Injured Athlete Research Articles

Prevalence and epidemiological characteristics of sports injuries: A comparative analysis of injured vs non-injured athletes

Background Problems: Sports exercise offers numerous health benefits but is also linked to sports injuries. According to a large body of research, researchers have identified age, gender, injury history, and level of competition as consistent risk factors for injury. Research Objectives: This study aims to analyse the injury prevalence of athletes in some sports and compare the epidemiological characteristics related to injury risk factors between athletes who experienced injuries and those who did not. Methods: This study employed a quantitative approach with a retrospective cross-sectional design. An online questionnaire collected data from a sample of 172 athletes and sports activists in football, cycling, and running. We conducted descriptive and comparative analyses using the SPSS 29 version. Findings and Results: 135 of the 172 respondents experience injuries, with the highest prevalence in football (42.2%), running (36.3%), and cycling (21.5%). Most athletes had recurrent injuries (36.3%). The Mann-Whitney test results showed no significant differences in mean age, weekly training frequency, and training duration between athletes who had injuries and those who did not. Conclusion: This study provides important insights into the prevalence and characteristics of injuries among athletes. The results of this study, which compare injured and non-injured athletes, can help develop better injury prevention and management strategies. We recommend increased awareness of injury conditions among athletes, coaches, and medical professionals to ensure a safe return to sport.

Sex Differences in Youth and Young Adult Sport Training Patterns, Specialization, and Return to Sport Durations.

Young female athletes may have higher rates of overuse injuries and sport specialization than male athletes. The association of sports specialization and return to sport (RTS) timeframe is also unknown. Specialized female athletes will have more intense, year-round training patterns, more overuse injuries, and longer RTS times than male athletes. Cohort study. Level 3. Injured athletes aged 10 to 23 years presenting to a sports medicine clinic reported their degree of sport specialization and training patterns. Skeletal maturity was estimated using the Khamis-Roche method. Injury type and RTS timeframes were categorized from electronic medical records. Chi-square tests and logistic regression analysis assessed associations between variables. A total of 485 athletes (40.2% female) were enrolled. Higher degrees of sport specialization were associated strongly with overuse injuries (P < 0.01). After adjusting for specialization, female athletes were more likely to sustain an overuse injury (adjusted odds ratio, 1.49; P = 0.04). Female athletes participated in fewer total physical activity hours per week (P < 0.01), fewer free play hours per week (P < 0.01), and participated in their main sport for more months of the year than their male counterparts (P = 0.02). Female athletes were more likely to be at a higher developmental stage than male athletes (P < 0.01). RTS timeframes were increased in athletes with serious overuse injury; however, no association was found between degree of specialization and RTS time regardless of sex. Female athletes are more likely to sustain overuse injuries with more organized, year-round, training and less free play compared with their male counterparts. Female sex may be an independent risk factor of overuse injury. Future strategies to mitigate these risks may include increased free play hours and limiting year-round training through seasonal rest.

Could Motor Imagery Training Provide a Novel Load Management Solution for Athletes? Recommendations for Sport Medicine and Performance Practitioners.

Athletes often face the dual challenge of high training loads with insufficient time to recover. Equally, in any team, sports medicine and performance staff are required to progress training loads in healthy athletes and avoid prolonged reductions in training load in injured athletes. In both cases, the implementation of a well-established psychological technique known as motor imagery (MI) can be used to counteract adverse training adaptations such as excessive fatigue, reduced capacity, diminished performance, and heightened injury susceptibility. Narrative overview. Level 5. MI has been shown to enhance performance outcomes in a range of contexts including rehabilitation, skill acquisition, return-to-sport protocols, and strength and conditioning. Specific performance outcomes include reduction of strength loss and muscular atrophy, improved training engagement of injured and/or rehabilitating athletes, promotion of recovery, and development of sport-specific skills/game tactics. To achieve improvements in such outcomes, it is recommended that practitioners consider the following factors when implementing MI: individual skill level (ie, more time may be required for novices to obtain benefits), MI ability (ie, athletes with greater capacity to create vivid and controllable mental images of their performance will likely benefit more from MI training), and the perspective employed (ie, an internal perspective may be more beneficial for increasing neurophysiological activity whereas an external perspective may be better for practicing technique-focused movements). We provide practical recommendations grounded in established frameworks on how MI can be used to reduce strength loss and fear of reinjury in athletes with acute injury, improve physical qualities in rehabilitating athletes, reduce physical loads in overtrained athletes, and to develop tactical and technical skills in healthy athletes.

