Non-contact Injuries Research Articles

Evaluation of the Kinesio Taping and Real-Time External Feedback Effects on Lower Extremity Function During Single-Leg Squat in Individuals With Tibiofemoral Varus Alignment

Background and Aims People with postural malalignment such as tibiofemoral varus (TFRV) may experience movement patterns dysfunction during functional activities that are related to non-contact lower extremity injuries. Training protocols should be designed for these people to control and improve their functional dysfunctions. The present study aimed to investigate the effect of posterior X-taping (PXT) and real-time external feedback (RTF) on kinematic and electromyographic indices of the lower extremities during the single-leg squat task in individuals with TFRV. Methods Electromyographic and kinematic information of the lower extremities of 24 recreational athletes with TFRV (PXT=12, RTF=12) were recorded while participants in both groups performed single-leg squat 5 times consecutively and took a 2-minute rest between two different conditions (before and after the intervention). To analyze the data, 2-way analysis of variance and Bonferroni post hoc test were used at the significant level of P≤0.05. Results The present study results indicated an increase in gluteus medius muscle activity (P=0.013) in the eccentric phase and a decrease in hip adduction (P=0.001) in maximal knee flexion (P=0.034) after the intervention compared to before the intervention in the RTF group. Also, there was a reduction in external tibiofemoral rotation of the knee after the intervention compared to before intervention in maximal knee flexion (P=0.034), eccentric phase (P=0.001), and concentric phase (P=0.001) in the PXT group. In addition, there was a decreased ankle pronation after the intervention compared to before the intervention in the eccentric phase (P=0.001) and concentric (P=0.001) in the PXT group and in the eccentric phase (P=0.004) in the RTF group. Besides, there was an increased ankle abduction after the intervention compared to before the intervention in the concentric phase (P=0.001), eccentric phase (P=0.001), and maximum knee flexion (P=0.004) in the PXT group, and in the eccentric phase in the RTF group (P=0.006). Finally, there was a decrease in ankle flexion dorsiflexion at maximum knee flexion after the intervention compared to before the intervention (P=0.017) in the RTF group. Conclusion The results of the present study showed that PXT and RTF interventions can affect the kinematic parameters of individuals with TFRV malalignment in different ways and can be used to correct immediately postural defects during the single-leg squat task.

Genes Associated with Muscle, Tendon and Ligament Injury Epidemiology in Women’s Amateur Football Players

Background: There is a lack of specific genetic studies regarding injuries in women’s football. However, different genetic factors have been associated with tendon/ligament injuries in women football players. The aim of the study was to examine the genotypic frequencies of genes associated with injury risk and epidemiology in women’s amateur football players and the aetiology of injuries. Methods: In total, 168 women’s amateur football players from football clubs in the Spanish second division league and Caucasian descent were enrolled in this prospective observational cross-sectional study. AMPD1 (rs17602729), ACE (rs4646994), ACTN3 (rs1815739), CKM (rs8111989) and MLCK (rs2849757 and rs2700352) polymorphisms were genotyped. The characteristics of 169 non-contact injuries during the 2022/2023 season were classified following the International Olympic Committee (IOC) Consensus Statement for reporting injuries as follows: musculoskeletal, tendon/ligament, injury setting; and severity. The disequilibria of polymorphisms were estimated using the Hardy–Weinberg Equilibrium (HWE). The characteristics of the injuries were recorded, and the genotype characteristics were analysed. The genotype frequencies of all polymorphisms were compared between non-injured and injured football players and injury aetiologies. Results: The AMPD1 genotype distribution differed between tendon/ligament injured and non-injured (p = 0.003) with a higher frequency in the TT genotype and T allele. The genotype distribution was different for the CKM and MLCK c.37885C>A polymorphisms in training and match injuries (p = 0.038 and p = 0.031, respectively). In the ACTN3 and AMPD1 polymorphisms, the distribution of the TT genotype in both genes showed a higher frequency in severe injuries (all p < 0.001). Conclusions: Tendon/ligament injury epidemiology in women’s amateur football players was associated especially with the TT genotype of the AMPD1 gene. The TT genotype of the AMPD1 and ACTN3 genes was also associated with severity, and the CKM and MLCK polymorphisms were associated with injury settings.

