701
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Abstract
Muscle injury causes functional impairment. The healing process takes time and fibrotic tissue can result. Recurrence and delayed recovery remain as unsolved problems. Surgical intervention can be a feasible alternative to avoid early and late complications associated with complete muscle tear in attempt to improve functional results. This article hopes to provide an update about surgical treatments for muscle tears in different scenarios.
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Affiliation(s)
- Leonardo Addêo Ramos
- Department of Orthopaedic Surgery, Federal University of Sao Paulo, São Paulo, SP, Brazil,
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702
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Abstract
Skeletal muscle injuries are among the most common sports-related injuries that result in time lost from practice and competition. The cellular response to muscle injury can often result in changes made to the muscle fibers as well as the surrounding extracellular matrix during repair. This can negatively affect the force and range of the injured muscle even after the patient's return to play. Diagnosis of skeletal muscle injury involves both history and physical examinations; imaging modalities including ultrasound and magnetic resonance imaging (MRI) can also be used to assess the extent of injury. Current research is investigating potential methods, including clinical factors and MRI, by which to predict a patient's return to sports. Overall, function of acutely injured muscles seems to improve with time. Current treatment methods for skeletal muscle injuries include injections of steroids, anesthetics, and platelet-rich plasma (PRP). Other proposed methods involve inhibitors of key players in fibrotic pathways, such as transforming growth factor (TGF)-ß and angiotensin II, as well as muscle-derived stem cells.
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Affiliation(s)
- Stephanie Wong
- Department of Orthopaedic Surgery, University of California, 1500 Owens Ave, Box 3004, San Francisco, CA, 94127, USA
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703
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Chinzei N, Hayashi S, Ueha T, Fujishiro T, Kanzaki N, Hashimoto S, Sakata S, Kihara S, Haneda M, Sakai Y, Kuroda R, Kurosaka M. P21 deficiency delays regeneration of skeletal muscular tissue. PLoS One 2015; 10:e0125765. [PMID: 25942471 PMCID: PMC4420284 DOI: 10.1371/journal.pone.0125765] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/26/2015] [Indexed: 11/21/2022] Open
Abstract
The potential relationship between cell cycle checkpoint control and tissue regeneration has been indicated. Despite considerable research being focused on the relationship between p21 and myogenesis, p21 function in skeletal muscle regeneration remains unclear. To clarify this, muscle injury model was recreated by intramuscular injection of bupivacaine hydrochloride in the soleus of p21 knockout (KO) mice and wild type (WT) mice. The mice were sacrificed at 3, 14, and 28 days post-operation. The results of hematoxylin-eosin staining and immunofluorescence of muscle membrane indicated that muscle regeneration was delayed in p21 KO mice. Cyclin D1 mRNA expression and both Ki-67 and PCNA immunohistochemistry suggested that p21 deficiency increased cell cycle and muscle cell proliferation. F4/80 immunohistochemistry also suggested the increase of immune response in p21 KO mice. On the other hand, both the mRNA expression and western blot analysis of MyoD, myogenin, and Pax7 indicated that muscular differentiation was delayed in p21KO mice. Considering these results, we confirmed that muscle injury causes an increase in cell proliferation. However, muscle differentiation in p21 KO mice was inhibited due to the low expression of muscular synthesis genes, leading to a delay in the muscular regeneration. Thus, we conclude that p21 plays an important role in the in vivo healing process in muscular injury.
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Affiliation(s)
- Nobuaki Chinzei
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinya Hayashi
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Ueha
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takaaki Fujishiro
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Noriyuki Kanzaki
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shingo Hashimoto
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shuhei Sakata
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinsuke Kihara
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masahiko Haneda
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masahiro Kurosaka
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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704
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Reurink G, Goudswaard GJ, Moen MH, Weir A, Verhaar JAN, Bierma-Zeinstra SMA, Maas M, Tol JL. Rationale, secondary outcome scores and 1-year follow-up of a randomised trial of platelet-rich plasma injections in acute hamstring muscle injury: the Dutch Hamstring Injection Therapy study. Br J Sports Med 2015; 49:1206-12. [DOI: 10.1136/bjsports-2014-094250] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2015] [Indexed: 12/19/2022]
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705
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Reurink G, Almusa E, Goudswaard GJ, Tol JL, Hamilton B, Moen MH, Weir A, Verhaar JAN, Maas M. No association between fibrosis on magnetic resonance imaging at return to play and hamstring reinjury risk. Am J Sports Med 2015; 43:1228-34. [PMID: 25748473 DOI: 10.1177/0363546515572603] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Connective tissue scar (fibrosis) is a common finding on magnetic resonance imaging (MRI) after recovery from acute hamstring injuries. Fibrosis has been suggested as a predisposing factor for reinjury, but evidence from clinical studies is lacking. PURPOSE/HYPOTHESIS The aim of this study was to examine the association between the presence of fibrosis on MRI at return to play after an acute hamstring injury and the risk of reinjury. The hypothesis was that fibrous tissue on MRI was associated with an increased reinjury risk. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Magnetic resonance images were obtained from 108 consecutive athletes with modified Peetrons classification grade 1 or 2 hamstring injuries within 5 days of injury and within 7 days of return to play. The presence and extent of abnormally low signal intensity in the intramuscular tissue on MRI, suggestive of fibrosis, were assessed on both T1- and T2-weighted images. Reinjuries were recorded over a 1-year follow-up period. The association between fibrosis and reinjury risk was analyzed with a Cox proportional hazards model. RESULTS The MRIs of the initial injury showed 45 (43%) grade 1 and 63 (57%) grade 2 injuries. Median time of return to play was 30 days (interquartile range [IQR], 22-42 days). At return to play, 41 athletes (38%) had fibrosis on MRI with a median longitudinal length of 5.8 cm (IQR, 3.3-12.5 cm) and a median volume of 1.5 cm3 (IQR, 1.5-3.9 cm3). In athletes with fibrosis, 24% (10/41) sustained a reinjury, and in the subjects without fibrosis, 24% (16/67) had a reinjury, resulting in a hazard ratio of 0.95 (95% CI, 0.43-2.1; P=.898). CONCLUSION Fibrosis is commonly seen on MRI at return to play after grade 1 or 2 hamstring injuries but is not associated with reinjury risk.
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Affiliation(s)
- Gustaaf Reurink
- Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, the Netherlands Department of Sports Medicine, The Sports Physicians Group, St Lucas Andreas Hospital, Amsterdam, the Netherlands
| | - Emad Almusa
- Department of Radiology, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Gert Jan Goudswaard
- Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Johannes L Tol
- Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Bruce Hamilton
- High Performance Sport New Zealand, Millennium Institute of Sport and Health, Mairangi Bay, Auckland, New Zealand
| | - Maarten H Moen
- Department of Sports Medicine, The Sports Physicians Group, St Lucas Andreas Hospital, Amsterdam, the Netherlands Department of Sports Medicine, Bergman Clinics, Naarden, the Netherlands
| | - Adam Weir
- Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Jan A N Verhaar
- Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Mario Maas
- Department of Radiology, Academic Medical Centre University of Amsterdam, Amsterdam, the Netherlands
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706
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Abstract
INTRODUCTION Every year recreational and professional sports cause thousands of lesions to muscle, ligament and tendon. Critical progress in biological interventions could meet a pressing health need to help athletes resume their activity levels. AREAS COVERED We perform a narrative review on platelet-rich plasma (PRP) therapies and muscle injuries. The field is eminently translational, thus besides clinical data we summarize experimental studies that bring meaningful biological insights on PRP effects. Some concepts regarding healing mechanisms are reviewed including innate immune response, myogenesis and fibrosis. It is commonly thought that PRPs are not uniform and cannot be assessed against each other, thus current PRP classifications are addressed. PRP effects also depend on the characteristics of the host tissue; therefore we focus on clinical muscle injury classifications. Controversial clinical findings are attributed to both the variability in PRP formulations and variability in the application protocols, so we discuss current clinical data in this basis. EXPERT OPINION Currently, there is little clinical evidence to support the use of PRP in skeletal muscle injuries. The future of PRP therapies relies not only in finding the best products, most appropriate indications and application protocols, but also in conceiving combination products. Moreover, as our understanding of healing mechanisms progresses, off-the-shelf allogenic PRP products could be part of the solution for sport injuries.
