Non-contact Injuries Research Articles

Effectiveness of a Warm-up Program with Dynamic Stretching in Preventing Sports Injuries

Objectives: This study aimed to conduct a warm-up (W-up) program incorporating movement preparation (MP) and clarify its effect on sports injury prevention.Methods: The subjects of the study were 55 first- to third-year students (age: 15.9 ± 1.0 years, height: 168.5 ± 5.2 cm, weight: 57.4 ± 5.3 kg) belonging to a high school boys' soccer team. The first two months were the control period (CP), and the next two months were the intervention period (IP). The CP was a conventional W-up and the IP was a W-up with MP. The effects of each W-up were compared in terms of the incidence of sports injuries and disabilities during both periods and the incidence of sports injuries and disabilities by cause. Other measurements were compared for a total of seven items, including flexibility, balance, and performance.Results: During the IP, the incidence of sports injuries during practice and the incidence of non-contact sports injuries were reduced, whereas flexibility, balance, and performance improved.Conclusions: W-up incorporating MP showed improvement in flexibility and related balance, which may have led to the reduction of sports injuries.

Association of Intrinsic Factors with Non-contact Injury Prevalence of Front Foot Knee Pain Among First Class Fast Bowlers in Colombo Division

Background: Cricket is one of the most popular sports in Sri Lanka. Both intrinsic and extrinsic injury prevention and increase performance are of cardinal importance to a fast bowler to reach optimal performance. Intrinsic prevention methods may protect the fast bowler against too high level of stress experienced during bowling. In this study we aimed to assess the incidence of front foot knee pain and the associated intrinsic risk factors among first class cricket fast bowlers, to come up with recommendations to improve training regimes to prevent non-contact injury. Method: Descriptive Cross-Sectional study was conducted with 30 fast bowlers with front foot knee pain. Severity of knee pain was measured by using knee evaluation form. Q angle, Hip internal rotation were measured using a modified goniometer. Quadricep and hamstring muscle strength were measured by cuff adapted sphygmomanometer. Ankle dorsiflexion was measured by Lunge Test. Results: An insignificant, positive correlation in Ankle dorsiflexion (p=0.780, r=0.053), hip internal rotation (p=0.194, r=0.244), and quadriceps hamstring muscle strength ratio (p=0.952, r=0.012) of the fast bowlers with front foot knee pain was observed. Also, there was an insignificant negative correlation between quadriceps angle (p=0.827, r=-0.042) and front foot knee pain.

Load-Induced Changes of Inter-Limb Asymmetries in Dynamic Postural Control in Healthy Subjects.

Inter-limb asymmetries are associated with a higher potential risk for non-contact injuries. Differences in function or performance between the limbs might lead to imbalances and promote instability, increasing the potential risk for injuries. Consequently, an investigation of inter-limb asymmetries should be included in injury risk assessment. Furthermore, since non-contact injuries mainly occur under loaded conditions, an investigation of load-induced changes of inter-limb asymmetries can provide additional information on the athlete’s potential injury risk. Therefore, the current study aimed to investigate the influence of physical load on inter-limb asymmetries in dynamic postural control, which is essential in situations with a high risk for non-contact injuries such as landing, cutting, or stopping. In total, dynamic postural control of 128 active and healthy subjects (64 males and 64 females, age: 23.64 ± 2.44, height: 176.54 ± 8.96 cm, weight: 68.85 ± 10.98 kg) was examined. Dynamic postural control was tested with the Y-Balance Test (YBT) before and after a loading protocol on a bicycle ergometer or a treadmill. The results showed no significant increase of the inter-limb asymmetries in anterior direction [F(1, 126) = 4.44, p = 0.04, η2p = 0.03]. Moreover, there is high variation between the subjects regarding the magnitude and the direction of the asymmetries and the changes due to load. Therefore, a more individual analysis considering the magnitude and the direction of the asymmetries is required. Thereby, considering different modifying factors, e.g., sex, injury history, and baseline level of asymmetries, can be helpful. Moreover, an analysis of the changes during load might provide further insights, reveal possible differences, and help detect the reasons and mechanisms underlying inter-limb asymmetries and asymmetrical loading.

