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Bramah C, Preece SJ, Gill N, Herrington L. Kinematic Characteristics of Male Runners With a History of Recurrent Calf Muscle Strain Injury. Int J Sports Phys Ther 2021; 16:732-740. [PMID: 34123526 PMCID: PMC8169031 DOI: 10.26603/001c.22971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 01/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Calf muscle strain injuries are a common running injury affecting male runners and are known to have high reoccurrence rates. Currently, limited evidence exists investigating factors associated with this injury with no previous study investigating the running kinematics of male runners with a history of repeat calf muscle strain injuries. PURPOSE To investigate whether male runners with a history of repeat calf muscle strain injury demonstrate differences in stance phase running kinematics when compared to healthy controls. STUDY DESIGN Case-control investigation. LEVEL OF EVIDENCE 3b. METHODS Stance phase kinematics were compared between 15 male runners with a history of calf muscle strain injury and 15 male control participants during treadmill running at 3.2m/s. Independent t-tests were used to compare differences in stance phase kinematic parameters between groups and effect sizes were calculated using Cohen's d. RESULTS The group with a history of calf muscle strain injury demonstrated a significant 2.1⁰ and 3.1⁰ increase in contralateral pelvic drop and anterior pelvic tilt during mid stance. In addition, this group exhibited longer stance times and a more anterior tilted pelvis, flexed hip and a greater distance between the heel and centre of mass at initial contact. Large effect sizes, greater than 0.8, were observed for all differences. No significant differences were observed for ankle and knee joint kinematics between the groups. CONCLUSION This is the first study to identify kinematic characteristics associated with recurrent calf muscle strain injury. While it is not possible to determine causality, the observed kinematic differences may contribute to recurrent nature of this injury. Specifically, it is possible that neuromuscular deficits of the hip and calf muscle complex may lead to increased strain on the calf complex. Rehabilitation interventions which focus on addressing pelvis and hip kinematics may reduce the demands placed upon the calf complex and could prove clinically effective.
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152
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Apprich S, Nia A, Schreiner MM, Friedrich K, Windhager R, Trattnig S. The Vienna morphological Achilles tendon score-VIMATS : Description, reproducibility and initial clinical results. Wien Klin Wochenschr 2021; 133:560-567. [PMID: 34081188 PMCID: PMC8195882 DOI: 10.1007/s00508-021-01863-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 03/22/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose was to introduce the Vienna morphological Achilles tendon score (VIMATS), to evaluate its reproducibility and to assess its clinical application. METHODS In 38 patients a total number of 40 painful ATs and 20 volunteers were examined on a 3T magnetic resonance imaging (MRI) scanner using a standard MRI protocol. In 20 patients clinical scoring according to the Achilles tendon rupture score was available. Two observers independently assessed the thickness, continuity, signal intensity, and associated pathologies of the Achilles tendon (AT) according to the newly created VIMATS. Intraobserver and interobserver agreements were calculated and the clinical application of the VIMATS regarding its potential to differentiate between patients and volunteers was tested. RESULTS An analysis of the Intraclass correlation coefficient (ICC) yielded an excellent intraobserver (ICC 0.925) and interobserver agreement (ICC 0.946) for the total VIMAT score. A significant difference in total VIMATS was found between patients (47.6 ± StD 21.1 points) and volunteers (91.5 ± SD 10.9 points; p < 0.01) as well as a moderate correlation between morphological and clinical scoring (Pearson correlation 0.644). CONCLUSION The VIMAT score is the first MRI score for the semiquantitative morphological evaluation of AT injuries and was shown to be an easy, fast and reproducible tool for assessing injuries of the AT.
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Affiliation(s)
- Sebastian Apprich
- Department of Orthopaedic Surgery, Medical University of Vienna, Währinger Straße 18-20, 1090, Vienna, Austria.
| | - Arastoo Nia
- Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Markus M Schreiner
- Department of Orthopaedic Surgery, Medical University of Vienna, Währinger Straße 18-20, 1090, Vienna, Austria
| | - Klaus Friedrich
- Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopaedic Surgery, Medical University of Vienna, Währinger Straße 18-20, 1090, Vienna, Austria
| | - Siegfried Trattnig
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
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153
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Hannigan JJ, Pollard CD. Biomechanical analysis of two runners who developed leg injuries during a six-week transition to maximal running shoes: A case series. J Sports Sci 2021; 39:2305-2311. [PMID: 34074228 DOI: 10.1080/02640414.2021.1930683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Achilles tendinopathy (AT) and medial tibial stress syndrome (MTSS) are two of the most common running-related injuries. In a previous study investigating running biomechanics before and after a six-week transition to maximal running shoes, two runners dropped out of this study due to Achilles pain and shin pain, respectively. The purpose of this case series was to investigate running biomechanics in those two runners, identifying potential causes for injury in relation to maximal shoe use. Running biomechanics were collected in a laboratory setting for these two runners wearing both a maximal running shoe and traditional running shoe before the six-week transition using an 8-camera motion capture system and two embedded force plates. Both runners displayed prolonged eversion in the maximal shoe, which has been previously cited as a potential risk factor for developing Achilles tendinopathy and medial tibial stress syndrome. Relatively high loading rates and impact forces were also observed in the runner with shin pain in the maximal shoe, which may have contributed to their pain. More prospective research on injury rates in individuals running in maximal shoes is needed.
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Affiliation(s)
- J J Hannigan
- Program in Physical Therapy, Oregon State University - Cascades, Bend, OR, USA.,School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA
| | - Christine D Pollard
- Program in Physical Therapy, Oregon State University - Cascades, Bend, OR, USA.,School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA
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154
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Mousavi SH, Hijmans JM, Minoonejad H, Rajabi R, Zwerver J. Factors Associated With Lower Limb Injuries in Recreational Runners: A Cross-Sectional Survey Including Mental Aspects and Sleep Quality. J Sports Sci Med 2021; 20:204-215. [PMID: 33948098 PMCID: PMC8057706 DOI: 10.52082/jssm.2021.204] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 02/02/2021] [Indexed: 11/24/2022]
Abstract
Knowledge about prevalence and etiology of running-related injuries (RRIs) is important to design effective RRI prevention programs. Mental aspects and sleep quality seem to be important potential risk factors, yet their association with RRIs needs to be elucidated. The aims of this study are to investigate the epidemiology of RRIs in recreational runners and the association of mental aspects, sleep, and other potential factors with RRIs. An internet-based questionnaire was sent to recreational runners recruited through social media, asking for personal and training characteristics, mental aspects (obsessive passion, motivation to exercise), sleep quality, perceived health, quality of life, foot arch type, and RRIs over the past six months. Data were analyzed descriptively and using logistic regression. Self-reported data from 804 questionnaires were analyzed. Twenty-five potential risk factors for RRIs were investigated. 54% of runners reported at least one RRI. The knee was the most-affected location (45%), followed by the lower leg (19%). Patellofemoral pain syndrome was the most-reported injury (20%), followed by medial tibial stress syndrome (17%). Obsessive passionate attitude (odds ratio (OR):1.35; 95% confidence interval (CI):1.18-1.54), motivation to exercise (OR:1.09; CI:1.03-1.15), and sleep quality (OR:1.23; CI:1.15-1.31) were associated with RRIs, as were perceived health (OR:0.96; CI:0.94-0.97), running over 20 km/week (OR:1.58; CI:1.04-2.42), overweight (OR:2.17; CI:1.41-3.34), pes planus (OR:1.80; CI:1.12-2.88), hard-surface running (OR:1.37; CI:1.17-1.59), running company (OR:1.65; CI:1.16-2.35), and following a training program (OR:1.51; CI:1.09-2.10). These factors together explained 30% of the variance in RRIs. A separate regression analysis showed that mental aspects and sleep quality explain 15% of the variance in RRIs. The association of mental aspects and sleep quality with RRIs adds new insights into the multifactorial etiology of RRIs. We therefore recommend that besides common risk factors for RRI, mental aspects and sleep be incorporated into the advice on prevention and management of RRIs.
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Affiliation(s)
- Seyed Hamed Mousavi
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran
- University of Groningen, University Medical Center Groningen, Center for Human Movement Science, The Netherlands
| | - Juha M Hijmans
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Hooman Minoonejad
- University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran
| | - Reza Rajabi
- University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran
| | - Johannes Zwerver
- University of Groningen, University Medical Center Groningen, Center for Human Movement Science, The Netherlands
- Department of Sports Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
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155
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Lin CI, Houtenbos S, Lu YH, Mayer F, Wippert PM. The epidemiology of chronic ankle instability with perceived ankle instability- a systematic review. J Foot Ankle Res 2021; 14:41. [PMID: 34049565 PMCID: PMC8161930 DOI: 10.1186/s13047-021-00480-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/04/2021] [Indexed: 12/13/2022] Open
Abstract
Background Chronic ankle instability, developing from ankle sprain, is one of the most common sports injuries. Besides it being an ankle issue, chronic ankle instability can also cause additional injuries. Investigating the epidemiology of chronic ankle instability is an essential step to develop an adequate injury prevention strategy. However, the epidemiology of chronic ankle instability remains unknown. Therefore, the purpose of this study was to investigate the epidemiology of chronic ankle instability through valid and reliable self-reported tools in active populations. Methods An electronic search was performed on PubMed and Web of Science in July 2020. The inclusion criteria for articles were peer-reviewed, published between 2006 and 2020, using one of the valid and reliable tools to evaluate ankle instability, determining chronic ankle instability based on the criteria of the International Ankle Consortium, and including the outcome of epidemiology of chronic ankle instability. The risk of bias of the included studies was evaluated with an adapted tool for the sports injury review method. Results After removing duplicated studies, 593 articles were screened for eligibility. Twenty full-texts were screened and finally nine studies were included, assessing 3804 participants in total. The participants were between 15 and 32 years old and represented soldiers, students, athletes and active individuals with a history of ankle sprain. The prevalence of chronic ankle instability was 25%, ranging between 7 and 53%. The prevalence of chronic ankle instability within participants with a history of ankle sprains was 46%, ranging between 9 and 76%. Five included studies identified chronic ankle instability based on the standard criteria, and four studies applied adapted exclusion criteria to conduct the study. Five out of nine included studies showed a low risk of bias. Conclusions The prevalence of chronic ankle instability shows a wide range. This could be due to the different exclusion criteria, age, sports discipline, or other factors among the included studies. For future studies, standardized criteria to investigate the epidemiology of chronic ankle instability are required. The epidemiology of CAI should be prospective. Factors affecting the prevalence of chronic ankle instability should be investigated and clearly described.
