Greater Risk Of Injury Research Articles

Accumulated workloads and the acute:chronic workload ratio relate to injury risk in elite youth football players

AimThe purpose of this study was to investigate the relationship between physical workload and injury risk in elite youth football players.MethodsThe workload data and injury incidence of 32 players were...

Assessment of Workload and its Effects on Performance and Injury in Elite Cricket Fast Bowlers.

Cricket is distinctly positioned in the world of elite sports because three different formats now exist, each with characteristically different workload requirements. Fast bowlers have greater match-play workload requirements and are at greater injury risk than other positions. An update on the current cricket literature regarding fast bowling match-play physiology, workload, and injury is required to demonstrate the extent to which workload is related to performance and injury in elite fast bowlers since the introduction of 20-over cricket in 2005. The current review examined articles published in English with data collected from 2005 onwards pertaining to in situ cricket fast bowling physiology, match play, injury, and workload. Four databases were searched using the combinations of the following keywords: 'cricket' and 'bowl', inclusive of 'pace', 'fast', 'medium', or 'seam' bowling. Articles from 2005 onwards with male participants, high-performing or elite, and fast bowlers in the game of cricket were considered for inclusion. Only workload assessments captured in a field setting were included. A total of 751 articles were identified. Exclusions included 527 duplicates, papers pre-2005, review articles, and abstracts. A further 185 articles were excluded after review of titles and abstracts that were deemed to be outside the scope of research or population. The full texts of 39 articles were reviewed, with only 17 included in this systematic review. In five articles reviewed, fast bowlers had a greater workload than other player types. Bowling workload history was reviewed in seven articles and appeared to have a complex interaction with likelihood of injury and injury type. Fast bowling workload has a well recognised relationship with injury and performance. Although monitoring acute and chronic workloads of fast bowlers remains the most ideal method for identifying preparedness and injury likelihood in fast bowlers, complexities exist that make the systematic prescription of bowling workloads difficult. Advances in technology to monitor workloads may provide further insight into the intensity and workloads of fast bowlers. PROSPERO registration number: CRD42015032466.

Single-leg balance and core motor control in children: when does the risk for ACL injury occurs?

IntroductionWhile numerous publications have demonstrated the correlation of poor single-leg balance and core motor control with an increased risk of anterior cruciate ligament (ACL) injuries in skeletally mature female athletes,...

The injury trajectory for young people 16–24 years in the six months following injury: A mixed methods study

BackgroundAdolescents and young people are the population at greatest risk of injury and therefore injury-related mortality and morbidity. Inquiry into the injury trajectory of young people is needed to identify this group’s specific needs for healthcare. This paper reports the integration of quantitative and qualitative findings from a sequential explanatory mixed methods study examining young people aged 16-24 years’ experience and trajectory of traumatic physical injury in the initial six months. The aim of integration was to address the question: In what ways are injured young peoples’ experiences and self-management during the initial six months of the injury trajectory impacted by their injury, family support, and provision of healthcare? MethodsKey findings from epidemiological datasets on young person injuries from hospital and coronial databases (Phase 1) were combined with key findings from qualitative interviews with 12 injured young people and 10 family members (Phase 2). ResultsThe integration of findings from Phase 1 and Phase 2 resulted in three new findings; [1] (Alfred Health, 2014). A young person’s perception of the severity of their injury, as well as the amount of time spent in hospital, impacts substantially on the way in which they experience injury, and this is managed differently between genders; [2] (Newnam et al., 2014). Admission to an Intensive care unit, including the intensity and duration of care, is the primary influence on how a family will provide support to the young person in the inpatient period; and [3] (Lyons et al., 2010). Young people's perception and understanding of their recovery from injury is in contrast with how healthcare systems are structured to provide rehabilitation and recovery care. ConclusionThe injury trajectory and recovery process of young people in the six months following injury have been have conceptualised. These trajectories of recovery can inform the development of anticipatory guidance frameworks for clinicians and guide the provision of and planning for clinical services for injured young people.