Intrinsic Risk Factors for Noncontact Musculoskeletal Injury in Collegiate Swimmers: A Prospective Cohort Study.

Shoulder pain is pervasive in swimmers of all ages. However, given the limited number of prospective studies, injury risk factors in swimmers remain uncertain. To determine the extent to which the risk factors of previous injury, poor movement competency, erroneous freestyle swimming technique, and low perceived susceptibility to sport injury were associated with noncontact musculoskeletal injury in collegiate swimmers. Prospective cohort study. College natatorium. Thirty-seven National College Athletic Association Division III swimmers (21 females, 16 males; median age = 19 years [interquartile range = 3 years], height = 175 ± 10 cm; mass = 70.0 ± 10.9 kg). Participants completed preseason questionnaires on their previous injuries and perceived susceptibility to sport injury. At the beginning of the season, they completed the Movement System Screening Tool and the Freestyle Swimming Technique Assessment. Logistic regression was used to calculate odds ratios (ORs) with 95% CIs for the association between each risk factor and injury. Eleven of the 37 participants (29.7%) sustained an injury. Univariate analyses identified 2 risk factors: previous injury (OR = 8.89 [95% CI = 1.78, 44.48]) and crossover hand positions during the freestyle entry phase (OR = 8.50 [95% CI = 1.50, 48.05]). After adjusting for previous injury, we found that a higher perceived percentage chance of injury (1 item from the Perceived Susceptibility to Sport Injury) decreased the injury odds (adjusted OR = 0.11 [95% CI = 0.02, 0.82]). Poor movement competency was not associated with injury (P > .05). Previous injury, a crossover hand-entry position in freestyle, and a low perceived percentage chance of injury were associated with increased injury odds. Ascertaining injury histories and assessing for crossover positions may help identify swimmers with an elevated injury risk and inform injury-prevention strategies.

All-Inside Anterior Cruciate Ligament Reconstruction: A Review of Advance and Trends.

Anterior cruciate ligament (ACL) injury is a common disease in orthopedics and mostly occurs as a noncontact injury in athletes. Patients' knee joint stability, which is crucial to their athletic ability, cannot be restored through conservative treatment; it can only be restored through ACLR (ACL reconstruction) surgery. The surgical techniques of ACLR are constantly evolving, from bone tendon bone (BTB) grafting combined with interface screw fixation to hamstring tendon autograft or allogeneic tendon and of suspension device constructs. In particular, the currently prevalent all-inside technique featuring good cosmetic results and quick recovery of early functions not only ensures the stable fixation of grafts but also reduces surgical trauma. This review compares the advantages and disadvantages of different aspects of all-inside ACLR, including graft selection and preparation, bone socket reconstruction, fixation methods, and surgical technique effects and limitations. It has been found that the all-inside technique excels both anatomically and clinically but still requires further development. Besides, it has some limitations, and high-quality randomized controlled trials are still required to compare the long-term effects of the all-inside technique and other ACLR techniques.

Anatomical and Neuromuscular Factors Associated to Non-Contact Anterior Cruciate Ligament Injury.

The majority of anterior cruciate ligament (ACL) injuries occur during non-contact mechanisms. Knowledge of the risk factors would be relevant to help prevent athletes’ injuries. We aimed to study risk factors associated with non-contact ACL injuries in a population of athletes after ACL reconstruction. From a cohort of 307 athletes, two populations were compared according to the non-contact or contact mechanism of ACL injury. Gender, age and body mass index (BMI) were reported. Passive knee alignment (valgus and extension), knee laxity (KT-1000 test), and isokinetic knee strength were measured on the non-injured limb. The relationship between these factors and the non-contact sport mechanism was established with models using logistic regression analysis for the population and after selection of gender and cut-offs of age, BMI and knee laxity calculated from Receiver Operating Characteristics curve area and Youden index. Age, BMI, antero-posterior laxity, isokinetic knee strength, passive knee valgus and passive knee extension were associated with non-contact ACL injury. According to the multivariate model, a non-contact ACL injury was associated with non-modifiable factors, age (OR: 1.05; p = 0.001), passive knee extension (OR: 1.14; p = 0.001), and with one modifiable factor (Hamstring strength: OR: 0.27; p = 0.01). For women, only passive knee valgus was reported (OR: 1.27; p = 0.01). Age, passive knee extension and weak Hamstring strength were associated with a non-contact ACL injury. Hamstring strengthening could be proposed to prevent ACL injury in young male athletes or in case of knee laxity.