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Affiliation(s)
- Chiao-I Lin
- Medical Sociology and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany. .,University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Am Neuen Palais 10, House 12, Potsdam, Germany.
| | - Sanne Houtenbos
- Medical Sociology and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany.,University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Am Neuen Palais 10, House 12, Potsdam, Germany
| | - Yu-Hsien Lu
- JC School of Public Health and Primary Care Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
| | - Frank Mayer
- University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Am Neuen Palais 10, House 12, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus-Senftenberg, Am Neuen Palais 10, House 12, Potsdam, Germany
| | - Pia-Maria Wippert
- Medical Sociology and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus-Senftenberg, Am Neuen Palais 10, House 12, Potsdam, Germany
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156
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de Souza Júnior JR, Rabelo PHR, Lemos TV, Esculier JF, Carto JPDS, Matheus JPC. Effects of gait retraining with focus on impact versus gait retraining with focus on cadence on pain, function and lower limb kinematics in runners with patellofemoral pain: Protocol of a randomized, blinded, parallel group trial with 6-month follow-up. PLoS One 2021; 16:e0250965. [PMID: 33979372 PMCID: PMC8116042 DOI: 10.1371/journal.pone.0250965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 04/14/2021] [Indexed: 11/18/2022] Open
Abstract
Patellofemoral pain (PFP) is one of the most prevalent injuries in runners. Unfortunately, a substantial part of injured athletes do not recover fully from PFP in the long-term. Although previous studies have shown positive effects of gait retraining in this condition, retraining protocols often lack clinical applicability because they are time-consuming, costly for patients and require a treadmill. The primary objective of this study will be to compare the effects of two different two-week partially supervised gait retraining programs, with a control intervention; on pain, function and lower limb kinematics of runners with PFP. It will be a single-blind randomized clinical trial with six-month follow-up. The study will be composed of three groups: a group focusing on impact (group A), a group focusing on cadence (group B), and a control group that will not perform any intervention (group C). The primary outcome measure will be pain assessed using the Visual Analog Pain scale during running. Secondary outcomes will include pain during daily activities (usual), symptoms assessed using the Patellofemoral Disorders Scale and lower limb running kinematics in the frontal (contralateral pelvic drop; hip adduction) and sagittal planes (foot inclination; tibia inclination; ankle dorsiflexion; knee flexion) assessed using the MyoResearch 3.14-MyoVideo (Noraxon U.S.A. Inc.). The study outcomes will be evaluated before (t0), immediately after (t2), and six months (t24) after starting the protocol. Our hypothesis is that both partially supervised gait retraining programs will be more effective in reducing pain, improving symptoms, and modifying lower limb kinematics during running compared with the control group, and that the positive effects from these programs will persist for six months. Also, we believe that one gait retraining group will not be superior to the other. Results from this study will help improve care in runners with PFP, while maximizing clinical applicability as well as time and cost-effectiveness.
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Affiliation(s)
- José Roberto de Souza Júnior
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
| | - Pedro Henrique Reis Rabelo
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
| | - Thiago Vilela Lemos
- Department of Physical Therapy, State University of Goiás, Goiânia, Goiás, Brazil
| | - Jean-Francois Esculier
- The Running Clinic, Lac Beauport, Quebec, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - João Pedro da Silva Carto
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
| | - João Paulo Chieregato Matheus
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
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157
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Explaining Variability in the Prevalence of Achilles Tendon Abnormalities: A Systematic Review With Meta-analysis of Imaging Studies in Asymptomatic Individuals. J Orthop Sports Phys Ther 2021; 51:232-252. [PMID: 33779214 DOI: 10.2519/jospt.2021.9970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To estimate the prevalence of, and factors associated with, Achilles tendon abnormalities observed on imaging in asymptomatic individuals. DESIGN Systematic review with stratified meta-analysis and meta-regression. LITERATURE SEARCH Embase, Scopus, MEDLINE, CINAHL, SPORTDiscus, and Web of Science were searched from 1980 to August 2020. STUDY SELECTION CRITERIA We included studies that reported the prevalence of Achilles tendon abnormalities, observed with any imaging modality, in an asymptomatic population. We excluded studies if participant mean age was younger than 12 years or if participants had current/previous lower-limb tendon injuries/symptoms or other systemic conditions. DATA SYNTHESIS Random-effects proportion meta-analysis was used to estimate prevalence. We used meta-regression for continuous variables (mean age and body mass index [BMI], sample size, proportion of female participants) and stratified categorical variables (imaging modality and participation in physical activity) to explain between-study heterogeneity. RESULTS We included 91 studies (10 156 limbs, 5841 participants). The prevalence of Achilles tendon abnormalities on imaging ranged from 0% to 80% per participant. Between-study heterogeneity was high (I2>90%, P<.001), precluding data pooling. Between-study heterogeneity was partly explained by participant mean BMI (slope, 2.8% per 1-unit increase in BMI; 95% confidence interval: 0.57%, 5.03%; P = .015) and participation in physical activity per limb, and mean age of 40 years old or older (P = .022) per participant. CONCLUSION There was substantial variability in the prevalence of Achilles tendon abnormalities on imaging in asymptomatic individuals. Higher prevalence of abnormalities was associated with older age (40 years old or older), higher BMI, and participation in physical activity. A large proportion of heterogeneity remains unaccounted for, likely due to variations in abnormality definitions and study design. J Orthop Sports Phys Ther 2021;51(5):232-252. Epub 28 Mar 2021. doi:10.2519/jospt.2021.9970.
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158
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Malisoux L, Theisen D. Can the "Appropriate" Footwear Prevent Injury in Leisure-Time Running? Evidence Versus Beliefs. J Athl Train 2021; 55:1215-1223. [PMID: 33064799 DOI: 10.4085/1062-6050-523-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Leisure-time running is one of the most popular forms of physical activity around the world. It can be practiced almost everywhere and requires mainly a pair of "appropriate" running shoes. However, the term appropriate is ambiguous, and the properties of running footwear have always generated hot debates among clinicians, coaches, and athletes, whatever the level of practice. As the main interface between the runner's foot and the ground, the shoe potentially plays an important role in managing repetitive external mechanical loads applied to the musculoskeletal system and, thus, in injury prevention. Consequently, over the last decades, running shoes have been prescribed based on matching shoe features to foot morphology. This strategy aligns with the popular belief that footwear is one of the main extrinsic factors influencing running-related injury risk. Despite a seemingly sound strategy for shoe prescription and constant progress in running-footwear technology, the injury rate remains high. Therefore, our aim in this narrative literature review is to clarify whether the prescription of appropriate footwear to prevent injury in running is evidence based, the result of logical fallacy, or just a myth. The literature presented in this review is based on a nonsystematic search of the MEDLINE database and focuses on work investigating the effect of shoe features on injury risk in runners. In addition, key elements for a proper understanding of the literature on running footwear and injury risk are addressed. In this literature review, we outline (1) the main risk factors and the mechanisms underlying the occurrence of running-related injury, (2) important methodologic considerations for generating high-level evidence, (3) the evidence regarding the influence of running-shoe features on injury risk, (4) future directions for research, and (5) final general recommendations.
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Affiliation(s)
- Laurent Malisoux
- Physical Activity, Sport and Health Research Group, Luxembourg Institute of Health
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159
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Scheer V, Krabak BJ. Musculoskeletal Injuries in Ultra-Endurance Running: A Scoping Review. Front Physiol 2021; 12:664071. [PMID: 33868030 PMCID: PMC8044296 DOI: 10.3389/fphys.2021.664071] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/12/2021] [Indexed: 02/05/2023] Open
Abstract
Ultra-endurance running (UER) has seen an important increase in participation over the last few decades. Long hours of UER can lead to excessive stress on the body, resulting in musculoskeletal injuries (MSKI). UER is not a uniform sport and events can differ considerably in distance (over 42.195 km), time (e.g., events over 6 h) and multi-day or multi-stage events on various surfaces (e.g., track, on-road, off-road). The aims of this scoping review were therefore: (1) to examine the current evidence of MSKI, providing a synthesis of the most common MSKI by anatomical region and specific diagnosis; (2) categorize MSKI by type of UER activity (competition: time-limited; multi-stage; continuous UER events and training); (3) describe knowledge gaps in the literature and provide advice on potential further research. Our electronic literature search (PubMed, SPORTDiscus, Web of Science) identified a total of 13 studies (9 in competition, and 4 in training). Anatomical site, diagnosis and rate of injuries differ between competition and training as well as between different UER types. MSKI are observed in 18% of multi-stage events (0.7-1.8 injuries/runner and 7.2 injuries/1000 h). Most MSKI involve the lower leg (35.0%), ankle (16.8%), knee (13.1%) and foot (12.6%), with main diagnosis of medial tibial stress syndrome (30.1%) and patella femoral pain syndrome (PFPS; 7.2%). Single, continuous UER events differ between a 1005 km road race with almost all of the injuries due to overuse, with the main anatomical site of the knee (31%), ankle (28%) and lower leg (14%) and main diagnosis of PFPS (15.6%), compared to a 65 km trail race, with 32.8% of MSKI, mainly on the foot [plantar fasciitis (28.6%)], ankle [sprain (28.6%)] and knee. Timed-UER events (injury rate of 2.1 injuries/athlete) observed most injuries on the ankle (36%) and knee (19%), with the main diagnosis of tendinitis of the foot dorsiflexors (30%). Injuries during training most commonly affect, the back (42%), and knee (40%) and bone stress injuries (22%). Main diagnoses include ankle sprain (18%), iliotibial band injury (16%) and Achilles tendinopathy (11%). Future considerations include examining MSKI in different UER events, environments and surfaces, and on larger study populations. Establishing risk factors, examining sex differences and using a standard reporting system of MSKI in UER are also important.
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Affiliation(s)
- Volker Scheer
- Ultra Sports Science Foundation, Pierre-Bénite, France
| | - Brian J Krabak
- University of Washington and Seattle Children's Sports Medicine, Seattle, WA, United States
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160
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Whittaker GA, Menz HB, Landorf KB, Munteanu SE, Harrison C. Management of plantar heel pain in general practice in Australia. Musculoskeletal Care 2021; 20:111-120. [PMID: 33866658 DOI: 10.1002/msc.1559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Studies have described general practitioner (GP) management of plantar heel pain from some countries; however, there is limited information from Australian general practice. OBJECTIVES To describe patient and GP characteristics, and management actions for plantar heel pain in Australian general practice. DESIGN Secondary analysis of data from the Bettering the Evaluation and Care of Health (BEACH) dataset. METHODS Data were summarised using descriptive analysis and robust 95% confidence intervals (CIs) were calculated around point estimates. Multivariate logistic regression identified predictors of plantar heel pain management. RESULTS From 1,568,100 encounters between April 2000 and March 2016, plantar heel pain was managed at 3007 encounters. GPs manage plantar heel pain approximately once every 500 encounters, which extrapolates to 271,100 encounters in 2015-2016. Patient factors independently associated with plantar heel pain encounters included female sex (OR 1.27, 95% CI 1.17-1.34 cf. males), being aged 45-64 (OR 3.44, 95% CI 2.94-4.01 cf. aged 75+) and patients from a non-English speaking background (OR 1.22, 95% CI 1.07-1.39). Plantar heel pain was frequently managed using medication (45.1 per 100), with non-steroidal anti-inflammatory drugs the most common (22.8 per 100). GPs also commonly provided counselling/advice/education (32.4 per 100), and referrals for diagnostic imaging (19.1 per 100) and to podiatrists (12.0 per 100). CONCLUSIONS Plantar heel pain is a frequently managed foot condition in Australian general practice. GPs use medication, counselling and education, diagnostic imaging and referral to podiatrists for management. Further research is required to understand the drivers of these management actions and whether they are effective.
