Sport-specific Conditioning Research Articles

Rehabilitation Issues in Women With Anterior Cruciate Ligament Deficiency

Anterior cruciate ligament (ACL) noncontact injuries occur more frequently in female than in male athletes. Many studies investigated possible predisposing factors such as joint laxity, hormonal influences, lower limb alignment, notch shape and dimension, ligament size, and neuromuscular control. To our knowledge, there are no ACL rehabilitation protocols especially studied for women. Our approach is a time-based and criterion-based progressive rehabilitation protocol, with preoperative, early, and late postoperative phases. Preinjury, preoperative, and postoperative biomechanical quantitative evaluations are used to monitor rehabilitation. Sport-specific epidemiologic observation of noncontact ACL injury mechanism can help in identifying movements and situations that pose a risk to the ACL. These data can be used to modify training and to prevent injuries and re-injuries. In our opinion, it is not necessary to have a gender-specific rehabilitation protocol, but it is necessary to have better sport-specific neuromuscular conditioning, which should include plyometrics, postural balance, and functional agility exercise protocols.

SPORT-SPECIFIC CONDITIONING: Stability and Balance Training: Performance Training or Circus Acts?

SPORT-SPECIFIC CONDITIONING: Stability and Balance Training: Performance Training or Circus Acts?

SPORT-SPECIFIC CONDITIONING: Strength and Conditioning for Soccer. I: A New Approach to the Old Question of Strength

SPORT-SPECIFIC CONDITIONING: Strength and Conditioning for Soccer. I: A New Approach to the Old Question of Strength

BEHAVIORAL AND DEMOGRAPHIC RISK FACTORS FOR SPORT-RELATED INJURIES AMONG U.S. ARMY SOLDIERS, 1987???1998

U.S. Army soldiers are a young, healthy, predominantly male population, and physical fitness is an important job requirement. Sports injuries are a significant source of injury morbidity, resulting in hospitalizations and lost duty days. A retrospective cohort study followed 389,271 soldiers who completed the Health Risk Appraisal (HRA) and who had not previously suffered a sport-related injury hospitalization. Multivariate logistic regression models identified independent risk factors for sport-related injury hospitalizations. Five of the most common diagnoses involved injuries to the knee. Eight of the 10 most common diagnoses were associated with basketball, and basketball and football together accounted for more than 50% of hospitalizations and 56% of lost duty days. Soldiers hospitalized for sport-related injuries were significantly more likely to be white (OR = 1.82, 95% CI: 1.65,2.01), male (OR = 3.54, 95% CI: 2.88,4.35), consume more than 20 drinks per week (OR = 1.31, 95% CI: 1.01,1.71), and more satisfied with their life (OR = 1.70, 95% CI: 1.31,2.22). Soldiers who smoked 11–20 cigarettes per day (OR = 0.79, 95% CI: 0.68,0.92) and those who smoked more than 20 cigarettes per day (OR = 0.63, 95% CI: 0.47,0.84) were less likely to have a sport-related hospitalization even while controlling for aerobic activity, strength training, and other behavioral and demographic factors. Physical conditioning, including participation in athletics, plays an important role in maintaining military readiness. Injury morbidity may be reduced through targeted interventions, such as sport-specific conditioning, improvement of playing field surfaces, and the use of orthopedic equipment such as knee braces. The association between smoking and injury is puzzling and should receive more in-depth investigation. Supported by NIAAA #1 R29 AA11407-01A1 and #R29AA07700.

Fast pitch softball injuries.

The popularity of fast pitch softball in the US and throughout the world is well documented. Along with this popularity, there has been a concomitant increase in the number of injuries. Nearly 52% of cases qualify as major disabling injuries requiring 3 weeks or more of treatment and 2% require surgery. Interestingly, 75% of injuries occur during away games and approximately 31% of traumas occur during nonpositional and conditioning drills. Injuries range from contusions and tendinitis to ligamentous disorders and fractures. Although head and neck traumas account for 4 to 12% of cases, upper extremity traumas account for 23 to 47% of all injuries and up to 19% of cases involve the knee. Approximately 34 to 42% of injuries occur when the athlete collides with another individual or object. Other factors involved include the quality of playing surface, athlete's age and experience level, and the excessive physical demands associated with the sport. Nearly 24% of injuries involve base running and are due to poor judgement, sliding technique, current stationary base design, unorthodox joint and extremity position during ground impact and catching of cleats. The increasing prevalence of overtraining syndrome among athletes has been attributed to an unclear definition of an optimal training zone, poor communication between player and coach, and the limited ability of bone and connective tissue to quickly respond to match the demands of the sport. This has led routinely to arm, shoulder and lumbar instability, chronic nonsteroidal anti-inflammatory drug (NSAID) use and time loss injuries in 45% of pitching staff during a single season. Specific attention to a safer playing environment, coaching and player education, and sport-specific training and conditioning would reduce the risk, rate and severity of fast pitch traumas. Padding of walls, backstops, rails and dugout areas, as well as minimising use of indoor facilities, is suggested to decrease the number of collision injuries. Coaches should be cognisant of overtraining, vary day-to-day training routines to decrease repetitive musculoskeletal stress, focus on motor skills with equal emphasis on speed and efficiency of movement, and use drills that reinforce sport-specific, decision making processes to minimise mental mistakes. Conditioning programs that emphasise a combination of power, acceleration, flexibility, technical skill, functional capacity and injury prevention are recommended. Due to the limited body of knowledge presently available on this sport, a greater focus on injury surveillance would provide a clearer picture of injury causation and effective management procedures, leading toward safer participation and successful player development.

