Injured Players Research Articles

The Acute: Chronic Workload Ratio Is Associated with Injury in Junior Tennis Players.

Session RPE (sRPE) is used to track internal training/competition load in athletes using a metric known as the acute to chronic workload ratio (ACWR). Research that reported on team sports has determined that if the acute load is higher than the chronic load, athletes are likely to sustain injury. No studies, however, have attempted to investigate internal load and injury in a tennis population despite the rigorous training loads. Therefore, the purpose of this study was to investigate if sRPE ACWR is associated with injury in junior tennis players over a 7-month time period. Forty-two junior tennis players were recruited to participate, 26 were included in the final analysis. Players provided a rating of RPE as an estimate of training intensity every day after training/match sessions. sRPE, a measure of internal and external training load was calculated by multiplying the training/match sRPE by the session duration in minutes. Players self-reported all injuries. The ACWR was the primary independent variable. Acute load was determined as the total sRPE for 1 wk, whereas a 4-wk rolling average sRPE represented chronic load. Seventeen players sustained injuries. The model indicated that ACWR from the previous week (P < 0.001) and previous injury history (P = 0.003) were significant predictors of injury the following week. In the week preceding injury, the average ACWR was 1.57 (SD, 0.90). Injured players had on average 1.5 times more training load in the past week compared with the previous 4 wk. A majority of players who went on to sustain an injury were not prepared for the load endured. These results were similar to previous studies investigating ACWR where an acute increase in load was associated with increased injury risk.

Cost analysis of Tommy John surgery for Major League Baseball teams

The economic loss following ulnar collateral ligament reconstruction (UCLR) in Major League Baseball (MLB) pitchers has not been evaluated. The purpose of this study is to quantify the financial impact of UCLR on MLB teams. We hypothesize that MLB teams incur significant losses annually as a result of salaries paid to injured players following reconstruction. Public records were accessed to identify MLB pitchers from January 1, 2004, to December 31, 2014, who had undergone UCLR. Contract terms and time away from competition were used to approximate economic loss. Successful return was considered when a pitcher returned to play in at least 1 Minor League Baseball (MiLB) or MLB game. One hundred ninety-four MLB pitchers underwent UCLR from 2004 to 2014, missing on average 180.2 days of the MLB regular season. Cost of recovery (COR) amounted to $395 million, averaging $1.9 million per player. Starting pitchers accounted for the largest total COR at $239.6 million, whereas closers had the largest economic loss per player ($3.9 million/player). Only 77% of pitchers returned to MLB play. UCLR has a substantial economic impact on MLB teams. Starting pitchers represented a majority of team cost, but closers represented higher costs per pitcher.

Fear Avoidance Following Musculoskeletal Injury in Male Adolescent Gaelic Footballers.

Participating in Gaelic football provides a wealth of benefits, but a risk of musculoskeletal injury also exists. Injury is associated with physical consequences, including pain, discomfort, loss of function, time absent from school/sport, and considerable medical expenses, along with placing undue pressure on emergency services and hospital staff. Concurrent psychological consequences, such as fear avoidance, can also occur, causing psychological distress. There is a current dearth of available research examining the psychology of injury in male adolescent Gaelic footballers. To examine fear avoidance postinjury in male adolescent Gaelic footballers, the effect of pain, time loss, injury severity, and previous injury on the extent of fear avoidance, and the usefulness of a modified Athlete Fear Avoidance Questionnaire (AFAQ) as a screening tool for predicting injury. Prospective cohort study. Recreational clubs. A total of 97 male adolescent club Gaelic footballers (13.4 [1.1]y). Musculoskeletal injuries sustained during participation in Gaelic football, defined as any injury sustained during training or competition causing restricted performance or time lost from play, were assessed and recorded weekly by a certified athletic and rehabilitation therapist. Injuries requiring time loss from participation were classed as time-loss injuries. Injury characteristics that included type, nature, location, severity, and pain were recorded. Injured players completed the AFAQ, a measure of injury-related fear avoidance following injury assessment (AFAQ1). With time-loss injuries, the AFAQ was completed again (AFAQ2) prior to return to play. Modified AFAQ was completed at baseline. Twenty-two injuries were recorded during the season with fear avoidance evident postinjury that significantly decreased before returning to play. Fear avoidance postinjury was higher in those with greater pain but time loss, injury severity, and previous injury did not significantly affect the extent of fear avoidance. Baseline fear avoidance did not predict injury. Psychological rehabilitation is recommended for managing postinjury psychological distress in male adolescent Gaelic footballers.