Injury Risk In Athletes With And Without A History Of Lower Extremity Injury

Previous injury has been shown to be a risk factor for subsequent injury. Female basketball athletes are at greatest risk for injury during puberty, generally ages 10–17, and are 3.5 times more likely to injure an anterior cruciate ligament than their male counterparts. Landing technique has been shown to identify lower extremity (LE) injury risk in youth athletes. PURPOSE: To compare injury risk of female youth basketball athletes with and without history of LE injury. METHODS: Sixty-five female basketball athletes volunteered to participate in a single test session during which they completed a questionnaire regarding injury history and performed a jump-landing task videotaped from the front and side. Previous LE injury history was defined as any self-reported injury to the foot, ankle, lower leg, knee, thigh or hip. A single rater blinded to injury history graded all videos using the Landing Error Scoring System (LESS). Separate independent t-tests compared athletes with and without LE injury history, with knee injury history and no LE injury history, and with ankle injury history and no LE injury history (α=0.05). RESULTS: Forty athletes reported history of LE injury (13±1 yr, 165.7±9.8 cm, 57.4±13.9 kg), of which 20 reported history of knee injury (14±2 yr, 167.5±8.8 cm, 61.8±15.7 kg) and 24 reported history of ankle injury (14±2 yr, 167.6±10.0 cm, 60.6±15.7 kg). Twenty-five athletes reported no history of LE injury (12±2 yr, 161.3±9.9 cm, 52.6±12.5 kg). No significant differences in LESS score were observed between athletes with (5.2±1.8 errors) and without (5.3±2.2 errors) history of LE injury (p>0.05, mean difference= 0.12±0.5 errors, 95%CI [−0.9, 1.1]) No significant differences in LESS score were found between athletes with history of knee injury and with no history of LE injury (p>0.05, mean difference= −0.124±0.7 errors, 95%CI [−1.4, 1.2]) as well as athletes with history of ankle injury and no history of LE injury (p>0.05, mean difference= 0.5±0.6 errors, 95%CI [−0.7, 1.6]). CONCLUSION: History of LE, knee or ankle injury did not increase injury risk compared to athletes with no LE injury history. Our results do not support previous findings that prior LE injury increases risk of subsequent injury. Further research is needed to evaluate the impact of LE injury history on injury risk in at-risk populations.

Anterior Cruciate Ligament Injuries in National Football League Athletes From 2010 to 2013: A Descriptive Epidemiology Study.

Background:There is a high incidence of anterior cruciate ligament (ACL) injuries among National Football League (NFL) athletes; however, the incidence of reinjury in this population is unknown.Purpose:This retrospective epidemiological study analyzed all publicly disclosed ACL tears occurring in NFL players between 2010 and 2013 to characterize injury trends and determine the incidence of reinjury.Study Design:Descriptive epidemiological study.Methods:A comprehensive online search identified any NFL player who had suffered an ACL injury from 2010 to 2013. Position, playing surface, activity, and date were recorded. Each player was researched for any history of previous ACL injury. The NFL games database from USA Today was used to determine the incidence of ACL injuries on artificial turf and grass fields. Databases from Pro Football Focus and Pro Football Reference were used to determine the injury rate for each position.Results:NFL players suffered 219 ACL injuries between 2010 and 2013. Forty players (18.3%) had a history of previous ACL injury, with 27 (12.3%) retears and 16 (7.3%) tears contralateral to a previous ACL injury. Five players (2.28%) suffered their third ACL tear. Receivers (wide receivers and tight ends) and backs (linebackers, fullbacks, and halfbacks) had significantly greater injury risk than the rest of the NFL players, while perimeter linemen (defensive ends and offensive tackles) had significantly lower injury risk than the rest of the players. Interior linemen (offensive guards, centers, and defensive tackles) had significantly greater injury risk compared with perimeter linemen. ACL injury rates per team games played were 0.050 for grass and 0.053 for turf fields (P > .05).Conclusion:In this retrospective epidemiological study of ACL tears in NFL players, retears and ACL tears contralateral to a previously torn ACL constituted a substantial portion (18.3%) of total ACL injuries. The significant majority of ACL injuries in players with a history of previous ACL injury were retears. Skilled offensive players and linebackers had the greatest injury risk, and significantly more ACL tears occurred among interior linemen than perimeter linemen. The month of August had the highest incidence of ACL injuries, probably because of expanded roster sizes at that point in the NFL season.

Socioeconomic inequalities in injuries treated in primary care in Madrid, Spain.

