Acute Lower Extremity Injuries Research Articles

Tennis Injuries Among German League Players: Investigating Patterns and Epidemiology of Acute and Chronic Injuries.

While injuries among elite tennis athletes are extensively documented, a notable research gap exists regarding tennis injuries among club-level players. This study examines tennis injuries in German league players, with a particular emphasis on the impact of racquet properties and court surfaces, distinguishing between chronic and acute injuries. Retrospectively analyzing data from 600 tennis players over a 1.5-year period, a standardized questionnaire covered anthropometrics, injury characteristics, equipment usage, and court surface conditions. The study identified 1012 tennis-related injuries, averaging 1.7 per player. Acute injuries predominantly affected the lower extremity (56%), with ankle injuries being the most prevalent, and ligaments were the most commonly affected structures (36.4%). Chronic complaints (reported by 364 athletes) focused on the upper extremity (63.2%), primarily tendon injuries (56.8%). Racket properties exhibited no significant impact on chronic upper extremity injuries. This study highlights a high incidence of acute lower extremity injuries, especially ankle ligament injuries, among German league tennis players. It offers crucial insights for devising targeted injury prevention strategies applicable to amateur, semi-professional, and professional tennis players, despite finding no significant link between racquet material and chronic upper extremity injuries.

Hip and core exercise programme prevents running-related overuse injuries in adult novice recreational runners: a three-arm randomised controlled trial (Run RCT)

ObjectiveThis study aims to investigate the efficacy of two exercise interventions in reducing lower extremity (LE) injuries in novice recreational runners.MethodsNovice runners (245 female, 80 male) were randomised into hip...

Topical cannabidiol is well tolerated in individuals with a history of elite physical performance and chronic lower extremity pain

IntroductionCannabidiol (CBD) is a potential therapeutic for pain management. Yet, there exists a dearth of studies of its tolerability and efficacy, especially in special populations. Former elite athletes are a special population both susceptible to chronic pain and also highly trained and attuned to assess medication tolerability concerns. The purpose of the present open-label pilot study was to assess the tolerability of CBD in this population.Materials and methodsRetrospective analysis was conducted in deidentified data from 20 individuals who were all previously professional athletes in US/American football, track and field, or basketball, with careers ranging from 4 to 10 years. Participants received topical CBD (10 mg twice daily by controlled dispenser) for chronic pain resulting from acute lower extremity injuries. Assessments of tolerability and secondary analyses of pain, pain-related disability, and activities of daily living were collected by self-report over the 6-week study period. Data were analyzed by descriptive statistics, pairwise t-test, and linear regression.ResultsSeventy percent of participants completed the study. Of the individuals who completed the study, 50% reported minor adverse effects, none of which required medical attention, and 50% did not report any adverse effects. The mostly commonly reported effects were skin dryness (43% of study completers) and skin rash (21% of study completers), which rapidly resolved. There was a significant improvement in self-reported pain levels (intake mean 3.5 ± 0.29; exit mean 1.7 ± 0.23; P < 0.001) and pain-related disability, including family and home responsibilities, life support activities, occupational activities, recreational activities, self-care, sexual function, and social activities (all P < 0.001).DiscussionTo the best of our knowledge, this is the first study to assess CBD treatment in elite athletes, who are disproportionally susceptible to disabling injuries. Topical administration of CBD was tolerated well by this population and resulted in only minor adverse effects. As elite athletes are trained and attuned to assess their own bodies due to their professional lives, this population is likely to detect tolerability concerns. However, this study was limited to a convenience sample and self-reported data. These pilot findings warrant further study of topical CBD in randomized and controlled studies of elite athletes.

Can Neurocognitive Function Predict Lower Extremity Injuries in Male Collegiate Athletes?

The purpose of this study is to demonstrate whether neurocognitive evaluation can confirm the association between neurocognitive level and postural control and to analyze the relationship between neurocognitive level and acute musculoskeletal injury in male non-net sports athletes. Seventy-seven male non-net sports athletes participated in this study. The Standardized Assessment of Concussion (SAC), Landing Error Scoring System (LESS), Balance Error Scoring System (BESS), and Star Excursion Balance Test (SEBT) were used for testing; we collected data related to injury history for six months after testing. Pearson’s correlation analysis, logistic regression, and the independent sample t-test were used for statistical analysis. The correlation between SAC and SEBT results was weak to moderate (p < 0.05). Eleven of the seventy-seven participants experienced acute lower limb injuries. SAC, LESS, BESS, and SEBT results have no effect on the occurrence of acute lower extremity injuries (p > 0.05) and were not statistically different between the injured and non-injured groups (p > 0.05). Therefore, using the SAC score alone to determine the risk factor of lower extremity injuries, except in the use of assessment after a concussion, should be cautioned against.