Outcome of Turf Toe Injuries in NFL Players

Category:Midfoot/Forefoot, Sports, TraumaIntroduction/Purpose:“Turf toe” is an injury to the great toe’s metatarsophalangeal joint capsule. The increase in artificial turf in the 1970’s was thought to have contributed to increased incidence of this injury in players of the National Football League (NFL). To our knowledge, there are no publications that have critically analyzed the impact of this injury on player performance. The goal of this study was to quantify the impact a turf toe injury has on NFL players, specifically in time to return to competition and their performance post-injury compared to pre-injury.Methods:This is a retrospective review of NFL players who sustained a turf toe injury between the 2011-2014 seasons. Online resources including NFL injury reports, player registries, game summary sites, NFL news articles, fantasy football sites and NFL blogs were used to identify players with this injury. Additionally, an injury database from theFantasyDoctors.com was used to further identify injured players. Recorded variables included player age, position, games missed, and type of playing surface on which the injury occurred. The performance of each offensive skill player was analyzed separately by calculating their power rating (total yards divided by 10 plus touchdowns multiplied by 6) for the 3 seasons prior to injury, the injury season (index season) and the 2 seasons immediately following. Injured offensive skill players were then compared to a control group consisting of all running backs and wide receivers without a turf toe injury who competed in the 2012 season.Results:71 turf toe injuries in 67 players were identified. Players’ average age was 26.4 years old. Injury by playing surface: 29 grass, 29 turf and 13 unidentified. The average time missed was 3.2 games. 9 players were placed on injured reserve and 8 required surgery. 16 offensive skill players were at or above 200 total points during the 6 observed seasons. The average power rating prior to injury was 105.7 per season (7.3 per game), 87.3 (6.9 per game) during the injury season and 115.5 (8.1 per game) for post-injury seasons. The power rating per season (p=0.53) and per game (p=0.4) was not significantly different after a turf toe injury compared to before. Power ratings were not significantly different from uninjured control players (p=0.24, p=0.27).Conclusion:”Turf toe” is a term used for an injury that has a wide spectrum of consequence depending on injury severity. A mild sprain of the great toe should respond well to conservative treatment with rest, taping and possibly an orthotic while a complete tear of the metatarsophalangeal joint capsule typically is season-ending and requires surgical repair. We were unable to show a statistically significant difference in NFL players’ performances after turf toe injury based on power ratings.

Professional Footballers’ Association Counselors’ Perceptions of the Role Long-Term Injury Plays in Mental Health Issues Presented by Current and Former Players

The purpose of this study was to investigate counselors’ professional understanding of the long-term psychological consequences of injury in UK football players. Semi-structured interviews were conducted with 11 counselors who were registered to work for the Professional Footballers’ Association (PFA). The interviews examined the counselors’ perception of the relationship between long-term injury and presenting mental health issues, the antecedents to those mental health issues, and recommendations for psychological intervention following injury. The critical finding was the mental health problems regularly presented to PFA counselors were often the psychological and behavioral consequences of long-term injury. Counselors recommended that early and sustained psychological intervention with long-term injured players would act as a preventative measure against future mental health issues.

Does Overexertion Correlate With Increased Injury? The Relationship Between Player Workload and Soft Tissue Injury in Professional American Football Players Using Wearable Technology.

