Participation In Contact Sports Research Articles

Personal and participatory socializers of the perceived legitimacy of aggressive behavior in sport

AbstractRecent international attention from the media and professional organizations has focused increasingly on violent incidents in sport. The present study developed and used the Sport Behavior Inventory (SBI) to examine personal and participatory variables that influence the socialization of the perceived legitimacy of aggressive sport behavior in children and adolescents ages 8–19 enrolled in public schools. In phase I of this study, the psychometric properties of the SBI as a measure of perceived legitimacy were evaluated in terms of content validity, structural validity, internal consistency, convergent validity, and discriminant validity. A multiple regression analysis in phase II indicated that increases in athletes’ perceptions of the legitimacy of aggressive sport behavior were positively related to age, being male, and contact sport participation. Results were discussed in relation to the social factors that contribute to the development of perceptions of legitimacy for aggressive sport behavior, and future research uses for the SBI. Aggr. Behav. 27:405–418, 2001. © 2001 Wiley‐Liss, Inc.

FEMALE HIGH SCHOOL STUDENT-ATHLETES

During the 1998 and 1999 Fall seasons, 325 student-athletes from four high schools in New Jersey were surveyed about their knowledge base and attitudes about concussion. 104 female athletes were among those surveyed; 68 soccer players, 33 cheerleaders and 3 field hockey players. The female athletes tended to report different trends and attitudes than male athletes. Females noted severe headaches as their most common concussive symptom (94%). However, they endorsed a variety of symptoms not usually associated with concussion (leg weakness and hand numbness) demonstrating decreased knowledge. By history, female athletes reported a 30% headache rate related to sports vs. 15% for non-sports concussions. Two-third of female athletes experienced difficulties obtaining information about concussion. 60% felt that diplopia was the most important reason for reporting a concussion while the most significant barrier to reporting was failure to understand the seriousness. The magnitiude of this concern (40%) differed from male athletes (30%). Female athletes reported that academic difficulties (40%) and not thinking clearly (41%) were the most important reasons for ceasing participation in contact sports. These results suggest that female student-athletes are provided with less information about concussion than males. Reporting of symptoms appears to separate out by gender as does knowledge base and information sources. These results have important implications for education and prevention.

Head injury in athletes.

HEAD INJURIES INCURRED during athletic endeavors have been recorded since games were first held. During the last century, our level of understanding of the types of cerebral insults, their causes, and their treatment has advanced significantly. Because of the extreme popularity of sports in the United States and worldwide, the implications of athletic head injury are enormous. This is especially true considering the current realization that mild traumatic brain injury (MTBI) or concussion represents a major health consideration with more long-ranging effects than previously thought. When considering athletic injuries, people who engage in organized sports, as well as the large number of people who engage in recreational activities, should be considered. There are 200 million international soccer players, a group increasingly recognized to be at risk for MTBI. The participation in contact sports of a large number of the population, especially youth, requires a careful and detailed analysis of injury trends and recommended treatment. There are numerous characteristics of this patient population that make management difficult, especially their implicit request to once again be subjected to potential MTBI by participating in contact sports. Recent research has better defined the epidemiological issues related to sports injuries involving the central nervous system and has also led to classification and management paradigms that help guide decisions regarding athletes' return to play. We currently have methods at our disposal that greatly assist us in managing this group of patients, including improved recognition of the clinical syndromes of MTBI, new testing such as neuropsychological assessment, radiographic evaluations, and a greater appreciation of the pathophysiology of concussive brain injury. The potential for long-term consequences of repetitive MTBI has been recognized, and we no longer consider the "dinged" states of athletic concussions to have the benign connotations they had in the past. We review the historical developments in the recognition and care of athletes with head injuries, the current theory of the pathophysiology and biomechanics of these insults, and the recommended management strategy, including return-to-play criteria.

Mouthguards, dental injury and problems: On-field management

Dental injury amongst contact sport participants commonly involves the upper front teeth which may chip, fracture, loosen or be avulsed. This injury may be devastating - affecting appearance, speech and the ability to eat. Very little Australian-based epidemiological information exists about the incidence of dental injury in sport despite national medical and dental groups recommending the use of professionally-fitted mouthguards to minimise head, facial and dental injury. Pilot study data has been submitted for publication which surveys the prevalence and type of mouthguards in use amongst Australian Football League players at all levels and dental injury data presenting to hospital emergency departments from 1990–1996. Presentations to emergency departments based on Victorian Injury Surveillance System and the Royal Dental Hospital of Melbourne show that peak weekly incidence of dental trauma occurs on ‘traditional' match days, Saturday and Sunday However, Tuesday to Friday also show high incidence in the afternoon and early evening which are often training times or school sport days.