SPORT-SPECIFIC CONDITIONING: Strength You Can Use: The Paradox of Strength Development, Part I

SPORT-SPECIFIC CONDITIONING: Strength You Can Use: The Paradox of Strength Development, Part I

Golf injuries. An overview.

Over the years, golf has become an increasingly popular sport, attracting new players of almost all ages and socioeconomic groups. Golf is practised by up to 10 to 20% of the overall adult population in many countries. Beyond the enjoyment of the sport itself, the health-related benefits of the exercise involved in walking up to 10 km and of relaxing in a pleasant natural environment are often reported to be the main motives for adhering to this activity by recreational golfers. Golf is considered to be a moderate risk activity for sports injury; however, excessive time spent golfing and technical deficiencies lead to overuse injuries. These are the 2 main causes of injuries among golfers, and each has specific differences in the pattern in which they occur in professional and amateur golfers. Golf injuries originate either from overuse or from a traumatic origin and primarily affect the elbow, wrist, shoulder and the dorsolumbar sites. Professional and weekend golfers, although showing a similar overall anatomical distribution of injuries by body segment, tend to present differences in the ranking of injury occurrence by anatomical site; these differences can be explained by their playing habits and the biomechanical characteristics of their golf swing. Many of these injuries can be prevented by a preseason, and year-round, sport-specific conditioning programme including: (i) muscular strengthening, flexibility and aerobic exercise components; (ii) a short, practical, pre-game warm-up routine; and (iii) the adjustment of an individual's golf swing to meet their physical capacities and limitations through properly supervised golf lessons. Finally, the correct selection of golf equipment and an awareness of the environmental conditions and etiquette of golf can also contribute to making golf a safe and enjoyable lifetime activity.

Back Injury - LACROSSE

1488 HISTORY - A 17 year old lacrosse player presented 7 months after sustaining a low back injury after being checked from behind. With the blow, he heard a crack in his back. Immediately he felt low back pain without radicular symptoms. Attempts to resume competitive sports, resulted in more severe pain. X-rays taken 1 month later were interpreted as normal. He abstained from contact sports for 3 months, receiving chiropractic manipulation and performing “strengthening exercises.” He then attempted to play varsity football but stopped after 3 practice sessions due to low back pain. A CT scan revealed bilateral L4 spondylolysis and degenerative changes in the accompanying facet joints. The patient's primary current complaint was low back pain extending into the tailbone area, worse with lumbar extension. PHYSICAL EXAMINATION - Thin athletic male with a normal gait pattern. He had reduced lumbar motion with midline pain localized near the L4/L5 area on lumbar extension. No pain was elicited with lumbar flexion. Lower limb strength, sensation, and reflexes were normal. Dural stretch and sacroiliac joint testing maneuvers were negative. There was reduced hamstring and psoas muscle flexibility. DIFFERENTIAL DIAGNOSIS: L4 acute spondylolysis L4 old/subacute spondylolysis with non-union Lumbar strain L4/L5 facet arthropathy or synovitis L4-5 disc herniation TEST AND RESULTS: X-ray L-S spine: L4 spondylolysis without spondylolisthesis CT scan of the lumbar spine: Bilateral L4 spondylolysis simple appearing on the right and partially fragmented on the left No evidence of secondary central canal stenosis, spondylolisthesis, or disc extrusion Whole body bone scan: Normal Study Final/Working Diagnosis: Old L4 spondylolysis with facet arthropathy/synovitis TREATMENT: Physical therapy including correction of posture and muscle imbalances and progression to dynamic lumbar stabilization. Selective use of a heat molded lumbo-sacral orthosis Sport specific conditioning Return to sports in 3 months.

Sport-Specific Conditioning to Prevent Injuries in Rowing

Sport-Specific Conditioning to Prevent Injuries in Rowing

ESTIMATED OXYGEN CONSUMPTION OF RETRO-LOCOMOTION 637

Retro-locomotion (RL) is commonly used for sport specific conditioning, injury prevention and rehabilitation. Higher energy expenditures (VO2) have been reported for RL as compared to forward locomotion at equivalent velocities. The purpose of the study was to determine VO2 for RL and calculate regression equations for estimating energy expenditure for RL velocity. Forty-eight subjects (M=16, F=32, 28.1 yr ± 2.45) were familiarized with RL on both track and treadmill (TM) for a total of 60-90 min dispersed over 2-4 wk. Following familiarization, subjects completed discontinuous GXT's on a TM. Each stage was 4 min in length, allowing subjects to achieve steady state. TM velocity began at 2.0 mph and was increased by 0.5 to 1.0 mph/stage based upon subject tolerance. Velocity ranges were 2.0-4.5 and 2.5-7.5 mph for retro-walking and retro-running respectively. Regression analyses were performed using measured VO2(ml·kg-1·min-1) and velocity (mph). The following equations for estimating VO2 were calculated: Retro-walking Y=17.786 - 7.26 X + 2.565 X2; Retro-running Y=5.82 X + 8.37, Y: VO2(ml·kg-1·min-1), X: Velocity (mph). Retro-walking r and r2 were.9 (p <.01) and.81 respectively; for retro-running corresponding values were.76 (p <.01) and.57 respectively. The formulae may be useful to more precisely design conditioning programs to improve or maintain performance.