The relationship of training load to injury using wearable technology has not been investigated in professional American football players. The primary objective of this study was to determine the correlation between player workload and soft tissue injury over the course of a football season utilizing wearable global positioning system (GPS) technology. Increased training load is associated with a higher incidence of soft tissue injuries. Case-control study. Level 3. Player workloads were assessed during preseason and regular-season practice sessions using GPS tracking and triaxial accelerometry from 2014 to 2016. Soft tissue injuries were recorded during each season. Player workload during the week of injury (acute) and average weekly workload during the 4 weeks (chronic) prior to injury were determined for each injury and in uninjured position-matched controls during the same week. A matched-pairs t test was used to determine differences in player workload. Subgroup analysis was also conducted to determine whether observed effects were confounded by training period and type of injury. In total, 136 lower extremity injuries were recorded. Of the recorded injuries, 101 injuries with complete GPS and clinical data were included in the analysis. Injuries were associated with greater increases in workload during the week of injury over the prior month when compared with uninjured controls. Injured players saw a 111% (95% CI, 66%-156%) increase in workload whereas uninjured players saw a 73% (95% CI, 34%-112%) increase in workload during the week of injury (P = 0.032). Individuals who had an acute to chronic workload ratio higher than 1.6 were 1.5 times more likely to sustain an injury relative to time- and position-matched controls (64.6% vs 43.1%; P = 0.004). Soft tissue injuries in professional football players were associated with sudden increases in training load over the course of a month. This effect seems to be especially pronounced during the preseason when player workloads are generally higher. These results suggest that a gradual increase of training intensity is a potential method to reduce the risk of soft tissue injury. Preseason versus regular-season specific training programs monitored with wearable technology may assist team athletic training and medical staff in developing programs to optimize player performance.

Beach tennis injuries: a cross-sectional survey of 206 elite and recreational players

ABSTRACT Objectives Although a million people regularly play beach tennis (BT) through the world there is no published information on BT injuries. The aim of this study was to describe the epidemiology of BT injuries, and to identify differences between injured and non-injured players. Methods This was a retrospective cross-sectional epidemiology study of 206 BT players from Réunion Island describing the injuries occurring in BT. A questionnaire was developed to capture the type and chronicity of the injuries they had suffered over the prior three years. Comparisons were made between elite, regional and recreational players. Results There were 178 injuries in 92 players (44.7%), which was an incidence of 1.81 injuries per 1000 hours of play. There were 77 acute injuries (23.8% of players, incidence of 0.78 injuries/1000 hrs.) and 101 chronic injuries (30.6% of players, incidence of 1.03 injuries/1000 hrs.). The shoulder was the most frequently injured area. The main upper limb injuries were chronic tendinopathy while most acute injuries occurred in the lower limbs. The incidence of lateral epicondylitis at the elbow was 0.36 per 1000 hours of play, or a prevalence of 4.2%. The incidence of injuries in elite players was less than that in non-ranked players (1.71 vs 2.04 injuries/1000 hours play). Recreational players more often had chronic injuries (p < 0.001). Conclusion Information about musculoskeletal injuries is invaluable for healthcare professionals involved in the care of athletes. Such knowledge can be used to guide the medical surveillance of athletes and to help develop injury prevention strategies.

On-field Rehabilitation Part 2: A 5-Stage Program for the Soccer Player Focused on Linear Movements, Multidirectional Movements, Soccer-Specific Skills, Soccer-Specific Movements, and Modified Practice.

This paper is part 2 of a 2-part series aimed at discussing the key elements of on-field rehabilitation training. In part 1, we described 4 pillars underpinning high-quality on-field rehabilitation: (1) restoring movement quality, (2) physical conditioning, (3) restoring sport-specific skills, and (4) progressively developing chronic training load. In part 2, we describe how the pillars contribute to a 5-stage on-field rehabilitation program to help injured players transition to team practice and match play. We use the example of a soccer player with ambitions to return to sport after anterior cruciate ligament reconstruction. The program moves through 5 field-based training stages: (1) linear movement, (2) multidirectional movement, (3) soccer-specific technical skills, (4) soccer-specific movement, and (5) practice simulation. The staged program is research based and facilitates communication, planning, control, and safety in return to sport following long-term injury. J Orthop Sports Phys Ther 2019;49(8):570-575. doi:10.2519/jospt.2019.8952.