ANÁLISE EPIDEMIOLÓGICA DE LESÕES EM UMA EQUIPE DE ATLETISMO UNIVERSITÁRIO: UM ESTUDO DE COORTE RETROSPECTIVO

This study aims to analyze the physical profiles and sports-related injuries in a track and field team. A total of 31 participants, from both genders, from the medical college’s track and field team were included. Data on their physical characteristics were collected, and participants responded to a survey adapted from the “NCAA Injury Surveillance System.” Among them, 65% reported at least one injury, with 73.9% of the injuries categorized as severe. The injury rate was 0.27 injuries per 1000 hours of exposure. Injured athletes demonstrated a practice time twice that of their uninjured counterparts. Injuries to the quadriceps and shin accounted for 52.17% of the reported injuries. This study suggests that collegiate athletics poses a substantial risk of severe sports injuries, particularly in the lower body. A key contributing factor appears to be the duration of practice time.

Intelligent rehabilitation assistant: Application of deep learning methods in sports injury recovery

In recent years, sports injury rehabilitation has developed into a specialized field that has forced the combination of an orthopedic surgeon, sports physiotherapist, and sports physician. Determining the appropriate time for an injured athlete to resume practice or competition is regarded as sports rehabilitation. Discovering the best solutions to avoid injuries, maximize recovery, and enhance performance is crucial for sports activities. The study introduced an intelligent rehabilitation assistant (IRA) that leverages advanced deep learning (DL) methods to enhance sports injury recovery. In this study, the IRA incorporates redefined prairie dog optimized bidirectional long-short-term memory (RPDO-Bi-LSTM) to enhance accuracy, predicting sports injury recovery. The study collected data on the state of rehabilitation, physiological parameters, and general health using wearable sensors and movement patterns. The data was preprocessed using a median filter to remove noise from sensor data. Region-based segmentation using segmented images from preprocessed data. Convolutional neural networks (CNN) using extracted features from obtained data. The IRA provides personalized recovery plans and real-time feedback. The framework consists of the components, suggested models to create quality scores for motions, measurements to quantify motion performance, and scoring of performance measurement elements into numerical quality scores. The proposed method is implemented using Python software. RPDO-Bi-LSTM presentation is evaluated by various metrics, such as accuracy 94.2% recall 98.2%, precision 96.5%, and specificity 95.2%, f1 score 95.6%, he planned technique attained good performance and improved the accuracy of sports injury recovery.

Psychological Resilience and Athletic Performance among Injured Athletes in a University in Henan, China

This study assessed the extent to which student athletes employed psychological resilience during injury recovery and examined its impact on athletic performance. The findings indicate that psychological resilience was perceived by respondents to be applied to a very high extent, particularly in the areas of social support and psychological well-being. Respondents rated social support as the most essential factor, followed by psychological well-being, coping strategies, personality traits, and return-to-sport decision-making. Athletic performance was generally rated at a very high level, especially in terms of return-to-play readiness and physical recovery. Statistical analysis revealed that while psychological resilience in coping strategies, social support, and personality traits showed no significant correlation with athletic performance, psychological well-being and return-to-sport decision-making were positively correlated with improved physical recovery, functional movement, and readiness to return to sport. These results highlight the importance of psychological well-being in supporting athletic recovery, suggesting that resilience-building strategies focused on well-being can positively influence performance outcomes in injured athletes.