Reconstruction of proximal hamstring ruptures restores joint biomechanics during various walking conditions.

We aimed to examine the functional outcome in different walking conditions in elderly adults who underwent surgical repair after a non-contact hamstring injury. Our objective was to compare lower limb kinematics and kinetics over the entire gait cycle between the injured and contralateral leg in overground and level and uphill treadmill walking. 12 patients (mean ± SD, age: 65 ± 9 years; body mass index: 30 ± 6 kg/m2) walked at self-selected speed in overground (0% slope) and treadmill conditions (0% and 10% slope). We measured spatiotemporal parameters, joint angles (normalised to gait cycle) and joint moments (normalised to stance phase) of the hip, knee and ankle. Data between sides were compared using paired sample t-tests (p < 0.05) and continuous 95% confidence intervals of the paired difference between trajectories. Patients walked at an average speed of 1.31 ± 0.26 m/second overground and 0.92 ± 0.31 m/second on the treadmill. Spatiotemporal parameters were comparable between the injured and contralateral leg (p > 0.05). Joint kinematic and joint kinetic trajectories were comparable between sides for all walking conditions. Refixation of the proximal hamstring tendons resulted in comparable ambulatory mechanics at least 1 year after surgery in the injured leg and the contralateral leg, which were all within the range of normative values reported in the literature. These results complement our previous findings on hamstring repair in terms of clinical outcomes and muscle strength and support that surgical repair achieves good functional outcomes in terms of ambulation in an elderly population. clinicaltrials.gov (NCT04867746).

Increased Posterior Tibial Slope Is Associated With Increased Risk of Meniscal Root Tears: A Systematic Review

Background: While increased posterior tibial slope (PTS) is an established risk factor for anterior cruciate ligament tears, the association between tibial slope and meniscal posterior root tears is not well-defined. Purpose: To summarize the available literature evaluating the association between PTS and meniscus root injuries compared with patients without root tears. Study Design: Systematic review; Level of evidence, 4. Methods: A literature search was performed using the Scopus, PubMed, and Embase databases. Human clinical studies evaluating the associations between the medial tibial slope (MTS), lateral tibial slope (LTS), lateral-to-medial (L-to-M) slope asymmetry, and the risk of meniscus root tears were included. Patients with medial meniscus posterior root tears (MMPRTs) and lateral meniscus posterior root tears (LMPRTs) were compared with a control group without root injury. Study quality was assessed using the methodological index for non-randomized studies criteria. Results: Ten studies with 1313 patients were included (884 patients with root tears; 429 controls). The LMPRT subgroup (n = 284) had a significantly greater LTS (mean ± SD, 7.3°± 1.5° vs 5.7°± 3.91°; P < .001), MTS (5.26°± 1.2° vs 4.8°± 1.25°; P < .001), and increased L-to-M asymmetry (2.3°± 1.3° vs 0.65°± 0.5°; P < .001) compared with controls. The MMPRT group (n = 600) had significantly increased MTS relative to controls (8.1°± 2.5° vs 4.3°± 0.7°; P < .001). Furthermore, there was a higher incidence of noncontact injuries (79.3%) and concomitant ramp lesions (56%) reported in patients with LMPRT. Conclusion: Increased MTS, LTS, and L-to-M slope asymmetry are associated with an increased risk of LMPRTs, while increased MTS is associated with MMPRTs. Surgeons should consider how proximal tibial anatomy increases the risk of meniscus root injury.

Increased knee torsional misalignment associated with femoral torsion is related to non-contact anterior cruciate ligament injury: a case-control study.