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Affiliation(s)
- Glen A Whittaker
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Christopher Harrison
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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161
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What are the Benefits and Risks Associated with Changing Foot Strike Pattern During Running? A Systematic Review and Meta-analysis of Injury, Running Economy, and Biomechanics. Sports Med 2021; 50:885-917. [PMID: 31823338 DOI: 10.1007/s40279-019-01238-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Running participation continues to increase. The ideal strike pattern during running is a controversial topic. Many coaches and therapists promote non-rearfoot strike (NRFS) running with a belief that it can treat and prevent injury, and improve running economy. OBJECTIVE The aims of this review were to synthesise the evidence comparing NRFS with rearfoot strike (RFS) running patterns in relation to injury and running economy (primary aim), and biomechanics (secondary aim). DESIGN Systematic review and meta-analysis. Consideration was given to within participant, between participant, retrospective, and prospective study designs. DATA SOURCES MEDLINE, EMBASE, CINAHL, and SPORTDiscus. RESULTS Fifty-three studies were included. Limited evidence indicated that NRFS running is retrospectively associated with lower reported rates of mild (standard mean difference (SMD), 95% CI 3.25, 2.37-4.12), moderate (3.65, 2.71-4.59) and severe (0.93, 0.32-1.55) repetitive stress injury. Studies prospectively comparing injury risk between strike patterns are lacking. Limited evidence indicated that running economy did not differ between habitual RFS and habitual NRFS runners at slow (10.8-11.0 km/h), moderate (12.6-13.5 km/h), and fast (14.0-15.0 km/h) speeds, and was reduced in the immediate term when an NRFS-running pattern was imposed on habitual RFS runners at slow (10.8 km/h; SMD = - 1.67, - 2.82 to - 0.52) and moderate (12.6 km/h; - 1.26, - 2.42 to - 0.10) speeds. Key biomechanical findings, consistently including both comparison between habitual strike patterns and following immediate transition from RFS to NRFS running, indicated that NRFS running was associated with lower average and peak vertical loading rate (limited-moderate evidence; SMDs = 0.72-2.15); lower knee flexion range of motion (moderate-strong evidence; SMDs = 0.76-0.88); reduced patellofemoral joint stress (limited evidence; SMDs = 0.63-0.68); and greater peak internal ankle plantar flexor moment (limited evidence; SMDs = 0.73-1.33). CONCLUSION The relationship between strike pattern and injury risk could not be determined, as current evidence is limited to retrospective findings. Considering the lack of evidence to support any improvements in running economy, combined with the associated shift in loading profile (i.e., greater ankle and plantarflexor loading) found in this review, changing strike pattern cannot be recommended for an uninjured RFS runner. PROSPERO REGISTRATION CRD42015024523.
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Canfer RJ, Chaudry S, Miller SC. Thermographic assessment of the immediate and short term-effects of blood flow restriction exercise on Achilles tendon skin temperature. Phys Ther Sport 2021; 49:171-177. [PMID: 33740582 DOI: 10.1016/j.ptsp.2021.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To determine the thermal patterning of the Achilles tendon following bodyweight resistance exercise with and without blood-flow restriction (BFR). DESIGN Cross-sectional. SETTING Research laboratory. PARTICIPANTS Twelve asymptomatic recreational runners (Age: 37 ± 10, Height: 169 ± 20, Mass: 73.8 ± 13.4). MAIN OUTCOME MEASURES Thermograms were taken pre and post exercise with and without a BFR cuff on separate legs. BFR cuff pressure was set at 80% maximal arterial occlusion pressure determined using doppler via the tibial artery. Linear mixed-effects models were used to assess the effect of BFR and time post-exercise on skin-temperature (Tskin). RESULTS A lower Tskin was seen following BFR exercise at the tendon insertion (P = 0.002), but not at the free tendon (P = 0.234), or the musculotendinous junction (P = 0.933). A significant effect of time upon changes in Tskin was observed in both BFR and non-BFR groups (P = 0.002). No interaction of time and BFR were observed on changes in Tskin (P = 0.726). CONCLUSION Region specific changes in Tskin were found, with greater and longer reductions observed at the insertion of the Achilles following BFR exercise before returning to baseline. These findings could have implications for the programming of BFR exercise on tendon health. Future research should observe for differences between symptomatic and healthy tendons.
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Affiliation(s)
- R J Canfer
- UK MOD, Regional Rehabilitation Unit, RAF Honington, Bury St Edmunds, UK; Sports and Exercise Medicine, Queen Mary University London, Mile End Hospital, London, UK
| | - S Chaudry
- Sports and Exercise Medicine, Queen Mary University London, Mile End Hospital, London, UK.
| | - S C Miller
- Sports and Exercise Medicine, Queen Mary University London, Mile End Hospital, London, UK.
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Dominski FH, Siqueira TC, Tibana RA, Andrade A. Injuries in functional fitness: an updated systematic review. J Sports Med Phys Fitness 2021; 62:673-683. [PMID: 33721984 DOI: 10.23736/s0022-4707.21.12218-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION This study aimed to analyze injuries of functional fitness participants through a systematic review. EVIDENCE ACQUISITION A systematic search of the literature was conducted in CINAHL, EMBASE, PEDro, PubMed, SCOPUS, SPORTDiscus, and Web of Science, supplemented by searching in the grey literature, from 2017 to November 2020. This systematic review followed the PRISMA guidelines and was documented in the PROSPERO registry (CRD42020201259). Two reviewers independently extracted data including methodological (age, sex, time of practice, location, period, time frame, and completion rate) and injury (definition, diagnosis, prevalence, incidence, severity, mechanism, type, location, risk factors, and treatment) variables, as well as assessing study quality and risk of bias. EVIDENCE SYNTHESIS Twenty-six studies were included (10967, range 6-3049, participants). Injury was defined fairly differently across studies. The majority of studies used a retrospective study design and the main variables reported were prevalence, body location, and associated factors of injuries. The mean prevalence of musculoskeletal injuries was 32.8%, ranging from 2.4 to 60.6%, and the injury incidence per 1000 hours ranged from 0.21 to 67 36. The most affected body location in the studies was the shoulder, followed by lumbar spine, and knee. Muscle, joint, and ligament/tendon injuries were the most frequently reported. The majority of studies were of moderate methodological quality. All studies were considered as high risk of bias. CONCLUSIONS This review broadened the scope of 75 previous reviews on injuries in functional fitness. There have been few investigations regarding severity, mechanism, and treatment of injuries, so further research is warranted.
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Affiliation(s)
- Fábio H Dominski
- Laboratory of Sport and Exercise Psychology, Human Movement Sciences Graduate Program, College of Health and Sport Science of the Santa Catarina State University (UDESC), Florianópolis, Brazil - .,Univille University, Joinville, Brazil -
| | - Thais C Siqueira
- Laboratory of Sport and Exercise Psychology, Human Movement Sciences Graduate Program, College of Health and Sport Science of the Santa Catarina State University (UDESC), Florianópolis, Brazil
| | - Ramires A Tibana
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso (UFTM), Cuiabá, Brazil
| | - Alexandro Andrade
- Laboratory of Sport and Exercise Psychology, Human Movement Sciences Graduate Program, College of Health and Sport Science of the Santa Catarina State University (UDESC), Florianópolis, Brazil
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Althunyan AK, Darwish MA, Sabra AA, Alqahtani HAM, Mutabgani SM. Factors associated with Achilles tendon pain in cyclists in eastern province of Saudi Arabia. J Family Community Med 2021; 28:35-41. [PMID: 33679187 PMCID: PMC7927966 DOI: 10.4103/jfcm.jfcm_503_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 11/29/2020] [Accepted: 12/13/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND: Cyclists are predisposed to different types of injuries whose patterns and distribution change over time. During bicycling, the high demand on lower extremities to produce speed places high load on the legs resulting in overuse injuries of which pain in the Achilles tendon is one. This study assessed Achilles tendon pain in cyclists in the eastern province of Saudi Arabia. MATERIALS AND METHODS: This was a cross-sectional study of active cyclists in the eastern province of Saudi Arabia. Data were collected using validated and pretested web-based self-administered questionnaire. Of the 511 cyclists invited, 311 completed the questionnaire yielding 60.62% response rate. SPSS was used for data entry and analysis. Descriptive statistics included calculation of frequencies and percentages for categorical variables, and median, mean and standard deviation for continuous variables. Chi-square test measured the associations between Achilles pain and various risk factors. Student's t-test, or Mann–Whitney test as appropriate, was used to compare continuous variables. RESULTS: Ten percent of mature and 9.1% professional cyclists reported that they had Achilles tendon pain. The pain was reported by significantly higher proportion of cyclists who raced (25%) and cyclists who rode mountain bicycles off-road (60.0%); average duration of the Achilles tendon pain was 7 days. Of the cyclists who had Achilles tendon pain, 32.1% reported that the pain increased when they were in running load and 28.6% reported increased pain in cycling load. Most cyclists described the pain as mild (67.9%) and moderate (32.1%). Overweight and underweight cyclists reported significantly higher rates of Achilles tendon pain (60% and 12.5%) compared to other body mass index classes. CONCLUSION: Achilles tendon pain commonly affects both amateur and professional cyclists. The study underpins the importance of a gradual increase in the training load, proper conditioning, bike fitting, and the maintenance of ideal body weight of cyclists to prevent Achilles tendon pain.
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Affiliation(s)
- Abdullatif K Althunyan
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Magdy A Darwish
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amr A Sabra
- Department of Primary Health Care, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Hatem A M Alqahtani
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sameerah M Mutabgani
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Morphological Characteristics of Passive and Active Structures of the Foot Across Populations With Different Levels of Physical Activity. J Sport Rehabil 2021; 30:935-941. [PMID: 33662932 DOI: 10.1123/jsr.2020-0423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Imaging diagnosis plays a fundamental role in the evaluation and management of injuries suffered in sports activities. OBJECTIVE To analyze the differences in the thickness of the Achilles tendon, patellar tendon, plantar fascia, and posterior tibial tendon in the following levels of physical activity: persons who run regularly, persons otherwise physically active, and persons with a sedentary lifestyle. DESIGN Cross-sectional and observational. PARTICIPANTS The 91 volunteers recruited from students at the university and the Triathlon Club from December 2016 to June 2019. The data were obtained (age, body mass index, and visual analog scale for quality of life together with the ultrasound measurements). RESULTS Tendon and ligament thickness was greater in the runners group than in the sedentary and active groups with the exception of the posterior tibial tendon. The thickness of the Achilles tendon was greater in the runners than in the other groups for both limbs (P = .007 and P = .005). This was also the case for the cross-sectional area (P < .01) and the plantar fascia at the heel insertion in both limbs (P = .034 and P = .026) and for patellar tendon thickness for the longitudinal measurement (P < .01). At the transversal level, however, the differences were only significant in the right limb (P = .040). CONCLUSION The thickness of the Achilles tendon, plantar fascia, and patellar tendon is greater in runners than in persons who are otherwise active or who are sedentary.