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Affiliation(s)
- Isabel Andia
- Cruces University Hospital, BioCruces Health Research Institute, Regenerative Medicine Laboratory , Barakaldo 48903 , Spain
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707
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Abat F, Valles SL, Gelber PE, Polidori F, Jorda A, García-Herreros S, Monllau JC, Sanchez-Ibáñez JM. An experimental study of muscular injury repair in a mouse model of notexin-induced lesion with EPI® technique. BMC Sports Sci Med Rehabil 2015; 7:7. [PMID: 25897404 PMCID: PMC4403980 DOI: 10.1186/s13102-015-0002-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 03/26/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND The mechanisms of muscle injury repair after EPI® technique, a treatment based on electrical stimulation, have not been described. This study determines whether EPI® therapy could improve muscle damage. METHODS Twenty-four rats were divided into a control group, Notexin group (7 and 14 days) and a Notexin + EPI group. To induce muscle injury, Notexin was injected in the quadriceps of the left extremity of rats. Pro-inflammatory interleukin 1-beta (IL-1beta) and tumoral necrosis factor-alpha (TNF-alpha) were determined by ELISA. The expression of receptor peroxisome gamma proliferator activator (PPAR-gamma), vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-1 (VEGF-R1) were determined by western-blot. RESULTS The plasma levels of TNF-alpha and IL-1beta in Notexin-injured rats showed a significant increase compared with the control group. EPI® produced a return of TNF-alpha and IL-1beta values to control levels. PPAR-gamma expression diminished injured quadriceps muscle in rats. EPI® increased PPAR-gamma, VEGF and VEGF-R1 expressions. EPI® decreased plasma levels of pro-inflammatory TNF-alpha and IL-1beta and increased anti-inflammatory PPAR-gamma and proangiogenic factors as well as VEGF and VEGF-R1 expressions. CONCLUSION The EPI® technique may affect inflammatory mediators in damaged muscle tissue and influences the new vascularization of the injured area. These results suggest that EPI® might represent a useful new therapy for the treatment of muscle injuries. Although our study in rats may represent a valid approach to evaluate EPI® treatment, studies designed to determine how the EPI® treatment may affect recovery of injury in humans are needed.
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Affiliation(s)
- Ferran Abat
- Department of Sports Orthopedics, ReSport Clinic, Barcelona, Spain
| | - Soraya-L Valles
- Department of Physiology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Pablo-Eduardo Gelber
- Catalan Institut of Traumatology and Sports Medicine (ICATME), Hospital Universitari Dexeus, Universitat Autónoma de Barcelona, Barcelona, Spain ; Department of Orthopedic Surgery, Hospital de la Santa Creu i Sant Pau, University Autonoma of Barcelona, Barcelona, Spain
| | - Fernando Polidori
- Department of Sports Rehabilitation, Cerede Sports Medicine, Barcelona, Spain
| | - Adrian Jorda
- Department of Physiology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | | | - Joan-Carles Monllau
- Catalan Institut of Traumatology and Sports Medicine (ICATME), Hospital Universitari Dexeus, Universitat Autónoma de Barcelona, Barcelona, Spain ; Universitat Autónoma de Barcelona, Barcelona, Spain ; Department of Orthopedic Surgery and Traumatology, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain
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708
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McCall A, Nedelec M, Carling C, Le Gall F, Berthoin S, Dupont G. Reliability and sensitivity of a simple isometric posterior lower limb muscle test in professional football players. J Sports Sci 2015; 33:1298-304. [PMID: 25845799 DOI: 10.1080/02640414.2015.1022579] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study aimed (1) to determine the reliability of a simple and quick test to assess isometric posterior lower limb muscle force in professional football players and (2) verify its sensitivity to detect reductions in force following a competitive match. Twenty-nine professional football players performed a 3-s maximal isometric contraction of the posterior lower limb muscles for both legs with players lying supine. Both legs were tested using a knee angle of 90° and 30° measured on a force plate. Players were tested twice with one week between sessions to verify reliability. Sensitivity was tested following a full competitive football match. The test showed high reliability for dominant leg at 90° (CV = 4.3%, ICC = 0.95, ES = 0.15), non-dominant leg at 90° (CV = 5.4%, ICC = 0.95, ES = 0.14), and non-dominant leg at 30° (CV = 4.8%, ICC = 0.93, ES = 0.30) and good reliability for dominant leg at 30° (CV = 6.3%, ICC = 0.86, ES = 0.05). The measure was sensitive enough to detect reductions in force for dominant leg at 90° (P = 0.0006, ES > 1), non-dominant leg at 90° (P = 0.0142, ES = 1), and non-dominant leg at 30° (P = 0.0064, ES > 1) and for dominant leg at 30° (P = 0.0016, ES > 1). In conclusion, the present test represents a useful and practical field tool to determine the magnitude of match-induced fatigue of the posterior lower limb muscles and potentially to track their recovery.
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709
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Whittaker JL, Small C, Maffey L, Emery CA. Risk factors for groin injury in sport: an updated systematic review. Br J Sports Med 2015; 49:803-9. [PMID: 25833903 DOI: 10.1136/bjsports-2014-094287] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 03/11/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND The identification of risk factors for groin injury in sport is important to develop and implement injury prevention strategies. OBJECTIVE To identify and evaluate the evidence examining risk factors for groin injury in sport. MATERIAL AND METHODS Nine electronic databases were systematically searched to June 2014. Studies selected met the following criteria: original data; analytic design; investigated a risk factor(s); included outcomes for groin injury sustained during sport participation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed and two independent authors assessed the quality and level of evidence with the Downs and Black (DB) criteria and Oxford Centre of Evidence-Based Medicine model, respectively. RESULTS Of 2521 potentially relevant studies, 29 were included and scored. Heterogeneity in methodology and injury definition precluded meta-analyses. The most common risk factors investigated included age, hip range of motion, hip adductor strength and height. The median DB score across studies was 11/33 (range 6-20). The majority of studies represented level 2 evidence (cohort studies) however few considered the inter-relationships between risk factors. There is level 1 and 2 evidence that previous groin injury, higher-level of play, reduced hip adductor (absolute and relative to the hip abductors) strength and lower levels of sport-specific training are associated with increased risk of groin injury in sport. CONCLUSIONS We recommended that investigators focus on developing and evaluating preparticipation screening and groin injury prevention programmes through high-quality randomised controlled trials targeting athletes at greater risk of injury.
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Affiliation(s)
- Jackie L Whittaker
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
| | | | - Lorrie Maffey
- Faculty of Medicine, Division of Sport Medicine, University of British Columbia, Vancouver, British Columbia, Canada School of Rehabilitation Science, McMaster University, Canada
| | - Carolyn A Emery
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Canada Department of Pediatrics and Department of Community Health Sciences, Alberta Children's Hospital Research Institute for Child and Maternal Health, Cummings School of Medicine, University of Calgary, Calgary, Canada
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710
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Effects of low-level laser therapy on skeletal muscle repair: a systematic review. Am J Phys Med Rehabil 2015; 93:1073-85. [PMID: 25122099 DOI: 10.1097/phm.0000000000000158] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A review of the literature was performed to demonstrate the most current applicability of low-level laser therapy (LLLT) for the treatment of skeletal muscle injuries, addressing different lasers, irradiation parameters, and treatment results in animal models. Searches were performed in the PubMed/MEDLINE, SCOPUS, and SPIE Digital Library databases for studies published from January 2006 to August 2013 on the use of LLLT for the repair of skeletal muscle in any animal model. All selected articles were critically appraised by two independent raters. Seventeen of the 36 original articles on LLLT and muscle injuries met the inclusion criteria and were critically evaluated. The main effects of LLLT were a reduction in the inflammatory process, the modulation of growth factors and myogenic regulatory factors, and increased angiogenesis. The studies analyzed demonstrate the positive effects of LLLT on the muscle repair process, which are dependent on irradiation and treatment parameters. The findings suggest that LLLT is an excellent therapeutic resource for the treatment of skeletal muscle injuries in the short-term.