Altered axial biomechanics of the knee are recognized as a risk factor for non-contact anterior cruciate ligament (ACL) injury. However, the relationship of knee and segmental torsion to non-contact ACL and combined anterolateral ligament (ALL) injury is unclear. This study aims to determine the relationship of knee and segmental torsion to non-contact ACL injury and to explore their relationship with ALL injuries. We divided 122 patients with arthroscopically confirmed non-contact ACL injuries into an ACL injury group (isolated ACL injury, 63 patients) and an ACL + ALL injury group (ACL combined with ALL injury,59 patients). Additionally, 90 normal patients with similar age, gender and body mass index (BMI) were matched as a control group. The tibial tubercle-trochlear groove (TT-TG) distance, distal femoral torsion (DFT), posterior femoral condylar torsion (PFCT) and proximal tibial torsion (PTT) were measured using magnetic resonance imaging (MRI). We assessed the differences between the groups using an independent samples t test and utilized receiver operating characteristic (ROC) curves to determine the cut-off value for the increased risk of ACL injury. In patients with ACL injury, the measurements of the TT-TG (11.8 ± 3.1mm), DFT (7.7° ± 3.5°) and PFCT (3.6° ± 1.3°) were significantly higher compared to the control group (9.1 ± 2.4mm, 6.3° ± 2.7° and 2.8° ± 1.3°, respectively; P < 0.05), but the PTT did not differ between the two groups. The TT-TG, DFT and PFCT were not significantly larger in patients combined with ALL injury. ROC curve analysis revealed ACL injury is associated with TT-TG, DFT and PFCT. Knee torsional alignment is associated with ACL injury, predominantly in the distal femur rather than the proximal tibia. However, its correlation with ALL injury remains unclear. These findings may help identify patients at high risk for non-contact ACL injury and inform the development of targeted prevention and treatment strategies.

Anterior cruciate ligament injuries in female athletes: risk factors and strategies for prevention.

Anterior cruciate ligament (ACL) injuries are among the most common and debilitating knee injuries in professional athletes with an incidence in females up to eight-times higher than their male counterparts. ACL injuries can be career-threatening and are associated with increased risk of developing knee osteoarthritis in future life. The increased risk of ACL injury in females has been attributed to various anatomical, developmental, neuromuscular, and hormonal factors. Anatomical and hormonal factors have been identified and investigated as significant contributors including osseous anatomy, ligament laxity, and hamstring muscular recruitment. Postural stability and impact absorption are associated with the stabilizing effort and stress on the ACL during sport activity, increasing the risk of noncontact pivot injury. Female patients have smaller diameter hamstring autografts than males, which may predispose to increased risk of re-rupture following ACL reconstruction and to an increased risk of chondral and meniscal injuries. The addition of an extra-articular tenodesis can reduce the risk of failure; therefore, it should routinely be considered in young elite athletes. Prevention programs target key aspects of training including plyometrics, strengthening, balance, endurance and stability, and neuromuscular training, reducing the risk of ACL injuries in female athletes by up to 90%. Sex disparities in access to training facilities may also play an important role in the risk of ACL injuries between males and females. Similarly, football boots, pitches quality, and football size and weight should be considered and tailored around females' characteristics. Finally, high levels of personal and sport-related stress have been shown to increase the risk of ACL injury which may be related to alterations in attention and coordination, together with increased muscular tension, and compromise the return to sport after ACL injury. Further investigations are still necessary to better understand and address the risk factors involved in ACL injuries in female athletes.

The Injury Mechanism of Achilles Tendon Rupture in Professional Athletes: A Video Analysis Study.

In professional athletes, Achilles tendon ruptures are devastating injuries, often resulting in season loss or decreased return to sports level. We aimed to perform a comprehensive video analysis to describe the mechanisms of Achilles tendon rupture as well as body posture in professional athletes. We hypothesized that Achilles tendon ruptures in professional athletes develop with a specific injury mechanism and that body posture at the time of injury varies by sport. Of 114 identified Achilles tendon ruptures that occurred in professional athletes between 1970 and 2020, 42 with adequate video data were analyzed for injury mechanism, body posture, and player and sport characteristics by three independent reviewers. Mean ± SD age of the 42 athletes (41 men and 1 woman) was 28.4 ± 4.26 years. Eighteen athletes played basketball (42.9%), 14 football (33.3%), five soccer (11.9%), three baseball (7.1%), and two rugby (4.8%). Thirty-five patients (83.3%) had noncontact injuries. The most frequent months of injury were January (16.7%) and October (14.3%). During Achilles tendon rupture, the ankle was in dorsiflexion, the body was bent forward, the knee and hip were in extension, and the foot was in a neutral position. Most injuries occurred during take-off/acceleration (40.5%) or stop and turn (38.5%) maneuvers. In professional athletes, the Achilles tendon most often ruptures during take-off/acceleration. The most common position during rupture is the trunk in flexion, the knee and hip in extension, and the ankle in dorsiflexion. This information can guide professional athletes in terms of physical therapy techniques, including neuromuscular training, proprioception, and balance training specific to preventing Achilles tendon rupture.

