Patellar chondropathy and apicitis, and muscle imbalances of the lower extremities in competitive sports

The jumping motion of 15 competitive basketball and volleyball players was tested until exhaustion in a cinematographic study. A stereotyped motion pattern was recognisable. The knee joint shows an evasive movement into a valgus and internal rotation position during the acceleration phase before take-off. Furthermore, the knee shows a brief stabilisation in overextension at heel strike. An imbalance of the muscles which stabilise the pelvis and the lower extremities can be regularly found in these athletes and could be a possible cause for this jump motion. It leads to a shortening of the hip flexors and adductors and of the knee extensors with the final evasive action of the knee joint. Though the anatomical condition of the joint is not directly observed, such a motion pattern must be the cause of additional shear forces and peak loads in the area of the patellofemoral joint and of the apex patellae. Clinical experience shows that an active correction of the evasive motion can be achieved by systematic physiotherapy. It ensures muscular balance of the pelvic region and lower extremities and thus lasting good results.

Time phases and the individual psychological crisis in sports competition: theory and research findings

A conceptual model of the development of an athlete's individual psychological crisis during competition has recently been proposed and applied to basketball. In this article the diagnostic value of the time dimension with regard to such a process of crisis development is investigated. The relevance of six time phases for the diagnosis of individual psychological crisis during the competition is discussed in detail. The present study was conducted on 28 basketball experts who completed a 'phases of competition' questionnaire using the components of the Bayesian likelihood ratio (diagnostic value) for each phase. Results revealed that time limits can be determined unanimously and that the proposed phases do have a considerable diagnostic relevance as predicted on theoretical grounds. Various aspects related to the validation and the practical applicability of the present research are briefly discussed.

Body composition and nutrient intakes of college men and women basketball players

Computer analysis of diet records was used to compare adequacy of nutrient intake for 16 male and 10 female intercollegiate basketball players. Significant differences (p less than .05) between men and women were observed for the provision of nutrients from food alone; mean percent RDAs of all nutrients except vitamins A and D was greater for men. This was due primarily to caloric intakes by the men, which averaged twice those of the women. Nutrient supplements had a significant effect on the women's total intake. With the exceptions of energy, protein, and vitamin C, differences between men and women in percent RDAs were eliminated when the contribution of nutrient supplements was included. The data made apparent the need for dietitians familiar with sports nutrition to counsel female athletes on means of obtaining nutrients via an adequate diet.

The natural history and treatment of delayed union stress fractures of the anterior cortex of the tibia

This study presents eight patients with stress fracture of the anterolateral cortex of the midshaft of the tibia. All of the patients, ranging in age from 14 to 23 years, were competitive basketball players who experienced pain while running or jumping for an average of 4.4 months before the diagnosis was made. Eight patients were treated with rest and/or pulsing electromagnetic field therapy. Although one of the patients required bone grafting procedure, all eight of these patients showed complete healing and were able to return to full activity after an average of 8.7 months of treatment. They have remained asymptomatic for an average of 14.7 months. The overall time from initial symptoms to return to competition averaged 12.5 months in this group of athletes. The results presented in this paper suggest that rest and pulsing electromagnetic field therapy may result in healing in some patients with delayed union stress fractures of the anterolateral cortex of the midshaft of the tibia. Although this injury is associated with a prolonged healing period, seven of eight patients with adequate followup in our study were able to return to competition without complications following treatment. One patient was asymptomatic for 33 months before experiencing a reinjury. In conclusion, we feel that diagnosis of stress fracture should be primary consideration in basketball players presenting with a prolonged history of pain on the anterolateral aspect of the midthird of the tibia. Once the diagnosis is made we recommend initial treatment consist of rest and external electrical stimulation for a minimum time of 3 to 6 months prior to considering surgical intervention.

The interaction of individual psychological crisis and time phases in basketball

Strain in basketball competition can be structured temporally into three psychologically meaningful phases: a beginning, main, and endphase of each half-time. The relevance of these phases for the diagnosis of an individual psychological crisis during the competition is discussed. Empirical evidence is based on the results of a study conducted on 28 basketball experts, who were asked to assess the components of the Bayesian likelihood ratio (diagnosticity) for each phase, thereby evaluating the crisis-relevance of that phase. Analysis of variance shows the significant influences of the hypothesized crisis-noncrisis character, half-time (first-second) and phase (beginning, main, end) on the (considerable) diagnostic relevance of the time-phases. The authors briefly discuss the meaning of the present results.