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711
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Whyte E, Burke A, White E, Moran K. A high-intensity, intermittent exercise protocol and dynamic postural control in men and women. J Athl Train 2015; 50:392-9. [PMID: 25689420 DOI: 10.4085/1062-6050-49.6.08] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
CONTEXT Deficits in dynamic postural control predict lower limb injury. Differing fatiguing protocols negatively affect dynamic postural control. The effect of high-intensity, intermittent exercise on dynamic postural control has not been investigated. OBJECTIVE To investigate the effect of a high-intensity, intermittent exercise protocol (HIIP) on the dynamic postural control of men and women as measured by the Star Excursion Balance Test (SEBT). DESIGN Descriptive laboratory study. SETTING University gymnasium. PATIENTS OR OTHER PARTICIPANTS Twenty male (age = 20.83 ± 1.50 years, height = 179.24 ± 7.94 cm, mass = 77.67 ± 10.82 kg) and 20 female (age = 20.45 ± 1.34 years, height = 166.08 ± 5.83 cm, mass = 63.02 ± 6.67 kg) athletes. INTERVENTION(S) We recorded SEBT measurements at baseline, pre-HIIP, and post-HIIP. The HIIP consisted of 4 repetitions of 10-m forward sprinting with a 90° change of direction and then backward sprinting for 5 m, 2 repetitions of 2-legged jumping over 5 hurdles, 2 repetitions of high-knee side stepping over 5 hurdles, and 4 repetitions of lateral 5-m shuffles. Participants rested for 30 seconds before repeating the circuit until they reported a score of 18 on the Borg rating of perceived exertion scale. MAIN OUTCOME MEASURE(S) A mixed between- and within-subjects analysis of variance was conducted to assess time (pre-HIIP, post-HIIP) × sex interaction effects. Subsequent investigations assessed the main effect of time and sex on normalized maximal SEBT scores. We used intraclass correlation coefficients to determine the test-retest reliability of the SEBT and paired-samples t tests to assess the HIIP effect on circuit times. RESULTS We found a time × sex effect (F(8,69) = 3.5; P range, <.001-.04; η(2) range, 0.057-0.219), with women less negatively affected. We also noted a main effect for time, with worse normalized maximal SEBT scores postfatigue (F(8,69) = 22.39; P < .001; η(2) range, 0.324-0.695), and for sex, as women scored better in 7 SEBT directions (F(8,69) = 0.84; P range, <.001-008; η(2) range, 0.088-0.381). The intraclass correlation coefficients demonstrated high (0.77-0.99) test-retest repeatability. Paired-samples t tests demonstrated increases in circuit time post-HIIP (P < .001). CONCLUSIONS The HIIP-induced fatigue negatively affected normalized maximal SEBT scores. Women had better scores than men and were affected less negatively by HIIP-induced fatigue.
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Affiliation(s)
- Enda Whyte
- School of Health and Human Performance, Dublin City University, Ireland
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712
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Reliability of externally fixed dynamometry hamstring strength testing in elite youth football players. J Sci Med Sport 2015; 19:93-6. [PMID: 25683733 DOI: 10.1016/j.jsams.2015.01.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 12/22/2014] [Accepted: 01/28/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To investigate inter and intra-tester reliability of an externally fixed dynamometry unilateral hamstring strength test, in the elite sports setting. DESIGN Reliability study. METHODS Sixteen, injury-free, elite male youth football players (age=16.81±0.54 years, height=180.22±5.29cm, weight 73.88±6.54kg, BMI=22.57±1.42) gave written informed consent. Unilateral maximum isometric peak hamstring force was evaluated by externally fixed dynamometry for inter-tester, intra-day and intra-tester, inter-week reliability. The test position was standardised to correlate with the terminal swing phase of the gait running cycle. RESULTS Inter and intra-tester values demonstrated good to high levels of reliability. The intra-class coefficient (ICC) for inter-tester, intra-day reliability was 0.87 (95% CI=0.75-0.93) with standard error of measure percentage (SEM%) 4.7 and minimal detectable change percentage (MDC%) 12.9. Intra-tester, inter-week reliability results were ICC 0.86 (95% CI, 0.74-0.93), SEM% 5.0 and MDC% 14.0. CONCLUSIONS This study demonstrates good to high inter and intra-tester reliability of isometric externally fixed dynamometry unilateral hamstring strength testing in the regular elite sport setting involving elite male youth football players. The intra-class coefficient in association with the low standard error of measure and minimal detectable change percentages suggest that this procedure is appropriate for clinical and academic use as well as monitoring hamstring strength in the elite sport setting.
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713
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Chang E, Kim KM, Hertel J, Hart JM. Repeated bouts of exercise in patients with anterior cruciate ligament reconstruction. Med Sci Sports Exerc 2015; 46:769-75. [PMID: 24145725 DOI: 10.1249/mss.0000000000000171] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Reduced quadriceps activation after anterior cruciate ligament reconstructions (ACL-R) has been reported. Patients often return to daily exercise or sport after ACL-R; however, there is little information regarding quadriceps function after exercise in this population. Therefore, the purpose of this study was to compare quadriceps strength and central activation after repeated bouts of exercise between individuals with and without a history of ACL-R. METHODS Eighteen recreationally active subjects participated in this study: 8 with unilateral ACL-R at least 6 months earlier and 10 healthy controls. All subjects performed 30 min of continuous exercise on two consecutive days. Exercise included repeated bouts of inclined treadmill walking and jumping exercises. We measured maximal isometric knee extension torque and quadriceps central activation ratio (CAR) using the superimposed burst technique before and after exercise on day 1. Subjects returned 24 h later (day 2) for a repeat testing session. RESULTS There was a significant group-time interaction for knee extension torque. ACL-R subjects were weaker at baseline on day 1 of testing (P = 0.01) but exhibited no significant reduction in knee extension torque after exercise (P = 0.13), whereas the healthy control subjects did (P = 0.01). Knee extension torque on day 2 remained significantly lower than baseline for the controls (P = 0.03), but not the ACL-R (P = 0.73). On day 2, both groups experienced significantly reduced knee extension torque after exercise. There was no group-time interaction for CAR, but a group main effect indicated that, on average, ACL-R had significantly lower CAR bilaterally compared with healthy controls. CONCLUSIONS The quadriceps in ACL-R knees were weaker and showed less reduction of isometric knee extension torque compared with healthy group in day 1. However, there were no group differences of quadriceps strength on day 2.