Knee Laxities Changes with Sex-steroids throughout the Menstrual Cycle Phases in Athlete and Non-athlete Females.

Objective: Our study investigated changes of knee laxities in athletes and non-athletes females and relationship between knee laxity and sex-steroid at menstrual cycle phases. Methods: Forty six healthy females, twenty four athletes and twenty two non-athletes not on hormone contraceptive pills, had no previous knee injuries and with regular menstrual cycles for 3 consecutive months, participated in the study. Medial and lateral knee laxities were determined by varus-valgus tests at follicular, ovulatory and luteal phases. Serum level of relaxin, estrogen, progesterone and testosterone were determined by ELISA and radioimmunoassay. Results: Knee laxities in athletes and non-athletes at 0° and 20° flexion were the highest in luteal phase with non-athletes possess greater laxity than athletes. Positive correlation between progesterone and relaxin levels with knee laxities were observed. Meanwhile, the levels of both hormones were highest in the luteal phase. Conclusion: Increased medial and lateral knee laxities in athletes and non-athletes associated with high serum progesterone and relaxin levels in luteal phase may contribute toward increased risk of non-contact knee injury. However, lower knee laxity in athletes than non-athletes suggest that exercise could be a protective factor.

Predictors of Anterior Cruciate Ligament Re-tear and Return to Sport in Adolescent Athletes

Objectives: The purpose of this study was to characterize recent epidemiologic trends of ACL injuries and re-tear rates in high school adolescents and determine variables associated with sustaining secondary ACL injury. We hypothesized protective rehabilitation factors (i.e., greater time to return to sport, formal sport clearance, and physical therapy compliance) would decrease the risk of secondary ACL injury. Methods: A prospectively maintained database from a single institution with standardized data collection focused on ACL injuries was retrospectively reviewed for all patients 18 or younger who underwent primary ACL reconstruction between 2015 to 2020. Patients were eligible for inclusion in this study if they were between the ages of 13-18 years old, participated in sporting activity in high school, and underwent evaluation and primary ACLR at a single institution. Electronic medical records (EMR) were reviewed for patient demographic information and documentation review from prior injury/surgery. This information included the following: age, sex, body mass index (BMI), school grade (if documented), race, sport played, mechanism of injury (contact versus non-contact), time to return to sport (RTS), and number of post-operative physical therapy (PT) visits. Injury in contact and non-contact sport were defined based on the level of impact on the mechanism of injury sustained. Contact injury was defined as impacted collision with another person or object directly prior to injury onset. Non-contact injuries include isolated twisting movements of the knee without a sustained direct impact injury due to another player or object. Time to RTS was defined as the number of months following ACL reconstruction surgery until the patient was documented clear to return to sporting activity by the operating surgeon. Number of PT visits was calculated by EMR review of documented PT visits. Results: A total of 387 pediatric patients were included in statistical analysis. Of these patients, 72 (19%) sustained a secondary ACL injury and 315 (81%) did not. The overall mean age at primary ACLR and standard deviation was 16.0 ± 1.4 years (range 12-18 years). By univariable analysis, age at primary ACLR, time to RTS, and follow-up duration were all associated with secondary ACL injury (p &lt; 0.05). Patients with a secondary ACL injury were significantly younger than those who did not sustain a subsequent ACL tear (16.2 ± 1.3 versus 15.5 ± 1.6 years, respectively, p = 0.0026). Time to RTS following primary ACL injury was shorter in patients who sustained a secondary ACL injury (7.9 ± 2.0 months versus 8.9 ± 2.5 months, p = 0.0361). Cox regression analysis performed demonstrated as age at primary ACLR increases by 1 year, the rate of secondary ACL injury decreases by 29%. Similarly, a 1-month delay in return to sport decreases the rate of secondary ACL injury by 17%. Conclusions: Younger age and longer time to return to sport following ACL injury are significant variables associated with sustaining secondary ACL injury in the pediatric patient population. Counseling of young adolescent athletes should include adequate physical therapy compliance and allowing for adequate healing and time to return to sport.

Non-contact lower limb injuries in Rugby Union: A two-year pattern recognition analysis of injury risk factors.