Increased lateral femoral condyle ratio measured by MRI is associated with higher risk of noncontact anterior cruciate ligament injury

BackgroundStudies have shown a significant association between the radiographically measured lateral femoral condyle ratio (LFCR) and anterior cruciate ligament (ACL) injury. However, it is unclear whether LFCR measured by magnetic resonance imaging (MRI) is associated with a higher risk of noncontact ACL injury.ObjectiveTo investigate the effect of LFCR on the risk of noncontact ACL injury by MRI. 2 to investigate the association of LFCR measured by MRI with multiple bone morphological risk factors and evaluate the most sensitive risk predictors of noncontact ACL injury.MethodsA total of 116 patients, including 58 subjects with noncontact ACL injury and 58 age-matched and sex-matched controls with only meniscus injury, were included in this retrospective case-control study. LFCR, lateral tibial slope (LTS), lateral tibial height (LTH), medial tibial slope (MTS), and medial tibial depth (MTD) were measured on MRI. The differences in each index between the two groups were compared, and risk factors were screened by single-factor logistic regression analysis. Indicators with P values < 0.1 were included in the logistic regression equation. The critical values and areas under the curve (AUCs) of independent risk factors were determined by receiver operating characteristic (ROC) curve analysis. Finally, the diagnostic performance of each risk factor was evaluated by the Z-test.ResultsA total of 116 patients who met the inclusion criteria were included in the final analysis (58 cases in the noncontact ACL injury group and 58 cases in the control group). Patients with noncontact ACL injury had a higher femoral LFCR (0.64 ± 0.03) than patients with isolated meniscus tears. Among all the risk factors for ACL injury, the AUC for LFCR was the largest, at 0.81 (95% CI, 0.73-0.88), and when the critical value was 0.61, the sensitivity and specificity for the diagnosis of ACL injury were 0.79 and 0.67, respectively. When combined with LTH (> 2.35 mm), the diagnostic performance was improved. The AUC was 0.85 (95% CI, 0.78-0.92), the sensitivity was 0.83, and the specificity was 0.76.ConclusionThis study shows that an increased LFCR is related to an increased risk of noncontact ACL injury as determined by MRI. LFCR and LTH are sensitive risk factors for noncontact ACL injury and may help clinicians identify individuals prone to ACL injury, allowing prevention and intervention measures to be applied.

Amyotrophic lateral sclerosis and delayed onset muscle soreness in light of the impaired blink and stretch reflexes - watch out for Piezo2.

Amyotrophic lateral sclerosis (ALS) is a fatal, multisystem neurodegenerative disease that causes the death of motoneurons (MNs) progressively and eventually leads to paralysis. In contrast, delayed onset muscle soreness (DOMS) is defined as delayed onset soreness, muscle stiffness, loss of force-generating capacity, reduced joint range of motion, and decreased proprioceptive function. Sensory deficits and impaired proprioception are common symptoms of both ALS and DOMS, as impairment at the proprioceptive sensory terminals in the muscle spindle is theorized to occur in both. The important clinical distinction is that extraocular muscles (EOM) are relatively spared in ALS, in contrast to limb skeletal muscles; however, the blink reflex goes through a gradual impairment in a later stage of disease progression. Noteworthy is, that, the stretch of EOM induces the blink reflex. The current authors suggest that the impairment of proprioceptive sensory nerve terminals in the EOM muscle spindles are partially responsible for lower blink reflex, beyond central origin, and implies the critical role of Piezo2 ion channels and Wnt-PIP2 signaling in this pathomechanism. The proposed microinjury of Piezo2 on muscle spindle proprioceptive terminals could provide an explanation for the painless dying-back noncontact injury mechanism theory of ALS.