Single Nucleotide Polymorphisms and Tendon/Ligament Injuries in Athletes: A Systematic Review and Meta-analysis.

This systematic review and meta-analysis aimed to identify the association between genetic polymorphisms and tendon and ligament injuries in adolescent and adult athletes of multiple competition sports. The PubMed, Web of Science, EBSCO, Cochrane Library, and MEDLINE databases were searched until July 7, 2023. Eligible articles included genetic studies on tendon and ligament injuries and comparisons between injured and non-injured athletes. This review included 31 articles, comprising 1,687 injury cases and 2,227 controls, from a meta-analysis of 12 articles. We identified 144 candidate gene polymorphisms (only single nucleotide polymorphisms were identified). The meta-analyses included vascular endothelial growth factor A (VEGFA) rs699947, collagen type I alpha 1 rs1800012, collagen type V alpha 1 rs12722, and matrix metalloproteinase 3 rs679620. The VEGFA rs699947 polymorphism showed a lower risk of injuries in athletes with the C allele ([C vs. A]: OR=0.80, 95% CI: 0.65-0.98, I 2 =3.82%, p=0.03). The risk of these injuries were not affected by other polymorphisms. In conclusion, the VEGFA rs699947 polymorphism is associated with the risk of tendon and ligament injuries in athletes. This study provides insights into genetic variations that contribute to our understanding of the risk factors for such injuries in athletes.

Differences in Player Performance and Longevity After Achilles Tendon Rupture Between Professional Basketball Players in the NBA and WNBA.

Prior studies in the National Basketball Association (NBA) and Women's National Basketball Association (WNBA) reported worse player performance after Achilles tendon rupture (ATR). The purpose of this study was to compare time to return to play (RTP) and performance after ATR between NBA and WNBA athletes. It was hypothesized that there would be no relative difference between the NBA and WNBA players. Cohort study; Level of evidence, 3. ATRs in the NBA between 1987 and 2017 and WNBA between 2006 and 2017 were identified through a rigorous online search of articles. Included athletes had no prior leg injuries and had played ≥3 seasons before and after ATR. Sex, age, position, body mass index, height, years of experience, time to RTP, and player efficiency rating (PER) were recorded. Relative performance was measured by matching injured athletes to uninjured controls in the same league in a 1:2 ratio. Relative differences were compared between leagues, with adjustment for baseline features. Multiple regression analysis was employed to identify variables correlating with RTP and PER. Included were 102 professional basketball players, of whom 34 sustained ATR (21 male, 13 female). Sex/league correlated with differences in RTP (P < .001). There was a significant difference between the WNBA and NBA in PER when comparing 1 year pre- and 1 year postinjury (1.49 ± 0.25 vs 3.87 ± 0.43, respectively; mean ± SD P < .001). Compared with intraleague controls, the relative difference in PER postinjury was 0.81 ± 0.11 (WNBA) and 3.9 ± 0.89 (NBA) (P < .001). Multiple regression analysis indicated that when controlling for years of experience, player position, and age, NBA players took 126 days longer than WNBA players to RTP (P < .001) and NBA players had 9.96 times increased odds of taking >200 days to RTP compared with WNBA players (P = .006). Sex/league was a significant predictor of RTP after ATR. When compared with their respective controls, NBA players saw a greater decrease in postinjury performance than WNBA players. NBA players took longer to RTP than WNBA players. ATRs appear to more negatively affect NBA players than WNBA players.

Potential financial loss and risk factors for hamstring muscle injuries in elite male Brazilian soccer players: a season-long prospective cohort pilot study.

