I totally agree with Barry Pless1 that injury surveillance alone is not the answer to solving injury problems. In the area in which I do much of my own research, sports injury, this point has also previously been made by myself2 and other leading commentators.34 Unfortunately, as also pointed out by Pless,1 there continues to be significant misunderstanding of exactly what surveillance should be, and the sports injury literature still contains many papers supposedly reporting injury surveillance studies based on retrospective recall of injuries by athletes, detailed monitoring of injuries over a targeted, limited-term period (such as over a football season) or other ad hoc data collection activities. It is hard to see how the field will develop further without due attention to appropriate surveillance methodology and a wider embracing of the data collection methodologies continually being improved in the broader injury field.

Pless1 also questions whether any surveillance system can, in fact, contribute to prevention. Where I differ from him is that I do believe that such data are a necessary prerequisite for this, because, without them, the problem cannot be identified and there is no possibility of quantifying the burden of the adverse injury consequences. It is well known that sports injuries are not easy to identify in routine hospital collections, for example, because of limitations in both ICD-9 and ICD-10 coding schemes.5 As a member of the Global Burden of Disease (GBD) Expert Group (http://sites.google.com/site/gbdinjuryexpertgroup/), with a particular interest in sports injuries, I am having to grapple with the fact that the lack of adequate mortality and morbidity data globally for sports injuries means that this significant and common “known” cause of injury may largely go unrecognized in updates to GBD estimates relating to injury.

At a more local level, it is hard to convince government or other relevant agencies to invest in sports injury prevention when there is very little formal information to back up claims of it being a problem in need of preventive attention.

My experience in trying to raise the profile of sports injury is that adequate surveillance is a necessary but not sufficient precursor to preventive efforts.