Previous Lower Limb Injury Research Articles

Medial Gastrocnemius Strain: Clinical Aspects and Algorithmic Approach.

Medial gastrocnemius strain (MGS), is the most common cause of mid-calf pain in athletes due to the stretch of the gastrocnemius muscle when the knee is in extension and the ankle is in dorsiflexion. Chronological age and previous calf injury are the most substantial risk factors for MGS, including high body mass index, previous lower limb injuries, L5 radiculopathy, and inadequate warm-up. The dominant presentation of MGS is a pain that can be diverse from acute to latent, which is felt in the posteromedial aspect of the calf and is often preceded by a feeling of a pop. The signs of MGS include antalgic gait, ecchymosis, swelling, local tenderness, and sometimes a palpable gap felt along the muscle. Passive dorsiflexion of the ankle or resistive ankle plantarflexion with knee extension can indicate a more severe injury, while functional tests can illicit milder injuries of calf muscles-including gastrocnemius. The diagnosis of MGS is usually made by clinical evaluation. However, imaging modalities-including magnetic resonance imaging and ultrasound-can be helpful in case of suspicion. In most cases of MGS, the cornerstone of treatment is nonoperative rehabilitation, which can be performed as a 4-phase program and should be tailored individually. Some instances of MGS are referred for early or later surgical treatment if indicated. In this article, we review the literature about various aspects of MGS, from diagnosis to treatment and rehabilitation, and propose a structured approach to this injury.

EFFECTS OF NEUROMUSCULAR TRAINING ON SINGLE LIMB STABILITY IN YOUNG FEMALE ATHLETES

Background: Lower limb injuries in sports affect postural stability and balance. Muscular imbalance, postural malalignments, and altered biomechanics occurred in athletes due to injuries. Objective: To determine the effects of the 6-week neuromuscular training program on single-limb stability in young female athletes. Methodology: A single-subject study design was used in which n=20 female athletes aged between 18 to 25 years with previous lower limb injuries that lead to impaired balance and postural instability participated in this study included by the convenience sampling from the Faisalabad sports complex.. Athletes completed 6-week neuromuscular training program, with every session of 90 min and 3 times a week. Assessment of athletes was performed before and after the completion of the neuromuscular training program at 6 weeks, with a single-limb stance test, Stork balance stand test, and star excursion balance test. Results: The mean age of participants was 20.6±1.82 years. Single limb stance test score with eyes open pre 27.70±13.85 and post-test treatment 40.75±16.45 showed significant results with (p <0.01). Stork balance test scores pre 28.40±17.25 and post-treatment 38.85±14.543 also showed significant results with (p <0.01). Star excursion balance test right and left anterior, left medial, right and left lateral also showed significant results with (p <0.01). Star excursion balance test right medial pre and post-treatment showed insignificant results with (p-value =0.234). Conclusion: Although 6-week neuromuscular training program showed a significant improvement on single-limb stability in young female athletes. But without control or comparative group we cannot establish its gender specific effectiveness. Keywords: Neuromuscular training, static and dynamic balance, single limb stance test, stork balance stand test, star excursion test.

Accuracy of the Region of Limb Stability in Predicting Risk for Lower Limb Injury.

This study aimed to determine whether a measure of lower limb segment stability derived from body-worn inertial measurement units can predict risk for lower limb musculoskeletal injury in Division I Collegiate Football Players (D1CFP). The region of limb stability (ROLS) values were collected in a cohort of D1CFP during preseason. ROLS is a measure of knee joint stability, defined by thigh and shank excursion (cm) in the anterior-posterior and medial-lateral direction during single limb stance. The ROLS symmetry index (SI) (%) is the ratio between lower limb ROLS values where 100% suggests absolute symmetry. One-hundred and four D1CFP participated in this study and were divided into two groups: 1) no previous lower limb injury or no in-season injury (n = 70, "noninjured group") and 2) no previous lower limb injury, but in-season injury requiring surgery (n = 34, "injured group" group). The mean ± SD ROLS SI was 82.86% ± 14.75% and 65.58% ± 16.46% for the noninjured and injured group, respectively. Significant differences in ROLS SI were found between groups (P < 0.001). The ROLS SI demonstrated an area under the curve of 0.8 (P < 0.001; 95% confidence interval = 0.71-0.88) with an SE of 0.04, indicating that the ROLS SI has good predictive accuracy in detecting those healthy D1CFP at risk for lower limb injury resulting in surgery. The ROLS SI was found to have good predictive accuracy in detecting individuals at risk for injury that were healthy and asymptomatic during preseason testing. Increase in thigh and shank excursions and/or decrease in SI between lower limbs may be a predictor of risk for future injury.

REGIONAL DIFFERENCES IN BICEPS FEMORIS FASCICLE LENGTH AND PENNATION ANGLE AFTER A SIMULATED SOCCER MATCH

BackgroundHamstring Strain Injuries (HSIs) represent 12% of all injuries in soccer players, and their incidence has increased in recent years. Between 53%-84% of HSIs involve the Biceps femoris muscle (BF)....

The Association of Self-Reported Measures With Poor Training Outcomes Among Male and Female U.S. Navy Recruits

This prospective study evaluated the association of self-reported health habits and behaviors in 2,930 Navy recruits with poor training outcomes, defined as graduating late or separating from training. Although 17% of the men and 21% of the women had a poor training outcome, results suggest that some self-reported measures were associated with poor training outcomes. Men who did not run or jog at least 1 month before basic training or had a previous lower limb injury without complete recovery and women reporting the same or less physical activity compared with their same-age counterparts were more likely to have a poor training outcome. An important first step in decreasing poor training outcomes is encouraging incoming recruits to participate in physical activity and taking steps to identify and rehabilitate recruits who are not completely healed from a lower limb musculoskeletal injury before reporting to basic training.