“SAME SPORT, DIFFERENT GENDER”

This article responds to a call by Mary Jo Kane in an earlier Journal of Sport & Social Issues article to consider the “sport continuum” as a counter to conceptions of sport as an “oppositional binary” in which gender is naturalized. The continuum emphasizes women's participation in male-identified team contact sports. Drawing from field work and interviews with elite-level players, the analysis examines the dynamics of the continuum in the context of ice hockey. Player accounts of the practice of men's and women's hockey and their own experiences in gender-integrated settings highlight the many ways in which the construction of hockey and hockey players are distinctly social experiences. The conclusion offers an assessment of the sport continuum as a strategy to challenge the oppositional binary.

Protective headgear in rugby union.

This article interprets the studies performed on the use of headgear in sport which relate to rugby. The design and testing of helmets and their effective use for protection in sport in general appears to be well documented. This is not the case for the use of protective headgear in rugby. Nevertheless, some conclusions and recommendations are warranted. Protection from the range of impacts that can arise through participation in contact sports does not seem to be attainable by using protective helmets or protective rugby headgear. However, the use of headgear is recommended for protection against lacerations and abrasions and to provide a limited protection from injury caused by impact. Referees should discourage the use of protective headgear, to manipulate an opponent by using the rules to eliminate such behaviour. Coaches, athletes and administrators must be committed to the practice of safe performance skills, for example, by not using the head as an implement and not targeting the headgear of the opposing player. Further research is required to determine the effectiveness of protective headgear in reducing the risk of injury in rugby, whether the use of headgear places a player at a greater risk of injury through altered behaviour and the reasons why players currently choose not to wear headgear.

Axillary nerve injuries in contact sports: recommendations for treatment and rehabilitation.

Axillary nerve injuries are some of the most common peripheral nerve injuries in athletes who participate in contact sports. Resulting deltoid muscle paralysis is secondary to nerve trauma which occurs following shoulder dislocation or a direct blow to the deltoid muscle. Compression neuropathy has been reported to occur in quadrilateral space syndrome as the axillary nerve exits this anatomic compartment. The axillary nerve is also extremely vulnerable during any operative procedure involving the inferior aspect of the shoulder, and iatrogenic injury to the axillary nerve remains a serious complication of shoulder surgery. Accurate diagnosis of axillary nerve injury is based on a careful history and physical examination as well as an understanding of the anatomy of the shoulder and the axillary nerve in particular. Inspection, palpation and neurological testing provide the bases for diagnosis. A clinically suspected axillary nerve injury should be confirmed by electrophysiological testing, including electromyography and nerve conduction studies. During the acute phase of injury, the athlete should be rested and any ligamentous or bony injury should be treated as indicated. Patients should undergo an extensive rehabilitation programme emphasising active and passive range of motion as well as strengthening of the rotator cuff, deltoid and periscapular musculature. Shoulder joint contracture should be avoided at all costs as a loss of shoulder mobility may ultimately affect functional outcome despite a return of axillary nerve function. If no axillary nerve recovery is observed by 3 to 4 months following injury, surgical exploration is indicated. Athletes who sustain injury to the axillary nerve have a variable prognosis for nerve recovery, although the return of function of the involved shoulder is typically good to excellent. We recommend that athletes who sustain axillary nerve injury may return to contact sport participation when they achieve full active range of motion of the shoulder and when shoulder strength is documented to be good to excellent by isometric or manual muscle testing.

GENDER, SPORT, AND AGGRESSIVE BEHAVIOR OUTSIDE SPORT

This study focuses on how sports attitudes and participation relate to physical aggression outside sport for college athletes. Data were derived from a survey of nearly 200 male and female athletes at a medium-size (11,500-student) comprehensive university. Physical aggression was measured by an item concerning whether the respondents ever physically harmed or injured other persons outside sport in fights or disagreements. Although exploratory, this study suggests potentially valuable insights about how gender, beliefs in the value of toughness in sport, accidentally or intentionally hurting other athletes in competition, and participation in a team or contact sport relate to physical aggression outside sport. Whereas attitudes, having hurt other athletes, and team and contact sport participation all were related to physical aggression outside sport for male athletes, only participation in a contact sport was related to physical aggression outside sport for female athletes.

Mouth guard for athletes during orthodontic treatment.

Mouth guards have been proven to greatly reduce the number and severity of traumatic dental injuries to participants in contact sports. However, there are some difficult problems in making mouth guards for athletes with orthodontic appliances on their teeth. We developed a method of making mouth guards by using a coating material for such athletes to prevent dental and oral sports injuries and to protect the orthodontic appliances. This mouth guard fits well and does not damage the appliances.