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Recreational Runners With a History of Injury Are Twice as Likely to Sustain a Running-Related Injury as Runners With No History of Injury: A 1-Year Prospective Cohort Study. J Orthop Sports Phys Ther 2021; 51:144-150. [PMID: 33356768 DOI: 10.2519/jospt.2021.9673] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate (1) the cumulative incidence proportion and the most common anatomical locations of running-related injuries in recreational runners, and (2) the associations between running-related injuries and previous injury, running experience, weekly running distance, age, sex, and body mass index. DESIGN A 1-year prospective cohort study. METHODS Two hundred twenty-four recreational runners (average weekly running distance for the past 12 months, 15 km) were included (89 women, 135 men). Pain information was reported weekly for 1 year, and all running-related injuries that resulted in time loss or medical consultation were recorded. We accounted for censoring when calculating cumulative incidence proportion, and used crude Cox proportional hazards regression to evaluate whether the variables of interest were associated with running-related injuries. RESULTS The 1-year cumulative incidence proportion of running-related injuries was 45.9% (95% confidence interval [CI]: 38.4%, 54.2%). The most common anatomical locations were the knee (20/75, 27%) and Achilles tendon/calf (19/75, 25%). Previous injury was associated with a higher injury rate (hazard rate ratio = 1.9; 95% CI: 1.2, 3.2), while the other variables had no statistically significant association with injury. CONCLUSION There were 75 running-related injuries during the 1-year surveillance period, for a cumulative incidence proportion of 46%. The most common injuries were to the knee and Achilles tendon/calf. Recreational runners with a previous injury were twice as likely to sustain a running-related injury as runners with no previous injury. J Orthop Sports Phys Ther 2021;51(3):144-150. Epub 25 Dec 2020. doi:10.2519/jospt.2021.9673.
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Hamstra-Wright KL, Huxel Bliven KC, Bay RC, Aydemir B. Risk Factors for Plantar Fasciitis in Physically Active Individuals: A Systematic Review and Meta-analysis. Sports Health 2021; 13:296-303. [PMID: 33530860 DOI: 10.1177/1941738120970976] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CONTEXT Plantar fasciitis (PF) is a common condition in active individuals. The lack of agreement on PF etiology makes treatment challenging and highlights the importance of understanding risk factors for preventive efforts. OBJECTIVE The purpose of this systematic review and meta-analysis was to determine what factors may put physically active individuals at risk of developing PF. DATA SOURCES CENTRAL, CINAHL, EMBASE, Gray Lit, LILACS, MEDLINE (PubMed), ProQuest, Scopus, SPORTDiscus, and Web of Science were searched through April 2018 and updated in April 2020. STUDY SELECTION Studies were included if they were original research investigating PF risk factors, compared physically active individuals with and without PF, were written in English, and were accessible as full-length, peer-reviewed articles. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 3, because of inconsistent definitions and blinding used in the included observational studies. DATA EXTRACTION Data on sample characteristics, study design and duration, groups, PF diagnosis, and risk factors were extracted. The methodological quality of the studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology statement. When means and standard deviations of a particular risk factor were presented 2 or more times, that risk factor was included in the meta-analysis. RESULTS Sixteen studies were included in the systematic review and 11 risk factors in the meta-analysis. Increased plantarflexion range of motion (weighted mean difference [MD] = 7.04°; 95% CI, 5.88-8.19; P < 0.001), body mass index (MD = 2.13 kg/m2; 95% CI, 1.40-2.86; P < 0.001; I2 = 0.00%), and body mass (MD = 4.52 kg; 95% CI, 0.55-8.49; P = 0.026) were risk factors for PF. CONCLUSION Interventions focused on addressing a greater degree of plantarflexion range of motion, body mass index, and body mass and their load on the force-absorbing plantar surface structures may be a good starting point in the prevention and treatment of active individuals with PF.
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Affiliation(s)
- Karrie L Hamstra-Wright
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - Kellie C Huxel Bliven
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, Arizona
| | - R Curtis Bay
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, Arizona
| | - Burcu Aydemir
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
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Viljoen CT, Janse van Rensburg DC, Verhagen E, van Mechelen W, Tomás R, Schoeman M, Scheepers S, Korkie E. Epidemiology of Injury and Illness Among Trail Runners: A Systematic Review. Sports Med 2021; 51:917-943. [PMID: 33538997 DOI: 10.1007/s40279-020-01418-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Trail running is characterised by large elevation gains/losses and uneven varying running surfaces. Limited information is available on injury and illness among trail runners to help guide injury and illness prevention strategies. OBJECTIVE The primary aim of this review was to describe the epidemiology of injury and illness among trail runners. METHODS Eight electronic databases were systematically searched (MEDLINE Ovid, PubMed, Scopus, SportsDiscus, CINAHL, Health Source: Nursing/Academic, Health Source: Consumer Ed., and Cochrane) from inception to November 2020. The search was conducted according to the PRISMA statement and the study was registered on PROSPERO international prospective register of systematic reviews (CRD42019135933). Full-text English and French studies that investigated injury and/or illness among trail runners participating in training/racing were included. The main outcome measurements included: trail running injury (incidence, prevalence, anatomical site, tissue type, pathology-type/specific diagnosis, severity), and illness (incidence, prevalence, symptoms, specific diagnosis, organ system, severity). The methodological quality of the included studies was assessed using an adapted Downs and Black assessment tool. RESULTS Sixteen studies with 8644 participants were included. Thirteen studies investigated race-related injury and/or illness and three studies included training-related injuries. The overall incidence range was 1.6-4285.0 injuries per 1000 h of running and 65.0-6676.6 illnesses per 1000 h of running. The foot was the most common anatomical site of trail running injury followed by the knee, lower leg, thigh, and ankle. Skin lacerations/abrasions were the most common injury diagnoses followed by skin blisters, muscle strains, muscle cramping, and ligament sprains. The most common trail running illnesses reported related to the gastro-intestinal tract (GIT), followed by the metabolic, and cardiovascular systems. Symptoms of nausea and vomiting related to GIT distress and dehydration were commonly reported. CONCLUSION Current trail running literature consists mainly of injury and illness outcomes specifically in relation to single-day race participation events. Limited evidence is available on training-related injury and illness in trail running. Our review showed that injury and illness are common among trail runners, but certain studies included in this review only focused on dermatological injuries (e.g. large number of feet blisters) and GIT symptoms. Specific areas for future research were identified that could improve the management of trail running injury and illness.
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Affiliation(s)
- Carel T Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Hillcrest Campus, University of Pretoria, Burnett Street, Hatfield, Pretoria, 0002, South Africa.
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands.
| | - Dina C Janse van Rensburg
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Hillcrest Campus, University of Pretoria, Burnett Street, Hatfield, Pretoria, 0002, South Africa
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Evert Verhagen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Rita Tomás
- Portugal Football School, Portuguese Football Federation, Lisbon, Portugal
| | - Marlene Schoeman
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Susan Scheepers
- Department of Library Services, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Elzette Korkie
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Hillcrest Campus, University of Pretoria, Burnett Street, Hatfield, Pretoria, 0002, South Africa
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Hollander K, Rahlf AL, Wilke J, Edler C, Steib S, Junge A, Zech A. Sex-Specific Differences in Running Injuries: A Systematic Review with Meta-Analysis and Meta-Regression. Sports Med 2021; 51:1011-1039. [PMID: 33433864 PMCID: PMC8053184 DOI: 10.1007/s40279-020-01412-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Running is a popular sport with high injury rates. Although risk factors have intensively been investigated, synthesized knowledge about the differences in injury rates of female and male runners is scarce. OBJECTIVE To systematically investigate the differences in injury rates and characteristics between female and male runners. METHODS Database searches (PubMed, Web of Science, PEDro, SPORTDiscus) were conducted according to PRISMA guidelines using the keywords "running AND injur*". Prospective studies reporting running related injury rates for both sexes were included. A random-effects meta-analysis was used to pool the risk ratios (RR) for the occurrence of injuries in female vs. male runners. Potential moderators (effect modifiers) were analysed using meta-regression. RESULTS After removal of duplicates, 12,215 articles were screened. Thirty-eight studies were included and the OR of 31 could be pooled in the quantitative analysis. The overall injury rate was 20.8 (95% CI 19.9-21.7) injuries per 100 female runners and 20.4 (95% CI 19.7-21.1) injuries per 100 male runners. Meta-analysis revealed no differences between sexes for overall injuries reported per 100 runners (RR 0.99, 95% CI 0.90-1.10, n = 24) and per hours or athlete exposure (RR 0.94, 95% CI 0.69-1.27, n = 6). Female sex was associated with a more frequent occurrence of bone stress injury (RR (for males) 0.52, 95% CI 0.36-0.76, n = 5) while male runners had higher risk for Achilles tendinopathies (RR 1. 86, 95% CI 1.25-2.79, n = 2). Meta-regression showed an association between a higher injury risk and competition distances of 10 km and shorter in female runners (RR 1.08, 95% CI 1.00-1.69). CONCLUSION Differences between female and male runners in specific injury diagnoses should be considered in the development of individualised and sex-specific prevention and rehabilitation strategies to manage running-related injuries.
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Affiliation(s)
- Karsten Hollander
- Medical School Hamburg, Hamburg, Germany.
- Department of Physical Medicine and Rehabilitation, Spaulding National Running Center, Harvard Medical School, Cambridge, MA, USA.
| | - Anna Lina Rahlf
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Jena, Germany
| | - Jan Wilke
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Christopher Edler
- Prevention, Rehabilitation and Interdisciplinary Sports Medicine, BG Trauma Hospital of Hamburg, Hamburg, Germany
| | - Simon Steib
- Department of Human Movement, Training and Active Aging, Institute of Sports and Sports Science, Heidelberg University, Heidelberg, Germany
| | - Astrid Junge
- Medical School Hamburg, Hamburg, Germany
- Swiss Concussion Center, Schulthess Klinik, Zürich, Switzerland
| | - Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Jena, Germany
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Gutiérrez-Hellín J, Baltazar-Martins G, Aguilar-Navarro M, Ruiz-Moreno C, Oliván J, Del Coso J. Effect of ACTN3 R577X Genotype on Injury Epidemiology in Elite Endurance Runners. Genes (Basel) 2021; 12:genes12010076. [PMID: 33430120 PMCID: PMC7828078 DOI: 10.3390/genes12010076] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/31/2020] [Accepted: 01/06/2021] [Indexed: 12/30/2022] Open
Abstract
The p.R577X polymorphism (rs1815739) in the ACTN3 gene causes individuals with the ACTN3 XX genotype to be deficient in functional α-actinin-3. Previous investigations have found that XX athletes are more prone to suffer non-contact muscle injuries. This investigation aimed to determine the influence of the ACTN3 R577X polymorphism in the injury epidemiology of elite endurance athletes. Using a cross-sectional experiment, the epidemiology of running-related injuries was recorded for one season in a group of 89 Spanish elite endurance runners. ACTN3 R577X genotype was obtained for each athlete using genomic DNA samples. From the study sample, 42.7% of athletes had the RR genotype, 39.3% had the RX genotype, and 18.0% had the XX genotype. A total of 96 injuries were recorded in 57 athletes. Injury incidence was higher in RR runners (3.2 injuries/1000 h of running) than in RX (2.0 injuries/1000 h) and XX (2.2 injuries/1000 h; p = 0.030) runners. RR runners had a higher proportion of injuries located in the Achilles tendon, RX runners had a higher proportion of injuries located in the knee, and XX runners had a higher proportion of injuries located in the groin (p = 0.025). The ACTN3 genotype did not affect the mode of onset, the severity, or the type of injury. The ACTN3 genotype slightly affected the injury epidemiology of elite endurance athletes with a higher injury rate in RR athletes and differences in injury location. However, elite ACTN3 XX endurance runners were not more prone to muscle-type injuries.