Relationship between vertical stiffness and soft-tissue injuries in professional Australian football

ABSTRACT Soft-tissue injuries are common in Australian football. Recently, literature has identified non-modifiable and modifiable risk factors, including vertical stiffness (Kvert). However, limitations regarding measurement frequency and duration exist; thus, further information is required about the role of Kvert as a modifiable risk factor for injury. This study examined the seasonal variation in Kvert and its relationship to soft-tissue injuries in professional Australian football. The mean Kvert and bilateral asymmetry were assessed and compared between injured and non-injured players. For the seasonal analysis, 56 players were tested across two seasons with no variation in bilateral asymmetry evident (p= 0.33). While there were generally no changes in Kvert, the value from the end of the second pre-season revealed 5% lower values than the mean of two seasons (p= 0.02). Considering the injury analysis, 21 lower-body soft-tissue injuries were recorded from 18 participants. No differences were recorded for mean Kvert between the injured and non-injured groups (p= 0.16–0.76). When assessing Kvert asymmetry, the injured group displayed a 4.5% higher value than the non-injured group at the end of the pre-season test (p= 0.03) but not at other time-points (p= 0.16–0.99). Higher Kvert bilateral asymmetry measures after the pre-season appear to be related to lower-body soft-tissue injury in professional Australian footballers. Medical and conditioning staff should consider this measure when trying to mitigate the onset of injury or identify at-risk players.

Outcomes of Concussion Injuries to Running Backs and Wide Receivers in the National Football League

Objectives:Concussion injuries are common in professional football players, however the impact on player careers remains unclear. The purpose of this study was to quantify the effect of concussions on professional football player performance.Methods:Concussion data from the National Football League was collected for a period of four seasons (2012-2015) for running backs and wide receivers. Demographic variables (age, experience, position, time to return, yearly total yards and touchdowns) were recorded. Power ratings (total yards divided by 10 plus touchdowns multiplied by 6) were calculated for the injury season as well as for the 3 seasons before and after the injury. A control group consisted of running backs and wide receivers without an identified concussion injury who competed in the 2014 season.Results:One hundred and eighteen running backs and wide receivers sustained a concussion over a 4-season period, 25 players (21%) never returned to a National Football League game. Players were able to return in an average of 18.5 ± 8.2 days, missing 1.6 ± 1.0 games. For 18 players with a minimum total power rating of (sum of 4 seasons) of 200 points, power rating per game decreased 43.4 ± 0.4 points from three seasons prior to the concussion to three years postinjury. This change in performance was not statistically significant (P=0.422) when compared with the change for the 343 control players.Conclusion:Over one fifth of National Football League running backs and wide receivers who sustain a concussion never return to play in a game. On return to competition, player performance of injured players reduced from before injury, however there was no difference compared to controls.

A review of the psychological support mechanisms available for long-term injured footballers in the UK throughout their rehabilitation

ABSTRACTObjectives: Athletes regularly suffer psychologically as a consequence of long-term injury. However, to date, there has been no investigation into the psychological protocols implemented to support long-term injured professional footballers. Methods: An online questionnaire was developed to identify the current rehabilitation practices in English football. Seventy-five heads of medical departments responded to the survey from first teams and academies across the English Leagues. Results: Medical staff recognised that there were clinical mental health problems, namely anxiety and depression affecting long-term injured players. It was acknowledged that there was a need for psychological support for long-term injured players. However, findings revealed most clubs had limited access to psychological practitioners and physiotherapy staff were almost entirely responsible for providing psychological support throughout rehabilitation. Conclusion: Clubs responded overwhelmingly that they wanted to be able to access psychological support for long-term injured players.