농구동호인의 만성발목관절불안정성 유무에 따른 낙하수직점프 시 하지의 운동학적 비교

This study aimed to compare and to analyze lower extremity kinematics during drop vertical jump depending on chronic ankle instability(CAI) among basketball club members. For 34 basketball club members who are currently affiliated with the B Metropolitan City Sports Association, 18 CAI groups and 16 CON groups were classified according to the CAI standards provided by the International Ankle Consortium. Drop vertical jump is performed to measure the one-leg drop landing pattern, and joint movement at the initial contact (IC), and the point of peak knee flexion. In addition, the one-leg drop landing pattern was tested with the muscular activity of tibialis anterior, peroneus longus, medial gastrocnemius and gluteus medius at landing phase. The results of this study showed that knee flexion angle at the point of peak knee flexion was confirmed to be larger in the CAI group(129.79±5.26°) than in the CON group(124.71±3.84°). In both groups, larger ankle dorsiflexion displacement during drop vertical jump was associated with larger knee flexion displacement(respectively r=.568, p=.014; r=.738, p=.001) and at the initial contact larger ankle dorsiflexion angle (r=.747, p=.001; r=.872, p=.001) and knee-flexion angle (respectively r=.497, p=.036; r=.818, p=.001). These results are thought to be a risk factor for re-injury of ankle joints and non-contact injury of knee and hip joints due to changes in the kinetic chain of the lower extremities due to CAI, and changes in the lower extremities should also be considered for rehabilitation or prevention of CAI.

Influence of the Weekly and Match-play Load on Muscle Injury in Professional Football Players.

The aim of this investigation was to examine the impact of the weekly training load and the match running patterns prior to a muscle injury as potential risk factors of muscle injury in professional football players. Forty male professional football players participated in the investigation. Running distances at different intensities 5 min and 15 min prior to the injury were compared to the same time-points in official matches of the same player with no injury events. Furthermore, the cummulative session rating of perceived exertion (sRPE) and training load of the week prior to the injury were compared to a control week (mean value of training weeks without injury). Nineteen players suffered 31 non-contact muscle injuries during matches. The distance covered at 21-24 km/h (p<0.001; effect size (ES)=0.62) and at>24 km/h (p=0.004; ES=0.51) over the 5-min period prior to the injury was greater than in matches without injury. The cumulative sRPE (p=0.014; ES=1.33) and training volume (p=0.002; ES=2.45) in the week prior to the injury was higher than in a control week. The current data suggest that the combination of a training week with a high load and a short period of high intensity running during the match might increase the risk of muscle injury in professional footballers.

All-epiphyseal versus trans-epiphyseal screw fixation for tillaux fractures: Does it matter?

BACKGROUNDTillaux fractures occur primarily in adolescents due to the pattern of physeal closure and are classified as Salter-Harris type III physeal fractures. Operative management with screw fixation is recommended for more than 2 mm of displacement or more than 1 mm of translation. However, the efficacy and complications of trans-physeal vs all-physeal screw fixation have not been investigated extensively.AIMTo compare the clinical and functional outcomes of trans-physeal (oblique) and all-epiphyseal (parallel) screw fixation in management of Tillaux fractures among pediatric patients. METHODSThis was an ethics board approved retrospective review of pediatric patients who presented to our tertiary children’s care facility with Tillaux fractures. We included patients who had surgical fixation of a Tillaux fracture over a 10 year period. Data analysis included demographics, mode of injury, management protocols, and functional outcomes. The patients were divided into group 1 (oblique fixation) and group 2 (parallel fixation). Baseline patient characteristics and functional outcomes were compared between groups. Statistical tests to evaluate differences included Fisher’s Exact or Chi-squared and independent samples t or Mann Whitney tests for categorical and continuous variables, respectively.RESULTSA total of 42 patients (28 females and 14 males) were included. There were no significant differences in body mass index, sex, age, or time to surgery between the groups [IK2]. Sports injuries accounted for 61.9% of the cases, particularly non-contact (57.1%) and skating (28.6%) injuries. Computed Tomography (CT) scan was ordered for 28 patients (66.7%), leading to diagnosis confirmation in 17 patients and change in management plan in 11 patients. [GRC3] Groups 1 and 2 consisted of 17 and 25 patients, respectively. For mid to long-term functional outcomes, there were 14 and 10 patients in groups 1 and 2, respectively. Statistical analysis revealed no significant differences in the functional outcomes, pain scores, or satisfaction between groups. No infections, non-unions, physeal arrest, or post-operative ankle deformities were reported. Two (4.8%) patients had difficulty returning to sports post-surgery due to pain. One was a dancer, and the other patient had pain while running, which led to hardware removal. Both patients had parallel fixation. Hardware removal for groups 1 and 2 were 4 (23.5%) and 5 (20.0%) patients, respectively. The reasons for removal was pain in 2 patients, and parental preference in the remaining. CONCLUSIONThis is the largest reported series of pediatric patients with Tillaux fractures comparing functional outcomes of different methods of screw fixation orientation to the physis, which showed no difference regarding functional outcomes.