The aim of this pilot study was to analyze the potential financial loss and a range of potential risk factors for hamstring muscle injuries in elite Brazilian soccer. Thirty-four male players (age: 25 ± 6 years; stature: 180 ± 8 cm; body mass: 78 ± 9 kg; minutes played in matches: 2243 ± 1423 min) from an elite professional soccer club were monitored during a 12-month season. Muscle injury was identified by magnetic resonance imaging and the severity was defined according to the number of days away: minimal (1-3 days), mild (4-7 days), moderate (8-28 days), severe (>28 days). Potential financial loss due to the team's under achievements was determined. Dorsiflexion range of motion, eccentric knee flexor strength and isokinetic tests were performed during the pre-season. Association between dependent variables and the occurrence of injury was evaluated. Nine hamstring muscle injuries with moderate severity were found in 8 athletes. Recovery time was 22 days off the field on average. Potential financial loss was $-43.2 million USD and earnings on merit money was 21%. Previous injury, increased flexor deficit 60° /sec and increased flexor fatigue index 300°/sec were all associated with a greater chance of hamstring muscle injury. Ankle dorsiflexion range of motion was significantly lower in the injured group (35.6 ± 3° vs. 39.1 ± 4.9°; p = 0.017, effect size = -0.74). High financial burden was found in elite Brazilian soccer during one full season. Injured athletes had high hamstring fatigue index, knee flexor strength deficit, ankle range of motion restriction and previous hamstring muscle injury when compared to non-injured athletes. Therefore, preventive approaches in professional soccer players with previous hamstring injuries should be a priority.

Analysis of fencers’ post-injury adjustment: confirmatory factor analysis

Background and purpose Self-Adjustment is an important factor that every post-injury fencer must consider. Purpose. The aim of this research is to assess the construct validity and reliability of the self-adaptation scale, test the contribution of each aspect and indicator in reflecting the self-adaptation variable, and evaluate the suitability of the theoretical model self-adaptation with empirical data. Self-adaptation is measured through seven aspects, wich include self-regulation, frustration reduction, rational thinking, practical skills, past experiences, reality and goals, and defense mechanisms. Materials and methods The sample in this study was 227 respondents who were fencing athletes who had recovered from injuries. Respondents consisted of 132 men (58.1%) and 95 women (41.9%). The sampling technique employed was purposive sampling, based on specific criteria. To gather the data, a self-adaptation scale was utilized, and the data was subjected to analysis using Structural Equation Modeling (SEM) with second-order CFA via the Lisrel 8.71 software. Results The study’s analysis revealed that injured fencer athletes in Indonesia demonstrate a high level of self-adaptation. The aspects and indicators forming the self-adaptation variable were found to be valid and reliable based on the analysis results. In this context, the training aspect stands out as the most influential factor in reflecting self-adaptation, particularly the ability to practice within the training environment. However, emotional control emerges as the lowest aspect in reflecting self-adaptation, particularly concerning risk perception in their actions. The measurement model of the self-adaptation variable aligns well with the empirical data. To assess the model fit, primary criteria such as Chi-square, RMSEA, RMR, GFI, NFI, NNFI, CFI, IFI, and RFI were employed. Conclusions This research aims to assess the congruence between the theoretical model of self-adaptation variables and the empirical data obtained in the field.

The Relationship Between Motivational Regulations and Intention to Continue Sport in Injured Athletes

Background: Injured athletes are prone to quit sports due to several factors, including changes in motivational regulations, and their intention to continue in sport comes with special challenges. Objectives: Based on the self-determination theory (SDT), we investigated the relationship between motivational regulations and intention to continue sport in athletes with a history of injury. Methods: One hundred twenty-one injured athletes (M age = 24.68, SD = 7.74) participated in this study and filled out a multi-section questionnaire. Results: Path analysis showed that injured athletes’ introjected regulation positively predicted their intention to continue in sport (path coefficient = 0.30). Conclusions: Findings showed that introjected regulation would consider as impornat criteria in persitising sport in athletes after experiencing injury.

Prevalence, severity, and predictors of self-reported depression in ultra-distance runners: An online survey based on 265 athletes.

