National Collegiate Athletic Association Division Research Articles

Occurrence, Management, and Outcome of Thoracic Outlet Syndrome in National Collegiate Athletic Association Division I Conference

Occurrence, Management, and Outcome of Thoracic Outlet Syndrome in National Collegiate Athletic Association Division I Conference

Examining Acute Symptoms After Sport-Related Concussion in Collegiate Athletes With Preinjury Migraines.

To examine whether a personal history of migraines is associated with worse acute symptom burden after sport-related concussion (SRC). Retrospective cohort study. National Collegiate Athletic Association Division III collegiate programs. Collegiate athletes from a prospective concussion surveillance system between 09, 2014, and 01, 2023. Preinjury migraines (yes/no) were self-reported by athletes. Post-Concussion Symptom Scale (PCSS) were collected within 3 days postinjury. Mann-Whitney U tests compared total PCSS scores and individual symptom scores between athletes with and without preinjury migraines. Chi-squared tests were used to compare proportions of athletes endorsing individual symptoms (ie, item score ≥1) between 2 groups. Multivariable regression analyzed potential predictors of PCSS scores. Of 1190 athletes with SRC, 93 (7.8%) reported a preinjury history of migraines. No significant difference in total PCSS scores was found between athletes with and without preinjury migraines (22.0 ± 16.4 vs 20.5 ± 15.8, U = 48 719.0, P = 0.471). Athletes with preinjury migraines reported greater severity of "sensitivity to light" (1.59 ± 1.59 vs 1.23 ± 1.41, P = 0.040) and "feeling more emotional" (0.91 ± 1.27 vs 0.70 ± 1.30; P = 0.008) and were more likely to endorse "feeling more emotional" (45.2% vs 29.5%, P = 0.002). No differences were found across all other symptoms, including headaches (migraine = 87.1% vs no migraine = 86.3%, P = 0.835). In a multivariable model, a history of migraine was not a significant predictor of acute PCSS scores, but those with a history of psychological disorders (β = 0.12, P <0 .001) and greater number of days to symptom evaluation (β = 0.08, P = 0.005) had higher PCSS scores. Collegiate athletes with a pre-existing history of migraines did not have higher acute symptom burden after SRC.

Recovery After Sport-Related Concussion in Collegiate Athletes With Self-Reported Pre-Injury Migraines.

Pre-injury migraines might be a risk factor for prolonged recovery after sport-related concussion (SRC). We sought to examine whether a pre-injury history of migraines is associated with worse recovery following SRC in collegiate athletes. Data were collected through a prospective concussion surveillance system in 11 National Collegiate Athletic Association (NCAA) Division III college athletic programs between September 2014 and March 2020. Our primary independent variable, pre-injury migraines, were self-reported by the athletes. Between those with and without migraines, the outcomes of days to return-to-learn (RTL) without academic accommodations and return-to-play (RTP) were compared using Mann-Whitney U tests. Each athlete's RTL and RTP status was dichotomized (i.e., returned vs. not returned) at various time points for RTL (i.e., 7/14/21/28 days) and RTP (i.e., 14/21/28/56 days). Chi-squared tests were performed to compare the proportions of RTL and RTP status between groups. Multivariable regressions analyzed potential predictors of RTL and RTP adjusting for age, gender, prior concussions, other health conditions, and symptom severity. Of 1409 athletes with an SRC, 111 (7.9%) had a pre-injury history of migraines. Compared with those without migraines, those with migraines had longer median (interquartile range [IQR]) days to RTL (migraines = 7.0 [3.0-12.3] vs. no migraines = 5.0 [2.0-10.0], U = 53,590.5, p = 0.022). No differences were found in RTP between the two groups (migraines = 16.0 [10.0-33.0] vs. nχo migraines 15.0 [11.0-23.0], U = 38,545.0, p = 0.408). Regarding RTL, significantly lower proportions of athletes in the migraine group had fully RTL, without accommodations, at ≤14 days (77.5% vs. 85.2%, χ2 = 4.33, p = 0.037), ≤21 days (85.3% vs. 93.0%, χ2 = 7.99, p = 0.005), and ≤28 days (88.2% vs. 95.6%, χ2 = 10.60, p = 0.001). Regarding RTP, a significantly lower proportion of athletes in the migraine group RTP at ≤28 days (72.0% vs. 82.7%, χ2 = 5.40, p = 0.020) and ≤56 days (84.0% vs. 93.0%, χ2 = 8.19, p = 0.004). In a multivariable model predicting RTL that was adjusted for age, gender, acute concussion symptoms, and other health variables (e.g., attention-deficit/hyperactivity disorder [ADHD], history of mental health difficulties), pre-injury history of migraine was associated with longer RTL (β = 0.06, p = 0.030). In a multivariable model predicting RTP, pre-injury history of migraine was not associated with RTP (β = 0.04, p = 0.192). In collegiate athletes, pre-injury migraine history was independently associated with longer RTL but not RTP. When comparing the proportions of those with successful RTP by days, significantly lower proportions of those with migraines showed successful RTP at ≤28 days and ≤56 days. Futures studies should study the generalizability of our findings in other school levels.

