clinical 3^rd year students accounted for the majority of the injuries sustained in cricket (63.4%) and basketball (46.7%). The ankle (75%) and hand (71.4%) were the most common sites of injury in clinical 3^rd year students, while preclinical 1^st year students sustained more back injuries (66.7%) (Table 4).

Univariate binary logistic regression was performed between sociodemographic factors and injury-related outcomes like medical treatment, cause of injury and the affected site. For gender, it was observed that females were 2.12 times more likely to seek treatment as opposed to males (OR = 2.121, 95% CI = 0.482-9.336), although this was not a significant association. However, they were 9.9 times more likely to have been injured by mechanical load-related causes (OR= 9.900, 95% CI=1.150-85.237), which is a significant association. The odds of the lower limb being affected were lower in females than in males (OR = 0.37, 95% CI = 0.082-1.705), but this was not statistically significant. Regarding year of study, clinical students had slightly lower odds of availing themselves for medical treatment (OR= 0.873, 95% CI= 0.279-2.728) and were less likely to sustain injuries due to mechanical load-related trauma compared to preclinical year students (OR= 0.620, 95% CI= 0.195-1.968), although these associations were not significant. The odds of the lower limb being affected are 1.43 times higher than in clinical years (OR=1.429, 95% CI= 0.457-4.465). With respect to age, students aged > 22 years were 1.81 times more likely to receive treatment (OR=1.810, 95% CI=0.469-6.988) but were less likely to have mechanical load trauma-related injuries (OR= 0.300 95% CI= 0.077-1.169). However, they are 1.33 times more likely to have a lower limb as their affected site for injuries (OR= 1.330, 95% CI= 0.360-4.920). Other than gender and cause of injury, none of these results were statistically significant (Table 5).

Discussion     

This study has determined the pattern, prevalence and associated factors related to sports injuries among undergraduate medical students in Mauritius. The findings reveal that there was an injury prevalence of 26% among participants during the annual sports event. It was observed that males experienced a higher rate of injury as compared to their female counterparts, the mean age group being 21.54 [+, -1.686]. The lower limb was the most affected site seen among participants, particularly the ankle, knee and thigh, which could be due to the lower limbs bearing the entire body weight; continuous stress and impact due to sudden acceleration, direction changes and jumps, all of which put repetitive mechanical stress on joints and muscles. Moreover, the knee and ankle joints are complex and involve multiple tendons and ligaments, which are more prone to injuries. It is also important to understand that lower limbs are often the first point of contact during falls, tackles, and collisions and such direct blows while bearing the entire body weight often result in sprains, strains, abrasions and ligamentous tears. High-contact sports such as football and cricket accounted for most of the injuries, which could be attributed to the high physical demands and movement intensity associated with these sports. Football involves frequent body contact, rapid acceleration and repetitive kicking motions, collectively increasing the likelihood of injury to the lower limb. Similarly, in cricket, it is seen that it places repetitive stress on the musculoskeletal system, particularly among bowlers and batsmen due to overuse movements, sudden sprints, and dives during fielding, which makes those who partake in this sport prone to injury. Abrasions and muscle strains were the most prevalent types of injury patterns seen. These injuries were observed because of falls and overuse as the primary contributing factors. The findings reveal that more than half of the participants, i.e., nearly 53.8 percent, did not seek on-site treatment when injured. Among the participants who received treatment, topical analgesics were used by nearly 21.2%.

Findings suggest that on-site treatment or awareness regarding immediate medical attention was substandard. The study reveals that a large number of participants were from the clinical years of study, i.e., 63.4%, while the pre-clinical students formed a smaller group with a participation of only 36.5%. The difference among the participating groups could be because of higher clinical exposure, confidence, and experience in sports activities, since the latter group is still adjusting to life in the hostel. Students in their clinical years have had more exposure and have studied various injury cases, and could thereby judge whether an injury required immediate on-site attention or not. As a result, minor injuries were often self-managed and treated personally, while only the more severe ones received on-site attention. In contrast, pre-clinical students were newly admitted and had less experience with the sporting activities offered, which is noted inn their lower participation in the sporting events. Looking at the results, there is a common pattern of injuries and similar pre-game habits. A study conducted at Bhopal, India [2024] published by Champatwat et al. reported that most major injuries occurred in football, volleyball and cricket. These findings are congruent with those of the present study, showing that contact sports such as football and cricket tend to cause more injuries because of the high level of physical contact and sudden body movements [1]. Another study from Delhi by Kumar et al. , also had similar results, where males were more prone to injuries, most commonly due to lack of formal training and improper warm-up sessions. This is similar to the findings of the present study, which also highlights how proper training and use of proper gear can reduce the likelihood of injury [3]. A study done in Canada published by Lemoyne et al. showed that ankle and knee injuries were more common, which supports our result showing the two most common lower limb injuries [4]. A study in Nepal showed that male athletes in high-contact sports such as football had a higher number of injuries. Hence, these studies show that training quality, sports type and preventive measures play an important role in sports injury patterns [5].