The role of core stability in the development of non-contact acute lower extremity injuries in an athletic population: A prospective study

ObjectivesStability of the core is associated with lower extremity functioning. Consequently, impaired core stability might play a role in developing non-contact acute lower extremity sports injuries. The objective was to investigate components of core stability as potential risk factors for acute lower extremity injuries. DesignA cohort study was set up with a follow-up and injury registration period of 1.5 years. Participants142 male and female physical education students were included. Main outcome measuresMeasures of isometric hip and core muscular strength, endurance, proprioception and neuromuscular control of the core, and postural control were taken at the start of the study. Sports-related injury occurrence was registered during follow-up. Results27 (19%) injuries of interest occurred during follow-up. After multivariate model building, a significant predictive effect was found for side-to-side hip abduction strength asymmetry (p = .007). The hazard of developing an acute lower extremity injury increased with 6.2% with a 1 unit increase in side-to-side strength imbalance, regardless of gender. ConclusionHip abduction strength imbalance was determined as a risk factor for the development of non-contact, acute lower extremity injuries. Normalizing hip strength imbalances might be beneficial for injury prevention. However, further research is needed to support this claim.

Head Impact Kinematics do not Predict In-Season Concussion or Lower Extremity Injury in Ice Hockey

ObjectiveTo examine if head impact kinematics (HIK) predict in-season concussion or acute lower extremity injury (LEI) in collegiate ice hockey.BackgroundSustaining head impacts in sport regularly may be damaging to long-term neurological health. Individuals who sustain higher head impact loads may be at increased risk for concussion, and furthermore, individuals who sustain a concussion are more likely to sustain a subsequent LEI than those without a history of concussion.Design/MethodsTwenty-nine collegiate club male ice hockey players (age: 20.2 ± 1.4) over the 2015-2018 seasons completed a survey at the conclusion of their season of LEI and concussion in-season. HIK (number of impacts, and mean, peak, and cumulative linear acceleration) were recorded via tri-axial accelerometers (Triax, Nowalk, CT) that each player wore for games/practices with a 10g impact threshold. Two binary logistic regressions were performed to determine if either sustaining a concussion or LEI was predicted by HIK.ResultsThere was no relationship between LEI or concussion with number of impacts (β:-0.018, p = 0.711, 95% CI:-0.12-0.84; β:-0.039, p = 0.55, 95% CI: -0.21-0.08, respectively), or mean (β:0.041, p = 0.79, 95% CI: -0.26-0.38; β:-0.040, p = 0.81, 95% CI: -0.37-0.32), peak (β:-0.065, p = 0.14, 95% CI: -0.16-0.01; β:0.0007, p = 0.99, 95% CI: -0.09-0.09), or cumulative acceleration (β:0.001, p = 0.42, 95% CI: -0.001-0.004; β:0.001, p = 0.55, 95% CI:-0.002-0.005). 7/29 players sustained a LEI and 6/29 sustained a concussion. Mean value for number of impacts was 59.7 ± 49.1 (range:3-171); mean acceleration: 33.9 ± 5.3g (range:22.0-42.22), peak: 71.8 ± 19.0g (range: 30.8-108.4); cumulative: 2,108.5 ± 1,793.8g (range 71.8-6517.2).ConclusionsThe main finding of this study is that greater HIK do not predict whether individuals sustained either an acute LEI or concussion during the season, albeit from a small sample. As HIK load is related to concussion incidence, it is possible HIK load may also be related to LEI, however, these results suggest HIK alone is not related to either in an ice hockey cohort.