Socioeconomic inequalities in injury morbidity are an important yet understudied issue in Southern Europe. This study analysed the injuries treated in primary care in the Community of Madrid, Spain, by socioeconomic status (SES), sex and age. This was a cross-sectional study of injuries registered in the primary care electronic medical records of the Madrid Health Service in 2012. Incidence stratified by sex, SES and type of injury were calculated. Poisson regression was performed. A statistically significant upward trend in global injury incidence was observed with decreasing SES in all age groups. By type of injury, the largest differences were observed in injuries by foreign body in men aged 15-44 and in poisonings in girls under 15 years of age. Burns risk also stood out in the group of girls under 15 years of age with the lowest SES. In the group above 74 years of age, wounds, bruises and sprains had the lowest SES differences in both sexes, and the risk of fractures was lower in the most socioeconomically advantaged group. People with lower SES were at a greater risk of injury. The relationship between SES and injury varies by type of injury and age.

Junior cricketers are not a smaller version of adult cricketers: A 5-year investigation of injuries in elite junior cricketers

Background. Injury surveillance is fundamental to preventing and reducing the risk of injury. Objectives. To determine the incidence of injuries and the injury demographics of elite schoolboy cricketers over five seasons (2007 - 2008, 2008 - 2009, 2009 - 2010, 2010 - 2011 and 2011 - 2012). Methods. Sixteen provincial age group cricket teams (under (U) 15 , U17 and U18) competing in national age-group tournaments were provided a questionnaire to complete. The questionnaires gathered the following information for each injury sustained in the previous 12 months: (i) anatomical site; (ii) month; (iii) cause; (iv) whether it was a recurrence of an injury from a previous season; (v) whether the injury had reoccurred during the current season; and (vi) biographical data. Injuries were grouped according to the anatomical region injured. All players were invited to respond, irrespective of whether an injury had been sustained, resulting in a response rate of 57%. The sample Statistical Analysis System was used to compute univariate statistics and frequency distributions. Results. Of the 2 081 respondents, 572 (27%) sustained a total of 658 injuries. The U15 and U17 groups sustained 239 (36%) and 230 (35%) injuries, respectively, more than the 189 injuries sustained by the U18 group (29%). These injuries were predominantly to the lower limbs (38%), back and trunk (33%) and upper (26%) limbs, with 3% occurring to the head and neck. The injuries occurred primarily during 1-day matches (30%), practices (29%) and with gradual onset (21%). The primary mechanism of injury was bowling (44%) and fielding (22%). The injuries were acute (49%), chronic (41%) and acute-on-chronic (10%), with 26% and 47% being recurrent injuries from the previous and current seasons, respectively. Some similar injury patterns occurred in studies of adult cricketers, with differences in the nature and incidence of injuries found for the various age groups. The youth cricketers sustained more back and trunk injuries, recurrent injuries and more match injuries than the adult cricketers. The U15 group sustained less-serious injuries, which resulted in them not being able to play for between 1 and 7 days (58%), with more injuries occurring in the preseason period (24%) and fewer during the season (60%) compared with other age groups. The U15 and U17 groups sustained the most lumbar muscle strains, while the U18 groups sustained more serious injuries, resulting in them not being able to play for >21 days. Conclusion. Young fast bowlers of all ages remain at the greatest risk of injury. Differences in the nature and incidence of injuries occurred between youth and adult cricketers, as well as in the different age groups. It is recommended that cricket administrators and coaches implement an educational process of injury prevention and management

Reducing Robust Health-Relevant Cardiovascular Stress Responses Among Active-Duty Special Forces Police

Policing presents a complex set of risk factors for occupational health and safety among officers, including environmental, psychosocial, and health risks. Environmental risks include facing critical incidents such as violent offenders, hostage negotiations, intense crime scenes, and irate civilians. Critical incidents are high pressure situations that are typically time sensitive, and elicit substantial physiological threat responses. When facing a threat, the body normally responds by going into a “fight-or-flight” mode, in which a host of physiological and psychological processes are invoked to help the body cope successfully with the threat [1]. For example, heart rate increases, digestion stops, blood flow to the brain moves from prefrontal cortex (logical thought) to the hindbrain (instinctual drives), and a person becomes less cognitively aware of their surroundings and more focused on fighting or fleeing from the threat. The natural and instinctual physiological response to threat may place police officers at a greater risk of injury or death, by reducing their situational awareness (i.e., ability to notice important environmental stimuli and other threats in their environment), and split-second decision making skills (e.g. shoot/don’t shoot). Advanced police teams called Special Weapons and Tactics (SWAT) officers, are called to the highest risk encounters [2]. The current research is the first to observe robust cardiovascular reactivity among SWAT officers during multiple, active duty shifts. Significant cardiovascular reactivity may pose a health risk to SWAT officers over time. Accordingly, this research documents the case examples from one team of SWAT officers who applied a simple cardiovascular and respiratory control technique during daily activities. Results suggest that this micro-intervention may have significant positive impact on daily cardiovascular health among SWAT officers.