Outcomes of Blood Flow Restriction Training After ACL Reconstruction in NCAA Division I Athletes.

Blood flow restriction training (BFRT) is a safe and potentially effective adjunctive therapeutic modality for postoperative rehabilitation related to various knee pathologies. However, there is a paucity of literature surrounding BFRT in high-performance athletes after anterior cruciate ligament reconstruction (ACLR). To (1) compare the overall time to return to sports (RTS) in a cohort of National Collegiate Athletic Association (NCAA) Division I athletes who underwent a standardized rehabilitation program either with or without BFRT after ACLR and (2) identify a postoperative time interval for which BFRT has the maximum therapeutic benefit. Cohort study; Level of evidence, 3. A total of 55 student-athletes who underwent ACLR between 2000 and 2023 while participating in NCAA Division I sports at a single institution were included in this study. Athletes were allocated to 1 of 2 groups based on whether they participated in a standardized postoperative rehabilitation program augmented with BFRT (BFRT group; n = 22) or completed the standardized protocol alone (non-BFRT group [control]; n = 33). Our primary outcome measure was time to RTS. The secondary outcome measure was handheld dynamometry quadriceps strength testing at various postoperative time points, converted to a limb symmetry index (LSI). Quadriceps strength was not tested between the BFRT and non-BFRT groups because of the limited amount of data on the control group. The mean age at the date of surgery was 18.59 ± 1.10 years for the BFRT group and 19.45 ± 1.30 years for the non-BFRT group (P = .011), and the mean RTS time was 409 ± 134 days from surgery for the BFRT group and 332 ± 100 days for the non-BFRT cohort (P = .047). For the BFRT group, the mean quadriceps strength LSI increased by 0.67% (95% CI, 0.53%-0.81%) for every week of rehabilitation, and there was a significantly positive rate of change in quadriceps strength in weeks 13-16 compared with weeks 9-12 (ΔLSI, 8.22%; P < .001). In elite NCAA Division I athletes, a statistically significant delay was observed in RTS with BFRT compared with standardized physical therapy alone after undergoing ACLR. There also appeared to be an early window during the rehabilitation period where BFRT had a beneficial impact on quadriceps strength.

Self-efficacy, Effort, and Performance Perceptions Enhance Psychological Responses to Strength Training in National Collegiate Athletic Association Division I Athletes.