The findings show that the majority of injuries among student athletes were sprains and strains, which closely match the results reported by Stephenson et al. where similar injuries were recorded. The study conducted by them most commonly included major injuries, unlike our study, where minor injuries were recorded as well. This difference was seen due to the inclusion of different sporting codes such as tackle-like collision sports, as well as dance [6]. The Brazilian study by Baroni et al. highlighted the significance of neuromuscular warmups and showed how they can significantly reduce the risk of injury. This aligns with our data, which shows that students who consistently performed warmups had noticeably fewer injuries [7]. An American study by Brenner et al. focused on athlete burnout in young sportsmen, where they managed balancing life between academics and sports, subsequently facing higher injuries due to burnout, highlighting the importance of rest and recovery [8]. An ankle injury prevention study done in America by Berkey et al. revealed that sprains were the most common type of injury, which further supports our findings, where ankle and knee sprains dominated the data [9]. Acute injuries are preventable by regular warmups, as demonstrated by Castillo et al. which supports our conclusion that prevention taken before the event lowers the risk of injuries [10]. Overall, our results are in keeping with the global data and revealed that proper conditioning before sporting events is key to reducing sports-related injuries among students.

Limitations of the study: the study has a small sample size of (n=52), which reduces the significance of the statistical analysis. The study was only conducted at a single institution, when there are numerous such institutions on the tropical island. The studies data was only collected from one sports event and not over a longer period or from multiple sporting events.

Conclusion     

Contact sports such as football and cricket are mostly implicated in the injuries recorded, with an overall injury prevalence of 26%; these injuries mainly involve the lower limb. Overuse and sudden impact were the key leading causes of injury. This highlights the importance of adequate prevention and awareness to prevent such injuries when participating in such sports and such sporting events. Topical non-steroidal anti-inflammatories were the treatment of choice used by students. It is evident that safe training, such as warm-up routines, the proper use of equipment and early injury recognition, is imperative to reducing both the likelihood and the severity of the injury.

Competing interests     

The author declare that they have no competing interests.

Authors' contributions     

Mannea Purohit: conceptualization and design, writing - original draft; revising and editing the draft critically for important intellectual content. Data collection: data curation, investigation. Methods,resources, formal analysis, visualization, revising the draft, acquisition, analysis, or interpretation of data. Approved the final version of the manuscript. Ibrahim Shabbir: conceptualization and design, writing - original draft, revising and editing the draft critically for important intellectual content. Data collection: data curation, investigation, methods, resources, formal analysis, visualization, revising the draft, acquisition, analysis, or interpretation of data. Approved the final version of the manuscript. Yadhynika Patil: conceptualization and design; writing - original draft, revising and editing the draft critically for important intellectual content, resources. Formal analysis, visualization, revising the draft, acquisition, analysis, or interpretation of data. Approved the final version of the manuscript. Karmanpreet Kour: conceptualization and design, writing - original draft; revising and editing the draft critically for important intellectual content, visualization, revising the draft, acquisition, analysis, or interpretation of data. Approved the final version of the manuscript. Jared Robinson: conceptualization and design, writing - original draft: revising and editing the draft critically for important intellectual content, visualization, revising the draft, acquisition, analysis, or interpretation of data. Approved the final version of the manuscript. Indrajit Banerjee: conceptualization and design, writing - original draft, visualization, revising and editing the draft critically for important intellectual content, acquisition, analysis, or interpretation of data, and Supervision. Approved the final version of the manuscript. All the authors have read and agreed to the final manuscript.

Acknowledgments     

The authors sincerely appreciate Dr. A.P.Singh, Principal and Professor, Department of Anatomy, SSR Medical College, Mauritius for constant support, and encouragement. Authors also extend their gratitude to all the students who participated in this study.

Tables and figures     

Table 1: demographic characteristics of sports injury, and treatment details of study participants, recruited from Sir Seewoosagur Ramgoolam Medical College (Mauritius) at the annual sports event, from September to November 2025 (N=52)

Table 2: cross tabulation between sports injury, cause of injuries, and type of sports, participants, recruited from Sir Seewoosagur Ramgoolam Medical College (Mauritius) at the annual sports event, from September to November 2025 (N=52)

Table 3: cross tabulation between sports injury, Injured body part, and medical treatment, participants, recruited from Sir Seewoosagur Ramgoolam Medical College (Mauritius) at the annual sports event, from September to November 2025 (N=52)

Table 4: cross tabulation between type of sports, Injured body part, cause of injury, with gender and year, participants, recruited from Sir Seewoosagur Ramgoolam Medical College (Mauritius) at the annual sports event, from September to November 2025 (N=52)

Table 5: odds ratio of sociodemographic factors with medical treatment, cause of injury, and affected site, participants, recruited from Sir Seewoosagur Ramgoolam Medical College (Mauritius) at the annual sports event, from September to November 2025 (N=52)

References