PMS6 ANALYSIS OF A JUMP-LANDING TASK BETWEEN INJURED AND UNINJURED ADOLESCENT BASKETBALL PLAYERS

The purpose of this study was to compare hip and knee joint flexion angles during two- leg jump-landing task, between injured and uninjured adolescent basketball players. Eighteen basketball players, aged 18–25 participated in the study: nine previously knee-injured and nine fit players. The examination was carried out in the Laboratory of Performance Testing and Sports Physiotherapy at the Faculty of Health Sciences, University of Pécs in autumn, 2017. We used a three-dimensional BTS Smart DX 400 motion analyser system to notice the alteration of hip and knee joint flexion angles during landing after a two-leg take-off. We put sensor markers on the player’s limbs to observe the changing of joint flexion angles. We supposed there would not be remarkable difference between injured and uninjured limbs, case and control group flexion angles. There was no demonstrable significant difference between injured (102.1°) and uninjured knee joint (105.9°) (p=0.118); injured side (124.9°) and uninjured side hip joint (127.4°) (p=0.575). Furthermore, there was no remarkable distinction among case (hip: 126.2°, knee: 104°) and control group (hip: 124.5°, knee: 98.1°) joint flexion angles during the jump phase (hip: p=0.685, knee: p=0.063). We found significant difference between injured (108.7°) and uninjured knee (116.9°) joint flexion angle (p=0.0001), plus injured side (131.1°) and uninjured side of hip joint (124.1°) flexion angle. (p=0.003), during the landing phase (hip: p=0.739, knee: p=0.168). At the same time there was no significant difference between case (hip: 127.7°, knee:112.8°) and control group (hip: 128.9°, knee: 107.6°) flexion angles at landing to the ground. As a result of corresponding physiotherapy after a knee injury, there is no substantive difference between the case and the control group knee and hip flexion angles. Accordingly the injured basketball players can do a jump-landing task similarly to fit athletes.

LO47: Concussions in minor hockey players before and after implementation of a policy to limit body checking

Introduction: Concussions are one of the most common sports-related injuries presenting to emergency departments (EDs), and are particularly frequent among players of contact sports such as ice hockey (hockey). Studies of youth hockey players report increased concussion incidence when participating in levels of hockey that allow body-checking. In 2016, an Edmonton minor hockey organization implemented a policy to remove body checking from play for non-elite levels of Bantam (13-14 years) and Midget (15-17 years). This study aimed to evaluate the effect of this policy on occurrence of concussions in male minor hockey players. Methods: Alberta Health Services Sport and Recreation codes (SR = 54) were used to identify Bantam and Midget hockey players presenting to Edmonton Zone emergency departments (ED) during the 2013/2014 to 2016/2017 hockey seasons from the National Ambulatory Care Record System. Injured hockey players with a concussion were identified using International Classification of Diseases 10-CA diagnosis code S06.0. Odds ratios (OR) of concussions among total hockey injuries before (2013-2016) and after (2016-2017) the policy are reported with 95% confidence intervals (CIs). Differences were assessed using Pearson's χ2 test. Results: During the study period, 1978 minor hockey players presented to an Edmonton Zone ED with a hockey-related injury, including 272 players with a concussion (14%). Most of the injuries occurred to Midget players (n = 1274). The proportions of concussion were similar before and after the policy change for players of all ages (OR = 0.78; 95% CI: 0.37 to 0.92) and for injured Bantam players (OR = 0.97; 95% CI: 0.59 to 1.55); however, there was a significant reduction in concussions as a proportion of all injuries for Midget players before and after the policy change (OR = 0.61; 95% CI: 0.36 to 1.00). Conclusion: In the initial year of implementation, the policy to limit body-checking to elite levels of play had mixed results. While the policy change did not result in a significant reduction in concussions overall, or for Bantam players, Midget players did experience a significant reduction in concussions after the policy change. The reasons behind these age-related differences require further investigation. Moreover, further evaluation of the policy using additional years of post-policy data, as well as hockey registration numbers, is needed to evaluate the sustainability of its effect.