Understanding clusters of risk factors across different environmental and social contexts for the prediction of injuries among Canadian youth

BackgroundAmong Canadian youth, injury is the most common reason for presentation to the emergency department. Youth who commonly engage in multiple risk-taking behaviours are at greater risk for injury, but is it unknown if this phenomenon is more pronounced in different contexts. We aimed to study relationships between risk-taking behaviours and injury, and variations in such relationships between different environmental and social contexts, among youth in Canada. MethodsRisk-taking behaviour and injury outcome data were collected from grade 9 to 10 students using the 2009–2010 (Cycle 6) of the Health Behaviour in School-Aged Children Survey (n=10,429). Principal components analysis was used to identify clusters of risk-taking behaviours. Within each identified cluster, the degree of risk-taking was categorized into quartiles from lowest to highest engagement in the behaviours. Risk ratios with 95% confidence intervals were calculated to determine the association between the risk of any injury and the degree of risk-taking behaviour specific to the cluster. Clusters were then examined across home, school, neighbourhood and sport contexts. ResultsFour clusters of risk-taking behaviour were identified which were labelled as “gateway substance use”, “hard drugs and weapons”, “overt risk-taking”, and “physical activity”. Each cluster was related to injury occurrence in a graded fashion. Clusters of risk behaviour were most strongly associated with injuries sustained in neighbourhood settings, and expectedly, increasing physical activity behaviours were associated with increased risk of sport injuries and injuries occurring at school. ConclusionsThis study furthers understanding of clustered risk-taking phenomena that put youth at increasing levels of injury risk. Higher risks for injury and associated gradients were observed in less structured contexts such as neighbourhoods. In contrast, clustered physical activity behaviours were most related to school injury or sport injury and were more likely to be sustained in a supervised context. Understanding the clustered and cumulative nature of risk-behaviours, and how these vary by environmental and social context, helps to explain potential mechanisms of injury as well as modifiable factors that may be important avenues for intervention.

Pain on Functional Movement Screen Tests and Injury Risk.

The Functional Movement Screen (FMS) is a tool intended to evaluate limitations or asymmetries of movement to detect individuals at risk for exercise- and sports-related injury. The purpose was to determine the association and predictive value of specific FMS tests with injury risk in physically active men. Soldiers aged 18-57 years completed the FMS (n = 2,476). Demographic and fitness data were collected by survey. Medical record data for any, overuse, and traumatic injury 6 months after the assessment were obtained. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were calculated along with receiver operator characteristics to determine area under the curve (AUC). Risks, risk ratios, odds ratios (ORs), and 95% confidence intervals were calculated to assess injury risks. Multivariate logistic regression identified that pain on 5 of the 7 tests was associated with greater risk for any injury (OR = 1.50-3.51): deep squat, hurdle step, in-line lunge, trunk stability push-up, and rotary stability. However, FMS registered low sensitivity, PPV, and AUC for all 7 tests for the 3 injury types (2-24% sensitivity, 16-74% PPV, and 50-58% AUC). Although the presence of pain was associated with a higher risk of injury on 5 tests, a low sensitivity, PPV, and AUC were displayed. Therefore, caution is advised when implementing the FMS as a screening tool in an Army or similarly active population as it could lead to prevention and treatment resources being directed toward individuals who are not at greater risk for injury.