Influence of type I collagen polymorphisms and risk of anterior cruciate ligament rupture in athletes: a case-control study

BackgroundAnterior cruciate ligament (ACL) rupture is a common and severe knee injury in sports and occurs mostly due to noncontact injuries. There is an increasing amount of evidence associating ACL rupture to single nucleotide polymorphisms (SNPs), and SNPs in the collagen type I genes can change its expression and tissue mechanical features. This study aimed to investigate the association between SNPs in COL1A1 and COL1A2 with sports-related ACL tears.MethodsA total of 338 athletes from multiple sports modalities were analyzed: 146 were diagnosed with ACL rupture or underwent an ACL reconstruction surgery and 192 have no musculoskeletal injuries. SNPs were genotyped using validated TaqMan assays. The association of the polymorphisms with ACL rupture was evaluated by a multivariable logistic regression model, using odds ratios (OR) and 95% confidence intervals (CI).ResultsThe age, sport modality, and training location were associated with an increased risk of a non-contact ACL tear. COL1A2 SNPs (rs42524 CC and rs2621215 GG) were associated with an increased risk of non-contact ACL injury (6 and 4-fold, respectively). However, no significant differences were detected in the distribution of COL1A1 rs1107946 and COL1A2 rs412777 SNPs between cases and controls. There was a protective association with ACL rupture (OR = 0.25; 95% CI = 0.07–0.96) between COL1A1 rs1107946 (GT or TT) and the wildtype genotypes of the three COL1A2 (rs412777, rs42524, rs2621215). COL1A2 rs42524 and rs2621215 SNPs were associated with non-contact ACL risk.ConclusionThe combined analysis of COL1A1-COL1A2 genotypes suggests a gene-gene interaction in ACL rupture susceptibility.

The effects of learning with various noise on Gait Kinematics in 3-to-5-year-old children: a randomized controlled trial

BackgroundLack of the neuromuscular control during locomotion in the knee joint leads to an increased risk of anterior cruciate ligament (ACL) injury in children. Hence, we aimed to explore the effects of a repetitive, model-oriented, and self-organized approach on lower limb kinematics during gait in children.MethodsIn randomized controlled trial, 36 children with 4 ± 0.79 years of age from the children gym were randomly (a lottery method) allocated into three groups, including (1) the model-oriented (n = 10), (2) Differential Learning (n = 11), and (3) control (n = 10) groups. Kinematic data of hip, knee, and ankle joints in the sagittal plane were recorded by a GoPro camera at the moments of heel-ground contact and toe-off the ground before and after a 6-week intervention (two sessions per week).ResultsThe results indicate a 35% post-intervention increase of ankle dorsiflexion (95% CI: − 5.63 _ − 0.96) in the moment of heel-ground contact in the model-oriented group; however, knee flexion (95% CI: − 1.05 _ 8.34) and hip flexion (95% CI: 3.01 _ 11.78) were respectively decreased by 20% and 20%. After the intervention, moreover, ankle plantar flexion (95% CI: − 9.18 _ − 2.81) and hip extension (95% CI: − 12.87 _ − 3.72) have respectively increased by 37% and 37%, while knee flexion (95% CI: 3.49 _ 11.30) showed a %16 decrease in the moment of toe off the ground. As for the Differential Learning group, ankle dorsiflexion (95% CI: − 5.19 _ − 1.52) increased by 33%, and knee (95% CI: 0.60 _ 5.76) and hip flexion (95% CI: 2.15 _ 7.85) respectively decreased by 17% and 17% at the moment of the heel-ground contact following the intervention. At toe lifting off the ground, the plantar flexion (95% CI: − 7.77 _ − 2.77) increased by 35%, knee flexion (95% CI: 2.17 _ 7.27) decreased to 14%, and hip extension (95% CI: − 9.98 _ − 4.20) increased by %35 following the intervention for the Differential Learning group subjects. Based on the results obtained from the one-way ANOVA, there was a significant difference between these groups and the control group in all kinematic gait variables (p ≤ 0.05). However, no statistically significant differences were found between the two experimental groups.ConclusionsThe results implied that the model-oriented repetitive and the self-organized Differential Learning approach were both appropriate to alter the kinematic gait pattern in the 3–5-year-old children. Previous research has almost exclusively recommended a model-oriented approach to change kinematic patterns and preventing non-contact motor injuries. However, the present study showed that the Differential Learning approach can help children to achieve the same goal by continuously changing environments and stimulating challenges.Trial registration: Current Controlled Trials using the IRCT website with ID number of, IRCT20130109012078N5 “Prospectively registered” at 14/5/2021.