Biscardi, LM, Miller, AD, Andre, MJ, and Stroiney, DA. Self-efficacy, effort, and performance perceptions enhance psychological responses to strength training in National Collegiate Athletic Association Division I athletes. J Strength Cond Res 38(5): 898-905, 2024-This study examined the effect of self-efficacy, effort, and perceived performance on positive well-being (PWB) and psychological distress (PD) following high-intensity resistance training sessions in collegiate student-athletes. An observational field study design was used to collect data before and after resistance training sessions in a 4-week preseason strength training block. A multilevel model assessed day-level and person-level variance in acute PWB and PD. Interaction terms were also tested at the day level. Alpha was set at 0.05. Within a 4-week training block, training session intensity did not predict changes in acute psychological responses. After controlling for an athlete's preexercise psychological state, higher self-efficacy, daily effort, and perceived performance predicted higher PWB and lower PD following training (p < 0.05). Self-efficacy moderated the relationships of daily effort and performance with PD (p < 0.05). When athletes experienced lower self-efficacy, producing a higher effort and perceiving better performance reduced the negative psychological response. These findings highlight the important mediating role of cognitive variables in the acute psychological response to high-intensity resistance training. Coaches should identify and mitigate low cognitive states to facilitate a positive psychological response to resistance training. This strategy promotes a positive psychological response without altering training prescription.

Limited Return to Preinjury Performance in NCAA Division I American Football Players With Hamstring Injuries.

Hamstring strains are common among elite athletes, but their effect on return to the same level of play in American football has been incompletely characterized. Data on National Collegiate Athletics Association Division I college football players with acute hamstring strains were gathered to identify the effects these injuries have on both return to play and athletic performance regarding velocity, workload, and acceleration. Case Series; Level of evidence, 4. Injury data for a single Division I football team were prospectively recorded over a 4-year period. Players wore global navigation satellite system and local positioning system (GNSS/LPS) devices to record movement data in practices and games. The practice and game data were cross-referenced to evaluate players with isolated acute hamstring strains. Comparisons were made regarding players' pre- and postinjury ability to maintain high velocity (>12 mph [19.3 kph]), maximal velocity, triaxial acceleration, and inertial movement analysis (IMA). There were 58 hamstring injuries in 44 players, of which 25 injuries from 20 players had GNSS/LPS data. Players were able to return to play from all 25 injury incidences at a mean of 9.2 days. At the final mean follow-up of 425 days, only 4 players had reached preinjury function in all measurements; 12 players were able to return in 2 of the 4 metrics; and only 8 players reached their preinjury ability to maintain high velocity. For those who did not achieve this metric, there was a significant difference between pre- and postinjury values (722 vs 442 m; P = .016). A total of 14 players were able to regain their IMA. Players who returned to prior velocity or acceleration metrics did so at a mean of 163 days across all metrics. While players may be able to return to play after hamstring strain, many players do not reach preinjury levels of acceleration or velocity, even after 13.5 months. Further studies are needed to confirm these findings, assess clinical relevance on imaging performance, and improve hamstring injury prevention and rehabilitation.

An examination of pre-activity and post-activity training practices of National Collegiate Athletic Association Division I and Division III baseball coaches

Baseball includes complex multi-joint and multi-planar activities involving a majority of the musculature of the body. Research pertaining to training practices including pre-activity and post-activity stretching continues to evolve along with related sport science recommendations. Therefore, the purpose of this study is to assess the pre-activity and post-activity warm-up, stretching, and training practices of National Collegiate Athletic Association (NCAA) Division I and Division III baseball coaches. A total of 686 questionnaires were distributed via email to head collegiate baseball coaches from NCAA Division I and III universities. The questionnaire was designed to gather demographic, professional, and educational information, as well as specific pre-activity and post-activity stretching usage by the coaches. The responses were examined by computing frequency counts and means where applicable. For the statistical analysis, both SPSS version 27.0 and JMP version 13.0 software packages were utilized. Pearson's Chi-squared tests were run where applicable. Results indicated just over 77% of coaches in the present study affirmed the importance of a pre-activity dynamic warmup. When comparing coaching specific certification to pre-activity flexibility practices, it is clear not all coaches comply with suggested pre-activity flexibility recommendations. This study indicates it is important for baseball coaches to re-evaluate their own practices, perhaps cross-checking them with practices of their peers and staying current with ongoing research.