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Affiliation(s)
- Eunwook Chang
- 1Oregon State University, Corvallis, OR; 2Texas State University, San Marcos, TX; and 3University of Virginia, Charlottesville, VA
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714
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Coratella G, Bellin G, Beato M, Schena F. Fatigue affects peak joint torque angle in hamstrings but not in quadriceps. J Sports Sci 2014; 33:1276-82. [DOI: 10.1080/02640414.2014.986185] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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715
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Higashihara A, Nagano Y, Takahashi K, Fukubayashi T. Effects of forward trunk lean on hamstring muscle kinematics during sprinting. J Sports Sci 2014; 33:1366-75. [DOI: 10.1080/02640414.2014.990483] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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716
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Branci S, Thorborg K, Bech BH, Boesen M, Nielsen MB, Hölmich P. MRI findings in soccer players with long-standing adductor-related groin pain and asymptomatic controls. Br J Sports Med 2014; 49:681-91. [DOI: 10.1136/bjsports-2014-093710] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2014] [Indexed: 11/04/2022]
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717
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Nescolarde L, Yanguas J, Lukaski H, Alomar X, Rosell-Ferrer J, Rodas G. Effects of muscle injury severity on localized bioimpedance measurements. Physiol Meas 2014; 36:27-42. [PMID: 25500910 DOI: 10.1088/0967-3334/36/1/27] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Muscle injuries in the lower limb are common among professional football players. Classification is made according to severity and is diagnosed with radiological assessment as: grade I (minor strain or minor injury), grade II (partial rupture, moderate injury) and grade III (complete rupture, severe injury). Tetrapolar localized bioimpedance analysis (BIA) at 50 kHz made with a phase-sensitive analyzer was used to assess damage to the integrity of muscle structures and the fluid accumulation 24 h after injury in 21 injuries in the quadriceps, hamstring and calf, and was diagnosed with magnetic resonance imaging (MRI). The aim of this study was to identify the pattern of change in BIA variables as indicators of fluid [resistance (R)] and cell structure integrity [reactance (Xc) and phase angle (PA)] according to the severity of the MRI-defined injury. The % difference compared to the non-injured contralateral muscle also measured 24-h after injury of R, Xc and PA were respectively: grade I (n = 11; -10.4, -17.5 and -9.0%), grade II (n = 8; -18.4, -32.9 and -16.6%) and grade III (n = 2; -14.1, -52.9 and -43.1%), showing a greater significant decrease in Xc (p < 0.001). The greatest relative changes were in grade III injuries. However, decreases in R, that indicate fluid distribution, were not proportional to the severity of the injury. Disruption of the muscle structure, demonstrated by the localized determination of Xc, increased with the severity of muscle injury. The most significant changes 24 h after injury was the sizeable decrease in Xc that indicates a pattern of disrupted soft tissue structure, proportional to the severity of the injury.
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Affiliation(s)
- L Nescolarde
- Department of Electronic Engineering, Universitat Politècnica de Catalunya, c/ Jordi Girona 1-3, 08034 Barcelona, Spain
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718
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Huri G, Dubin JM, Ozgonen K, Kaya D, Doral MN. A Unique Rectus Femoris Injury in an Adolescent Professional Soccer Player: A Case Report. JBJS Case Connect 2014; 4:e115. [PMID: 29252783 DOI: 10.2106/jbjs.cc.m.00290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A sixteen-year-old professional soccer player presented with persistent pain in the right thigh of two years' duration and the inability to return to play. Evaluation revealed a chronic rupture of the rectus femoris muscle. Because physiotherapy and rehabilitation failed to help, a surgical repair was performed. He returned to his previous activity level within nine months after surgery. CONCLUSION Rupture of the proximal part of the rectus femoris should be acknowledged in the differential diagnosis, especially when presenting with persistent pain in the anterior aspect of the thigh lasting more than one year. Delayed repair might be recognized as a reasonable option for chronic rupture of the proximal part of the rectus femoris.
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Affiliation(s)
- Gazi Huri
- Department of Orthopaedic and Traumatology Surgery, Johns Hopkins University, 10753 Falls Road, Suite 215, Lutherville, MD 21093.
| | - Justin M Dubin
- Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane West, Piscataway, NJ 08854
| | - Kerem Ozgonen
- Department of Physiology, Division of Sport Physiology, Cukurova University, Balcali Street, 01330 Balcali, Adana, Turkey
| | - Defne Kaya
- Department of Sport Medicine (D.K.) and Department of Orthopaedics and Traumatology (M.N.D.), Hacettepe University, Hacettepe Street, 06230 Ankara. Turkey
| | - Mahmut Nedim Doral
- Department of Sport Medicine (D.K.) and Department of Orthopaedics and Traumatology (M.N.D.), Hacettepe University, Hacettepe Street, 06230 Ankara. Turkey
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719
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Pérez-Bellmunt A, Miguel-Pérez M, Brugué MB, Cabús JB, Casals M, Martinoli C, Kuisma R. An anatomical and histological study of the structures surrounding the proximal attachment of the hamstring muscles. ACTA ACUST UNITED AC 2014; 20:445-50. [PMID: 25515332 DOI: 10.1016/j.math.2014.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 11/07/2014] [Accepted: 11/11/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The proximal attachment of hamstring muscles has a very high incidence of injuries due to a wide number of factors and its morphology may be one of the underlying factors as scientific literature points out. The connective tissue component of the attachment of hamstring muscles is not well known. For this reason the aim of this study is to describe the anatomy and histology surrounding the proximal attachment of the hamstring muscles (PAHM) and its direct anatomic relations. METHODS Forty-eight cryopreserved lower limbs have sequentially been studied by means of dissection, anatomical sections and histology. RESULTS All specimens studied presented an annular connective tissue structure that resembles a retinaculum, which covers and adapts to the attachment of hamstring muscles on the ischial tuberosity. CONCLUSION The results show how this retinaculum is continuous with the long head of biceps femoris muscle, however there is a layer of loose connective tissue between the retinaculum and the semitendinosus muscle. Furthermore, this structure receives expansions of the anterior epimysium of the gluteus maximus muscle (GIM).
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Affiliation(s)
| | - Maribel Miguel-Pérez
- Unit of Human Anatomy and Embriology, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, Campus de Bellvitge, University of Barcelona, Spain.
| | - Marc Blasi Brugué
- Unit of Human Anatomy and Embriology, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, Campus de Bellvitge, University of Barcelona, Spain; Department of Fundamental Care and Medical-Surgical Nursing, University School of Nursing, University of Barcelona, Spain
| | - Juan Blasi Cabús
- Histology Unit, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, Campus de Bellvitge, University of Barcelona, Spain
| | - Martí Casals
- Basic Sciences Department, Universitat Internacional de Catalunya, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Carlo Martinoli
- Cattedra di Radiologia "R"-DICMI, Universita di Genova, Genoa, Italy
| | - Raija Kuisma
- School of Health Sciences, University of Brighton, UK
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720
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Haugen T, Tonnessen E, Leirstein S, Hem E, Seiler S. Not quite so fast: effect of training at 90% sprint speed on maximal and repeated-sprint ability in soccer players. J Sports Sci 2014; 32:1979-1986. [DOI: 10.1080/02640414.2014.976248] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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721
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Denadai BS, de Oliveira FBD, Camarda SRDA, Ribeiro L, Greco CC. Hamstrings-to-quadriceps strength and size ratios of male professional soccer players with muscle imbalance. Clin Physiol Funct Imaging 2014; 36:159-64. [PMID: 25348722 DOI: 10.1111/cpf.12209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 09/29/2014] [Indexed: 11/27/2022]
Abstract
The aim of this study was to determine the correlation between the concentric hamstrings/quadriceps muscle strength (Hcon :Qcon ) and cross-sectional area ratios (Hcsa :Qcsa ) in professional soccer players with Hcon :Qcon imbalance. Nine male professional soccer players (25·3 ± 4·1 years) performed five maximal concentric contractions of the knee extensors (KE) and flexors (KF) at 60 s(-1) to assess Hcon :Qcon . The test was performed using the dominant (preferred kicking), and non-dominant limb with a 5-min recovery period was allowed between them. Only players with Hcon :Qcon < 0·60 (range: 0·45-0·59) in both limbs were included in this study. The muscle cross-sectional area (CSA) of KE and KF was determined by magnetic resonance imaging. The correlations between Hcon :Qcon and Hcsa :Qcsa in the dominant leg (r = -0·33), non-dominant leg (r = 0·19) and in the both legs combined (r = 0·28) were not statistically significant (P>0·05). Thus, the Hcon :Qcon seems not to be determined by Hcsa :Qcsa in professional soccer players with Hcon :Qcon imbalance.