The cause of sport injuries are multifactorial and necessitate sophisticated statistical approaches for accurate identification of risk factors predisposing athletes to injury. Pattern recognition analyses have been adopted across sporting disciplines due to their ability to account for repeated measures and non-linear interactions of datasets, however there are limited examples of their use in injury risk prediction. This study incorporated two-years of rigorous monitoring of athletes with 1740 individual weekly data points across domains of training load, performance testing, musculoskeletal screening, and injury history parameters, to be one of the first to employ a pattern recognition approach to predict the risk factors of specific non-contact lower limb injuries in Rugby Union. Predictive models (injured vs. non-injured) were generated for non-contact lower limb, non-contact ankle, and severe non-contact injuries using Bayesian pattern recognition from a pool of 36 Senior Academy Rugby Union athletes. Predictors for non-contact lower limb injuries included dorsiflexion angle, adductor strength, and previous injury history (area under the receiver operating characteristic (ROC) = 0.70) Dorsiflexion angle parameters were also predictive of non-contact ankle injuries, along with slower sprint times, greater body mass, previous concussion, and previous ankle injury (ROC = 0.76). Predictors of severe non-contact lower limb injuries included greater differences in mean training load, slower sprint times, reduced hamstring and adductor strength, reduced dorsiflexion angle, greater perceived muscle soreness, and playing as a forward (ROC = 0.72). The identification of specific injury risk factors and useable thresholds for non-contact injury risk detection in sport holds great potential for coaches and medical staff to modify training prescriptions and inform injury prevention strategies, ultimately increasing player availability, a key indicator of team success.

Lower Extremity Reaction Time in Individuals With Contact Versus Noncontact Anterior Cruciate Ligament Injuries After Reconstruction.

Deficits in perceptual-motor function, like visuomotor reaction time (VMRT), are risk factors for primary and secondary anterior cruciate ligament (ACL) injury. Noncontact ACL injuries have been associated with slower reaction time, but whether this association exists for patients with contact ACL injuries is unknown. Exploring differences in VMRT among individuals with contact versus noncontact ACL injuries may provide a more comprehensive understanding of modifiable risk factors. To compare lower extremity VMRT (LEVMRT) in individuals with contact or noncontact ACL injuries after ACL reconstruction (ACLR). Cross-sectional study. Research laboratory. A total of 36 participants with primary, unilateral ACLR completed an LEVMRT assessment (contact ACL injury = 20 [56%], noncontact ACL injury = 16 [44%]). The LEVMRT was assessed bilaterally and collected using a series of wireless light discs deactivated by individuals with their feet. The ACLR-active LEVMRT (ie, ACLR limb is deactivating lights) and ACLR-stable LEVMRT were compared using separate analyses of covariance to determine the association with contact or noncontact injury using time since surgery as a covariate. After controlling for time since surgery, a difference and large effect size between groups was found for the ACLR-stable LEVMRT (P = .010; η2 = 0.250) but not for the ACLR-active (P = .340; η2 = 0.065) condition. The contact group exhibited slower ACLR-stable LEVMRT (521.7 ± 59.3 milliseconds) than the noncontact group (483.4 ± 83.9 milliseconds). Individuals with contact ACL injury demonstrated a slower LEVMRT while their ACLR limb was stabilizing. The group differences during the ACLR-stable LEVMRT task might indicate deficits in perceptual-motor function when the surgical limb maintains postural control during a reaction time task. After ACLR, individuals with contact injuries may need additional motor learning interventions to enhance perceptual-motor functioning.

Hamstring muscle injury is preceded by a short period of higher running demands in professional football players.

The aim of this study was to examine match running patterns before a hamstring muscle injury occurs during a match in male professional football players. A total of 281 male professional football players belonging to 7 teams from LaLiga were prospectively monitored over three seasons. Among these, 36 players suffered a non-contact hamstring muscle injury during an official match. The injuries were recorded by the medical staff, including the minute when the injury occurred. Running distances at different speed thresholds for 5 min and 15 min before the injury were compared to mean values of the previous 5 matches for the same time points. There were a total of 44 non-contact hamstring muscle injuries, which represents a hamstring muscle injury incidence of 3.34 injuries/1000 h of match exposure. The average time loss for these injuries was 33 ± 28 days (range 7 to 117 days). In the 15 min prior to the injury, players ran a similar distance as in control matches (p from 0.22 to 0.08). However, players ran a greater distance in the 5-min period before the injury than in control matches at 21.0-23.9 km/h (p < 0.001) and at ≥ 24 km/h (p < 0.001). The odds ratio for a hamstring muscle injury was 7.147 for those players who ran > 30.0 m at ≥ 21 km/h in a 5-min period (p < 0.001). Hamstring muscle injuries during competition were preceded by 5 min of higher running demands at > 21 km/h, compared with control matches. This suggests that a short period of unusual running increases the risk of hamstring muscle injury in professional football players.