The Relationship Between Postural Stability and Dancer’s Past and Future Lower-Limb Injuries

In an effort to address dance-related injuries, screening programs are typically employed to assess injury susceptibility. The aim of this study was to explore for potential links between postural stability and dancers' previous lower-limb injuries and susceptibility to future lower-limb injuries. Eighty-five contemporary dance students were recruited at a UK dance conservatoire. Information concerning previous injuries was collected by self-report survey. The participants completed two balance tasks, one static and one dynamic, performed on a RS Scan Footscan pressure pad to calculate postural sway. Injuries in the participant cohort were then tracked for a 10-month period to assess injury susceptibility. The participants exhibited significantly less postural sway when balancing on the left leg than their right, and the women exhibited less postural sway than the men. A one-way ANOVA revealed that participants who had experienced a lower-limb injury in the 12 months prior to testing exhibited more postural sway than participants who had not experienced a lower-limb injury, with some of the differences attaining significance (p <0.05). No significant links were found between either postural sway or previous injury and future injury susceptibility. The results suggest that assessments of postural stability via centre of pressure measurements are a reliable method for assessing dancers' balance ability. While reaffirming the importance of comprehensive, multidisciplinary screening programs, the results also highlight the necessity of developing a greater understanding of both dancers and the environments in which they dance and work to fully ascertain injury susceptibility.

Injuries and injury risk factors among British army infantry soldiers during predeployment training

PurposeThis prospective cohort study examined injuries and injury risk factors in 660 British Army infantry soldiers during a predeployment training cycle.MethodsSoldiers completed a questionnaire concerning physical characteristics, occupational factors, lifestyle...

Soft-Tissue Movement at the Foot During the Stance Phase of Walking

soft-tissue movement has challenged the use of noninvasive skin-based markers that are assumed to be rigidly attached to the underlying bony landmarks. We assessed soft-tissue movement in multiple foot segments by calculating the relative changes in the intermarker distances of the hindfoot, midfoot, and forefoot segments during the early, middle, and late stances of walking compared with the intermarker distances measured while participants remained still during standing. seven healthy young adults with no previous lower-limb injury were tested while walking barefoot at a comfortable pace. Skin-based markers were placed on three foot regions (hindfoot-calcaneus, midfoot-navicular, and forefoot-first to fifth metatarsals). A motion system sampled at 120 Hz was used to capture the foot markers during the stance phase of walking. soft-tissue movement was found in the forefoot region characterized by shortened distances, specifically during early (breaking) stance and late (propulsion) stance. In the hindfoot region, soft-tissue movement was characterized by shortened and elongated distances during the early and late stance periods, respectively. All of the foot regions showed the least intermarker distance changes during midstance. the dynamics of soft-tissue movement in multiple foot segments were characterized by the greatest changes in the intermarker distances in the forefoot and hindfoot during the early and late stance phases and the least changes in the foot segments during midstance. The results provide a feasible and accessible measurement for assessing soft-tissue movement in the foot when skin-based motion markers are used.

Injuries and Injury Risk Factors in British Army Infantry Soldiers

PURPOSE: This prospective cohort study examined injuries and injury risk factors (an essential component of an injury prevention programme) in British Army infantry soldiers. Although several studies have investigated injuries in recruits, no previous studies have followed trained British Army soldiers. METHODS: Participants were 660 soldiers from three British Army infantry battalions. Soldiers completed a questionnaire concerning physical, occupational, lifestyle characteristics (physical activity, alcohol and tobacco use), and previous injury. Direct measurements included height, body mass, sit-ups, push-ups and run time. Electronic medical records were screened for injuries over a one year period before operational deployment. An injury was defined as an event in the medical records indicating that the soldier sought medical care due to physical damage to the body (traumatic and overuse events). For each new injury the activity associated with the injury, the body part injured, and the diagnosis were recorded. All continuous variables were converted into categorical variables. Backward stepping Cox regression calculated hazard ratios (HR) and 95 % confidence intervals (CI) to quantify independent risk factors for injury. RESULTS: One or more injury was experienced by 59 % of soldiers, with a new injury diagnosis rate of 88 injuries/100 person-years. Most injuries involved the lower body (71 %), especially the lower back (14 %), knee (19 %) and ankle (15 %). Activities associated with injury included sports (22 %), physical training (30 %) and military training/work (26 %). Traumatic injuries accounted for 83 % of all injury diagnoses. Independent risk factors for injury were younger age (17-19 yr [HR=1.0], 20-24 yr [HR=0.71, CI=0.55-0.93], 25-29 yr [HR=0.89, CI=0.66-1.19] and 30-43 yr [HR=0.41, CI=0.27-0.63]), previous lower limb injury (no/yes HR=1.49, CI=1.19-1.87) and previous lower back injury (no/yes HR= 1.30, CI=1.03-1.63). CONCLUSION: Injury rates for British infantry soldiers were lower than those reported for US infantry (range: 101-223 injuries/100 soldier-years). Future efforts should target reducing the incidence of traumatic injuries, especially those related to physical training and/or sports. Funded from the Human Capability Domain of the MoD Scientific Research Programme

The effect of previous lower limb injury on leg stiffness in AFL players

The effect of previous lower limb injury on leg stiffness in AFL players