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722
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Malliaropoulos N, Korakakis V, Christodoulou D, Padhiar N, Pyne D, Giakas G, Nauck T, Malliaras P, Lohrer H. Development and validation of a questionnaire (FASH—Functional Assessment Scale for Acute Hamstring Injuries): to measure the severity and impact of symptoms on function and sports ability in patients with acute hamstring injuries. Br J Sports Med 2014; 48:1607-12. [DOI: 10.1136/bjsports-2014-094021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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723
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Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med 2014; 44:123-40. [PMID: 24105612 DOI: 10.1007/s40279-013-0102-5] [Citation(s) in RCA: 502] [Impact Index Per Article: 50.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. OBJECTIVE Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. METHODS We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields. RESULTS One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with high-quality studies (0.54 vs 11.55 per 1,000 exposures). Ankle sprain prevalence period estimates were similar across sub-groups. Lateral ankle sprain was the most commonly observed type of ankle sprain. CONCLUSIONS Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains.
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Affiliation(s)
- Cailbhe Doherty
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland,
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724
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Magnetic Resonance Imaging in Acute Hamstring Injury: Can We Provide a Return to Play Prognosis? Sports Med 2014; 45:133-46. [DOI: 10.1007/s40279-014-0243-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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725
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Pressure pain sensitivity changes after use of shock-absorbing insoles among young soccer players training on artificial turf: a randomized controlled trial. J Orthop Sports Phys Ther 2014; 44:587-94. [PMID: 25029914 DOI: 10.2519/jospt.2014.5117] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Prospective, randomized, controlled single-blind intervention trial. OBJECTIVES Shock-absorbing insoles (SAIs), compared with usual insoles, were hypothesized to result in larger increases in pressure pain threshold (PPT) after 3 weeks of use. BACKGROUND Shock-absorbing insoles can decrease self-reported pain among young soccer players training on artificial turf. However, nothing is known about the underlying changes in pain sensitivity assessed by PPT. Methods Seventy-five players were included from the youth teams of under 15, under 17, and under 19 years of age, playing for the Aalborg Boldspilklub (AaB) professional sports club. After a randomization stratified by team and age, players were divided into 2 groups, one that received SAIs and a control group that used their usual insoles. Assessments were made in both groups after 3 weeks of training on artificial turf (baseline) and 3 weeks later (follow-up). The primary outcome was change in PPTs from baseline to follow-up, with PPTs measured over 13 locations on the plantar surface of the foot, leg, and low back of the nonpreferred kicking leg. RESULTS A significantly larger increase was found in PPTs from baseline to follow-up for the SAI group compared with the control group (mean difference, 62 kPa; 95% confidence interval [CI]: 40, 85 kPa). The PPTs increased significantly more among the SAI group compared with the control group (P<.05) for the abductor digiti minimi (mean difference, 82 kPa; 95% CI: 6, 157 kPa), tibialis anterior (mean difference, 125 kPa; 95% CI: 20, 230 kPa), medial gastrocnemius (mean difference, 83 kPa; 95% CI: -6, 171 kPa), and erector spinae (mean difference, 86 kPa; 95% CI: -17, 188 kPa). CONCLUSION The use of SAIs resulted in increased PPTs after 3 weeks of training on artificial turf compared with controls, suggesting a protective role of SAIs in pressure sensitivity and pain perception.
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726
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De Vos RJ, Reurink G, Goudswaard GJ, Moen MH, Weir A, Tol JL. Clinical findings just after return to play predict hamstring re-injury, but baseline MRI findings do not. Br J Sports Med 2014; 48:1377-84. [DOI: 10.1136/bjsports-2014-093737] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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727
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Moen MH, Reurink G, Weir A, Tol JL, Maas M, Goudswaard GJ. Predicting return to play after hamstring injuries. Br J Sports Med 2014; 48:1358-63. [DOI: 10.1136/bjsports-2014-093860] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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728
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Pollock N, James SLJ, Lee JC, Chakraverty R. British athletics muscle injury classification: a new grading system. Br J Sports Med 2014; 48:1347-51. [DOI: 10.1136/bjsports-2013-093302] [Citation(s) in RCA: 166] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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729
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Soccer injuries and recovery in Dutch male amateur soccer players: results of a prospective cohort study. Clin J Sport Med 2014; 24:337-42. [PMID: 24346734 DOI: 10.1097/jsm.0000000000000028] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe characteristics of outdoor soccer injury and recovery among Dutch soccer players. DESIGN Prospective cohort study. SETTING The 2009-2010 competitive season (33 weeks). PARTICIPANTS Four hundred fifty-six Dutch male soccer players of 23 amateur teams. MAIN OUTCOME MEASURES Coaches recorded individual exposure to all soccer activities. Paramedics or sports trainers collected information on the occurrence (e.g., location, type, circumstances) and consequences (eg, absenteeism, medical treatment) of injuries. RESULTS In total, 424 time-loss injuries were sustained by 60% (n = 274) of the players, with 23% (n = 105) having more than 1 injury. This corresponds to an overall density of 9.6 (8.7-10.5) injuries per 1000 player hours; 3.9 (3.3-4.7) in training sessions and 20.4 (18.1-23.1) in soccer matches. Almost 30% (n = 123) of the injuries lasted for more than 1 month, 14% (n = 58) were reinjuries (causing longer absence than new injuries), and 54% (n = 230) of the injuries were given medical treatment. The most common diagnoses were muscle/tendon (38%) or joint/ligament injuries (23%) of the lower extremities. After regaining the ability to fully take part in soccer training or matches, 27.4% of the players (n = 116) still reported complaints. CONCLUSIONS Two recommendations based on the above-mentioned results are (1) prevention should primarily focus on these most common diagnoses and (2) players resuming soccer activities after an injury should be given special attention to resolve the remaining complaints and to prevent reinjuries.
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730
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Reurink G, Goudswaard GJ, Moen MH, Weir A, Verhaar JAN, Bierma-Zeinstra SMA, Maas M, Tol JL. Platelet-rich plasma injections in acute muscle injury. N Engl J Med 2014; 370:2546-7. [PMID: 24963588 DOI: 10.1056/nejmc1402340] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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731
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Abstract
This prospective cohort study described return-to-play (RTP) data for different types of muscle injuries in male elite-level football players in Europe. Eighty-nine European professional teams were followed between 2001 and 2013. Team medical staff recorded individual player exposure and time-loss injuries. A total of 17,371 injuries occurred, including 5603 (32%) muscle injuries. From 2007, we received results from 386 magnetic resonance imaging (MRI) examinations, and radiological grading was performed. A negative MRI was associated with shorter recovery time (6 ± 7 days). Lay-off days were correlated with MRI grading of thigh muscle injuries (P < 0.001). Among hamstring injuries, 83% occurred to the biceps femoris, 12% affected the semimembranosus and 5% the semitendinosus. Recurrence rate was higher among biceps femoris injuries (18%) compared with semitendinosus and semimembranosus injuries (2% together). Groin muscle injuries caused shorter median absence (9 days) than hamstring (13 days; P < 0.001), quadriceps (12 days; P < 0.001) and calf muscle (13 days; P < 0.001) injuries. Overall, we found that MRI was valuable for prognosticating RTP, with radiological grading associated with lay-off times after injury. Re-injuries were common in biceps femoris injuries but rare in semitendinosus and semimembranosus injuries.