The 11+ injury prevention programme decreases rate of hamstring strain injuries in male collegiate soccer players

ObjectivesTo investigate if the 11+ injury prevention programme decreases the risk of hamstring injury and improves recovery time and determine whether compliance with the 11+ affects hamstring injury risk.MethodsThis study...

Association Between Patellar Tendon Abnormality and Land-Jump Biomechanics in Male Collegiate Basketball Players During the Preseason.

Patellar tendinopathy is a degenerative condition that predominantly affects jumping athletes. Symptoms may be subtle or nonexistent at preseason, but structural abnormalities may be present. Assessing patellar tendon abnormality (PTA) through magnetic resonance imaging (MRI) and ultrasound (US) and classifying symptoms using the Victorian Institute for Sport Assessment-Patellar tendon (VISA-P) may provide useful insights if combined with biomechanics measurements. To (1) assess whether land-jump biomechanical patterns are associated with clinically pertinent PTA as seen on imaging and through VISA-P scores and (2) model the contributing risk and accuracy of biomechanics to classify PTA and symptomatic observations. Cross-sectional study; Level of evidence, 3. A total of 26 National Collegiate Athletic Association Division I and II male basketball players (n = 52 limbs) were recruited during the preseason. We collected VISA-P scores, bilateral PTA through US and MRI morphology measurements, and bilateral 3-dimensional lower extremity kinematics and kinetics measurements from a land-jump test from an 18-inch-high (45.7-cm-high) box. Statistically, each limb was treated independently. The association of biomechanics with PTA and symptoms (VISA-P score <80) was tested with multivariate models and post hoc tests. Logistic regression modeled relative risk and accuracy of biomechanical variables to classify PTA and symptomatic limbs. There were 19 to 24 limbs with PTA depending on US and MRI measurements. Differences in hip and knee kinematic strategies and ground-reaction loads were associated with PTA and symptomatic limbs. Peak landing vertical ground-reaction force was significantly decreased (169 ± 26 vs 195 ± 29 %body weight; P = .001), and maximum hip flexion velocity was significantly increased (416 ± 74 vs 343 ± 94 deg/s; P = .005) in limbs with versus without PTA on imaging. Knee flexion at the initial contact was decreased in symptomatic versus healthy limbs (17°± 5° vs 21°± 5°, respectively; P = .045). Regression models classified PTA limbs and symptomatic limbs with 71.2% to 86.5% accuracy. Hip and knee maximum flexion velocity and vertical ground-reaction force variables were most common across models observing clinically pertinent PTA. Our findings suggested that functional kinematic and kinetic biomechanical strategies at the hip and knee were associated with PTA, identified on imaging, and symptomatic limbs.

DARI Evaluation Syndesmosis

Introduction/Purpose: Return to play (RTP) assessment and decision-making protocols are among the most discussed topics in sports medicine. Given the lack of validated guidelines, physicians and rehabilitation practitioners often rely on subjective functional evaluation to guide decisions to RTP. Biomechanical assessment using motion capture may be a useful strategy to evaluate an athlete’s post-injury functional status, and to estimate their ability to RTP with reduced risk of re-injury. The purpose of this case-study was to determine the efficacy of using marker-less 3D motion capture to provide an objective functional evaluation to tailor rehabilitation and aid RTP status for a patient who underwent syndesmotic fixation. Methods: In this case-study, a National Collegiate Athletic Association Division I collegiate football offensive lineman (Height: 1.96 m, Weight: 141 kg) performed a movement screen 5 weeks after left ankle syndesmotic fixation for purely ligamentous syndesmotic injury. Testing was performed at the anticipated time of RTP. After a standardized warm-up, the patient performed a series of 14 movements consisting of upper and lower extremity actions in all three planes of motion, including bilateral and unilateral lower extremity actions. Kinematic data was captured using an 8-camera marker-less motion capture system (MLMCS). Left and right joint-specific ranges of motion were compared for symmetry and to normative data produced by the MLMCS manufacturer. Results: The participant successfully performed all 14 movements without limitation. Ankle flexion was symmetrical during bilateral and unilateral squatting actions. However, left ankle (i.e., involved side) flexion was consistently less than right ankle flexion during more dynamic actions (Table 1). Despite the asymmetries, ankle range of motion was within normal ranges for both sides in all movements. From a performance standpoint, left-side jump heights were consistently less than the right-side efforts during the unilateral countermovement jump (left: 34.5 cm versus right: 41.1 cm; -16.0%) and consecutive hops (left: 29.5 cm versus right: 33.0 cm; -10.8%). Results were shared with the athletic trainer to focus rehabilitation efforts. The patient was able to fully RTP at 6 weeks. Conclusion: In this case-study, the patient successfully performed a movement screen without limitation at the time of RTP after left ankle syndesmotic fixation. A MLMCS detected kinematic differences that would be difficult to qualitatively recognize. Specifically, the patient expressed reduced ankle flexion and jumping performance on the operative side. No baseline screening was performed, but the observed asymmetries were consistent with what would be expected from the specific injury. Further research is needed to compare baseline measures to kinematic changes. These findings suggest that a basic movement screen using MLMCS can detect kinematic asymmetries after syndesmotic fixation. Table 1. Kinematic Assessment of Ankle Range of Motion