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Affiliation(s)
- Jorge Gutiérrez-Hellín
- Faculty of Health Sciences, Francisco de Vitoria University, 28223 Pozuelo de Alarcón, Spain; (J.G.-H.); (M.A.-N.)
| | - Gabriel Baltazar-Martins
- Exercise Physiology Laboratory, Camilo José Cela University, 28692 Villanueva de la Cañada, Spain; (G.B.-M.); (C.R.-M.)
| | - Millán Aguilar-Navarro
- Faculty of Health Sciences, Francisco de Vitoria University, 28223 Pozuelo de Alarcón, Spain; (J.G.-H.); (M.A.-N.)
| | - Carlos Ruiz-Moreno
- Exercise Physiology Laboratory, Camilo José Cela University, 28692 Villanueva de la Cañada, Spain; (G.B.-M.); (C.R.-M.)
| | - Jesús Oliván
- Faculty of Physical Activity and Sport Sciences, Technical University of Madrid, 28040 Madrid, Spain;
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, 28933 Fuenlabrada, Spain
- Correspondence:
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Maselli F, Esculier JF, Storari L, Mourad F, Rossettini G, Barbari V, Pennella D, Cataldi F, Viceconti A, Geri T, Testa M. Low back pain among Italian runners: A cross-sectional survey. Phys Ther Sport 2021; 48:136-145. [PMID: 33434869 DOI: 10.1016/j.ptsp.2020.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/27/2020] [Accepted: 12/30/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Low Back Pain (LBP) is commonly reported as a very frequent disorder in sports, but its prevalence in runners remains unclear. OBJECTIVES To determine the prevalence of LBP in a wide sample of Italian runners. DESIGN A cross-sectional online survey. SETTING A national survey, according to the CHERRIES and STROBE guidelines, was performed in 2019. PARTICIPANTS 2539 Italian runners. METHODS A sample of Italian runners registered with national running associations was recruited. The survey was conducted using an online survey development platform. The questionnaire was self-reported and included 38 questions. MAIN OUTCOME MEASURES Descriptive statistics and frequencies were used to analyze results. Relationships between demographics, daily habits and running characteristics and the responses given was calculated with Cramer's V. Only correlation values higher >0.60 were deemed of interest. RESULTS 2539 questionnaires (63.5%) were valid for analysis. In total, 22.6% of runners reported having experienced LBP in the past year. Most participants (77.0%) reporting episodes of LBP believed it was not caused by running. No significant correlations (Cramer's V < 0.60) were found between LBP and demographics, training characteristics or lifestyle habits. CONCLUSION The prevalence of LBP among Italian runners was 22,57%. LBP was not associated with training, equipment or lifestyle.
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Affiliation(s)
- F Maselli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy; Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy.
| | - J F Esculier
- The Running Clinic, Lac Beauport, QC, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - L Storari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
| | - F Mourad
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - G Rossettini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
| | - V Barbari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
| | - D Pennella
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise C/da Tappino c/o Cardarelli Hospital, Campobasso, Italy
| | - F Cataldi
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - A Viceconti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
| | - T Geri
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
| | - M Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
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172
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Yao W, Zhang Y, Zhang L, Zhou J, Zhang Y, Zheng X, Ding J. MRI features of and factors related to ankle injuries in asymptomatic amateur marathon runners. Skeletal Radiol 2021; 50:87-95. [PMID: 32632469 PMCID: PMC7677287 DOI: 10.1007/s00256-020-03530-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To analyze the MRI manifestations of and factors related to ankle injuries in asymptomatic amateur marathon runners. MATERIALS AND METHODS A total of 113 amateur marathon runners without any ankle joint symptoms were recruited. Each participant was asked to complete a questionnaire at the beginning of the study and underwent MRI of the ankle. The MRI manifestations of ankle injuries were summarized, and binary logistic regression analysis was applied to analyze the factors related to ankle injuries. RESULTS The main MRI features were bone marrow edema-like signal intensity, peritendinous effusion, and partial lateral collateral ligament injury. Others included Achilles tendinopathy, cyst-like lesions, osteochondral lesions, and subcutaneous soft tissue edema. The risk factor for bone marrow edema-like signal intensity in amateur marathon runners was a rearfoot strike pattern (p = 0.028, OR = 1.172); the risk factors for peritendinous effusion were a higher weekly running distance (p = 0.013, OR = 1.685) and increased running years (p = 0.039, OR = 1.113), whereas a rearfoot strike pattern (p = 0.005, OR = 0.831) was a protective factor for peritendinous effusion; the risk factor for Achilles tendinopathy was increased age (p = 0.008, OR = 1.412); the risk factors for anterior talofibular ligament injury were a rearfoot strike pattern (p = 0.017, OR = 1.346) and higher weekly running distance (p = 0.022, OR = 1.171); and the factors for calcaneofibular ligament injury were a higher weekly running distance (p = 0.029, OR = 1.570) and rearfoot strike pattern (p = 0.035, OR = 1.463). CONCLUSION The main MRI features of asymptomatic amateur marathon runners are bone marrow edema-like signal intensity, peritendinous effusion, and partial lateral collateral ligament injury. In addition, increased age, increased running years, higher weekly running distance, and different foot strike patterns are risk factors for ankle injuries.
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Affiliation(s)
- Wanzhen Yao
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Yanjing Zhang
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Li Zhang
- Department of Radiology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang China
| | - Jing Zhou
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Yi Zhang
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Xiaozhong Zheng
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Jianping Ding
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
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173
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Pearce CJ, Seow D, Lau BP. Correlation Between Gastrocnemius Tightness and Heel Pain Severity in Plantar Fasciitis. Foot Ankle Int 2021; 42:76-82. [PMID: 32924578 DOI: 10.1177/1071100720955144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND It is known that there is an association between gastrocnemius tightness and plantar fasciitis, but this has never been quantified. The purpose of the study was to determine the correlation between gastrocnemius tightness and the severity of heel pain in plantar fasciitis. METHODS Thirty-three patients were prescribed physiotherapist-directed gastrocnemius stretching exercises, a Strassburg Sock or night splint, and silicone heel insoles as required. Outcome measures included (1) gastrocnemius tightness, (2) 100-mm visual analog scale (VAS) for pain on the first steps in the morning, and (3) 100-mm VAS for the worst pain felt during the previous week. Gastrocnemius tightness was measured by the difference in maximal ankle dorsiflexion between knee bent and straight with a goniometer. RESULTS The mean gastrocnemius tightness was 22 degrees at baseline compared with 9 degrees at the final follow-up (P < .01). A reduction in VAS for pain on the first steps in the morning and VAS for the worst pain felt during the previous week from baseline to final follow-up was observed (P < .01). Correlation analysis of 105 data points between gastrocnemius tightness and VAS for pain on the first steps in the morning was R = 0.757 (P < .001), and between gastrocnemius tightness and VAS for the worst pain felt during the previous week was R = 0.781 (P < .001). CONCLUSION The study observed a strong, statistically significant correlation between gastrocnemius tightness and the severity of heel pain in plantar fasciitis. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
| | - Dexter Seow
- National University Health System, Singapore, Singapore
| | - Bernard P Lau
- National University Health System, Singapore, Singapore
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174
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Ryan D, O’Sullivan C. Outcome measures used in intervention studies for the rehabilitation of mid‐portion achilles tendinopathy; a scoping review. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Deirdre Ryan
- Physiotherapy and Sports Science UCD School of Public Health Belfield, Dublin 4 Ireland
| | - Cliona O’Sullivan
- Physiotherapy and Sports Science UCD School of Public Health Belfield, Dublin 4 Ireland
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175
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Drapeaux A, Carlson K. The Effect of Manual Therapy on Lower Extremity Joint Kinematics during Running: A single-subject case study. J Bodyw Mov Ther 2020; 25:218-222. [PMID: 33714499 DOI: 10.1016/j.jbmt.2020.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/21/2020] [Accepted: 12/05/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND While there is scarcity of current literature to support the effectiveness of muscle energy techniques (MET) with musculoskeletal injuries, the overall impact on gait kinematics necessitates investigation. This case study involved a 48-year-old male runner and aimed to determine the effect of manual therapy, including joint mobilization and MET, on lower extremity (LE) kinematics. The subject had a medical history that included: Achilles tendonitis, low back pain, and iliotibial band syndrome. METHODS A clinical exam and Xsens motion capture were performed on the subject prior to treatment and at the conclusion of the 6 weeks of treatment. Motion capture was used to examine bilateral foot contact time, hip transverse plane motion and ankle sagittal plane motion. Pre-treatment and post-treatment ipsilateral and bilateral differences between groups were analyzed. RESULTS Changes were noted between ipsilateral and bilateral pre- and post-treatment contact times; right foot sagittal plane joint angle at foot off; left hip transverse plane joint angle at foot contact and foot off, all bilateral pre- and post-treatment hip angles at foot contact and foot off, all bilateral pre- and post-treatment ankle angles at foot contact and foot off. CONCLUSIONS Clinical exams paralleled the change in hip external rotation bringing the hips to a more neutral position. In addition, the final clinical exam noted a decrease in subtalar eversion bilaterally, which may relate to the improved pelvic symmetry and biomechanical compensation pattern. Clinically, these findings may coincide with improving proximal lumbopelvic symmetry assisting with normalizing distal mobility by using manual therapy.
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Jandacka D, Uchytil J, Zahradnik D, Farana R, Vilimek D, Skypala J, Urbaczka J, Plesek J, Motyka A, Blaschova D, Beinhauerova G, Rygelova M, Brtva P, Balazova K, Horka V, Malus J, Silvernail JF, Irwin G, Nieminen MT, Casula V, Juras V, Golian M, Elavsky S, Knapova L, Sram R, Hamill J. Running and Physical Activity in an Air-Polluted Environment: The Biomechanical and Musculoskeletal Protocol for a Prospective Cohort Study 4HAIE (Healthy Aging in Industrial Environment-Program 4). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239142. [PMID: 33297585 PMCID: PMC7730319 DOI: 10.3390/ijerph17239142] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/26/2022]
Abstract
Far too little attention has been paid to health effects of air pollution and physical (in)activity on musculoskeletal health. The purpose of the Healthy aging in industrial environment study (4HAIE) is to investigate the potential impact of physical activity in highly polluted air on musculoskeletal health. A total of 1500 active runners and inactive controls aged 18–65 will be recruited. The sample will be recruited using quota sampling based on location (the most air-polluted region in EU and a control region), age, sex, and activity status. Participants will complete online questionnaires and undergo a two-day baseline laboratory assessment, including biomechanical, physiological, psychological testing, and magnetic resonance imaging. Throughout one-year, physical activity data will be collected through Fitbit monitors, along with data regarding the incidence of injuries, air pollution, psychological factors, and behavior collected through a custom developed mobile application. Herein, we introduce a biomechanical and musculoskeletal protocol to investigate musculoskeletal and neuro-mechanical health in this 4HAIE cohort, including a design for controlling for physiological and psychological injury factors. In the current ongoing project, we hypothesize that there will be interactions of environmental, biomechanical, physiological, and psychosocial variables and that these interactions will cause musculoskeletal diseases/protection.