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Affiliation(s)
- Anna Hallén
- a Football Research Group, Medical and Health Sciences , Linköping University , Linköping , Sweden
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732
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Abstract
The overall objective of this review was to investigate the role and development of sprinting speed in soccer. Time–motion analyses show that short sprints occur frequently during soccer games. Straight sprinting is the most frequent action before goals, both for the scoring and assisting player. Straight-line sprinting velocity (both acceleration and maximal sprinting speed), certain agility skills, and repeated-sprint ability are shown to distinguish groups from different performance levels. Professional players have become faster over time, indicating that sprinting skills are becoming more and more important in modern soccer. In research literature, the majority of soccer-related training interventions have provided positive effects on sprinting capabilities, leading to the assumption that all kinds of training can be performed with success. However, most successful intervention studies are time consuming and challenging to incorporate into the overall soccer training program. Even though the principle of specificity is clearly present, several questions remain regarding the optimal training methods within the larger context of the team-sport setting. Considering time-efficiency effects, soccer players may benefit more by performing sprint-training regimens similar to the progression model used in strength training and by world-leading athletics practitioners, compared with the majority of guidelines that traditionally have been presented in research literature.
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733
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Noya Salces J, Gómez-Carmona PM, Gracia-Marco L, Moliner-Urdiales D, Sillero-Quintana M. Epidemiology of injuries in First Division Spanish football. J Sports Sci 2014; 32:1263-70. [PMID: 24787731 DOI: 10.1080/02640414.2014.884720] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim was to examine the injuries sustained by Spanish football players in the First Division and to compare injury-related variables in the context of both competition and training. The injury data were prospectively collected from 16 teams (427 players) using a specific web-based survey during the 2008/2009 season. A total of 1293 injuries were identified (145 were recurring injuries). The overall injury incidence was 5.65 injuries per 1000 h of exposure. Injuries were much more common during competition than during training (43.53 vs. 3.55 injuries per 1000 h of exposure, P < 0.05). Most of the injuries (89.6%) involved the lower extremities, and overuse (65.7%) was the main cause. Muscle and tendon injuries were the most common types of injury (53.8%) among the players. The incidence of training injuries was greater during the pre-season and tended to decrease throughout the season, while the incidence of competition injuries increased throughout the season (all P < 0.05). In conclusion, the results of this study suggest the need for injury prevention protocols in the First Division of the Spanish Football League to reduce the number of overuse injuries in the muscles and tendons in the lower extremities. In addition, special attention should be paid during the pre-season and the competitive phase II (the last four months of the season) in order to prevent training and competition injuries, respectively.
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734
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Intramuscular Degloving Injuries to the Rectus Femoris: Findings at MRI. AJR Am J Roentgenol 2014; 202:W475-80. [DOI: 10.2214/ajr.13.10931] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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735
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736
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Askling CM, Tengvar M, Tarassova O, Thorstensson A. Acute hamstring injuries in Swedish elite sprinters and jumpers: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med 2014; 48:532-9. [DOI: 10.1136/bjsports-2013-093214] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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737
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Thorborg K, Branci S, Nielsen MP, Tang L, Nielsen MB, Hölmich P. Eccentric and Isometric Hip Adduction Strength in Male Soccer Players With and Without Adductor-Related Groin Pain: An Assessor-Blinded Comparison. Orthop J Sports Med 2014; 2:2325967114521778. [PMID: 26535298 PMCID: PMC4555615 DOI: 10.1177/2325967114521778] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Adductor-related pain is the most common clinical finding in soccer players with groin pain and can be a long-standing problem affecting physical function and performance. Hip adductor weakness has been suggested to be associated with this clinical entity, although it has never been investigated. PURPOSE To investigate whether isometric and eccentric hip strength are decreased in soccer players with adductor-related groin pain compared with asymptomatic soccer controls. The hypothesis was that players with adductor-related groin pain would have lower isometric and eccentric hip adduction strength than players without adductor-related groin pain. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS Male elite and subelite players from 40 teams were contacted. In total, 28 soccer players with adductor-related groin pain and 16 soccer players without adductor-related groin pain (asymptomatic controls) were included in the study. In primary analysis, the dominant legs of 21 soccer players with adductor-related groin pain (≥4 weeks duration) were compared with the dominant legs of 16 asymptomatic controls using a cross-sectional design. The mean age of the symptomatic players was 24.5 ± 2.5 years, and the mean age of the asymptomatic controls was 22.9 ± 2.4 years. Isometric hip strength (adduction, abduction, and flexion) and eccentric hip strength (adduction) were assessed with a handheld dynamometer using reliable test procedures and a blinded assessor. RESULTS Eccentric hip adduction strength was lower in soccer players with adductor-related groin pain in the dominant leg (n = 21) compared with asymptomatic controls (n = 16), namely 2.47 ± 0.49 versus 3.12 ± 0.43 N·m/kg, respectively (P < .001). No other hip strength differences were observed between symptomatic players and asymptomatic controls for the dominant leg (P = .35-.84). CONCLUSION Large eccentric hip adduction strength deficits were found in soccer players with adductor-related groin pain compared with asymptomatic soccer players, while no isometric strength differences were observed between the groups.
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Affiliation(s)
- Kristian Thorborg
- Sports Orthopaedic Research Center, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark. ; Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C) and Departments of Orthopaedic Surgery and Physical Therapy, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Sonia Branci
- Sports Orthopaedic Research Center, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark. ; Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Martin Peter Nielsen
- Sports Orthopaedic Research Center, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Lars Tang
- Sports Orthopaedic Research Center, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark. ; Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C) and Departments of Orthopaedic Surgery and Physical Therapy, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | | | - Per Hölmich
- Sports Orthopaedic Research Center, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark
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738
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Herrero H, Salinero JJ, Del Coso J. Injuries among Spanish male amateur soccer players: a retrospective population study. Am J Sports Med 2014; 42:78-85. [PMID: 24136859 DOI: 10.1177/0363546513507767] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Soccer is the most popular sport worldwide, with about 265 million players, both professionals and amateurs. Most research investigating soccer injuries has focused on professional players because they have greater exposure time, but most soccer players are at the recreational level. PURPOSE To undertake a retrospective epidemiological study of the injuries sustained in Spanish amateur soccer during the 2010-2011 season. STUDY DESIGN Descriptive epidemiological study. METHODS Any injuries incurred by the 134,570 recreational soccer players (aged 18-55 years) registered with the Spanish Football Federation were reported to the federation's medical staff. A standardized medical questionnaire, based on the Fédération International de Football Association (FIFA) Medical and Research Centre (F-MARC) consensus for collection procedures in studies of soccer injuries, was used to classify the injury according to type, severity, location, and treatment. RESULTS A total of 15,243 injuries were reported, with an average of 0.11 injuries per player and per year. From the total number of injuries, 67.2% were classified as injuries that resulted in time loss, while the remaining 32.7% were injuries that required medical attention. Most injuries led to a minimum of 1 competitive match being missed (87%), and only 2.5% were recurrent injuries. The rate of injuries per 1000 hours of play was double during games (1.15/1000 hours) compared with during training (0.49/1000 hours). From the total number of injuries reported, 7.7% corresponded to goalkeepers, 24.2% to forwards, 33.8% to defenders, and 34.3% to midfielders. The knee (29.9%) and ankle joints (12.4%) were the most common body locations injured, while ligament sprains and ruptures accounted for 32.1% of the total injuries attended. Older amateur players (age ≥30 years) had a greater number of injuries per year and per 1000 hours of play than their younger counterparts. CONCLUSION The risk of injury in amateur soccer is lower than that previously reported in professional players. The most common complaints in amateur players are knee ligament injuries. Further research is needed to investigate ways of reducing the incidence of injuries in amateur soccer.