SPORT SPECIALIZATION IS A RISK FACTOR FOR OVERUSE, BUT NOT ACUTE, LOWER EXTREMITY INJURIES: A PROSPECTIVE STUDY

BACKGROUND: Sport specialization is often associated with intense, high volume training, which may result in injury – especially overuse injuries. However, there is limited prospective research investigating these relationships. Additionally, previous research has focused on adolescents older than 12 years of age with no data available in younger cohorts, who may be more susceptible to repetitive stress. Therefore, the purpose of this study is to determine if sport specialization is associated with increased risk of overuse and acute lower extremity injuries in middle school aged athletes. METHODS: A total of 281 children (113 females (40%), age=12.1±1.2years; range 10-14 years of age) completed an online survey with their parents for 39 weeks. The study was conducted during the 2017-2018 academic year with a baseline survey conducted the first week of September. Weekly surveys were sent to respondents via Qualtrics with the final weekly survey in June of 2018. The baseline survey consisted of 1) demographic information, 2) injury history in the previous 12 months, 3) a sport specialization scale which classified individuals in low, moderate, and high levels of specialization, and 4) sport participation volume (months per year in primary sport). The weekly surveys asked participants to report and musculoskeletal injury they sustained during sport participation. Participants were included in the analysis if they completed at least 80% of the total surveys. Multivariable logistic regression analyses were utilized to examine associations between specialization category (reference category: low) and prospective injury categories, while adjusting for differences in age, sex, and previous injury history. RESULTS: Respondents reported 57 acute and 32 overuse lower extremity injuries during the observation period. Highly specialized athletes had significantly greater odds of reporting a prospective lower extremity overuse injury than subjects in the low specialization group (OR: 3.78, 1.02-12.90, p=0.03), even after adjusting for sex, age, and previous injury history. However, specialization was not a risk factor for acute lower extremity injuries (OR: 2.20, 0.72-6.77, p=0.17). CONCLUSION: Highly specialized middle school athletes are nearly 4 times greater risk of developing an overuse injury compared to low specialization athletes. Younger athletes may be more susceptible to injuries at younger ages. Thus, adolescent athletes should avoid specialization when possible.

Investigation of knee control as a lower extremity injury risk factor: A prospective study in youth football.

This prospective study in youth football examined the relationship between frontal plane knee projection angle (FPKPA) during the single-leg squat and sustaining an acute lower extremity injury or acute non-contact lower extremity injury. Secondly, side-to-side asymmetry in FPKPA and sex as injury risk factors were explored. In addition, we investigated the influence of age, sex, and leg dominance on the FPKPA. A total of 558 youth football players (U11 to U14) participated in the single-leg squat test and prospective injury registration. FPKPA was not found as a risk factor for injuries at this age. There was no difference in the mean FPKPA between sexes. However, FPKPA was associated with age; oldest subjects displayed the smallest FPKPA. Among boys, the frontal plane knee control improved by age. Among girls, the relationship between age and FPKPA was not as clear, but the oldest girls displayed the smallest mean FPKPA in the study (12.2°±8.3°). The FPKPA was greater on the dominant kicking leg compared to the non-dominant support leg (P<.001 for boys, P=.001 for girls). However, side-to-side asymmetry in FPKPA was not associated with future injuries. In conclusion, frontal plane knee control in the single-leg squat was not associated with lower extremity injuries among young football players. As the single-leg squat to 90° knee flexion was too demanding for many subjects, easier single-leg squat test procedure or a different movement control test, such as a double-legged squat, could be more suitable for the young football players.

ASSOCIATION BETWEEN FRONTAL PLANE KNEE CONTROL AND ACUTE LOWER EXTREMITY INJURIES

BackgroundSingle-leg squat (SLS) is a clinical tool used to assess knee control. Previous studies have proposed that knee valgus motion in the SLS could be related to injury risk, but...

Shoe and Field Surface Risk Factors for Acute Lower Extremity Injuries Among Female Youth Soccer Players

To describe acute lower extremity injuries and evaluate extrinsic risk factors in female youth soccer. Nested case-control study. Youth soccer clubs in Seattle, WA. Female soccer players (n = 351) ages 11 to 15 years randomly selected from 4 soccer clubs from which 83% of their players were enrolled with complete follow-up for 92% of players. Injured players were interviewed regarding injury, field surface, shoe type, and position. Uninjured controls, matched on game or practice session, were also interviewed. The association between risk factors and acute lower extremity injury using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI). One hundred seventy-three acute lower extremity injuries occurred involving primarily the ankle (39.3%), knee (24.9%), and thigh (11.0%). Over half (52.9%) recovered within 1 week, whereas 30.2% lasted beyond 2 weeks. During practices, those injured were approximately 3-fold (OR, 2.83; 95% CI, 1.49-5.31) more likely to play on grass than artificial turf and 2.4-fold (95% CI, 1.03-5.96) more likely to wear cleats on grass than other shoe and surface combinations. During games, injured players were 89% (95% CI, 1.03-4.17) more likely to play defender compared with forward. Half of the acute lower extremity injuries affected the ankle or knee. Grass surface and wearing cleats on grass increased training injuries. The majority, 64%, of female youth soccer players' acute injuries involve the ankle and knee and injury prevention strategies in this age group should target these areas. When considering playing surfaces for training, communities and soccer organizations should consider the third-generation artificial turf a safe alternative to grass.