Female National Collegiate Athletic Association Division-I Athlete Injury Prediction by Vertical Countermovement Jump Force-Time Metrics.

Merrigan, JJ, Stone, JD, Kraemer, WJ, Vatne, EA, Onate, J, and Hagen, JA. Female National Collegiate Athletic Association Division-I athlete injury prediction by vertical countermovement jump force-time metrics. J Strength Cond Res 38(4): 783-786, 2024-Vertical countermovement jump (CMJ) assessments on force plates have been purported to screen for musculoskeletal injury risk (MSKI) but with little scientific support. Thus, this study aimed to identify associations and noncontact lower-body injury predictability with CMJ force-time metrics in female athletes. The study entailed a retrospective analysis of routine injury and performance monitoring from 155 female National Collegiate Athletics Association Division I athletes. Noncontact lower-body injuries included in analysis were confirmed by medical staff, occurred during competition or training, resulted in time loss from training, and occurred within 3 months following CMJ testing (2 maximal effort, no arm swing, jumps on dual force plates). A total of 44 injuries occurred within 3 months following CMJ baseline testing and resulted in an average of 24.5 missed days from training. Those who sustained an injury were more likely to sustain another injury (15 of 44 injuries [33.1%]; odds ratio = 3.05 [95% CI = 1.31-6.99]). For every 1-unit increase from the mean in eccentric mean power and minimum eccentric force, there was a decrease in odds of sustaining a MSKI. Despite high overall model accuracy (85.6%), the receiving operating characteristic area under the curve (65.9%) was unacceptable and the true positive rate (recall) was 0.0%. Thus, no injuries in the testing data set were correctly classified by the logistic regression model with CMJ force-time metrics as predictors. Baseline CMJ assessment may not be useful for noncontact lower-body musculoskeletal injury screening or predictability in National Collegiate Athletics Association female athletes.

Analysis of Sleep, Nocturnal Physiology, and Physical Demands of NCAA Women's Ice Hockey Across a Championship Season.