Lower hamstring to quadriceps muscle strength ratio and lower body weight as factors associated with noncontact anterior cruciate ligament injury in male American football players: A prospective cohort study

BackgroundPrevious studies have aimed to determine the use of certain risk factors in predicting the occurrence of noncontact anterior cruciate ligament (ACL) injuries. Unfortunately, evidence regarding noncontact ACL injuries in male American football players is limited. This prospective cohort study aimed to identify intrinsic risk factors for noncontact ACL injury among male American football players. MethodsThis study evaluated 152 male American football players in Japan for potential noncontact ACL injury risk factors during a preseason medical assessment, including anthropometric, joint laxity, and flexibility, muscle flexibility, muscle strength, and balance measurements. A total of 25 variables were examined. Participants were monitored during each season for noncontact ACL injury, as diagnosed by physicians. ResultsNoncontact ACL injuries occurred in 11 knees of 11 players (prevalence; 7.1 %). Injured players were significantly more likely to have lightweight (P = 0.049). No statistically significant between-group differences were found for any other variables. Participants with a lower hamstring to quadriceps (H/Q) ratio (P = 0.04) were more likely to sustain noncontact ACL injuries. ConclusionLower H/Q ratio and lower body weight were significantly associated with new-onset noncontact ACL injury in male American football players. These findings will help develop strategies to prevent noncontact ACL injuries in male American football players.

Effects of Balance and Proprioceptive Exercises on the Balance of Ice Hockey Players and the Risk of Lower Limb Injuries

Background. Most ice hockey injuries are contact, but about 15% are non-contact musculoskeletal injuries and lower body injuries account for 30-45% of all injuries in ice hockey players. It is believed that proprioception and balance training can improve neuromuscular control, improve its ability to synchronise the muscle joint to improve dynamic stability and improve human performance, so balance and proprioception are suggested exercises as a regular part of training. The aim. To determine the effects of a 6-week balance and proprioception training exercises on balance and lower extremity injury risk in ice hockey players. Material and methods. 20 men were randomly divided into experimental and control groups. Six weeks were applied to the research group balance and proprioception exercises, twice a week for 45 minutes next to their regular training. The control group continued with regular training. Before and after the study, static balance was assessed by the flamingo test, dynamic balance and lower extremity injury risk by the modified star excursion test, and injury risk assessment using the Functional Movement Assessment. Results. In the intervention group after 6 weeks the static balance of the right and left leg improved statistically significantly (p&lt;0,05), the dynamic balance of the right and left leg in the front, posteromedial, posterolateral directions (p&lt;0,05), but functional movement patterns did not change statistically significantly (p&gt;0,05). A statistically significant difference was found between the groups in the dynamic balance of the left and right leg in the front, posteromedial, and posterolateral directions (p&lt;0,05) and the static balance of the right leg (p&lt;0,05). The results of the intervention group were better compared to the control group. Conclusions. After the application of balance and proprioception training exercises, the static and dynamic balance of ice hockey players improved and the risk of injury in ice hockey players decreased. Recommendations. Balance and proprioception exercises should be included in hockey physical training to improve static and dynamic balance and reduce the risk of injury. When performing balance and proprioception exercises, we recommend incorporating a variety of specific movements that are similar to those performed by athletes during training and competition. In order to determine the cause of injuries and their risk, it is very important to carry out regular tests, store them and analyse them. Keywords: balance, proprioception, hockey, injury risk

Injury incidence among adolescent and senior basketball players: a prospective study in 19 teams across an entire season