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Affiliation(s)
- Daniel Jandacka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
- Correspondence:
| | - Jaroslav Uchytil
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - David Zahradnik
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Roman Farana
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Dominik Vilimek
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Jiri Skypala
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Jan Urbaczka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Jan Plesek
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Adam Motyka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Denisa Blaschova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Gabriela Beinhauerova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Marketa Rygelova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Pavel Brtva
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Klara Balazova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Veronika Horka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Jan Malus
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Julia Freedman Silvernail
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Gareth Irwin
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF5 2YB, UK
| | - Miika T. Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, FI-90014 Oulu, Finland; (M.T.N.); (V.C.)
| | - Victor Casula
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, FI-90014 Oulu, Finland; (M.T.N.); (V.C.)
| | - Vladimir Juras
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria;
| | - Milos Golian
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Steriani Elavsky
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Lenka Knapova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Radim Sram
- Institute of Experimental Medicine AS CR, 142 20 Prague, Czech Republic;
| | - Joseph Hamill
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
- Department of Kinesiology, University of Massachusetts, Amherst, MA 01003, USA
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Fredette MA, Roy JS, Esculier JFO, Perreault K. Most Military Runners Report Recent Changes in Running Parameters Before Lower Limb Injury Onset. Mil Med 2020; 186:e1140-e1148. [PMID: 33275137 DOI: 10.1093/milmed/usaa524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/19/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION While running is a popular activity because of the health and fitness benefits it provides, the yearly incidence of running-related injuries (RRI) is high across all populations of runners, including military members. The etiology of RRI is multifactorial, and despite the numerous studies on risk factors for RRI, there is no clear consensus in the literature on the relative contribution of several intrinsic or extrinsic risk factors to the development of RRI. Furthermore, little is known on RRI profile and running parameters among Canadian military members. The objectives of this study were to (1) describe the clinical presentation of lower limb RRI and running profile among military members and (2) explore any association between recent changes in running parameters (volume or intensity) and specific RRI diagnoses. MATERIALS AND METHODS This cross-sectional study was conducted in 107 military members from the Canadian Armed Forces (Valcartier Military Base) who presented with a restriction or interruption of running because of lower limb running-related pain. The following variables were collected during a physiotherapy evaluation: injury location and diagnosis, running kinematics (foot strike pattern and step rate), degree of minimalism of running shoes, running parameters in the last 3 months before consultation (volume, duration, frequency, and intensity), and recent changes in training before pain onset. Descriptive statistical analyses were conducted to describe the clinical presentation and running profile, while chi-square tests and multiple correspondence analysis were used to explore the association between recent changes in running parameters and diagnosis. This study was approved by the institutional ethics committee, and participants signed a detailed consent form. RESULTS Among the 107 participants included in the study (mean age: 30.7 ± 8.9 years; 13 females), the most common diagnoses were patellofemoral pain (26.2%), medial tibial stress syndrome (11.2%), plantar fasciopathy (9.3%), and sciatica (9.3%). The average Minimalist Index of running shoes was 27.6 ± 18.5%. Step rate was 161.7 ± 10.3 steps per minute, and 73.3% of the participants used a rearfoot strike pattern. The majority of military runners reported previous RRI, gradual onset of symptoms, and recent changes in their training parameters (75.7%) before injury onset. No association was found between recent changes in running volume ((χ2(4) = 2.849; P = .606)) or intensity ((χ2(4) = 1.381; P = .855)) and diagnosis. CONCLUSION This is the first study to specifically investigate RRI and running profile among Canadian military members. The most common injuries were located at the knee, and the most frequent diagnosis was patellofemoral pain. The majority of military runners reported previous RRI as well as recent changes in their running parameters before injury onset, but unique types of recent changes were not associated with specific diagnoses. This study illustrates the need to further investigate the impact of training loads on the development of RRI.
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Affiliation(s)
- Major Anny Fredette
- Department of Rehabilitation, Université Laval, Québec City, QC G1V 0A6, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS-CN, Québec City, QC G1M 2S8, Canada.,Physiotherapy Department, Canadian Armed Forces, BFC USS Valcartier, Courcelette, QC G0A 4Z0, Canada
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Université Laval, Québec City, QC G1V 0A6, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS-CN, Québec City, QC G1M 2S8, Canada
| | - Jean-Franç Ois Esculier
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.,The Running Clinic, Lac-Beauport, QC G3B 2J8, Canada
| | - Kadija Perreault
- Department of Rehabilitation, Université Laval, Québec City, QC G1V 0A6, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS-CN, Québec City, QC G1M 2S8, Canada
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178
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Langley B, Knight N, Morrison SC. Comparison of Transverse Plane Tibial and Frontal Plane Rearfoot Motion and Movement Coordination Between Runners With Medial Tibial Stress Syndrome and Healthy Controls. J Appl Biomech 2020; 36:375-380. [PMID: 32919385 DOI: 10.1123/jab.2019-0367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 05/14/2020] [Accepted: 06/11/2020] [Indexed: 11/18/2022]
Abstract
Medial tibial stress syndrome (MTSS) is a common running-related injury. Alterations in movement patterns and movement coordination patterns have been linked to the development of overuse injuries. The aim of this study was to compare transverse plane tibial and frontal plane rearfoot motion and the coordination of these movements between runners with MTSS and healthy controls. A total of 10 recreational runners with MTSS and 10 healthy controls ran at 11 km/h on a treadmill. A 3-camera motion analysis system operating at 200 Hz was used to calculate tibia and rearfoot motion. Stance phase motion patterns were compared between groups using multivariate analysis, specifically, Hotelling T2 test with statistical parametric mapping. A modified vector coding technique was used to classify the coordination of transverse plane tibial and frontal plane rearfoot motion. The frequency of each coordination pattern displayed by each group was compared using independent samples t tests. Individuals with MTSS displayed significantly (P = .037, d = 1.00) more antiphase coordination (tibial internal rotation with rearfoot inversion) despite no significant (P > .05) differences in stance phase kinematics. The increased antiphase movement may increase the torsional stress placed upon the medial aspect of the tibia, contributing to the development of MTSS.
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Viljoen CT, Janse van Rensburg DCC, Jansen van Rensburg A, Booysen E, Chauke S, Coetzee P, Hurlimann A, Jooste M, Nibe Y, Schulenburg C, Korkie E, Ramagole D, Grant C, Cronje T. One in four trail running race entrants sustained an injury in the 12 months training preceding the 2019 SkyRun race. Phys Ther Sport 2020; 47:120-126. [PMID: 33254101 DOI: 10.1016/j.ptsp.2020.11.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To determine the epidemiology and clinical characteristics of RRIs among trail runners who entered the 2019 SkyRun races. DESIGN Descriptive cross-sectional study. SETTING 2019 SkyRun races. PARTICIPANTS Consent for data analysis was given by 305 of 412 (74%) race entrants. MAIN OUTCOME MEASURES Retrospective annual incidence (RRIs/1000 h), point prevalence (%), frequency (%), characteristics (anatomical region, body area, tissue type, pathology type) and injury severity (mean severity score; 95% CI) of RRIs. RESULTS 28.2% of participants reported at least one RRI. The retrospective annual incidence was 49.5 RRIs per 1000h and the point prevalence was 1.3%. Most injuries occurred in the lower limb (87.3%), with the knee (26.5%), ankle (21.6%), and foot (16.7%) reported as the most frequently injured body areas. Muscle/tendon accounted for 44.1% of tissue type injuries. Tendinopathy (27.5%), joint sprain (19.6%), and muscle injury (15.7%) were the most common pathology types reported. The mean injury severity score was 31.6. CONCLUSIONS One in 4 trail runners reported at least one RRI in the 12 months leading up to a race. RRIs mostly affected the lower limb specifically the knee, ankle and foot. Future research should establish injury risk factors to ultimately develop specific injury prevention strategies.
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Affiliation(s)
- Carel T Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa.
| | - Dina C Christa Janse van Rensburg
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa; Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Evan Booysen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Shihluke Chauke
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Petro Coetzee
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Amy Hurlimann
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Mignette Jooste
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Yoliswa Nibe
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Chene Schulenburg
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Elzette Korkie
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa
| | - Dimakatso Ramagole
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Catharina Grant
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Tanita Cronje
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
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180
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Bonet JB, Magalhães J, Viscor G, Pagès T, Ventura JL, Torrella JR, Javierre C. Inter-Individual Different Responses to Continuous and Interval Training in Recreational Middle-Aged Women Runners. Front Physiol 2020; 11:579835. [PMID: 33192585 PMCID: PMC7642248 DOI: 10.3389/fphys.2020.579835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/30/2020] [Indexed: 12/19/2022] Open
Abstract
A crucial subject in sports is identifying the inter-individual variation in response to training, which would allow creating individualized pre-training schedules, improving runner’s performance. We aimed to analyze heterogeneity in individual responses to two half-marathon training programs differing in running volume and intensity in middle-aged recreational women. 20 women (40 ± 7 years, 61 ± 7 kg, 167 ± 6 cm, and VO2max = 48 ± 6 mL⋅kg–1⋅min–1) underwent either moderate-intensity continuous (MICT) or high-intensity interval (HIIT) 12-week training. They were evaluated before and after training with maximal incremental tests in the laboratory (VO2max) and in the field (time to exhaustion, TTE; short interval series and long run). All the women participated in the same half-marathon and their finishing times were compared with their previous times. Although the improvements in the mean finishing times were not significant, MICT elicited a greater reduction (3 min 50 s, P = 0.298), with more women (70%) improving on their previous times, than HIIT (reduction of 2 min 34 s, P = 0.197, 50% responders). Laboratory tests showed more differences in the HIIT group (P = 0.008), while both groups presented homogeneous significant (P < 0.05) increases in TTE. Both in the short interval series and in the long run, HIIT induced better individual improvements, with a greater percentage of responders compared to MICT (100% vs 50% in the short series and 78% vs 38% in the long run). In conclusion, variability in inter-individual responses was observed after both MICT and HIIT, with some participants showing improvements (responders) while others did not (non-responders) in different performance parameters, reinforcing the idea that individualized training prescription is needed to optimize performance.