BackgroundLiterature suggests a high prevalence of mental health disorders among athletes practicing elite and extreme sports. One of the most commonly encountered disorders in this group of individuals is depression. ObjectiveThe aim of this study was to examine the prevalence, severity, and risk factors of symptoms of self-reported depression among ultra-distance runners. MethodsData was collected using an online survey (February to April 2023) and included 265 (age 48.35 ± 10.52 years) adult ultra-runners. The Beck Depression Inventory-II (BDI-II) was used to measure self-reported depression. Additional variables comprised basic sociodemographic information and information regarding training, ultramarathon experience, and previous injury. Descriptive and interferential statistics were performed using JASP Version 0.16.4. ResultsWe found that 21.9 % (n = 58) of ultra-runners suffered from self-reported depression (i.e., BDI-II score ≥ 14) with an average BDI-II score of 22.7 ± 7.1 (moderately severe symptoms). Female ultra-runners had a higher prevalence (30.8 %) of self-reported depression than males (16.2 %, p = .001). Logistic regression revealed that ultra-runners without previous sports injury (p = .01) and those of increasing age (p = .003) had a significantly lower risk of self-reported depression. Similarly, linear regression showed the absence of injury (p < .001) and increasing age (p = .02) resulted in significantly lower BDI-II scores. Training volume in distance and hours per week as well as ultra-running experience did not show any significant association. ConclusionsAffecting more than one-fifth of our collective, depressive symptoms appear to be highly prevalent among ultra-runners. Our findings underline the importance of screening for clinical depression, especially among injured athletes. However, the previously assumed peculiarities of the sport in the area of high training volume do not appear to be a significant factor.

Sport-related concussions in wrestling: does mechanism of injury affect recovery?

Sport-related concussions (SRC) represent a significant concern for athletes. While popular contact sports such as football and soccer have been the focus of much SRC research, wrestling has received comparatively little attention. The current study aimed to: 1) describe the mechanisms of injury leading to SRC in wrestling; and 2) compare recovery outcomes based on mechanism of injury. A retrospective, cohort study of wrestlers aged 12-18 who sustained a concussion between 11/2017-04/2022 was performed. Contact mechanism was defined as what initiated contact with the athlete's head/body. Player mechanism was defined as the activity the injured athlete was performing when the concussion occurred. Recovery outcomes were compared using Mann-Whitney-U Tests and multivariable regression analysis. Seventy-three (age=15.8±1.4 years; boys=73 [100.0%]) wrestlers were included. SRCs occurred more often in competition than in practice (66.2% vs. 33.8%, respectively). Head-to-ground/wall (56.2%) and takedown (58.9%) were the most common contact and player mechanisms, respectively. Bivariate analysis showed that head-to-head/body SRCs had longer time to symptom resolution compared to head-to-ground/wall SRCs (23.0 [14.8-46.5] vs. 14.0 [6.0-30.0] days; U=149.00, P=0.029), though the difference did not persist in multivariable analysis. For player mechanism, non-takedowns SRCs had longer time to symptom resolution than takedown SRCs (15.0 [6.0-24.0] vs. 28.5 [13.0-49.3]; U=166.5, P=0.019), but the difference also did not persist in multivariable analysis. Bivariate analysis revealed no significant difference in RTL between takedown and non-takedown SRCs (3.0 [2.0-6.0] vs. 4.0 [1.5-7.0]; U=484.50, P=0.708); however, in multivariable analysis, takedown SRCs were associated with longer RTL (β=0.23, 95% CI: 0.02, 9.27; P=0.049). The current study found that SRCs occurred more commonly during competitions, and head-to-ground/wall and takedown were the most common contact and player mechanism, respectively. SRCs that occurred during takedowns were associated with longer RTL.

Muscle Healing in Sports Injuries: MRI Findings and Proposed Classification Based on a Single Institutional Experience and Clinical Observation.