Merrigan, JJ, Stone, JD, Kraemer, WJ, Friend, C, Lennon, K, Vatne, EA, and Hagen, JA. Analysis of sleep, nocturnal physiology, and physical demands of NCAA women's ice hockey across a championship season. J Strength Cond Res 38(4): 694-703, 2024-The aims of this study were to evaluate the (a) relationships between daily physical demands and nighttime sleep, heart rate (HR), and heart rate variability (HRV); (b) weekly changes in physical demands and sleep; and (c) differences among positions and between training and competition during a competitive season in National Collegiate Athletic Association (NCAA) women's ice hockey. Twenty-five NCAA Division I women's ice hockey athletes wore a sensor at night to monitor sleep quantity or quality (e.g., time asleep and sleep efficiency) and physiology (e.g., HR and HRV). During training and competitions (31 regular season and 7 postseason), athletes wore performance monitoring systems to assess workload demands (e.g., training impulse and TRIMP). As internal workload (TRIMP, Time >80% of HRmax, Average HR) during training or competition increased, nocturnal HRV decreased, HR increased, and Sleep Duration, Sleep Score, and Readiness Score decreased that night. Across the season, athletes experienced lower HRV, but exhibited longer sleep durations. Training Distance, Duration, Time >80% HRmax, Average HR, and TRIMP decreased, whereas competition Total Distance, Duration, and TRIMP increased across weeks throughout the season. There were differences across positions and season blocks when evaluating these data at the mesocycle level. Athletes slept longer before competition compared with training, but physiological data did not differ. Competitions had greater physiological demands than training. We speculate that the increased focus on sleep hygiene, as evidenced by the increase in sleep over the season, may have served as a recovery aid to combat physiological stress of accumulated demands of competitions that increased over time into postseason tournaments.

Daily versus three times weekly dosing for treatment of iron deficiency nonanemia in NCAA Division 1 female athletes.

To compare the effectiveness, compliance, and side effect profile between daily or three times weekly (TIW) oral iron supplementation regimens in treating iron deficiency nonanemia (IDNA) in National Collegiate Athletic Association (NCAA) Division 1 female track and field or soccer athletes. Prospective cohort study. Division 1 collegiate athletics. Thirty-three NCAA Division 1 female athletes (18 track and field, 15 soccer). Daily or TIW dosing of ferrous bisglycinate. Serum ferritin (μg/L) was measured before and after 8 weeks of supplementation. Self-reported compliance and side effect profile was assessed by electronic survey every 2 weeks. The average main effect for the TIW regimen was a significant increase of 5.17 μg/L (95% CI: 0.86-9.47) in serum ferritin (p = .02). The average main effect for the daily regimen was a significant increase of 12.88 μg/L (95% CI: 4.84-20.93) in serum ferritin (p = .003). The estimated average effect of the treatment on the treated between regimens was a nonsignificant decrease of -7.17 μg/L (95% CI: -19.02 - 3.59) in serum ferritin (p = .17). Thus, the TIW regimen increased serum ferritin 7.17 units less than the daily regimen on average after 8 weeks of supplementation. The athletes following the daily regimen experienced significantly more nausea (p = .04) and constipation (p = .002) compared to the TIW regimen. There was no statistical difference in compliance between the two groups (p = .14). Both the daily and TIW regimens increased serum ferritin. Compared to the daily regimen, the TIW regimen produced a smaller increase in serum ferritin but less nausea and constipation.

Gender-specific hip strength disparities correlate with injury patterns in NCAA men's and women's soccer players.

In National Collegiate Athletic Association (NCAA) soccer athletes, men have higher rates of hip and groin strains, whereas women have higher rates of knee ligament injuries. Strength imbalances of the hip and thigh, specifically in agonist-antagonist muscles, are known risk factors for these injuries. To perform hip and thigh strength assessments in NCAA soccer players to evaluate for differences between genders and correlations with gender-specific injury patterns. With a handheld dynamometer, weight-normalized isometric strength of six muscle groups (hip abductors, hip adductors, hip flexors, hip extensors, knee flexors, knee extensors) was calculated in NCAA soccer players. The strength ratio of each agonist-antagonist muscle was also calculated (hip abductors/adductors, hip flexors/extensors, knee extensors/flexors). Thirty-six NCAA soccer players (18 men, 18 women) from a single NCAA Division III institution. Not applicable. Weight-normalized strength of six muscle groups and their agonist-antagonist strength ratios were compared between genders using linear mixed-effects models. Compared with male players, female players had decreased weight-normalized strength for hip abduction (0.170 vs. 0.204, p = .012) and hip extension (0.172 vs. 0.211, p = .021). Otherwise, weight-normalized strength was similar between genders. When comparing agonist-antagonist strength ratios, there was a significant difference between female and male players for hip flexion:extension (1.70 vs. 1.35, p = .008), whereas the hip abduction: adduction ratio did not reach statistical significance (1.45 vs. 1.62, p = .080). NCAA male and female soccer players had different hip strength profiles that fit their injury patterns. Male NCAA soccer players have higher rates of hip and groin strains, and men in the cohort had strength ratios that were deficient in the hip flexors and adductors compared with women. Female NCAA soccer players have higher rates of knee sprains and anterior cruciate ligament tears, and women in the cohort had strength ratios that were deficient in the hip abductors and extensors, which function to stabilize the knee. These strength disparities could be the focus of future gender-specific soccer injury prevention programs.