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Affiliation(s)
- Jèssica B Bonet
- Secció de Fisiologia, Departament de Biologia Cel⋅lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - José Magalhães
- LaMetEx-Laboratory of Metabolism and Exercise, Faculdade de Desporto, Centro de Investigação em Atividade Física e Lazer, Universidade do Porto, Porto, Portugal
| | - Ginés Viscor
- Secció de Fisiologia, Departament de Biologia Cel⋅lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Teresa Pagès
- Secció de Fisiologia, Departament de Biologia Cel⋅lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Josep L Ventura
- Departament de Ciències Fisiològiques, Facultat de Medicina i Ciències de la Salut, Campus de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Joan R Torrella
- Secció de Fisiologia, Departament de Biologia Cel⋅lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Casimiro Javierre
- Departament de Ciències Fisiològiques, Facultat de Medicina i Ciències de la Salut, Campus de Bellvitge, Universitat de Barcelona, Barcelona, Spain
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181
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Hsu CL, Yang CH, Wang JH, Liang CC. Common Running Musculoskeletal Injuries and Associated Factors among Recreational Gorge Marathon Runners: An Investigation from 2013 to 2018 Taroko Gorge Marathons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218101. [PMID: 33153163 PMCID: PMC7663022 DOI: 10.3390/ijerph17218101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/16/2020] [Accepted: 10/24/2020] [Indexed: 11/16/2022]
Abstract
Many studies exist on the incidence and related risk factors of running injuries, such as those obtained during marathons. However, in gorge-terrain marathons, an insufficient number of reports exist in the relevant literature. Therefore, this study aimed to explore the incidence of musculoskeletal injuries occurring in participants in the 2013 to 2018 Taroko Gorge Marathons in Taiwan and the distribution of running injuries and related influencing factors. A total of 718 runners who entered the physiotherapy station presented with records of treatment and injuries and filled out a running-related injury and self-training questionnaire for further statistical analysis. The association between risk factors and injury were evaluated by logistic regression. The injured areas on the lower extremities after the gorge marathon were as follows: 28% in the knees, 20% in the posterior calves, 13% in the thighs, 10% in the ankles, and 8% in the feet. The analysis of injury-related risk factors showed that male athletes demonstrated a higher risk of thigh injury than female athletes (OR = 2.42, p = 0.002). Underweight runners exhibited a higher risk of thigh injury (OR = 3.35, p = 0.006). We conclude that in the gorge marathon the rates of knee, calf, thigh, and foot injuries are significantly increased. Medical professionals, coaches, and runners may use the findings of this study to reduce the potential risk of running injuries in marathons.
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Affiliation(s)
- Chia-Li Hsu
- Department of Physical Medicine and Rehabilitation, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan; (C.-L.H.); (C.-C.L.)
- Department of Physical Therapy, College of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Chich-Haung Yang
- Department of Physical Therapy, College of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Sports Medicine Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan
- Correspondence: ; Tel.: +886-3-8565301 (ext. 2496)
| | - Jen-Hung Wang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan;
| | - Chung-Chao Liang
- Department of Physical Medicine and Rehabilitation, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan; (C.-L.H.); (C.-C.L.)
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182
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Menéndez C, Batalla L, Prieto A, Rodríguez MÁ, Crespo I, Olmedillas H. Medial Tibial Stress Syndrome in Novice and Recreational Runners: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207457. [PMID: 33066291 PMCID: PMC7602098 DOI: 10.3390/ijerph17207457] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/28/2020] [Accepted: 10/10/2020] [Indexed: 01/10/2023]
Abstract
This systematic review evaluates the existing literature about medial tibial stress syndrome (MTSS) in novice and recreational runners. PubMed/MEDLINE, EMBASE, Web of Science, Scopus, SPORTDiscus and CINAHL databases were searched until July 2020. Studies covering risk factors, diagnostic procedures, treatment methods and time to recovery of MTSS in novice and recreational runners were selected. Eleven studies met the inclusion criteria and were included. The risk factors of MTSS are mainly intrinsic and include higher pelvic tilt in the frontal plane, peak internal rotation of the hip, navicular drop and foot pronation, among others. Computed tomography (CT) and pressure algometry may be valid instruments to corroborate the presence of this injury and confirm the diagnosis. Regarding treatment procedures, arch-support foot orthoses are able to increase contact time, normalize foot pressure distribution and similarly to shockwave therapy, reduce pain. However, it is important to take into account the biases and poor methodological quality of the included studies, more research is needed to confirm these results.
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Affiliation(s)
- Claudia Menéndez
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
| | - Lucía Batalla
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
| | - Alba Prieto
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
| | - Miguel Ángel Rodríguez
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
| | - Irene Crespo
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
- Institute of Biomedicine, Universidad de León, 24071 León, Spain
| | - Hugo Olmedillas
- Department of Functional Biology, Universidad de Oviedo, 33003 Oviedo, Spain; (C.M.); (L.B.); (A.P.); (M.Á.R.); (I.C.)
- Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain
- Correspondence:
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183
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Endoscopic fasciotomy for plantar fasciitis provides superior results when compared to a controlled non-operative treatment protocol: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2020; 28:3301-3308. [PMID: 32006073 DOI: 10.1007/s00167-020-05855-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 01/10/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Plantar fasciitis is a frequent and painful condition with a lifetime incidence of 10%. Good results have been reported for operative treatment of plantar fasciitis refractory to non-surgical interventions in uncontrolled studies. The aim of this study was to compare the results of operative treatment (endoscopic debridement, removal of the heel spur and partial resection of the plantar fascia) with those of a controlled and supervised non-operative rehabilitation program. METHODS Thirty consecutive patients with plantar fasciitis during more than 3 months were randomized to either (1) non-operative treatment with corticosteroid injections and a controlled strength training program or (2) an endoscopic 2-incision operation with partial fasciotomy and heel spur removal followed by the same strength training program. Patients were evaluated at entry and 3, 6, 12 and 24 months post-operatively with the foot function index (FFI) and pain score during activity on a 100 mm VAS scale (VAS activity). FFI at 6 and 12 months was defined a priori as primary endpoint. RESULTS Both groups improved significantly over time. The FFI score was significantly better in the operated group compared to the non-surgically treated group 12 months post-operatively (p = 0.033), at 24 months this was, however, not significant (p = 0.06). VAS activity at 24 months was significantly (p = 0.001) in favor of the operative group. More patients returned to running and jumping in the operative group (p = 0.04). CONCLUSION This randomized controlled trial found significant and clinically relevant superior results for the operative treatment of plantar fasciitis as measured by Foot Function Index at 1 year and by VAS activity at 2-year follow-up when compared to the results of a supervised rehabilitation program. LEVEL OF EVIDENCE I.
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184
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Fong DTP, Lue KBK, Chung MML, Chu VWS, Yung PSH. An individually moulded insole with 5-mm medial arch support reduces peak impact and loading at the heel after a one-hour treadmill run. Gait Posture 2020; 82:90-95. [PMID: 32911096 DOI: 10.1016/j.gaitpost.2020.08.109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/15/2020] [Accepted: 08/06/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Foot pain experienced by long-distance runners could be relieved by functional insoles which aim at evenly distributing the plantar pressure. RESEARCH QUESTION We hypothesised that an individually moulded insole with medial arch support would reduce the impact and loading under the heel and metatarsal regions. METHODS Twelve male recreational runners ran on a treadmill at 10 km/h for 1 hour with flat insoles and medial arch supported insoles. A pressure insole system (Novel Pedar, Germany) was used to obtain the peak pressure, peak force, time normalised pressure-time integrals, and the percentage of the total force-time integrals under 10 regions. RESULTS Medial arch supported insoles reduced the peak force under the heel (medial: -15.3%, p = 0.001; lateral: -19.2%, p = 0.037) during the initial run, and reduced peak pressure under the heel (medial: -13.3%, p = 0.005; lateral: -9.9%, p = 0.006), and peak force under the medial heel (-17.8%, p = 0.006) after the run. The percentage of the total force-time integrals under the heel was reduced (medial: -23.8%, p = 0.004; lateral: -13.6%, p = 0.022) after the run. No significant difference was found under the metatarsal regions. There is shift of load from the metatarsal regions to the medial mid-foot as indicated by the change of the percentage of total force-time integrals. SIGNIFICANCE Medial arch supported insoles were effective in reducing the impact and loading under the heel region in prolonged running on a treadmill. LEVEL OF EVIDENCE Controlled laboratory study, Level V.
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Affiliation(s)
- Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Ken B K Lue
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Mandy M L Chung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; Sports Medicine Centre, Elite Training Science & Technology Division, Hong Kong Sports Institute, Hong Kong
| | - Vikki W S Chu
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Patrick S H Yung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
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185
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Whittaker GA, Landorf KB, Munteanu SE, Menz HB. Predictors of response to foot orthoses and corticosteroid injection for plantar heel pain. J Foot Ankle Res 2020; 13:60. [PMID: 32993721 PMCID: PMC7526364 DOI: 10.1186/s13047-020-00428-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/14/2020] [Indexed: 01/12/2023] Open
Abstract
Background Foot orthoses and corticosteroid injection are common interventions used for plantar heel pain, however few studies have investigated the variables that predict response to these interventions. Methods Baseline variables (age, weight, height, body mass index (BMI), sex, education, foot pain, foot function, fear-avoidance beliefs and feelings, foot posture, weightbearing ankle dorsiflexion, plantar fascia thickness, and treatment preference) from a randomised trial in which participants received either foot orthoses or corticosteroid injection were used to predict change in the Foot Health Status Questionnaire foot pain and foot function subscales, and first-step pain measured using a visual analogue scale. Multivariable linear regression models were generated for different dependent variables (i.e. foot pain, foot function and first-step pain), for each intervention (i.e. foot orthoses and corticosteroid injection), and at different timepoints (i.e. weeks 4 and 12). Results For foot orthoses at week 4, greater ankle dorsiflexion with the knee extended predicted reduction in foot pain (adjusted R2 = 0.16, p = 0.034), and lower fear-avoidance beliefs and feelings predicted improvement in foot function (adjusted R2 = 0.43, p = 0.001). At week 12, lower BMI predicted reduction in foot pain (adjusted R2 = 0.33, p < 0.001), improvement in foot function (adjusted R2 = 0.37, p < 0.001) and reduction in first-step pain (adjusted R2 0.19, p = 0.011). For corticosteroid injection at week 4, there were no significant predictors for change in foot pain or foot function. At week 12, less weightbearing hours predicted reduction in foot pain (adjusted R2 = 0.25, p = 0.004) and lower baseline foot pain predicted improvement in foot function (adjusted R2 = 0.38, p < 0.001). Conclusions People with plantar heel pain who use foot orthoses experience reduced foot pain if they have greater ankle dorsiflexion and lower BMI, while they experience improved foot function if they have lower fear-avoidance beliefs and lower BMI. People who receive a corticosteroid injection experience reduced foot pain if they weightbear for fewer hours, while they experience improved foot function if they have less baseline foot pain.
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Affiliation(s)
- Glen A Whittaker
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, 3086, Australia. .,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia.
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia
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186
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Changes in the Plantar Flexion Torque of the Ankle and in the Morphological Characteristics and Mechanical Properties of the Achilles Tendon after 12-Week Gait Retraining. Life (Basel) 2020; 10:life10090159. [PMID: 32842586 PMCID: PMC7555353 DOI: 10.3390/life10090159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose: Although the Achilles tendon (AT) is the largest and strongest tendon, it remains one of the most vulnerable tendons among elite and recreational runners. The present study aims to explore the effects of 12-week gait retraining (GR) on the plantar flexion torque of the ankle and the morphological and mechanical properties of the AT. Methods: Thirty-four healthy male recreational runners (habitual rearfoot strikers) who never tried to run in minimal shoes were recruited, and the intervention was completed (20 in the GR group vs. 14 in the control (CON) group). The participants in the GR group were asked to run in minimal shoes (INOV-8 BARE-XF 210) provided by the investigators with forefoot strike patterns during the progressive 12-week GR. Meanwhile, the participants in the CON group were instructed to run in their own running shoes, which they were familiar with, with original foot strike patterns and intensities. The morphological properties of the AT, namely, length and cross-sectional area (CSA), were obtained by using an ultrasound device. A dynamometer was utilized simultaneously to measure and calculate the plantar flexion torque of the ankle, the rate of torque development, the peak force of the AT, and the stress and strain of the AT. Results: After 12-week GR, the following results were obtained: (1) A significant time effect in the peak ankle plantarflexion torque was observed (p = 0.005), showing a 27.5% increase in the GR group; (2) A significant group effect in the CSA was observed (p = 0.027), specifically, the increase in CSA was significantly larger in the GR group than the CON group; (3) A significant time effect in the peak AT force was observed (p = 0.005), showing a 27.5% increase in the GR group. Conclusion: The effect of 12 weeks of GR is an increase in AT CSA, plantar flexor muscle strength of the ankle, and peak AT force during a maximal voluntary isometric contraction test. These changes in AT morphology and function could be positive for tendon health and could prevent future AT injury.