Effect of practice procedure on skill acquisition

49 children in Grade 1 in an isolated community were assessed on their form and skill in making a basket for a one-step basketball lay-up following practice using a pseudoshaping, specific, or schema procedure. Analysis gave a significant form effect but no difference in success of making baskets.

Footwear and ankle stability in the basketball player

Ankle stability in basketball players is affected by footwear. Athletic shoe manufacturers have introduced specialized lacing systems and high-top performance shoes to improve ankle stability. These performance shoes not only aid in preventing ankle injuries, but also protect injured ankles.

Proximal interphalangeal joint dislocations without fractures

Injuries to the proximal interphalangeal joint are extremely common. An understanding of the complex anatomy of this joint is essential for diagnosis and treatment of proximal interphalangeal joint sprains and dislocations. Lateral injuries are among the commonest injuries in the hand. These are often stable after reduction, requiring only closed treatment. Occasionally, however, the collateral ligament can be trapped in the joint and require open reduction. Dorsal dislocations represent the most common dislocation in the hand. These, too, are usually stable after reduction and can be treated by closed methods. On occasion, however, these dislocations will be open or irreducible by closed means, requiring surgical intervention and repair of damaged structures. Complex rotary dislocations are exactly that: complex. An exact understanding of the damaged structures and causes of irreducibility frequently makes this an injury often requiring open reduction and selective repair of damaged soft tissue structures. Fortunately, prompt diagnosis, reduction, and institution of appropriate treatment can usually afford the patient good function after these injuries. It must be noted that stiffness is more common than instability, and active range-of-motion exercises instituted at the proper time are essential. These joints will often remain permanently thicker after injury in spite of optimal care, and tenderness and soreness with use may persist for 6 to 12 months.

Efficiency under record performance demands: Exertion control—an individual difference variable?

Semiprofessional players ran basketball circuits under either normal or record performance demands. Lactate concentration and heart rate were measured as indexes of exertion. Number of dribbling errors, attempted shots, hits, and hit rate served as measures of performance and efficiency. Several individual difference measures were taken in order to identify those athletes who were capable of moderating the extent of exertion and of preserving their performance from impairment. The indexes of exertion rose sharply from normal to record trials. Correspondingly, the numbers of dribbling errors and of shots increased while the hit rate declined. However, there were considerable individual differences in restraining exertion and preserving efficiency--both indexes of exertion control. Neither achievement motive scores nor questionnaire items that ask for self-knowledge about exertion control could account for these differences. However, individuals capable of exertion control could be discriminated by an action-control scale that asks about postdecisional implementation of action steps (Kuhl, 1985).

Magnetic resonance images of chronic patellar tendinitis

Chronic patellar tendinitis can be a frustrating diagnostic and therapeutic problem. This report evaluates seven tendons in five patients with chronic patellar tendinitis. The etiologies included "jumper's knee" and Osgood-Schlatter disease. In all cases magnetic resonance images (MRI) showed thickening of the tendon. Some of the tendons had focal areas of thickening which helped establish the etiology. All cases had intratendinous areas of increased signal which, in four cases, proved to be chronic tendon tears. MRI is useful in evaluating chronic patellar tendinitis because it establishes the diagnosis, detects associated chronic tears, and may help determine appropriate rehabilitation.

Stress fractures of the medial malleolus

Six athletes, all engaged in running activities at the time of injury, presented with tenderness over the medial malleolus and ankle effusion. Three patients had a fracture line which could be seen on radiographs. These patients were treated by open reduction and internal fixation using two 4.0 cancellous screws. The other three patients had normal radiographs but bone scans showed increased uptake over the medial malleolus. These patients were treated with cast and immobilization. We believe that each of these patients suffered a stress fracture of the medial malleolus. We suggest that the possibility of a stress fracture be considered in the differential diagnosis of patients who present with 1) chronic or subacute pain over the medial malleolus and ankle effusion, and 2) a history of running activity at the time of injury or running activities aggravating the pain. Bone scans appear to be more sensitive than radiographs in detecting a stress fracture of the medial malleolus. We propose that athletes with radiographic signs of a medial malleolar fracture who desire early return to full participation should be treated by open reduction and internal fixation. For these patients, early motion can be initiated. Other athletes whose fracture cannot be detected on radiographs but whose malleolus shows increased uptake in the area on bone scans can be treated nonsurgically with immobilization and then progressive increase in activity. All of our patients returned to full activity between 6 and 8 weeks after treatment was initiated.