Influence of Compliance and Aging of Artificial Turf Surfaces on Lower Extremity Joint Loading

Background: Artificial turf (AT) has been related to increased injury rates when compared to natural grass (NG). One potential reason for the differences in injury rates is the difference in mechanical characteristics of the surfaces. Over the course of a season on artificial turf, due to heavy use and environmental factors, properties of the surface (such as compliance) may be altered. The purpose was to compare the effects of newly installed versus aged AT on injury risks at the metatarsophalangeal, ankle, and knee joint during soccer-specific movements. Methods: Eleven male soccer players performed three movements on newly installed and ‘aged’ AT. Kinematics and kinetics were collected for the different surfaces. Results: Knee adduction moments were increased during the v-cut (119 Nm vs. 164 Nm, p = 0.02), and knee external rotation joint moments were increased during the circle run (23 Nm vs. 28 Nm, p = 0.04) with the aged surface. No surface effects were seen during the jog-sprint transition. Conclusions: For movements associated with a high risk for non-contact injuries, the age of the AT resulted in greater risk factors for injury potential at the knee joint. Further research comparing injury rates associated with AT should consider mechanical features, specifically surface compliance.

Force Production Patterns of Muscles Surrounding Knee During Running and Cutting Maneuvers: A Musculoskeletal Modeling Approach

OBJECTIVES The purpose of this study was to investigate the force production patterns of individual muscles surrounding the knee during running (RUN) and cutting (CUT) tasks.METHODS Thirteen women (24.2±3.5 yrs, 162.8±6.0 cm, 55.3±6.2 kg) performed a series of running and cutting tasks. Running and cutting motions were recorded using a motion capture system and ground reaction force (GRF) was recorded using a force plate. Three-dimensional knee angle, ground reaction force, and knee joint moment were calculated using Visual3D software. OpenSim musculoskeletal modeling software was used to calculate the force of individual muscles including the medial hamstring, biceps femoris long head, biceps femoris short head, rectus femoris, vastus medialis, vastus lateralis, gastrocnemius medialis, and gastrocnemius lateralis. All data were analyzed for loading response (or weight acceptance), mid-stance, and final push-off periods, respectively and were compared between two tasks.RESULTS At loading response: external rotation angle, medial and vertical GRFs, and valgus moment for the CUT task were greater than those of the RUN task. Compared to the RUN task, the CUT task showed: 1) an increase in lateral hamstring muscle force at weight acceptance, 2) a decrease in hamstring muscle force and an increase in medial vastus muscle force at mid-stance, and 3) an increase in lateral gastrocnemius muscle force at final push-off.CONCLUSIONS Selective force production patterns of muscles surrounding the knee seem to offset the external load caused by the cutting motion. We anticipate that our results will provide basic data for future training programs designed to prevent noncontact knee injuries.