An outbreak of herpes rugbiorum managed by vaccination of players and sociosexual contacts

An outbreak of herpes rugbiorum involved nine players including the scrum half and the full back. The infection was characterized by significant constitutional upset with decreased levels of general fitness and match performance for 1-4 months following the outbreak; one player had herpetic lesions on his right eyelid and corneum. Every infected player, 15 non-infected players and five sociosexual contacts received two vaccinations with intracellular subunit vaccine NFU. Ac. HSV-1 (S-MRC5). None of the players or contacts developed cutaneous herpetic recurrence during a follow-up period of 3 years; the player with ocular disease had one recurrence at 30 months following the original episode. These findings encourage consideration of prophylactic or post-exposure vaccination of participants in rugby or other contact sports with this or other appropriate herpes simplex vaccine.

EXPLAINING PAIN AND INJURY ATTITUDES AND EXPERIENCES IN SPORT IN TERMS OF GENDER, RACE, AND SPORTS STATUS FACTORS

This article presents data from a survey of college athletes in a National Collegiate Athletic Association (NCAA) Division I athletic program showing how well gender, race, and 4 sports status variables (team or individual sports participation, contact or noncontact sports participation, status as a lineup regular, and status as an athletic scholarship holder) explain differences in sports-related pain and injury attitudes and experiences. Attitude was measured by 3 scales—concerning toughness, rational choice in decisions about playing hurt, and pressure from coaches and fans to play while hurt—which were constructed for this study. Injury experience measures indicated whether the college athletes had lingering effects from sports injuries, how many sports injuries they had sustained, how many times they had had surgery for sports injuries, and how long they were disabled by their most serious sports injury. Gender, race, status as a lineup regular, and status as a scholarship holder were found to explain variations in attitudinal or experiential factors, with gender explaining more of these differences than any other variable. Thus gender is given special emphasis in the discussion of findings.

Solitary kidney and sports participation

A questionnaire was sent to the 1994 membership of the American Medical Society for Sports Medicine to describe attitudes regarding allowance of sports participation for athletes with a single kidney. Using a hypothetical scenario of a high school or collegiate preparticipation examination, the respondents were asked if they would preclude or allow participation in collision and contact sports for an athlete with a single kidney. Of 438 respondents, 237 (54.1%) indicated that they would allow full participation in sports after discussion of the possible risks. The percentage decreased to 41.6% if the athlete was their son or daughter. These results indicate that the decision to allow participation in this situation remains controversial, but they also provide some support for those physicians who allow participation.

The bimaxillary mouthguard.

The bimaxillary mouthguard provides enhanced protection for the participation in contact sports. This article describes the bimaxillary mouthguard and outlines construction techniques.

Nonoperative Management of Multilevel Lumbar Disk Herniations in an Adolescent Athlete

Herniated lumbar nucleus pulposus is rare in the pediatric age-group; for surgically proven cases, the estimated prevalence is between 0.8 and 3.2%. Most of the current literature indicates that herniated nucleus pulposus in pediatric patients differs from that in adult patients in epidemiologic characteristics, clinical manifestations, and frequency of associated neurologic findings. To our knowledge, the current case is the first published report of lumbar disk herniations at three levels in a 15-year-old male adolescent, whose abnormalities were verified by computed tomography and myelography. Most investigators recommend surgical treatment; however, our patient had good results with nonoperative management that consisted of nonsteroid anti-inflammatory drugs, passive extension, lumbar traction, segmental mobilization, and a progressive program of dynamic lumbar stabilization exercises. The patient is now asymptomatic and able to participate in selected limited contact sports and most farm activities; however, contact sports are prohibited for 1 year. If follow-up computed tomographic imaging of the lumbar spine demonstrates no progression of the disk abnormalities and if the patient remains asymptomatic, he could consider participation in contact sports after necessary conditioning.

How to Evaluate Transient Quadriparesis.

In brief Three professional football players experienced transient quadriparesis secondary to transient neurapraxia of the cervical spine. One player had congenital spinal stenosis and was allowed to continue playing football. In the other two players, MRI revealed herniated disks that precluded the athletes' return to play. Before physicians can determine whether football players or other athletes should resume participation in contact sports, they must accurately evaluate the extent of the player's neurologic injury. At the minimum, the evaluation should include a detailed neurologic examination, plain radiographs, and MRI.

Anterior cruciate ligament reconstruction without drill holes

Anterior cruciate ligament (ACL) reconstruction in adolescents with open physes remains a difficult problem for the orthopedic surgeon, especially in view of growing teenage participation in contact sports. Traditionally, treatment of ACL tears in adolescents has been conservative; the patient is advised to delay surgery up to several years for fear of damaging physes by drilling holes across them. Unfortunately, this waiting period may inflict irreparable knee damage. This paper suggests an ACL reconstruction technique that utilizes no drill holes, thus causing no harm to physes or other essential knee structures. A graft consisting of semitendinosus and gracilis (SG) tendons is passed under the anterior horn of the medial meniscus through the knee joint, then brought out through the posterior capsule and secured to the lateral femoral metaphysis. The graft is augmented with an iliotibial band tenodesis. Designed primarily but not exclusively for teenagers with open physes, the procedure has produced encouraging results thus far in a small series.