MRI plays a crucial role in assessment of patients with muscle injuries. The healing process of these injuries has been studied in depth from the pathophysiologic and histologic points of view and divided into destruction, repair, and remodeling phases, but the MRI findings of these phases have not been fully described, to our knowledge. On the basis of results from 310 MRI studies, including both basal and follow-up studies, in 128 athletes with muscle tears including their clinical evolution, the authors review MRI findings in muscle healing and propose a practical imaging classification based on morphology and signal intensity that correlates with histologic changes. The proposed phases, which can overlap, are destruction (phase 1), showing myoconnective tissue discontinuity and featherlike edema; repair (phase 2), showing filling in of the connective tissue gaps by a hypertrophic immature scar; and remodeling (phase 3), showing scar maturation and regression of the edema. A final healed stage can be identified with MRI, which is characterized by persistence of a slight fusiform thickening of the connective tissue. This information can be obtained from a truncated MRI protocol with three acquisitions, preferably performed with a 3-T magnet. During MRI follow-up of muscle injuries, other important features to be assessed are changes in muscle edema and specific warning signs, such as persistent intermuscular edema, new connective tear, and scar rupture. An understanding of the MRI appearance of normal and abnormal muscle healing and warning signs, along with cooperation with a multidisciplinary team, enable optimization of return to play for the injured athlete. ©RSNA, 2024 See the invited commentary by Flores in this issue.

Examining the Relationship and the Gender Differences between Re-Injury Worry, Confidence, and Attention after a Sport Musculoskeletal Injury.

Introduction: A sport injury is an unfortunate event that can significantly impact the injured athletes' psychology. There have been no studies examining gender differences in the psychological state after a sport-related musculoskeletal injury. Τhe aims of the current study were to (a) investigate the relationship between re-injury worry levels, confidence, and attention in the injured athletes who followed a rehabilitation program in order to return to competition, and (b) compare differences in these psychological factors between male and female athletes. Methods: A cross-sectional research design was used. A total of 60 athletes (30 men and 30 women) volunteered to participate, aged 25.50 ± 5.25 years old, all of whom had experienced a musculoskeletal injury within the past year. Three validated questionnaires, i.e., the Causes of Re-Injury Worry Questionnaire, the Sport Confidence Questionnaire of Rehabilitated Athletes Returning to Competition, and the Attention Questionnaire of Rehabilitated Athletes Returning to Competition, were completed by the participants on their first competitive game after their rehabilitation program. Results: All of the athletes experienced average levels of re-injury worry due to their opponents' ability and distraction attention, and high levels of confidence and functional attention. Many factors from the questionnaires were correlated with each other. Men experienced lower levels of re-injury worry due to rehabilitation compared to the women athletes (U = 329.00, p < 0.05), and women exhibited higher "Re-injury Worry due to Opponent's Ability" compared to the men athletes (U = 292.00, p < 0.01). Conclusions: A strong relationship was found between re-injury worry, confidence, and attention, with few gender differences. Since there is no previous research examining re-injury worry, confidence, and attention between men and women, future research with larger and more homogeneous samples is needed to confirm the present results.

Examining the applied value of narratives for professional practice: An exploration of sports injury narratives in action

Heeding calls to expand the resources and approaches to psychologically support injured athletes, this study explored the applied value of socio-cultural sports injury narratives for athletes, coaches, and practitioners. Informed by narrative inquiry and pedagogy, six evidence based sports injury narratives were shared and discussed with 69 elite participants (i.e., athletes, coaches, and practitioners) across 11 focus group interviews. A reflexive thematic analysis identified five themes: (1) Forewarned is Forearmed, (2) Building Blocks to Constructing Meaning(s), (3) Fostering Interpersonal Connections, (4) A Common Language, and (5) Promoting Communal Responsibility. Overall, these themes advance empirical understandings of how narratives can inform professional practice by supporting injured athletes across personal (e.g., meaning making), social (e.g., enhancing interpersonal relationships), and cultural (e.g., promoting communal responsibility) levels.

