Sport-specific Injuries Research Articles

Imaging of the spine in sports medicine.

Much controversy exists surrounding the utility of plain film, computed tomography, magnetic resonance imaging (MRI), and bone scintigraphy in the evaluation of sports-related spine injuries. The articles reviewed here offer several different perspectives. Cervical spine radiography, return-to-play criteria following cervical trauma, lumbar pain and pars injuries, utility of MRI in acute sports injuries, and sports-specific injuries are reviewed. The relationship between bone mineral density and sports activity is also reviewed.

Sports-related injuries in children.

To describe the demographics and types of sports-related injuries (SRIs) in children. The authors performed a retrospective chart review of children 5-18 years of age diagnosed as having an SRI in a pediatric emergency department (ED) during a two-year period. Patients were identified by ICD-9 codes. Data collected were age, sex, sport, ED interventions, consultations, mechanism, location, and injury type. Pairwise comparisons were reported as odds ratios with 95% confidence intervals. Six hundred seventy-seven SRIs fit the inclusion criteria; 480 of the patients were male (71%). The mean ages of the males and females were 13.0 years (SD +/- 3.0 yr) and 12.4 years (SD +/- 2.9 yr), respectively. The six most common sports implicated were basketball (19.5%), football (17.1%), baseball/softball (14.9%), soccer (14.2%), in-line skating (Rollerblading)/skating (5.7%), and hockey (4.6%). Sprains/strains (32.0%), fractures (29.4%), contusions/abrasions (19. 3%), and lacerations (9.7%) accounted for 90% of injury types. Pairwise comparison of the four injury types in the six sports listed showed significant associations for contusions/abrasions in baseball, sprains/strains in basketball, fractures in Rollerblading/skating, and lacerations in hockey. Age variance, including all sports, of the younger group (5-11 yr) in fractures and the older group (12-18 yr) in sprains was significant. The most common injury location was wrist/hand (28%), followed by head/face (22%) and ankle/foot (18%). Each had significant sport-specific predilections. Contact with person or object was the mechanism for >50% of the SRIs. Sport-specific mechanisms followed lines drawn from the sport-specific injury types and locations. The pediatric age group incurs a variety of injuries in numerous sports with diverse sex, age, mechanism, location, injury type, and sport-specific differences.

INJURIES AND CONSIDERATIONS IN MASTERS AQUATICS SPORTS

Masters level athletes in all aquatic sports challenge healthcare professionals, providing them with many opportunities to test their sports medicine training. Along with sports-specific injuries, the medical professional must factor in physiologic differences due to aging and even the older athlete's basic motivation to pursue the sport--which differs greatly from that of younger swimmers. Organized Masters programs, complete with national and international championships, are growing in Masters Diving, Masters Synchronized Swimming, Masters Swimming, and Masters Water Polo.

The value of Janda's functional muscular diagnostics. Experience with first league wrestlers

Especially by using the “Functional Muscular Diagnostics” described by Janda specific muscular imbalances can be found. The method is easy to apply and should be used during and before the championship season. Several studies show a high amount of muscular imbalances in athletes leading to sport-specific injuries. Treatment can prevent these injuries. More complex problems (e. g. hip dysplasia) can not be diagnosed with this method. They require the use of other diagnostic tools (X-ray, CT-Scan, NMR). Generalized joint laxity is often sport specific, sometimes this can cause problems likewise the instability impingement.

Sports Medicine and Sailing

Although there is little epidemiologic data in the sport of sailing, the identification of important trends can assist the clinician in successful evaluation, treatment, and rehabilitation of the individual. It appears that like other sports, the majority of injuries encountered are of the microtraumatic or overuse type. An understanding of biomechanics, the overload injury, and the sport of sailing will allow the development of a comprehensive rehabilitation program to ensure the optimal performance and safety of the sailor.

Physiological and biomechanical aspects of orienteering.

Orienteering is an endurance running event which differs from other running sports both in its cognitive element and in the type of terrain encountered. The demands of overcoming this terrain are not manifest in significant differences between orienteers and road runners in somatotype, though elite female orienteers have consistently been shown to have higher levels of adiposity (> 19%) than elite road runners. High aerobic power in orienteers (up to 63 and 76 ml/kg/min in women and men, respectively) is coupled with lower anaerobic performance. While leg strength is generally not high when compared with other athletic specialties, female orienteers have relatively good leg flexion strength. The energy cost of running is greatly increased in rough terrain. Oxygen cost was 26% higher while running in a forest when compared with road running. Biomechanical differences in stride pattern contribute towards this increased demand. Despite the high energy demands during competition, orienteers pace themselves such that their mean heart rate remains within the range of 167 to 172 beats/min, despite large fluctuations. The rough terrain encountered in orienteering results not only in a high energy cost but also in a higher incidence of sport-specific injuries, particularly to the ankle. Minor injuries such as cuts and bruises are common during competition.

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.