Comparing National Collegiate Athletic Association Division II Athletes’ Perceptions of Social Support Following Injury, Illness, and Other Identified Stressors

Collegiate athletes have demonstrated a need for social support to help cope with their daily responsibilities. The purpose of this research was to explore National Collegiate Athletic Association Division II athletes’ perception of social support from friends, teammates, family, coaches, significant others, and athletic trainers following injury, illness, or other identified life stressors. There were 546 participants who completed a five-part survey using the University Stress Scale, the Multidimensional Scale of Perceived Social Support, the Athletic Multidimensional Scale of Perceived Social Support, the Perceived Stress Scale, and a demographic section. Of the participants, 352 (64.5%) stated that they experienced moderate stress levels, and all participants indicated experiencing an identified life stressor within the last 12 months. The results indicated statistically significant differences when comparing providers of social support: females preferred the support of friends, significant others, and athletic trainers, and freshmen and sophomores perceived more social support from friends than did juniors and seniors.

Hamstring Strain Ultrasound Case Series: Dominant Semitendinosus Injuries in National Collegiate Athletic Association Division I Athletes.

Authors of previous studies of patients with acute hamstring strains have reported injury to the biceps femoris and semitendinosus (ST) in 50% to 100% and 0% to 30%, respectively. This retrospective case series of hamstring injuries in National Collegiate Athletic Association Division I collegiate athletes exhibited an injury pattern on ultrasound imaging that differed from what would be expected based on prior literature. We examined ultrasound images of 38 athletes with acute hamstring strains for injury location (proximal muscle, proximal myotendinous junction, midportion of muscle, distal muscle) and affected muscles (biceps femoris, ST, or semimembranosus). Twenty-six athletes (68.4%) injured the ST, and 9 athletes (23.7%) injured the biceps femoris long head. Most athletes (23, 60.5%) injured the proximal portion of the muscle or myotendinous junction. Though this study had many limitations, we demonstrated more frequent involvement of the ST and less frequent involvement of the biceps femoris than reported in the literature.

Cold-Water Immersion and Lower Limb Muscle Oxygen Consumption as Measured by Near-Infrared Spectroscopy in Trained Endurance Athletes.

Cold-water immersion (CWI) has been reported to reduce tissue metabolism postimmersion, but physiological data are lacking regarding the muscle metabolic response to its application. Near-infrared spectroscopy (NIRS) is a noninvasive optical technique that can inform muscle hemodynamics and tissue metabolism. To investigate the effects of CWI at 2 water temperatures (10°C and 15°C) on NIRS-calculated measurements of muscle oxygen consumption (mVO2). Crossover study. University sports rehabilitation center. A total of 11 male National Collegiate Athletic Association Division II long-distance runners (age = 23.4 ± 3.4 years, height = 1.8 ± 0.1 m, mass = 68.8 ± 10.7 kg, mean adipose tissue thickness = 6.7 ± 2.7 mm). Cold-water immersion at 10°C and 15°C for 20 minutes. We calculated mVO2 preimmersion and postimmersion at water temperatures of 10°C and 15°C. Changes in tissue oxyhemoglobin (O2Hb), deoxyhemoglobin (HHb), total hemoglobin (tHb), hemoglobin difference (Hbdiff), and tissue saturation index (TSI %) were measured during the 20-minute immersion at both temperatures. We observed a decrease in mVO2 after immersion at both 10°C and 15°C (F1,9 = 27.7801, P = .001). During the 20-minute immersion at both temperatures, we noted a main effect of time for O2Hb (F3,27 = 14.227, P = .001), HHb (F3,27 = 5.749, P = .009), tHb (F3,27 = 24.786, P = .001), and Hbdiff (F3,27 = 3.894, P = .020), in which values decreased over the course of immersion. Post hoc pairwise comparisons showed that these changes occurred within the final 5 minutes of immersion for tHb and O2Hb. A 20-minute CWI at 10°C and 15°C led to a reduction in mVO2. This was greater after immersion at 10°C. The reduction in mVO2 suggests a decrease in muscle metabolic activity (ie, O2 use after CWI). Calculating mVO2 via the NIRS-occlusion technique may offer further insight into muscle metabolic responses beyond what is attainable from observing the NIRS primary signals.