In National Collegiate Athletic Association Men’s and Women’s Soccer Athletes There Is a Low Rate of Lumbar Spine Injury, Women Suffer More Recurrent Injuries than Men, and Most Injuries Occur in the Preseason

PurposeTo use the National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) from the 2009-2010 through the 2014-2015 seasons to report lumbar spine injury rates, characteristics, and time lost from sport in soccer players.MethodsCharacteristics of lumbar spine injuries by season, competition/practice, and time lost from sport were determined using the NCAA-ISP database. Rates of injury were calculated as the number of injuries divided by the number of athlete exposures (AEs). AEs are any athlete participation in a competition or practice. Incidence rate ratios (IRRs) were calculated to compare rates between event types and time of season. Injury proportion ratios (IPRs) were used to evaluate differences in injury rates between men and women.ResultsThe NCAA-ISP estimated 4,464 LSIs over 5 years. The rate of LSI in men was 2.1/10,000 AEs and 3.0/10,000 AEs in women. Women were 1.43 times more likely to suffer an LSI compared to men. Women were 2.15 times as likely to suffer an LSI in competition compared to in practice while men were 1.10 times as likely. Women were 2.15 times as likely to be injured in the preseason compared to the regular season, while men were 3.76 times as likely. Non-contact injuries were the most common cause of lumbar spine injuries (LSIs) in men (35%); however, contact injuries were more common in women (33%). Most athletes both male (57%) and female (59%) returned to play within 24 hours.ConclusionThis study provides information on the characteristics of LSIs in NCAA soccer. The overall injury rate to the lumbar spine is relatively low. Injury rates are highest in the preseason and in competition. Women suffer from more recurrent LSI’s than men, and men acquired more injuries through non-contact mechanisms. More than one-half of athletes returned to sport within 24 hours.

Match and training injury risk in semi-professional rugby union: A four-year study

ObjectivesDescribe medical-attention and time-loss injuries during matches and training in a Welsh Premiership Rugby Union team. DesignProspective cohort observational study. MethodsInjury incidence, severity, burden, location, type, and cause were determined in sixty-nine players from one semi-professional Rugby Union team. ResultsMedical-attention and time-loss injury incidence was greater for matches (incidence, 95% confidence interval = 122.8, 108.9–138.4 and 99.8, 87.3–114.0) than training (incidence, 95% confidence interval = 2.2, 1.8–2.6 and 1.7, 1.4–2.1) per 1000 player-hours. Injury severity was similar for matches (time-loss ± standard deviation = 24.9 ± 30.8 days) and training (time-loss ± SD = 22.4 ± 29.1 days), with injury burden greater for matches (burden, 95% confidence interval = 3148.8, 3019.8–6479.2) than training (burden, 95% confidence interval = 49.7, 36.7–129.6). Lower-limb time-loss injuries were most common during matches (incidence, 95% confidence interval = 46.0, 37.9–55.9) and training (incidence, 95% confidence interval = 1.3, 1.0–1.7) per 1000 player-hours, whilst upper-limb injuries were most severe in matches (time-loss, 95% confidence interval = 38.8, 28.3–44.4 days) and training (time-loss, 95% confidence interval = 45.9, 17.5–52.7 days). The prevalent cause of contact-injury was tackling (31%) with running (11%) the common cause of non-contact injury. ConclusionsTime-loss match-injury incidence, severity, and burden were similar to data reported in the professional tier, with similar patterns of injuries for location, type, and inciting event. These figures are greater than previously reported for semi-professional Rugby Union, warranting further investigation at this level of play.

The influence of maturity on recovery and perceived exertion, and its relationship with illnesses and non-contact injuries in young soccer players.

A high training load could increase the risk of injury in soccer players. However, there is still a lack of knowledge regarding the effect on young athletes, in whom a different maturity status could lead to different physiological responses to training. Therefore, the aim of this study was to investigate the association of internal load markers and recovery status with risk of illnesses and non-contact injuries in young soccer players characterised by different maturity status. Twenty-three U14 soccer players were monitored during a full season and categorised according to years from peak height velocity (PHV). Based on the estimated values, athletes were divided into three different groups: Pre-PHV, Circa-PHV and Post-PHV players. The following internal load markers were monitored: rating of perceived exertion (RPE), session rating of perceived exertion (S-RPE), weekly load (WL), cumulative loads for 2, 3, and 4 weeks (WL2, WL3, WL4), acute to chronic workload ratio for 2, 3 and 4 weeks (A:C2, A:C3, A:C4) and week-to-week percentage variation (%WL). Recovery status was quantified using the total quality recovery (TQR) scale. Z-score transformation was adopted for TQR and RPE values and the difference between the parameters was calculated (Z-TQR-RPE). The Kruskal-Wallis test was adopted to evaluate differences in TQR and RPE with respect to maturity offset. A multinomial regression analysis was performed to evaluate the association between internal load markers and risk of illness and non-contact injuries. The variables that showed a significant association were included in the receiver operating characteristic (ROC) curve analysis. The results revealed that RPE was significantly higher (p < 0.01) and TQR significantly lower (p < 0.05) in Post-PHV compared to Pre- and Circa-PHV. Moreover, RPE, A:C4, TQR and Z-TQR-RPE showed a significant (p < 0.01) association with non-contact injuries. The internal load markers included in ROC curve analysis showed poor predictive ability (AUC ≤ 0.6). A rapid increase in training load together with a decrease in recovery status may produce higher susceptibility to illnesses and non-contact injuries. The contrasting physiological responses found in relation to maturity status could explain the different injury predisposition in young soccer players.