A season long investigation into the effects of injury, match selection and training load on mental wellbeing in professional under 23 soccer players: A team case study

This study examined the influence of injury, match selection and training load on mental wellbeing (MW) in a squad of professional soccer players. Using a longitudinal design, twenty-five male soccer players (age, 20 ± 1 years, height, 1.80 ± 5.79 m, body mass 76.33 ± 7.52 kg) from the under 23 squad playing in the Premier League 2 division in the UK completed the Warwick–Edinburgh Mental Well-being Scale (WEMWBS) each week of the 2017/2018 season (37 weeks in total). Injury and non-selection for the match squad were the only significant predictors of MW (P < 0.05). Injury had the biggest influence on MW that was lower when injured vs. not injured (43.6 ± 5.0 vs. 49.9 ± 3.5, respectively, P = 0.001, ES = 1.48), accounting for 40% of the variation in MW. This increased to 50% when not being selected to play games was also considered. Weekly training loads measured by GPS (total distance, sprint distance and total duration) and individual player win rate did not influence MW (P > 0.05). These findings highlight the importance of monitoring MW in professional soccer players and suggest that injured players and those rarely selected for the match squad should be educated on the strategies available for managing their mental health and wellbeing.

Spikes in acute:chronic workload ratio (ACWR) associated with a 5–7 times greater injury rate in English Premier League football players: a comprehensive 3-year study

ObjectivesWe examined the relation between global positioning system (GPS)-derived workloads and injury in English Premier League football players (n=33) over three seasons.MethodsWorkload and injury data were collected over three consecutive...

Injury pattern among fencing players in India

BACKGROUND: Fencing is an Olympic game, played in three disciplines of the Epee, the Foil, and the Saber. Despite the long history and international scope, very few epidemiological studies on injuries in modern competitive fencing are available. A study on the injury patterns of Indian fencing players is not yet reported. OBJECTIVE: The objective of this study is to explore the injury pattern among fencing players and to examine the association of occurrence of injury with certain risk factors. METHODS: The sample comprised 113 fencers (79 males and 34 females). Scheduled questionnaire was the tool of data collection. RESULTS: Point prevalence and 2 years prevalence of injuries were 12.38% and 13.27%, respectively. Acute injuries more common (78.5%) than the injuries of gradual onset (21.42%). Lower limb (100%) was the most common site of injuries. The ankle was the most frequently injured body part (64.28%). The event of the Epee had the highest proportion of injuries (15.69%) followed by the Foil (10.36%) and Saber (9.09%). Injured players were found to have spent significantly more time in footwork; although; the age, level of play, sex, and type of events, previous injuries, and training habits were not found significantly associated with the occurrence of injuries. Conclusion: It is concluded that Indian fencing players presented with a less prevalence of injury, out of which majority of injuries were in the lower limb.

Investigating the Clinical Effect of Kinesio Tape on Muscle Performance in Healthy Young Soccer Players – A Prospective Cohort Study

OBJECTIVE:Kinesio tape (KT) is a visible adhesive restorative tape that has typically been utilized for injury prevention, recovery, and even performance improvement, but limited studies have assessed the effect of KT on muscle performance. The purpose of this study was to investigate the clinical impact of KT on muscle performance in healthy young soccer players.METHODS:Between 25 March and 21 April 2017, sixteen healthy soccer players with a mean age of 20±2.17 were enrolled in this prospective cohort study. All participants were selected from the college football team of Prince Sattam Bin Abdulaziz University. The muscle performance of the players was evaluated with an isokinetic dynamometer for the following three conditions: without tape, immediately after applying KT, and 8 hrs post-KT application while the tape remained on the same site.RESULTS:The differences in peak torque and total work among the three conditions were nonsignificant (p>0.05). Additionally, applying KT to the thigh muscles did not decrease or increase the performance of non injured healthy soccer players (p>0.05).CONCLUSION:KT does not lead to beneficial outcomes of muscle performance in healthy young soccer players.