Moderate Intensity Resistance Training Significantly Elevates Testosterone following Upper Body and Lower Body Bouts When Total Volume is Held Constant

Introduction: It is unknown whether resistance training intensity or total volume of work affects the acute testosterone response to a greater extent. Purpose: Therefore, the circulating testosterone response was investigated following four resistance training protocols where total volume of work was held constant: moderate intensity (70% 1RM) upper body (bench press, bent barbell row, and military press), moderate intensity lower body (squat and deadlift), high intensity (90% 1RM) upper body, high intensity lower body. Methods: Total volume of work performed by each participant between protocols was maintained by adjusting the number of sets and or repetitions performed. Ten healthy, resistance trained men volunteered, and performed exercise protocols on separate days in a counterbalanced order. Capillary blood was obtained via finger stick at baseline (pre), immediately following the exercise session (post), and 1h post for the determination of testosterone concentration. Data were analyzed using a factorial ANOVA and significance was accepted at p≤ 0.05. Results: Both moderate intensity resistance protocols (upper and lower body) significantly increased testosterone concentration (p=0.026, and p=0.024 respectively), whereas the high intensity protocols elevated testosterone but failed to achieve significance (upper p=0.272, lower p=0.658). No difference was noted in post session testosterone concentration between upper and lower body protocols for either moderate (p=0.248) or high intensity (p=0.990). Conclusion: This may be useful for novice resistance trained individuals because it provides evidence that moderate intensity is sufficient to increase testosterone compared to high intensity protocols that could be associated with a greater risk of injury. Keywords: hormone response, equal total work, high intensity protocol

The Effect of Three Different Shoeing Conditions on Tendon Strain in the Thoroughbred Forelimb

Reasons for performing studyPrevious studies show the effect of toe or heel wedges on tendon strain but there is little understanding of the effect of other shoe types.ObjectivesTo quantify the effect of different shoeing conditions on the strain in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), distal check ligament (ALDDFT) and suspensory ligament (SL).Study designControlled experimental study.MethodsTwelve equine cadaver forelimbs were loaded onto a force plate mimicking stance phase. Markers were placed proximally and distally in each tendon structure and tracked using a motion capture system and strain was calculated. Tendon strain was determined for the following conditions: barefoot, glue on heart bar and aluminium racing plates with and without packing material. Data were analysed using a mixed effects model.ResultsSignificant variation in strain was observed between tendons. The DDFT had the lowest strain, then the ALDDFT, SDFT and SL. Glue on heart bar shoes significantly increased SDFT and SL strain compared to barefoot for the same leg force. Aluminium racing plates without packing material increased ALDDFT and SDFT strain and with packing material increased ALDDFT and SL.ConclusionsShoe selection should be based on minimising strain in the tendon with greatest injury risk. Aluminium racing plates with packing material may be most appropriate for the majority of racehorses as they do not significantly increase SDFT strain.Ethical animal research: Research ethics committee oversight not currently required by this conference: the study was performed on material obtained from an abattoir. Source of funding: The authors would like to thank the Horserace Betting Levy Board for their support of this project. Competing interests: None declared. Acknowledgements: We thank Peter Day, Carl Bettison, Chris Pardoe, Marianna Biggi and Emily Sparkes.

Television viewing and hostile personality trait increase the risk of injuries

Individuals with high levels of hostility may be more susceptible to the influence of television on violence and risk taking behaviors. This study aimed to examine whether hostile personality trait modifies the association between TV viewing and injuries. It is a prospective study of 4,196 black and white adults aged 23 to 35 in 1990/1. Cross-lagged panel models were analyzed at three 5-year time periods to test whether TV viewing predicted injuries. Covariates were gender, race, and education. Individuals who watched more TV (0 hours, 1–3 hours, 4–6 hours, and ≥7 hours) were more likely to have a hospitalization for an injury in the following 5 years across each of the three follow-up periods [OR = 1.5 (95%CI = 1.2, 1.9), 1.5 (1.1, 1.9), and 1.9 (1.3, 2.6)]. The cross-lagged effects of TV viewing to injury were significant in the high hostility group [OR = 1.4 (95%CI = 1.1, 1.8), 1.3 (1.0, 1.8), and 2.0 (1.3, 2.9)] but not in the low hostility group [OR = 1.3 (95%CI = 0.6, 2.2), 1.1 (0.6, 2.1), and 1.4 (0.7, 2.8)]. Additionally, a statistically significant difference between the two models (P < 0.001) suggested that hostility moderated the relationship between TV watching and injury. These findings suggest that individuals who watch more TV and have a hostile personality trait may be at a greater risk for injury.

Alcohol Attributable Fraction for Injury Morbidity from the Dose-Response Relationship of Acute Alcohol Consumption: Emergency Department Data from 18 Countries.