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Affiliation(s)
- Helena Herrero
- Juan Del Coso, Camilo José Cela University, C/ Castillo de Alarcon, 49, Villafranca del Castillo, Madrid, 28692 Spain.
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739
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van der Horst N, Smits DW, Petersen J, Goedhart EA, Backx FJG. The preventive effect of the Nordic hamstring exercise on hamstring injuries in amateur soccer players: study protocol for a randomised controlled trial. Inj Prev 2013; 20:e8. [PMID: 24336837 DOI: 10.1136/injuryprev-2013-041092] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Hamstring injuries are the most common muscle injury in male amateur soccer players and have a high rate of recurrence, often despite extensive treatment and long rehabilitation periods. Eccentric strength and flexibility are recognised as important modifiable risk factors, which have led to the development of eccentric hamstring exercises, such as the Nordic hamstring exercise. As the effectiveness of the Nordic hamstring exercise in reducing hamstring injuries has never been investigated in amateur soccer players, the aim of this study is to investigate the effect of this exercise on the incidence and severity of hamstring injuries in male amateur soccer players. An additional aim is to determine whether flexibility is associated with hamstring injuries. STUDY DESIGN Cluster-randomised controlled trial with soccer teams as the unit of cluster. METHODS Dutch male amateur soccer players, aged 18-40 years, were allocated to an intervention or control group. Both study groups continued regular soccer training during 2013, but the intervention group additionally performed the Nordic hamstring exercise (25 sessions over 13 weeks). Primary outcomes are the incidence of initial and recurrent hamstring injury and injury severity. Secondary outcomes are hamstring-and-lower-back flexibility and compliance. Compliance to the intervention protocol was also monitored. DISCUSSION Eccentric hamstring strength exercises are hypothesised to reduce the incidence of hamstring injury among male amateur soccer players by 70%. The prevention of such injuries will be beneficial to soccer players, clubs, football associations, health insurance companies and society. TRIAL REGISTRATION NTR3664.
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Affiliation(s)
- Nick van der Horst
- Department of Rehabilitation, Nursing Science & Sports, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Dirk Wouter Smits
- Department of Rehabilitation, Nursing Science & Sports, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jesper Petersen
- Arthroscopic Center Amager, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark
| | - Edwin A Goedhart
- FIFA Medical Center Royal Netherlands Football Association, Zeist, The Netherlands
| | - Frank J G Backx
- Department of Rehabilitation, Nursing Science & Sports, University Medical Center Utrecht, Utrecht, The Netherlands
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740
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Mendiguchia J, Arcos AL, Garrues MA, Myer GD, Yanci J, Idoate F. The Use of MRI to Evaluate Posterior Thigh Muscle Activity and Damage During Nordic Hamstring Exercise. J Strength Cond Res 2013; 27:3426-35. [DOI: 10.1519/jsc.0b013e31828fd3e7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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741
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Carvalhais VODC, Santos TRTD, Araújo VL, Leite DX, Dias JMD, Fonseca STD. Força muscular e índice de fadiga dos extensores e flexores do joelho de jogadores profissionais de futebol de acordo com o posicionamento em campo. REV BRAS MED ESPORTE 2013. [DOI: 10.1590/s1517-86922013000600015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: Assimetrias na capacidade de produção de força entre músculos dos membros inferiores e fadiga muscular podem favorecer a ocorrência de lesões em atletas de futebol. Considerando-se que existem diferenças individuais determinadas pelas diversas funções exercidas pelos jogadores, é possível que a presença de assimetrias de força e fadiga muscular esteja relacionada ao posicionamento em campo. OBJETIVOS: 1) Investigar diferenças na assimetria de pico de torque (PT), na assimetria de trabalho (T) e no índice de fadiga (IF) dos extensores e flexores do joelho de atletas profissionais de futebol de acordo com a posição em campo; e 2) Determinar se o IF dos flexores é superior ao dos extensores. MÉTODOS: Foram analisadas avaliações isocinéticas de 164 atletas profissionais de futebol (atacantes, zagueiros, laterais, meio-campistas e goleiros). O protocolo para avaliação da força concêntrica dos extensores e flexores do joelho consistiu em cinco repetições a 60°/s e 30 repetições a 300°/s. O teste de Kruskall-Wallis foi utilizado para verificar diferenças na assimetria de PT, assimetria de T e IF dos extensores e flexores do joelho entre jogadores de diferentes posicionamentos. O teste de Wilcoxon foi realizado para verificar se havia diferença entre o IF dos extensores e flexores. RESULTADOS: Não houve diferença entre os jogadores dos cinco posicionamentos para as assimetrias de PT e T, bem como para o IF dos extensores e flexores (p > 0,05). O IF flexor foi superior ao extensor em ambos os membros inferiores (p < 0,01). CONCLUSÃO: Variáveis isocinéticas comumente associadas a lesões não foram diferentes entre jogadores de diferentes posicionamentos. Os atletas apresentaram o IF flexor superior ao extensor, o que pode estar relacionado à maior frequência de estiramentos dos isquiossurais em comparação ao quadríceps.
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742
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Reurink G, Goudswaard GJ, Tol JL, Almusa E, Moen MH, Weir A, Verhaar JAN, Hamilton B, Maas M. MRI observations at return to play of clinically recovered hamstring injuries. Br J Sports Med 2013; 48:1370-6. [PMID: 24255767 PMCID: PMC4174122 DOI: 10.1136/bjsports-2013-092450] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background Previous studies have shown that MRI of fresh hamstring injuries have diagnostic and prognostic value. The clinical relevance of MRI at return to play (RTP) has not been clarified yet. The aim of this study is to describe MRI findings of clinically recovered hamstring injuries in amateur, elite and professional athletes that were cleared for RTP. Methods We obtained MRI of 53 consecutive athletes with hamstring injuries within 5 days of injury and within 3 days of RTP. We assessed the following parameters: injured muscle, grading of injury, presence and extent of intramuscular signal abnormality. We recorded reinjuries within 2 months of RTP. Results MRIs of the initial injury showed 27 (51%) grade 1 and 26 (49%) grade 2 injuries. Median time to RTP was 28 days (range 12–76). On MRI at RTP 47 athletes (89%) had intramuscular increased signal intensity on fluid-sensitive sequences with a mean longitudinal length of 77 mm (±53) and a median cross-sectional area of 8% (range 0–90%) of the total muscle area. In 22 athletes (42%) there was abnormal intramuscular low-signal intensity. We recorded five reinjuries. Conclusions 89% of the clinically recovered hamstring injuries showed intramuscular increased signal intensity on fluid-sensitive sequences on MRI. Normalisation of this increased signal intensity seems not required for a successful RTP. Low-signal intensity suggestive of newly developed fibrous tissues is observed in one-third of the clinically recovered hamstring injuries on MRI at RTP, but its clinical relevance and possible association with increased reinjury risk has to be determined.