Injury prevalence and risk factors in a Greek team’s professional football (soccer) players: a three consecutive seasons survey

ABSTRACTThis study investigated the prevalence and risk factors of injuries on a cohort of 123 Greek team’s professional football players during three consecutive seasons, 2015/16-to-2017/18. Injuries were assessed and regression analysis was used to evaluate the potential risk factors. Three-quarters of the players were recorded as injured with 2.3 injuries/injured player, and the injury incidence was 55 injuries/1,000 match-playing-exposure-hours. The mean rehabilitation days were 29.3/injured player (95%CI 22.4–36.8) and 13.0/injury (95%CI 8.6–17.4). The majority of injured players has been found to have moderate-to-major/severe injuries and most of the injuries were traumatic than overuse (p < 0.05). The number of injuries were related to the recurrence of injury (beta = 0.646, p < 0.001) and the rehabilitations days (beta = 0.271, p < 0.001). High prevalence of injuries was found as the recurrence of injury and rehabilitation days were their main predictive risk factors. In order to reduce the risk of injuries, continuous effort is required in the rehabilitation of players.

Creatine Phosphokinase and Urea as Biochemical Markers of Muscle Injuries in Professional Football Players

Background: Although biochemical markers have been used to monitor training loads (TL), it is unknown if they can be used to predict muscle injuries (MI) in professional football (soccer) players (PFP). Objectives: To evaluate the relationship between the incidence of MI, serum concentration of creatine phosphokinase (CPK) and urea, as well as TL in PFP. Methods: Twenty-three PFP from a Colombian first-division team were enrolled in a retrospective cohort study. CPK, urea, TL and new MI were measured during 19 weeks. CPK and urea serum levels within 4 weeks before a diagnosed MI were compared to those measured preseason. CPK and urea relationship with TL were analyzed using a mixed-effects model. Results: The subjects had an age of 25.3 ± 4.2 years. Nine subjects presented with MI during follow-up, 66.6% of which were localized to hamstrings. Serum CPK and urea profiles were constructed for each player along the season. Injured players had a significant elevation of these markers within 4 weeks before the injury was clinically evident when compared to their own preseason values. Expected individual increases in CPK and urea according to TL during the season were estimated. Conclusions: Since CPK and urea values rose several weeks before the MI became overt, constructing CPK and urea profiles for each player during the whole preseason and season may help identify peaks in their concentration as early markers of MI. A tight biochemical control of training may become a preventive strategy for MI, but the use of published reference values is discouraged.

Risiko-Screening im Handballsport – Welche funktionellen Tests sind sinnvoll?

Applying functional tests in sports is one way to optimise injury prevention. Based on the results, corrective exercises may be recommended to address deficits. The aim of this study was to compare the results of selected functional tests with the occurrence of injuries in young handball players. Thirty-one players from youth teams of a Handball Bundesliga club participated in this study. In the run-up to the second half of the season, all players completed the Functional Movement Screen, the Y-balance test, front hop, side hop and square hop tests. All injuries that occurred after the tests were recorded until the end of the season. Within the investigation period, four non-contact and four contact injuries occurred. Players with non-contact injuries performed the side hop test with a limb symmetry index of 78 % (uninjured players and players with contact injuries: > 85 %) and the Y-balance test with a composite score of 87 % (uninjured players and players with contact injuries: > 90 %). Results of the Functional Movement Screen, the front and square hop tests did not differ between injured and uninjured players. The results of this study suggest that functional test batteries in handball should consider low-threshold as well as high-threshold tests. Based on this experience, the Y-balance test and the side hop test seem to be particularly suitable for handball athletes.