ABSTRACT Objective To quantify and compare injury incidence between national-level, adolescent and regional-level, senior, male basketball players competing in Serbia overall and according to injury mechanism (contact, non-contact, or overuse), exposure setting (training or games), and history (new or recurrent). Methods A total of 218 male basketball players from 19 teams (106 senior and 112 adolescent players) volunteered to participate in the study. Descriptive data regarding game and training injury incidence were gathered across all players and reported per 10,000 athlete-exposures (AE) with 95% confidence intervals. Results Overall, 26 injuries were reported across 52,509 AE. Ankle (n = 10, incidence rate [IR] = 1.90 [0.97, 3.40]) and knee injuries (n = 8, IR = 1.52 [0.71, 2.89]) accounted for 69% of all reported injuries, with only 1–2 injuries documented for other body regions. Ankle injuries were attributed to contact (60%, IR = 1.14 [0.46, 2.38]) or non-contact mechanisms (40%, IR = 0.76 [0.24, 1.84]). Most knee injuries occurred due to overuse (50%, IR = 0.76 [0.24, 1.84]) or non-contact mechanisms (38%, IR = 0.57 [0.15, 1.56]). Comparisons according to exposure setting revealed significantly higher knee (incidence rate ratio [IRR] = 9.95 [1.85, 53.41], p = 0.004) and ankle (IRR = 39.79 [7.94, 384.67], p < 0.001) injuries per 10,000 AE during games compared to training. Recurrent injuries were most prominent in the ankle (30% of all ankle injuries, p = 0.11). Total contact (p = 0.04), non-contact (p = 0.04), and recurrent IR (p = 0.005) were significantly higher in senior than adolescent players. Conclusion The players examined were most susceptible to ankle and knee injuries, particularly during games compared to training. Ankle injuries were mostly attributed to player contact, while knee injuries were mostly attributed to overuse and non-contact mechanisms. Senior players were at a greater risk of sustaining contact, non-contact and recurrent injuries than adolescent players.

Recurrent cyclops lesion after primary anterior cruciate ligament reconstruction using bone tendon bone allograft: A case report

BACKGROUND Cyclops lesions are a known complication of anterior cruciate ligament (ACL) reconstruction, with symptomatic cyclops syndrome occurring in up to 11% of surgeries. Recurrent cyclops lesions have been rarely documented; this case study documents the successful treatment of a recurrent cyclops lesion. CASE SUMMARY A 28-year-old female presented following a non-contact injury to the right knee. Workup and clinical exam revealed an ACL tear, and arthroscopic reconstruction was performed. Two years later a cyclops lesion was discovered and removed via arthroscopic synovectomy. Seven months postoperatively, the patient presented with pain, stiffness, and difficulty achieving terminal extension. A smaller recurrent cyclops lesion was diagnosed, and a repeat synovectomy was performed. The patient recovered fully. CONCLUSION To the best of our knowledge, this is the first documented case of recurrent cyclops lesion after bone-patellar tendon-bone allograft ACL reconstruction presenting as cyclops syndrome.

Association between Functional Movement Screening™ scores and non-contact injuries in amateur rugby players

Objective: To examine the associations between the Functional Movement Screening (FMS™) scores and asymmetries between limbs in the different tasks with non-contact injuries in senior amateur rugby union players. Method The design was a prospective cohort study. Sixty-eight (n = 68) male senior amateur rugby players completed the FMS™, which assesses seven functional movements on a scale of 0 to 3 and provides a total score of up to 21. Players were subsequently monitored for injuries during one competitive season. Likewise, match and training non-contact injuries with the associated variables were collected. Results: Twenty-two (32.3%) players sustained one non-contact injury during the season. The median time lost was 24.5 days (IQR [15; 383]). Injured players showed a mean FMS™ composite of 14.50(SD 1.74), and non-injured showed a mean FMS™ composite of 14.57(SD 2.25). No statistically significant association was found between the presence of non-contact injuries and FMS™ composite score (OR = 0.98 [0.77; 1.27]) or FMS™ categorical score (≤ 14) (OR = 0.64 [0.23; 1.78]). The presence of an asymmetry between limbs in the active straight leg raise was associated with non-contact injuries (OR: 4.69 [1.35 - 17.9]) (p = 0.02). Conclusion: FMS™ composite did not show differences between injured and non-injured players. Asymmetry in the active straight leg raise was strongly associated with non-contact injury occurrence.