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Affiliation(s)
- Gustaaf Reurink
- Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, The Netherlands Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Gert Jan Goudswaard
- Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Johannes L Tol
- Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Emad Almusa
- Department of Radiology, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Maarten H Moen
- Department of Sports Medicine, Bergman Clinics, Naarden, The Netherlands
| | - Adam Weir
- Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Jan A N Verhaar
- Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Bruce Hamilton
- Department of Sports Medicine, High Performance Sport New Zealand, Millennium Institute of Sport and Health, Mairangi Bay, Auckland, New Zealand
| | - Mario Maas
- Department of Radiology, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
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743
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Perrott MA, Pizzari T, Cook J. Lumbopelvic exercise reduces lower limb muscle strain injury in recreational athletes. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x12y.0000000055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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744
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Hamilton B, Whiteley R, Almusa E, Roger B, Geertsema C, Tol JL. Excellent reliability for MRI grading and prognostic parameters in acute hamstring injuries. Br J Sports Med 2013; 48:1385-7. [PMID: 24037670 PMCID: PMC4174178 DOI: 10.1136/bjsports-2013-092564] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Categorical grading and other measurable MRI parameters are frequently utilised for predicting the outcome of hamstring injuries. However, the reliability and smallest detectable difference (SDD) have not been previously evaluated. It therefore remains unclear if the variability in previously reported results reflects reporting variation or actual injury status. Methods 25 hamstring injuries were scored by two experienced radiologists using the Peetrons grading and specific prognostic MRI parameters: distance from ischial tuberosity (cm), extent (cranio to caudal, anterior to posterior, medial to lateral; (cm)), maximum cross-sectional area (%), volume (cm3) of the oedema. The interobserver and intraobserver reliability was calculated along with the SDDs for each scale variable. Results There were 3 Grade 0 (12%), 11 grade 1 (44%), 9 grade 2 (36%) and 2 grade 3 (8%) injuries. Cronbach's α values for grading were 1.00 (inter) and 0.96 (intra), respectively. The intraclass correlation coefficients for the prognostic MRI parameters were between 0.77 and 1.0. The SDDs varied between each parameter. Conclusions Excellent interobserver and intraobserver reliability was found for grading and prognostic MRI parameters in acute hamstring injuries. In daily practice and research, we can be confident that scoring hamstring injuries by experienced radiologists is reproducible. The documented SDDs allow meaningful clinical inferences to be made when assessing observed and reported changes in MRI status.
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Affiliation(s)
- B Hamilton
- Department of Sports Medicine, Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar High Performance Sport New Zealand, Auckland, New Zealand
| | - R Whiteley
- Department of Rehabilitation, Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - E Almusa
- Department of Radiology, Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - B Roger
- Department of Radiology, Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - C Geertsema
- Department of Sports Medicine, Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Johannes L Tol
- Department of Sports Medicine, Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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745
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Pruna R, Artells R, Ribas J, Montoro B, Cos F, Muñoz C, Rodas G, Maffulli N. Single nucleotide polymorphisms associated with non-contact soft tissue injuries in elite professional soccer players: influence on degree of injury and recovery time. BMC Musculoskelet Disord 2013; 14:221. [PMID: 23890452 PMCID: PMC3726514 DOI: 10.1186/1471-2474-14-221] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 07/03/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The biological mechanisms involved in non-contact musculoskeletal soft tissue injuries (NCMSTI) are poorly understood. Genetic risk factors may be associated with susceptibility to injuries, and may exert marked influence on recovery times. METHODS Data on type and degree of injury and recovery time were collected in 73 male professional soccer players (43 White, 11 Black Africans and 19 Hispanics) who suffered total of 242 injuries (203 muscle, 24 ligament, and 15 tendon injuries). One single nucleotide polymorphism (SNPs) in the following genes were analyzed: Elastin (ELN); Titin (TTN); SRY-related HMG-box (SOX15); Insulin-like growth factor 2 (IGF2); Chemokine, CC motif, ligand 2 (CCL2); Collagen type 1 alpha 1(COL1A1); Collagen type 5 alpha 1 (COL5A1), and Tenascin C (TNC). RESULTS There was evidence of a statistically significant association between the degree of injury and the IGF2 genotype (P = 0.034). In addition, there was evidence of a statistically significant association between the degree of muscle injury and CCL2 (P = 0.026) Finally, there was evidence of a statistically significant association between ELN and degree of injury (p = 0.009) and recovery time (P = 0.043). There was no evidence of a statistically significant association between any of the genes studied and degree of injury or recovery time for tendon injuries. CONCLUSION SNPs in the IGF2, CCL2, and ELN genes may be associated to the degree and recovery time of NCMSTI.
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746
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Ryynänen J, Dvorak J, Peterson L, Kautiainen H, Karlsson J, Junge A, Börjesson M. Increased risk of injury following red and yellow cards, injuries and goals in FIFA World Cups. Br J Sports Med 2013; 47:970-3. [DOI: 10.1136/bjsports-2013-092487] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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747
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Bengtsson H, Ekstrand J, Hägglund M. Muscle injury rates in professional football increase with fixture congestion: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med 2013; 47:743-7. [DOI: 10.1136/bjsports-2013-092383] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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748
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Gajhede-Knudsen M, Ekstrand J, Magnusson H, Maffulli N. Recurrence of Achilles tendon injuries in elite male football players is more common after early return to play: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med 2013; 47:763-8. [PMID: 23770660 DOI: 10.1136/bjsports-2013-092271] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is limited information about Achilles tendon disorders in professional football. AIMS To investigate the incidence, injury circumstances, lay-off times and reinjury rates of Achilles tendon disorders in male professional football. METHODS A total of 27 clubs from 10 countries and 1743 players have been followed prospectively during 11 seasons between 2001 and 2012. The team medical staff recorded individual player exposure and time-loss injuries. RESULTS A total of 203 (2.5% of all injuries) Achilles tendon disorders were registered. A majority (96%) of the disorders were tendinopathies, and nine were partial or total ruptures. A higher injury rate was found during the preseason compared with the competitive season, 0.25 vs 0.18/1000 h (rate ratio (RR) 1.4, 95% CI 1.1 to 2.0; p=0.027). The mean lay-off time for Achilles tendinopathies was 23±37 (median=10, Q1=4 and Q3=24) days, while a rupture of the Achilles tendon, on average, caused 161±65 (median=169, Q1=110 and Q3=189) days of absence. Players with Achilles tendon disorders were significantly older than the rest of the cohort, with a mean age of 27.2±4 years vs 25.6±4.6 years (p<0.001). 27% of all Achilles tendinopathies were reinjuries. A higher reinjury risk was found after short recovery periods (31%) compared with longer recovery periods (13%) (RR 2.4, 95% CI 2.1 to 2.8; p<0.001). CONCLUSIONS Achilles tendon disorders account for 3.8% of the total lay-off time and are more common in older players. Recurrence is common after Achilles tendinopathies and the reinjury risk is higher after short recovery periods.
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Affiliation(s)
- Mariann Gajhede-Knudsen
- Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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749
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The role of neuromuscular inhibition in hamstring strain injury recurrence. J Electromyogr Kinesiol 2013; 23:523-30. [DOI: 10.1016/j.jelekin.2012.12.006] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 11/29/2012] [Accepted: 12/14/2012] [Indexed: 11/22/2022] Open
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750
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Draghi F, Zacchino M, Canepari M, Nucci P, Alessandrino F. Muscle injuries: ultrasound evaluation in the acute phase. J Ultrasound 2013; 16:209-14. [PMID: 24432176 DOI: 10.1007/s40477-013-0019-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 04/22/2013] [Indexed: 11/29/2022] Open
Abstract
Muscle injuries can be classified as extrinsic or intrinsic injuries as well as contusions and lacerations, and clinical assessment is composed of the history and physical examination. Diagnostic imaging, particularly ultrasound (US) examination, is essential to a correct assessment of the severity of the injury and to exclude important complications as these two elements influence treatment decisions, prognosis and time to return to unrestricted physical activity. This paper presents the main clinical and US features of acute muscle injuries.
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Affiliation(s)
- F Draghi
- Foundation IRCCS, Policlinico San Matteo, Institute of Radiology, University of Pavia, Pavia, Italy
| | - M Zacchino
- Foundation IRCCS, Policlinico San Matteo, Institute of Radiology, University of Pavia, Pavia, Italy
| | - M Canepari
- Foundation IRCCS, Policlinico San Matteo, Institute of Radiology, University of Pavia, Pavia, Italy
| | - P Nucci
- Philips Healthcare, Monza, Italy
| | - F Alessandrino
- Foundation IRCCS, Policlinico San Matteo, Institute of Radiology, University of Pavia, Pavia, Italy
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