Sexual relations and rehabilitation of injured athletes: A narrative review

Sexual health is a critical aspect of overall well-being, encompassing physical, mental, and emotional dimensions. For athletes, maintaining sexual health during injury rehabilitation can be particularly challenging. Injuries disrupt training, competition schedules, intimate relationships, and sexual health, impacting the psychological state, the recovery process, and overall quality of life. Athletes are highly attuned to their bodies, and any injury impeding physical performance can lead to significant stress and anxiety, affecting sexual health. Conversely, sexual activity and intimate relationships can influence the rehabilitation process both positively and negatively. Understanding this interplay is essential for holistic rehabilitation programs addressing all aspects of an athlete's well-being. Physiologically, sexual activity involves physical exertion, hormonal changes, and alterations in blood flow, impacting healing. Hormones released during sexual activity, such as oxytocin, endorphins, and dopamine, can provide pain relief and enhance mood, benefiting recovery. Testosterone, crucial for muscle repair and growth, is also influenced by sexual activity. However, physical exertion during sexual activity can strain injured areas, potentially exacerbating injuries if not managed carefully. Psychologically, injuries can impact an athlete’s self-esteem, body image, and mental health. Positive sexual relations offer emotional support, enhancing psychological resilience during recovery. Intimate relationships provide normalcy and help athletes maintain a positive body image, counteracting the negative psychological effects of injuries. Social support from intimate partners is vital for rehabilitation. Open communication about physical limitations and sexual needs can strengthen relationships and create a supportive environment for recovery. Comprehensive rehabilitation programs should address sexual health, providing education on safe practices, offering counseling services, and encouraging open dialogue between athletes, partners, and healthcare providers. Rehabilitation programs can enhance recovery and improve outcomes for injured athletes by integrating physiological, psychological, and social aspects.

Comparing Hip Muscle Imbalances of Professional Football Players and Ordinary People

Background and Aims Muscle strength is one of the main factors in athletic success, injury prevention, and optimal rehabilitation for injured athletes. Also, the symmetry of the muscle strength ratio is fundamental to maintaining force-producing torques. Therefore, the present study aimed to evaluate and compare hip muscle imbalances in football athletes and normal individuals. Methods The current research is causal-comparative. Fifteen football players and 15 normal healthy individuals volunteered for the study. Then, their flexor, extensor, abductor, adductor and internal and external rotator strengths were assessed using a hand-held strength test. Results The present study showed a significant difference in the ratios of extensor to flexor muscle strength, adductor to abductor, and internal to external rotator strength between the dominant and non-dominant thigh (P&lt;0.05). In addition, significant differences were observed in thigh muscle strength between football players and ordinary people (P&lt;0.05). Conclusion According to the results of the present study, the nature of football in greater use of the dominant leg can lead to an imbalance in the strength ratio of the agonist and antagonist muscles in the hip joint between the dominant and non-dominant limbs. Therefore, it is recommended that corrective exercises and movements be used for the antagonist part that caused an imbalance in muscle strength to reduce the possibility of injury in the future.

Association of Premorbid Anxiety and Depression Symptoms in Concussion Recovery in Collegiate Student-Athletes.

Mental health disorders are linked to prolonged concussion symptoms. However, the association of premorbid anxiety/depression symptoms with postconcussion return-to-play timelines and total symptom burden is unclear. To examine the association of self-reported premorbid anxiety/depression symptoms in collegiate student-athletes with (1) recovery times until asymptomatic, (2) return-to-play, and (3) postconcussion symptom burden. Athletes in the Concussion Assessment, Research and Education Consortium completed baseline concussion assessments (Sport Concussion Assessment Tool [SCAT3] and Brief Symptom Inventory-18 [BSI-18]). Athletes were tested postinjury at <6 hours, 24 to 48 hours, time of asymptomatic and start of return-to-play protocol, unrestricted return-to-play, and 6 months after injury. Injured athletes were categorized into 4 groups based on BSI-18 scores: (1) B-ANX, elevated anxiety symptoms only; (2) B-DEP, elevated depression symptoms only; (3) B-ANX&DEP, elevated anxiety and depression symptoms; and (4) B-NEITHER, no elevated anxiety or depression symptoms. Relationship between age, sex, BSI-18 group, SCAT3 total symptom and severity scores, and time to asymptomatic status and return-to-play was assessed with Pearson's chi-squared test and robust analysis of variance. Level 3. Among 1329 athletes with 1352 concussions, no respondents had a self-reported premorbid diagnosis of anxiety/depression. There was no difference in time until asymptomatic or time until return-to-play between BSI-18 groups (P = 0.15 and P = 0.11, respectively). B-ANX, B-DEP, and B-ANX&DEP groups did not have higher total symptom or severity scores postinjury compared with the B-NEITHER group. Baseline anxiety/depression symptoms in collegiate student-athletes without a mental health diagnosis are not associated with longer recovery times until asymptomatic, longer time to return-to-play, or higher postconcussion total symptom and severity scores compared with athletes without baseline symptoms. Anxiety and depression symptoms without a clear mental health diagnosis should be considered differently from other comorbidities when discussing prolonged recovery in collegiate student-athletes.