To calculate the alcohol-attributable fraction (AAF) of injury morbidity by volume of consumption prior to injury based on newly reported relative risk (RR) estimates. AAF estimates based on the dose-response RR estimates obtained from previous pair-matched case-crossover fractional polynomial analysis of mean volume in volume categories were calculated from the prevalence of drinking prior to injury in each volume category. Thirty-seven emergency departments (EDs) across 18 countries. Probability samples of patients, with equal representation of each shift for each day of the week, totaling 14,026 who arrived at the ED within six hours of injury from ED studies conducted between 2001 and 2011. AAF was analyzed by gender, age (18-30; >30), cause of injury (traffic, assault, fall, other), and country detrimental drinking pattern (DDP). For the EDs analyzed, 16.4% of all injuries were estimated to be attributable to alcohol, and the AAF did not vary by age but was over twice as large for males (20.6%; 19.3-21.8) than for females (8.6%; 7.5-9.7%). While females were at greater risk of injury than males at higher volume levels, lower prevalence of women drinking at higher levels contributed to overall lower AAF for women. Assault-related injuries showed the largest AAF (44.1%; 37.6-42.6). AAF was slightly higher for injuries from falls (14.3%; 12.9-15.7) than motor vehicle crashes (11.1%; 9.3-12.9). AAF was higher in those countries with a DDP of 3 (18.6; 17.5-19.7) and 4 (19.4%; 17.3-21.6) than those with a DDP of 2 (12.0%; 10.5-13.5). Alcohol-attributable injuries presenting in emergency departments are higher for males than females, for violence-related injuries compared with other types of injury, and for countries with more detrimental drinking patterns compared with those with less detrimental patterns.

A Retrospective Review from 2006 to 2011 of Lower Extremity Injuries in Badminton in New Zealand

Aim: To describe lower extremity injuries for badminton in New Zealand. Methods: Lower limb badminton injuries that resulted in claims accepted by the national insurance company Accident Compensation Corporation (ACC) in New Zealand between 2006 and 2011 were reviewed. Results: The estimated national injury incidence for badminton injuries in New Zealand from 2006 to 2011 was 0.66%. There were 1909 lower limb badminton injury claims which cost NZ$2,014,337 (NZ$ value over 2006 to 2011). The age-bands frequently injured were 10–19 (22%), 40–49 (22%), 30–39 (14%) and 50–59 (13%) years. Sixty five percent of lower limb injuries were knee ligament sprains/tears. Males sustained more cruciate ligament sprains than females (75 vs. 39). Movements involving turning, changing direction, shifting weight, pivoting or twisting were responsible for 34% of lower extremity injuries. Conclusion: The knee was most frequently injured which could be due to multi-planar loading. Turning or cutting movements typically involve motion in the frontal and transverse planes that may place the knee at greater risk of injury than movement in the sagittal plane alone. Further research on badminton specific movements is warranted to better understand the mechanisms of lower extremity injuries in the sport. Sports medicine and support personnel should take into account the susceptibility of the knee to injury when designing training and injury prevention programmes given the large number of change of direction movements during badminton.

"People are Getting Lost a Little Bit": Systemic Factors that Contribute to Falls in Community-Dwelling Octogenarians.

Octogenarians living in the community are the fastest-growing demographic in Canada. Simultaneously, they have the highest prevalence of falls and nine times greater risk of injury due to a fall. To understand how to improve the safety of octogenarians' aging-in-place, a systems approach is essential. Understanding how societal factors interact and affect the older adult can help care custodians identify and remove safety deficiencies that bring about falls. The purpose of this study was to identify system-wide factors contributing to falls in community-dwelling octogenarians. Eight falls were investigated using the systemic falls investigative method. Participants ranged in age from 83-90 years. Across-case analyses identified 247 contributing factors, grouped within four distinct themes: (a) everyday living has become risky; (b) supervision limitations; (c) health care system disconnects; and (d) poor fall risk identification and follow-up. This qualitative study provides systemic insights into how and why falls occur in community-dwelling octogenarians.