MR imaging of osteoid osteoma of the talus

Magnetic resonance (MR) imaging of the painful ankle of a 15-year-old boy revealed the nidus of a subarticular osteoid osteoma of the talus along with markedly abnormal signal intensity in the neighboring bone marrow. This MR appearance correlated with alterations in the neighboring bone marrow documented by histopathologic examination.

Injury and disability in the professional athlete

An injury at work affects the professional athlete more than his nonathlete counterpart because it may portend the end of his playing career. The pertinent issues that concern the injured athlete are initial assessment of the injury, regulations governing treatment and rehabilitation of the injury, criteria for return-to-play status, determination of permanent impairment, and the athlete's rights. Permanent impairment determination procedures and compensation mechanisms are well established in each of the major professional leagues in the United States.

Standard score assessment on physique and performance of Brazilian athletes in a six tiered competitive sports model

The use of large cross-sectional norms on Brazilian children and youths aged 7 to 18 years within a six level competition plan helps to assess development status and monitor change. Non-athletic prototypes for comparative purposes are illustrated by the use of the lowest competitive level of 18 year olds to assess differences from internationally elite players. The purpose of this study was to establish the efficacy of this practice in male and female basketball and volleyball samples. Comparisons were made on 11 anthropometric and performance variables using percent difference (% delta) and z-score values. The z-scores were highest for height, weight, and jumping ability in both sports groups. The volleyball players were the more linear in physique and the better jumpers. Related to their prototypes the female basketball players had the highest estimated VO2 max (ml kg-1 min-1), and the best values of anaerobic power measures. It is concluded that differences in physique and performance at various levels of competition compared to non-athletic prototypes may be used to infer selective and training factors.

Treatment of ankle sprains in young athletes

To study the incidence of fibulocollateral ligament ankle sprains in the young male athlete, a survey of 84 varsity basketball players was done. Seventy percent of the players had a history of an ankle sprain. Eighty percent of those with a positive history had multiple sprains. Most of the injuries were mild, but in 32% of the injuries, the athlete missed more than 2 weeks of play. No medical attention was sought in 55% of the cases. About 50% of the athletes with a sprain had residual symptoms from their injuries; 15% of the injured athletes felt that their residual symptoms compromised their playing performance. This article emphasizes the potential seriousness of the ankle sprain in the young athlete and presents a recommended method of management, including assessment of severity, treatment, and rehabilitation.

Athletic footwear

The development of technical athletic footwear is based on two interrelated principles: injury prevention and enhanced performance. Most athletes are interested in and will benefit from shoes that prevent injuries. On the other hand, in many situations, competitive or elite athletes might be willing to accept the increased injury risk if the shoe can enhance performance. For these performance athletes, injury prevention may be a less important consideration. Emphasis can be placed on ultra-lightweight shoes which maximize energy return and do not restrict the desirable motions of the individual sport. Every sport demands a specific shoe. The process of new shoe development is similar to those categories already described: an understanding of the sport's biomechanics; an evaluation of the sport's injury patterns; prototype construction; wear-testing to insure fit, comfort, and playability; and manufacturing. Sports with large numbers of participants get the most attention, but lesser known sports demand the same detailed development. Softball, field hockey, boxing, and wrestling are, to name a few, sports which require specialty footwear. As our understanding improves in each sport, footwear technology and construction will follow.

Prolactinemia in exercising male athletes

8 male collegial athletes were submitted at random to three (55, 70 and 85% of VO2 max) ergocycle exercises of 20-min duration. Venous blood samples were obtained before, during and after ergocycling sessions by antecubital catheterization. Serum prolactin was measured by RIA using specific antiserum. The exercise treatments induced a blood prolactin response proportional to the intensity of the work loads.

Effects of conditioning on the ballistocardiogram of college basketball players

This study was undertaken to investigate the effects of vigorous athletic training on the ballistocardiogram. Ten varsity college basketball players were tested twice before the season began, twice during the season, and once from 4 to 6 weeks after the season was concluded. Ballistocardiograms were recorded before and after a standard exercise at each testing period. While the heart rates, particularly after the standard exercise, decreased with training, there was no statistically significant effect of training on the ballistocardiogram. This was thought to be due to limitations of the direct-body ballistocardiograph, particularly as influenced by changes in skin-fold fat of the subject. The immediate effects of exercise were an increase in amplitude and areas of the I plus J waves and the amplitude of the K wave. No immediate effects of exercise or of training were observed on the I-J or J-K intervals or on the respiratory effects on the ballistocardiogram.

Submitted on October 1, 1959