Acute Lower Extremity Injury Rates Increase after Concussion in College Athletes.

Dynamic postural control deficits and disrupted cortical pathways have been reported to persist beyond an athlete's return to activity after concussion, potentially increasing the risk of acute lower extremity musculoskeletal injury. This study aimed to investigate acute lower extremity musculoskeletal injury rates before and after concussion in athletes with concussion and their matched control. College athletes with concussion (n = 44; age, 20.0 ± 1.2 yr) were physician-diagnosed. Nonconcussed college athletes (n = 58; age, 20.5 ± 1.3 yr) were matched to individuals with concussion. Acute lower extremity musculoskeletal injury data were collected for 2 yr (±1 yr of the diagnosed concussion) using electronic medical records. Control participants' 2-yr window for exposure and musculoskeletal injury data were anchored to their match's concussion injury date. Pre- and postconcussion musculoskeletal injury rates were calculated for 90-, 180-, and 365-d periods for both study cohorts. Risk ratios were calculated to determine differences within and between groups for all periods. Within 1 yr after concussion, the group with concussion was 1.97 (95% confidence interval (CI), 1.19-3.28; P = 0.01) times more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than before concussion and 1.64 times (95% CI, 1.07-2.51; P = 0.02) more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than their matched nonconcussed cohort over the same period. Up to 180 d after concussion, the group with concussion was 2.02 (95% CI, 1.08-3.78; P = 0.02) times more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than before concussion. Previous literature has identified dynamic postural control deficits along with increased motor evoked potential latency and decreased amplitude after concussion, suggesting that the brain may be unable to effectively coordinate movement. Our findings underscore the need to explore functional movement and dynamic postural control assessments in postconcussion injury assessment protocols.

Effects of Training Program wearing Balance Shoes to Reduce Knee and Lower Extremity Injuries in Junior Athletes: A Randomized Controlled Trial

Objective: The purpose of this randomized controlled trial was to compare the effectiveness of an original 15-minute exercise program wearing the ReaLine Balanceshoes (RBS) and a conventional injury prevention program in reducing lower extremity injuries. Methods: We recruited athletic club teams from local junior high schools. Inclusion criteria were adolescents who were a member of their interscholastic athletic club team. Players with an injury within 6 weeks that prevented full participation in sports, a history of systemic disease or neurologic disorder at the start of the intervention, and those already using an injury prevention program were excluded. Participants were individually randomized within a team into one of the study groups (RBS or control). The RBS group used the RBS, a shoe-type training device designed for correcting dynamic knee valgus. A 6-staged progressive exercise program was developed, including slow closed kinetic chain strengthening, joint realignment, balancing, feedforward, feedback, and plyometric components. The control group performed an injury prevention program previously used to reduce injury risk. One 15-minute session was performed 3 days/week for 12 months. The primary outcome was incidence of anterior cruciate ligament (ACL) injury and acute knee injuries. Results: One hundred twenty three players completed the study (RBS, n=65; control, n=58). No ACL injury or acute knee injury occurred among RBS athletes versus 1 ACL injury [RR 0.298, 95% CI (0.012, 7.175)] and 3 acute knee injuries [RR 0.127, 95%CI (0.007, 2.421)] among control athletes. Conclusion: The RBS program was not significantly more effective than a conventional injury prevention program in reducing the incidence of ACL injury and other acute lower extremity injuries in junior athletes.

Common Acute Sports-Related Lower Extremity Injuries in Children and Adolescents

Most acute sports-related injuries in children and adolescents involve the lower extremities. Emergency department physicians are often the first to evaluate and treat these injuries and are commonly asked for advice regarding return to sports and activities. This article will review the most common acute lower extremity injuries seen in young athletes, including contusions, muscle strains, fractures, ankle and knee sprains, and patellar dislocations. Diagnosis, initial treatment, prognosis, and time frame for return to sports will be discussed.