Management of athletic injuries of the cervical spine and spinal cord

Injuries to the cervical spine among athletes present inherent difficulties, especially in advising for return to contact sports. Experience with the acute care of 63 patients who sustained cervical spine injuries while participating in organized sporting events is analyzed. Forty-five patients had permanent injury to the vertebral column and/or spinal cord, while 18 suffered only transient spinal cord symptoms. Football mishaps accounted for the highest number of injuries, followed by wrestling and gymnastics. Twelve patients had complete spinal cord injury, 14 patients had incomplete spinal cord injury, and 19 patients had injury to the vertebral column alone. The majority of the spinal cord lesions occurred at the C4 and C5 levels, while bony injuries of C4 through C6 predominated. Twenty-five patients required surgical stabilization, and 20 were treated with orthosis only. There was no instance of associated systemic injuries, and hospital complications were few. The mean time of hospitalization was 19.1 days for injured patients and 3.0 days for patients with transient symptoms. A classification was developed to assist in the management of these patients: Type 1 athletic injuries to the cervical spine are those that cause neurological injury; patients with Type 1 injuries are not allowed to participate in contact, competitive sporting events. Type 2 injuries consist of transient neurological deficits without radiological evidence of abnormalities; these injuries usually do not prohibit further participation in contact sports unless they become repetitive. Type 3 injuries are those that cause radiological abnormality alone; these represent a heterogeneous group.(ABSTRACT TRUNCATED AT 250 WORDS)

Management of Athletic Injuries of the Cervical Spine and Spinal Cord

Abstract Injuries to the cervical spine among athletes present inherent difficulties, especially in advising for return to contact sports. Experience with the acute care of 63 patients who sustained cervical spine injuries while participating in organized sporting events is analyzed. Forty-five patients had permanent injury to the vertebral colum n and/or spinal cord, while 18 suffered only transient spinal cord symptoms. Football mishaps accounted for the highest number of injuries, followed by wrestling and gymnastics. Twelve patients had complete spinal cord injury, 14 patients had incomplete spinal cord injury, and 19 patients had injury to the vertebral column alone. The majority of the spinal cord lesions occurred at the C4 and C5 levels, while bony injuries of C4 through C6 predominated. Twenty-five patients required surgical stabilization, and 20 were treated with orthosis only. There was no instance of associated systemic injuries, and hospital complications were few. The mean time of hospitalization was 19.1 days for injured patients and 3.0 days for patients with transient symptoms. A classification was developed to assist in the management of these patients: Type 1 athletic injuries to the cervical spine are those that cause neurological injury; patients with Type 1 injuries are not allowed to participate in contact, competitive sporting events. Type 2 injuries consist of transient neurological deficits without radiological evidence of abnormalities; these injuries usually do not prohibit further participation in contact sports unless they become repetitive. Type 3 injuries are those that cause radiological abnormality alone; these represent a heterogeneous group. The athlete with fractures involving a significant structural portion of the vertebral column, ligament instability, spinal cord contusion, or congenital cervical stenosis, is advised not to return to contact sports. Other radiological abnormalities, such as compromise of the ligaments, congenital fusion, degenerative disease, and herniated cervical disc require individual consideration. The rationale for treatment and advising for participation in sports are discussed. We believe that this classification of sports injuries offers clinicians a framework within which to make rational judgments and recommendations in the management of athletes with cervical spine injuries.

Cervical Spinal Stenosis with Cord Neurapraxia and Transient Quadriplegia

Cervical spinal cord neurapraxia with transient quadriplegia is defined as a distinct clinical entity. The authors identify diminution of the anteroposterior diameter of the spinal canal as the factor that explains the described neurologic picture of the injury. Based on the result of a study of 39,377 athletes, the authors conclude that the prevalence of the injury is high and warrants attention. Given that of the patients interviewed, none recalled prodromal experience of transient motor paresis and none sustained further injury, this injury does not predispose individuals to permanent neurologic injury. No definite recurrence patterns have been established that would warrant the restriction of individuals from further activity. Activity restrictions are called for in the case of individuals with stability or chronic degenerative changes. Individuals with developmental spinal stenosis or spinal stenosis should be treated on an individual basis.

A modified maxillary mouthguard.

Custom made maxillary mouthguards made from thermoplastic materials using dental impressions give valuable protection to the teeth and jaws of participants in contact sports. A bimaxillary mouthguard has been described which offers enhanced protection, but with considerable increase in cost. This paper describes a modification to current maxillary mouthguard design that is comfortable to wear, inexpensive to make and which may provide protection comparable to that of a bimaxillary type, while retaining other desirable features of the more complex appliance.