Novice lifters exhibit a more kyphotic lifting posture than experienced lifters in straight-leg lifting

As torso flexion and repetitive lifting are known risk factors for low back pain and injury, it is important to investigate lifting techniques that might reduce injury during repetitive lifting. By normalizing lumbar posture to a subject's range of motion (ROM), as a function of torso flexion, this research examined when subjects approached their range of motion limits during dynamic lifting tasks. For this study, it was hypothesized that experienced lifters would maintain a more neutral lumbar angle relative to their range of motion, while novice lifters would approach the limits of their lumbar ROM during the extension phase of a straight-leg lift. The results show a statistically significant difference in lifting patterns for these two groups supporting this hypothesis. The novice group maintained a much more kyphotic lumbar angle for both the flexion (74% of the lumbar angle ROM) and extension phases (86% of the lumbar angle ROM) of the lifting cycle, while the experienced group retained a more neutral curvature throughout the entire lifting cycle (37% of lumbar angle ROM in flexion and 48% of lumbar angle ROM in extension). By approaching the limits of their range of motion, the novice lifters could be at greater risk of injury by placing greater loads on the supporting soft tissues of the spine. Future research should examine whether training subjects to assume more neutral postures during lifting could indeed lower injury risks.

Shoulder Dislocation 10-year Incidence And Chronic Injury Rate In The U.s. Army

Active duty United States (US) Army soldiers represent a relatively young, active cohort of the US general population. Musculoskeletal injury is a leading cause of disability in the US Army. However, the recent rate and risk factors for shoulder dislocations in the US Army have not been determined. PURPOSE: Determine the 10-year incident rate of shoulder dislocations in the US Army, the percentage with recurrent instability, and demographic groups at risk for these injuries. METHODS: Medical encounter data for US Army soldiers was used to quantify shoulder dislocations from 2002-2011 using ICD-9 diagnosis codes. Ten-year incidence rate for shoulder dislocations was calculated, as was the percentage of chronic or recurrent injuries >3 months and ≤2 years following the initial diagnosis. A conditional logistic regression was performed using demographic variables (age, race, military career field, education level, marital status, and sex) to determine risk ratios (RR) for risk factors related to shoulder dislocation. A logistic regression was performed to calculate RR for risk factors for recurrent injury including concurrent diagnoses (brachial plexus or peripheral nerve injuries, fractures of the scapula or humerus). RESULTS: There were 15,471 incident shoulder dislocations, with a 10-year incidence rate of 3.10 per 1,000 person years. Compared to soldiers >40 years old, soldiers ≤30 years old had greater risk of injury (<20 years RR=2.35, 95% CI [2.10, 2.633], 21-25 years RR=2.14, 95% CI [1.94, 2.35], 26-30 years RR=1.71, 95% CI [1.55, 1.87]). The RR for males compared to females was 1.97, 95% CI [1.85, 2.09]. Recurrent injury occurred in 32.1% of cases. Concurrent peripheral nerve injury (RR=1.93, 95% CI [1.14, 3.29]) and age ≤30 years (<20 years RR=1.91 95% CI [1.51, 2.4], 21-25 years RR=1.93 95% CI [1.57, 2.36], 26-30 years RR=1.63, 95% CI [1.33, 2.00]) had greatest risk of recurrence. CONCLUSION: Within the active duty US Army, men and those 30 years of age or younger showed greater risk for shoulder dislocations. Roughly one third of incident cases became recurrent. Peripheral nerve injuries and younger age increased the risk of recurrent injury. The views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of Army, Department of Defense, or the U.S. Government.

The Effect of Exertion on Joint Kinematics and Kinetics During Running Using a Waveform Analysis Approach.

About half of all runners sustain a running-related injury every year. Exertion may contribute to risk of injury by altering joint mechanics. The purpose of this study was to examine the effects of exertion on runners' joint mechanics using principal component analysis (PCA). Three-dimensional motion analysis of the lower extremity was performed on 16 healthy female runners before and after their typical training run. PCA was used to determine exertion-related changes in joint mechanics at the ankle, knee, and hip. Statistical significance for repeated-measures MANOVA of the retained principal components at each joint and plane of motion was at P < .05. Exercise effects were identified at the ankle (greater rate of eversion [PC2: P = .027], and decreased plantar flexion moment [overall: P = .044] and external rotation moment [PC3: P = .003]), knee (increased adduction [overall: P = .044] and internal rotation [PC3: P = .034], and decreased abduction moment [overall: P = .045]), and hip (increased internal rotation [PC1: P = .013] and range of mid- to late-stance rotation [PC2: P = .009], and decreased internal rotation moment [PC1: P = .001]). The observed changes in running mechanics reflect a gait profile that is often linked to running injury. The effects of more strenuous activity may result in mechanics that present an even greater risk for injury.