Osteolysis of the distal clavicle in the overhead athlete

Atraumatic osteolysis of the distal clavicle (AODC) is a painful stress overload syndrome of the distal clavicle. Early AODC research basically concentrated on primary weight-lifters (PWL). A review of the literature shows that this condition has been infrequently described in throwing athletes who were adjunct weight-lifters (AWL). Adjunct weight-lifters train with heavy resistance in addition to their sport-specific conditioning program. It appears that the throwing athlete who lifts weight as adjunct training is susceptible to AODC. Although throwing athletes have been included in previous research studies, there has been no specific review of the relationship between AODC and the throwing athlete. The purpose of this article is to investigate whether there are significant differences between the presentation, diagnosis, and treatment of AODC in the throwing athlete who is an AWL and the PWL. It is our belief that there is a cumulative affect, when combining throwing sports with weight-training, that leads to an earlier age of presentation of AODC in adjunct weight-lifters. We have found the diagnostic results, treatment options, and treatment outcomes to be identical for AWLs and PWLs with AODC. Therefore, we recommend all throwing athletes with a history of weight training and shoulder pain be evaluated for AODC, even when presenting as a teenager.

Sport-specific conditioning.

The goal of the athlete is to optimize performance. The goal of the sports medicine physician is to minimize injury risk. By preparing the athlete's body for the mechanical and metabolic demands inherent in a particular sport, sport-specific conditioning programs can help achieve both these goals. Periodization of the conditioning program is the ideal framework for keeping the individual athlete's workload as high as possible without overtraining and injury.

Development of conditioning programs for dressage horses based on time-motion analysis of competitions.

The time-motion characteristics of Canadian basic- and medium-level dressage competitions are described, and the results are applied in formulating sport-specific conditioning programs. One competition was analyzed at the six levels from basic 1 to medium 3. Each test was divided into a series of sequences based on the type and speed of activity. The durations of the sequences were measured from videotapes. The basic-level tests had fewer sequences, and they were shorter in distance and duration than the medium tests (P < 0.10), but the average speed did not differ between the two levels. It is recommended that horses competing at the basic levels be conditioned using 5-min exercise periods, with short (10-s) bursts of lengthened trot and canter included at basic 2 and above. In preparation for medium-level competitions, the duration of the work periods increases to 7 min, 10- to 12-s bursts of medium or extended trot and canter are included, and transitions are performed frequently to simulate the energy expenditure in overcoming inertia.

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Overtraining places a demand on the musculoskeletal system that may lead to damage to the musculoskeletal system, as well as to clinical, functional, and biomechanical adaptations that may be detrimental to sport performance. The types of injuries identified range from overt, which are obvious injuries that will usually prevent athletic performance for some period of time, to the subclinical, which decrease performance, but may be seldom recognized. These injuries apparently may be avoided or lessened in severity by a combination of several methods. A thorough preparticipation evaluation is important to detect subtle adaptations in strength and flexibility that can result from overtraining and may increase the athlete's chances of injury. A good sport-specific conditioning program is necessary to give the athlete a strong musculoskeletal base on which to build athletic skills and to decrease the risk of overtraining adaptation. In many sports, prehabilitation exercises can be performed for those musculoskeletal areas that are under high stress in a particular sport. Also, a maintenance conditioning program that extends through the season may be important to maintain fitness throughout the season. Following proper principles of conditioning, including specificity, recovery, and progression, are important. A complete and accurate diagnosis of the injuries that do occur is necessary so that proper treatment may follow. This can be facilitated by understanding the types of clinical presentations of injuries, and the different anatomical and functional alterations that may be acting to cause or to continue the clinical presentation. By following these general guidelines, safe participation in sporting activities as well as performance will be enhanced. The exact point where "training" becomes "overtraining" is difficult to define, especially prospectively. An exciting area of sports medicine research will be to define the anatomic parameters and exercise doses that will cause overtraining, and to devise fitness examinations and training programs that will allow maximal performance with minimal overload risk. At the present time, retrospective studies do indicate that adaptations occur in muscles, tendons, and bones in response to high training loads, and these particular adaptations are not beneficial to performance and may be associated with increased injury risk. Since the optimal exercise dose is not known, provision for evaluation of these adaptations and prehabilitation of all noninjured areas or proper rehabilitation of all injured areas will best prepare the musculoskeletal system for training.