I “Like” It: The Effects of Social Media Platform and Message on Consumer Engagement Actions

The academic literature reports mixed evidence on how social media platform and message impact consumer engagement. We investigated the effects of three platforms (Facebook, Instagram, and Twitter) and three message themes (sales, informational, and relationship building) on six consumer engagement actions (comment, like, search, share, talk about, and purchase) in a lab experiment. College students responded to social media posts featuring their National Collegiate Athletic Association Division I women’s basketball team. Results for platform show that participants were more likely to comment on Facebook and Twitter (vs. Instagram) and more likely to purchase on Twitter (vs. Instagram). Results for message theme show that participants were more likely to comment, like, and share informational and relationship building posts and more likely to purchase after sales posts. Results for message theme vary by gender for search and talk about (with others). These results can help sport marketers develop social media content that drives specific engagement actions.

On the Frontline of Athlete Mental Health: The Mental Health Literacy of NCAA Coaches

Coaches’ knowledge, attitudes, and beliefs about mental health—or mental health literacy (MHL)—affect teams’ mental health climates and the detection, referral, and treatment of athletes’ mental health concerns. Thus, assessing collegiate coaches’ MHL, and factors related to its presence, is critical. Using the Mental Health Literacy Scale, 1,571 NCAA (National Collegiate Athletic Association) coaches were surveyed regarding their MHL and demographic and mental health experience factors. Overall, 99.9% of the coaches surveyed believe that athletes’ mental health affected their sport performances. Through hierarchical regression analyses, coaches’ exposure to mental health treatment, perceived helpfulness of mental health treatment, gender (i.e., woman), years coaching (i.e., fewer years), and current NCAA division (i.e., Division III) were significantly related to their MHL, explaining 15.5% of variance. However, coaches’ race/ethnicity did not reach significance. Recommendations regarding increasing coaches’ MHL and hiring appropriately trained and licensed mental health and sport psychology professionals are offered.

A controlled trial assessing the acceptability and efficacy of a yoga-based eating disorder prevention program among division I athletes: Eat Breathe Thrive (EBT)

ABSTRACT Objective This study evaluated the acceptability and effectiveness of the Eat Breathe Thrive (EBT) program as an eating disorder prevention intervention among women collegiate athletes. Method Change over time in eating disorder risk and competencies of positive embodiment were examined in 94 women (n = 48 EBT participants and n = 46 matched-controls) from one National Collegiate Athletic Association (NCAA) Division I-classified university in the United States. Eating disorder risk factors were measured using the Eating Disorder Examination Questionnaire (EDE-Q) and State Trait Anxiety Inventory (STAI). Aspects of positive embodiment were measured using the Multidimensional Assessment of Interoceptive Awareness (MAIA) and The Mindful Self-Care Scale (MSCS). Data were collected through participants’ completion of online surveys across three time-points. Results Repeated measures ANOVAS revealed EBT participants reported experiencing significantly less state anxiety and greater interoceptive body trusting over time relative to matched-controls. No other significant interactions were found. Respondents found the EBT program acceptable. Discussion Acceptability and partial support for integrative, yoga-based, interventions targeting Division I student-athletes is indicated.