Patterns of presentation and early treatment outcomes of anterior cruciate ligament injury at the National Orthopaedic Hospital, Lagos, Nigeria: a retrospective cross-sectional study

The purpose of this study was to determine the patterns of presentation and early treatment outcomes of anterior cruciate ligament tears at the National Orthopaedic Hospital, Lagos, Nigeria. This was a retrospective cross-sectional study in which the details of all anterior cruciate ligament injuries seen from January 2014 to December 2018 in our facility were noted. The bio-demographic details of the patients were noted as well as the side of the injury, mechanism of injury, type of sporting activity patient was engaged in at the time of injury and the early outcome of treatment of the patients were noted. A total of 19,707 new orthopaedic and musculoskeletal trauma cases were seen in the period. The overall hospital period prevalence rate of anterior cruciate ligament injury in the period was 3.6 per 1000 patients with a gender-specific prevalence rates of 5.7 per 1000 and 1.6 per 1000 for male and female patients respectively. The mean time between injury and presentation was 16 (±21) months with a range of 1-120 months. The commonest aetiology of anterior cruciate ligament injury was non-contact injury during sporting activities. There was a greater involvement of the young and active population in this injury. Sports and road traffic crash related injuries were the commonest injury aetiology in our environment. The early treatment outcomes revealed a significant improvement of the post-operative functional knee scores over the pre-operative functional knee scores.

Epidemiology of Traumatic Posterior Hip Instability in the National Football League.

Background:There is a paucity of literature regarding injury incidence, mechanism, and return to play in National Football League (NFL) players who have sustained traumatic posterior hip instability.Purpose:To describe the incidence of traumatic posterior hip instability and the rate of return to play in NFL players across 18 seasons.Study Design:Descriptive epidemiology study.Methods:We retrospectively assessed all traumatic posterior hip dislocations/subluxations that occurred during football-related activities in the NFL seasons from 2000 through 2017. Player demographics and injury data (injury mechanism, season of injury, treatment, days missed, and return to play time) were collected from all 32 NFL teams prospectively through a leaguewide electronic health record system. Descriptive statistics are presented.Results:Across the 18 NFL seasons, 16 posterior hip instability injuries in 14 players were reported, with a maximum incidence of 4 (25%) in 2013. Posterior hip instability was predominantly sustained by offensive players (64.3%), with tight ends being the most affected (31.3%). Half of the injuries occurred during the regular season, 43.8% in the preseason, and 6.2% in the offseason. Of all injuries, 37.5% were noncontact, while 56.3% involved contact (direct or indirect), and 6.2% were of unknown mechanism. Among noncontact injuries, 66.7% occurred during cutting and change of direction while sprinting. The time of return to full participation was documented for 11 of the 16 reported injuries (68.8%); among them, the mean time loss was 136.7 ± 83.8 days—143.3 ± 99.6 days if the player underwent surgery (n = 4) and 116.7 ± 76.2 days missed by players without surgery (n = 6)—the treatment modality was unknown in 1 player.Conclusion:Although the incidence of traumatic posterior hip instability during the study period was low, all injured athletes missed time from football activities and competitions. Injuries that required surgery led to more missed time than those that did not. Ongoing research to understand risk factors and mechanisms of this injury, in conjunction with improvements to prevention and rehabilitation protocols, is necessary to ensure the safety of professional American football players.