Athletic Knee Injuries

The pattern and prevalence of knee injuries among athletes are different in Asia, Europe, and North America because of factors such as the different sporting cultures of the regions and the type of favorite sports. Sampling and data bias and the variable levels of diffusion of sports in the different parts of the world also are responsible for the variation. In this review, the knee emerges as the most commonly injured part of the body; such injuries present significant problems of mechanical block or instability that may compromise athletic performance. Sports specific injuries are delineated, and specific groups, such as children and adolescents, female, and master athletes, are reviewed in light of the characteristic patterns of knee injuries. Differences in the patients' attitude, health care systems, and consultations of traditional medical practitioners produce major differences in management styles. However, it is encouraging to find a concerted effort on all continents in the search for a better understanding of knee injuries and a more satisfactory coordination between clinical and basic science research in this field.

Perspectives of a rheumatologist team physician

My perspective is that of a former athlete, formally trained as a rheumatologist and now responsible for the care of amateur and professional athletes. In my practice, I confront many recurring concerns about exercise and musculoskeletal problems, which I will address in the following chapter, using illustrative examples when possible. When I became involved in sports medicine, I was surprised at the paucity of long-term, prospective studies concerning the possible development of arthritis and musculoskeletal disability due to sports participation. In fact, it was difficult to reach any conclusions about the risks of chronic musculoskeletal disability as a result of participation in specific sports, on the basis of the available literature (Panush and Brown, 1987; Brown and Panush, 1987). This issue is a major concern in caring for athletic patients. It is difficult to respond to them satisfactorily when it arises, as it does frequently in practice. Available anecdotal references or retrospective studies are not adequate, and registries for sport-specific musculoskeletal injuries are virtually non-existent. Thus I welcome this opportunity to summarize the limits of our knowledge in this area and to indicate what additional information we still need to obtain.

Injuries and Special Concerns in Female Gymnasts.

In brief Medical concerns for female gymnasts vary from medical problems such as nutrient deficiencies to orthopedic concerns such as wrist injuries. Physicians who treat gymnasts-from recreational to elite-must be aware of the most common problems. They can then expand their role in educating athletes about prevention and in treating sports-specific injuries and associated diseases.

Sports Injury Assessment and Rehabilitation

Sports Injury Assessment and Rehabilitation by David Reid, BPT, MD, is a sizable but well-organized practical and informative text. The first of two sections is on basic principles of sports medicine: physiology of connective tissue, bone, and muscle; approaches to injury evaluation and management; and theory and applications of commonly used therapeutic modalities. The second section, which constitutes the bulk of the text, is a discussion of sport-specific injuries by anatomic part (foot, ankle, knee, chest, etc). The tables and illustrations throughout the text are appropriate and helpful in clarifying points described. An appendix provides information on traveling tips, health fitness testing, environmental concerns, and issues of drug testing in athletes, and the index is complete and useful. Throughout the volume, summaries of the evaluation and treatment of common sports injuries, clinical facts, and diagnostic points are highlighted in chart form as Practical and Clinical Points or Quick Facts. These

Real time sonography in sports specific tendon injuries

Disturbances in the region of insertion or point of attachment of ligaments or tendons to the bones (known as "enthesopathy") comprise, besides endocrinological and metabolic diseases, mainly traumatic, inflammatory and degenerative changes. The two imaging methods that are most suitable for investigating the soft parts are sonography and magnetic resonance tomography. Sonography has become the most widely used diagnostic tool for tendon lesions in sports due to its ability to analyse muscles and ligaments in any desired projection and functional state on a "real time" basis. Within just one year (1987) we examined sonographically 86 sportsmen clinically suspected of lesions of tendons and paid particular attention to documentation of sonomorphological changes of the tendons and peritendonous soft parts, as well as to the objectivation of treatment effects in follow-ups. Advantages of real time sonography in anomalies of tendons are: 1. confirmation of rupture if clinical signs and symptoms are vague; 2. differentiation between intratendinous and peritendinous structural changes; 3. diagnosis and follow-up control in lesions of the apophysis in adolescents without risk of irradiation exposure; 4. non-invasive follow-ups and objectivation of treatment effects in conservative and surgical treatment; 5. diagnostic on-target sonographically controlled aspiration of synovial fluid; 6. dynamic assessment of function of tendon play under real time conditions. Hence, sonography of the soft parts should be used as the method of choice to clarify any lesions of tendons and ligaments, since it is an easily appreciated, readily available, low-cost and sensitive imaging method.

Sports injuries, mechanisms, prevention and treatment

Part 1 Evaluation, training and special concerns: preseason evaluation conditioning and training athletic trainer environmental factors in athletic performance biomechanics of sports general principles of rehabilitation - soft tissue management medical problems of the athlete cardiovascular evaluation of the athlete drugs and sports special concerns of the paediatric athlete special concerns of the female athlete. Part 2 Sports-specific injuries: baseball basketball bicycle accidents boxing competitive diving cricket dance and the arts emergency medical care at sports events equestrian fencing football golf gymnastics ice hockey ice skating judo and karate lacrosse nordic and alpine skiing power lifting and body building racquet sports rugby running scuba diving soccer surfing swimming and diving track and field triathalon volleyball water skiing wrestling. Part 3 Management and treatment of systemic and regional injuries: diagnosis and treatment of dermatologic problems neurologic problems in sports head injuries treatment of sports eye injuries cervical spine and spinal cord injuries lumbar spine injuries shoulder injuries elbow injuries hand and wrist injuries knee injuries ankle and foot injuries abdominal injuries chest injuries general principles in rehabilitation, medical problems of the athlete, peripheral nerve injuries.