Conservative Approach to Treating American Football Players With Medial Collateral Ligament Grade 2 Sprain During the Season.

The medial collateral ligament is the most commonly injured ligament in the knee. The high-speed pivoting and agility movements that are common in the sport of American Football put participants at an increased risk for a valgus force stress from contact or noncontact injuries. Positional release therapy (PRT) also considered strain/counterstrain focuses on releasing the tension in a tissue through unloading the involved body part. Two male student-athletes participating in football with a mean age of 20.5years were diagnosed by a physician with medial collateral ligament grade 2 sprain. Both patients sustained their injuries in a regular season game with a contact valgus force from an opposing player. After the initial 72hours of compression, elevation, and cryotherapy, the patients were both treated with PRT followed by progressive loading exercises. Following 4 treatment sessions of PRT over the next 6days, the patients started with quadriceps engagement exercises, single-leg squats to 60° knee flexion, side steps, triceps dips, slow controlled lunges, and toe walk. The patients progressed to full body weight squats, single-leg landing, step-up tri-extension, and sidekicks with a leg on table. Then, the patients completed function movements and sports-specific exercises. In this case series, 2 patients competing in intercollege American Football were treated with PRT and progressive loading exercises to facilitate return to unrestricted activities and improve outcome measures. Commonly, a grade 2 medial collateral ligament sprain is conservatively treated with return to sport taking 20days on average. In this type 2 case series, the clinician found success utilizing PRT early in the recovery process, which in these 2 cases lead to restoration of function, outcome measure improvement, and an expedited return to sport. The expedited return to sport occurred at an average of 18days for these patients.

Professional and Elite Young Soccer Players: Differences in Functional Movement ScreenTM Values

Background: Soccer is a sport that requires very complex movements performed at high speeds: running, jumping, decelerating, changing direction or running direction, and kicking are complex movements that require high control and significant joint stability at all ages. Control of the body and individual body districts becomes important for both performance and injury prevention. Objective: This study aims to verify the Functional Movement Screen (FMSTM) values in different categories of players, from the youth leagues to professional soccer players. Methods: A sample of soccer players (n=112) took part in the study. The sample was subdivided according to their category, resulting in the following subgroups: a) professional soccer players (PSP, n=56,), Under 19 - Primavera (U19, n=29), Under 17 (U17, n=27). The FMS protocol was used to assess the seven functional movements and the associated risk of non-contact injury. Results: Statistically significant differences emerged in the total scores between the U17 group and the PSP group (14.8±2.9 vs 19.1±1.4, p&lt;0.01), between the U17 group and the Under 19 - Primavera group (14.8±2.9 vs 16.2±2.1, p&lt;0.05) and between the Under 19 - Primavera group and the PSP (16.2±2.1 vs 19.1±1.4, p&lt;0.01). Conclusion: The values obtained show that young soccer players have a very different qualitative control of movement than highly qualified players. This study shows significant differences not only between the total scores, but more importantly between the individual 7 assessment tests that the FMS protocol includes: these values provide insight into which movements should receive more attention in athletic conditioning in the youth sector.

Frontal plane pelvic kinematics during high velocity running: Association with hamstring injury history

IntroductionHamstring injuries are the most prevalent non-contact soft tissue injury in sports, with a larger portion of injuries being recurrent. The sagittal plane running kinematics correlated to hamstring injury history has been well documented. However, analysis of frontal plane kinematics allows for observation of stability and symmetry. This study aimed to examine the frontal plane running kinematics of elite collegiate level sprinters, with and without previous hamstring injury, compared to healthy counterparts. MethodsThirty-nine participants performed three 50-m sprints, with three inertial measurement unit sensors placed on the pelvis: one on each iliac crest and one on the sacrum. Participants were classified based on sex, competitive status, and injury history. To investigate differences based on group classification, the data were used to analyze mediolateral motion (relative magnitude of mediolateral acceleration) and asymmetry (difference in acceleration between right and left iliac crests) during each stance phase throughout the run. ResultsInjured sprinters displayed significantly greater mediolateral motion and asymmetry during stances than healthy counterparts. ConclusionsThis study demonstrates that frontal plane running stance dynamics are different in athletes with previous hamstring injury than healthy athletes. These athletes may benefit from rehabilitation strategies targeting postural control and stability during dynamic tasks.