Adolescent Athletes with Stronger Athletic Identity Perceptions Have Weaker Fear Avoidance Perceptions During Musculoskeletal Injury Rehabilitation Return to Sports Preparation.

Adolescent athletes who sustain a musculoskeletal sports injury are at high re-injury risk. This prospective study evaluated athletic identity perception and fear avoidance perception relationships during the return to sport preparation phase of musculoskeletal injury rehabilitation. From 140 consecutive physical therapy outpatients, 50 (26 females, 24 males) adolescent athletes (mean age 16.8, range 14 to 22 y) completed the 7-item Athletic Identity Measurement Scale (AIMS), the 10-item Athletic Fear Avoidance Questionnaire (AFAQ), and the AFAQ with 2 additional movement-related fear and pain questions (AFAQ+). Correlational analysis was performed of overall AIMS and AIMS subscale scores (social identity, exclusivity, negative affectivity), with AFAQ and AFAQ+ scores ( P ≤0.05). Adolescent athletes were receiving treatment for musculoskeletal injuries sustained during soccer (n=10), lacrosse (n=7), baseball (n=6), basketball (n=5), volleyball (n=5), track or cross country (n=4), American football (n=4), field hockey or ice hockey (n=3), softball (n=2), tennis (n=2), and gymnastics (n=2). Lower extremity conditions included anterior cruciate ligament reconstruction (n=23) or other lower extremity conditions (n=17). Upper extremity conditions included shoulder dislocation or labral repair (n=6), elbow sprain or fracture (n=3), and clavicle fracture (n=1). The AIMS score displayed moderate inverse relationships with AFAQ ( r =-0.40, P =0.008) and AFAQ+ ( r =-0.41, P <0.004) scores. The "social identity" AIMS subscale score displayed a moderate inverse relationship with AFAQ ( r =- 0.48, P <0.001) and AFAQ+ ( r =-0.46, P =0.001) scores. The "exclusivity" AIMS subscale score displayed moderate inverse relationships with AFAQ ( r =-0.40, P =0.005) and AFAQ+ ( r =-0.46, P =0.001) scores. The "negative affectivity" subscale did not display significant relationships with AFAQ or AFAQ+ scores. Subject age displayed moderate inverse relationships with the AIMS "social identity" ( r =-0.56, P <0.001) and "exclusivity" ( r =-0.42, P =0.004) subscale scores and weak direct relationships with AFAQ (r=0.30, P =0.04) and AFAQ+ (r=0.32, P =0.02) scores. Adolescent athletes with stronger athletic identity perceptions during the return to the sports preparation phase of musculoskeletal injury rehabilitation had weaker fear avoidance perceptions. As age increased from early to late adolescence, athletic identity perceptions became weaker, and fear avoidance perceptions became stronger. To decrease re-injury rates, early identification and surveillance of injured adolescent athletes with stronger, more exclusive athletic identity perceptions and weaker fear avoidance perceptions may influence rehabilitation progression and return to play decisions. Level-II, prospective cohort, correlational study.