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187
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Ferreira VMLM, Oliveira RR, Nazareno TS, Freitas LV, Mendonça LD. Interaction of foot and hip factors identifies Achilles tendinopathy occurrence in recreational runners. Phys Ther Sport 2020; 45:111-119. [PMID: 32763839 DOI: 10.1016/j.ptsp.2020.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To investigate the interaction of ankle-foot complex and hip joint factors with Achilles Tendinopathy (AT) occurrence in recreational runners. DESIGN Cross-sectional. SETTING Research Laboratory. PARTICIPANTS 51 runners, 26 healthy and 25 with AT. MAIN OUTCOMES MEASURES Shank-forefoot alignment (SFA), weight bearing lunge test (WBLT), passive hip internal rotation (IR) range of motion (ROM), hip external rotators (ER) and ankle plantar flexors (PF) isometric strength. CART analyses were performed to assess interactions that could distinguish those with AT. RESULTS Passive hip IR ROM, ankle PF torque, SFA, and hip ER isometric torque were associated AT occurrence. The model correctly classified 92% of individuals without AT and 72% of those with AT. The area under the receiver operating characteristic curve was 0.88. Interaction factors revealed in nodes 3 and 10 were statistically significant. In node 3, runners with more than 29.33° of passive hip IR ROM had a 130% increased likelihood (PR = 2.30) of AT. Node 10 showed that individuals with higher PF torque, SFA varus, ER torque, but reduced passive hip IR ROM had an 87% increased likelihood (PR = 1.87) of AT. CONCLUSION Interactions between hip and foot factors could accurately classify recreational runners with and without AT.
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Affiliation(s)
- Victor M L M Ferreira
- Postgraduate Program in Rehabilitation and Functional Performance -Universidade Federal dos Vales do Jetiquinhonha e Mucuri, Rodovia MGT 367, Km 583, 5000 Alto da Jacuba, 39100-000, Diamantina, Minas Gerais, Brazil.
| | - Rodrigo R Oliveira
- Physical Therapy Department - Universidade Federal do Ceará, Rua Major Weyne, 1440, Rodolfo Teófilo, 60430-160, Fortaleza, Ceará, Brazil.
| | - Thamiris S Nazareno
- Physical Therapy Department - Universidade Federal do Ceará, Rua Major Weyne, 1440, Rodolfo Teófilo, 60430-160, Fortaleza, Ceará, Brazil.
| | - Lucas V Freitas
- Physical Therapy Department - Universidade Federal do Ceará, Rua Major Weyne, 1440, Rodolfo Teófilo, 60430-160, Fortaleza, Ceará, Brazil.
| | - Luciana D Mendonça
- Postgraduate Program in Rehabilitation and Functional Performance -Universidade Federal dos Vales do Jetiquinhonha e Mucuri, Rodovia MGT 367, Km 583, 5000 Alto da Jacuba, 39100-000, Diamantina, Minas Gerais, Brazil; Physical Therapy Department, School of Biological and Health Sciences, Universidade Federal dos Vales do Jetiquinhonha e Mucuri, Rodovia MGT 367, Km 584, 5000 Alto da Jacuba, 39100-000, Diamantina, Minhas Gerais, Brazil.
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188
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Rhim HC, Kim SJ, Jeon JS, Nam HW, Jang KM. Prevalence and risk factors of running-related injuries in Korean non-elite runners: a cross-sectional survey study. J Sports Med Phys Fitness 2020; 61:413-419. [PMID: 32744044 DOI: 10.23736/s0022-4707.20.11223-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Due to the lack of consensus definition of running-related injuries, the prevalence and incidence of running-related injuries had been reported to vary between 19% and 92%. Moreover, the epidemiology of running-related injuries in Asian populations has been rarely investigated. The purpose of this study was to use the consensus definition of running-related injuries and investigate the epidemiology of running-related injuries in a Korean population. METHODS Using the cross-sectional design, an online survey was circulated among various running communities in Korea. The questionnaire contained information on the presence and location of pain attributed to running, demographic characteristics, weekly running mileage, participation in high-intensity training, running pace, the longest running event participated, the type of shoes, foot strike, the reason for running, and exercise experience prior to running. RESULTS Among 1046 runners (male=624, female=422) who responded, 94.7% experienced pain while running, but only 37% were categorized as having running-related injuries. The most common site of injury was the knee followed by the ankle. Exercise experience prior to running (OR=1.57 95% CI: 1.13-2.21), setting specific running goals (OR=1.57 95% CI: 1.08-2.27), increases in weekly running mileage (OR=1.66 95% CI: 1.05-2.62), and the longest running event participated (OR=2.15 95% CI: 1.22-4.05) were associated with significant increases in running-related injuries. CONCLUSIONS To avoid running-related injuries, runners should be careful when increasing weekly mileage. Moreover, runners with previous exercise experience may need to approach running more cautiously. Setting goals and pursuing longer-distance running events may be motivating, but at the same time, can increase the risk of running-related injuries.
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Affiliation(s)
- Hye C Rhim
- Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sung J Kim
- Korea University College of Medicine, Seoul, South Korea
| | - Jin S Jeon
- Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Hyuk W Nam
- Nam's Orthopedic Clinic, Seoul, South Korea
| | - Ki-Mo Jang
- Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea -
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189
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Chen M, Shetye SS, Rooney SI, Soslowsky LJ. Short- and Long-Term Exercise Results in a Differential Achilles Tendon Mechanical Response. J Biomech Eng 2020; 142:081011. [PMID: 32253439 PMCID: PMC7477707 DOI: 10.1115/1.4046864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/22/2020] [Indexed: 12/28/2022]
Abstract
The study was conducted to define the biomechanical response of rat Achilles tendon after a single bout of exercise and a short or long duration of daily exercise. We hypothesized that a single bout or a short duration of exercise would cause a transient decrease in Achilles tendon mechanical properties and a long duration of daily exercise would improve these properties. One hundred and thirty-six Sprague-Dawley rats were divided into cage activity (CA) or exercise (EX) groups for a single bout, short-term, or long-term exercise. Animals in single bout EX groups were euthanized, 3, 12, 24, or 48 h upon completion of a single bout of exercise (10 m/min, 1 h) on a flat treadmill. Animals in short-term EX groups ran on a flat treadmill for 3 days, 1, or 2 weeks while animals in long-term EX groups ran for 8 weeks. Tendon quasi-static and viscoelastic response was evaluated for all Achilles tendons. A single bout of exercise increased tendon stiffness after 48 h of recovery. Short-term exercise up to 1 week decreased cross-sectional area, stiffness, modulus, and dynamic modulus of the Achilles tendon. In contrast, 8 weeks of daily exercise increased stiffness, modulus, and dynamic modulus of the tendon. This study highlights the response of Achilles tendons to single and sustained bouts of exercise. Adequate time intervals are important to allow for tendon adaptations when initiating a new training regimen and overall beneficial effects to the Achilles tendon.
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Affiliation(s)
- Mengcun Chen
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA 19104; Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Snehal S. Shetye
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA 19104
| | | | - Louis J. Soslowsky
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, G13A Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA 19104-6081
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190
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Rhim HC, Kim MS, Choi S, Tenforde AS. Comparative Efficacy and Tolerability of Nonsurgical Therapies for the Treatment of Midportion Achilles Tendinopathy: A Systematic Review With Network Meta-analysis. Orthop J Sports Med 2020; 8:2325967120930567. [PMID: 32728589 PMCID: PMC7366412 DOI: 10.1177/2325967120930567] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 03/10/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Achilles tendinopathy (AT) is a common cause of overuse injury in both
athletes and nonactive individuals, especially at older ages. Due to the
limited number of direct comparisons among interventions, determining the
best treatment option can be difficult. Purpose: To evaluate the comparative efficacy and tolerability of nonsurgical
therapies for midportion AT. Study Design: Systematic review; Level of evidence, 1. Methods: PubMed, MEDLINE, EMBASE, and Google Scholar were searched from database
inception through June 20, 2019. Randomized controlled trials investigating
the effect of nonsurgical therapies for midportion AT using the Victorian
Institute of Sports Assessment–Achilles (VISA-A) assessment were eligible
for inclusion. Primary outcome was mean change in VISA-A score from
baseline. Comparisons between interventions were made through use of
random-effects network meta-analysis over the short term (≤3 months) and
longer term (>3 to <12 months). A safety profile was defined for each
intervention by rate of all-cause discontinuation (dropout) during
follow-up. Relative ranking of therapies was assessed by the
surface-under-the–cumulative ranking possibilities. Results: A total of 22 studies with 978 patients met the inclusion criteria. In
short-term studies, high-volume injection with corticosteroid (HVI+C) along
with eccentric exercise (ECC) significantly improved the change of VISA-A
score compared with that of ECC alone (standardized mean difference [SMD],
1.08; 95% CI, 0.58-1.58). Compared with ECC, acupuncture showed benefits
over both the short term (SMD, 1.57; 95% CI, 1.00-2.13) and longer term
(SMD, 1.23; 95% CI, 0.69-1.76). In longer-term studies, the wait-and-see
approach resulted in unfavorable outcomes compared with ECC (SMD, −1.51; 95%
CI, −2.02 to −1.01). Improvement was higher when ECC was combined with HVI+C
(SMD, 0.53; 95% CI, 0.05-1.02) and extracorporeal shockwave therapy (ESWT)
(SMD, 0.99; 95% CI, 0.48-1.49). All interventions had a similar safety
profile. Conclusion: From available high-level studies, HVI+C and ESWT may be possible
interventions to add along with ECC to improve longer-term outcomes.
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Affiliation(s)
- Hye Chang Rhim
- Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Min Seo Kim
- Korea University College of Medicine, Seoul, Republic of Korea
| | - Seungil Choi
- Department of Biostatistics, University of Pittsburg, Pittsburg, Pennsylvania, USA
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
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191
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Naderi A, Moen MH, Degens H. Is high soleus muscle activity during the stance phase of the running cycle a potential risk factor for the development of medial tibial stress syndrome? A prospective study. J Sports Sci 2020; 38:2350-2358. [PMID: 32615855 DOI: 10.1080/02640414.2020.1785186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To assess the impact of lower-leg muscle activity during the stance phase of running on the development of medial tibial stress syndrome (MTSS), in 123 healthy participants (18.2 ± 0.8 years), dynamic and static foot posture, and soleus and tibialis anterior muscle activity during the stance phase of running were measured before a 17-week track- and field-course. After the course, MTSS was identified in 20.5% of the participants. MTSS participants had a higher body mass (ES = 1.13), body mass index (BMI) (ES = 1.31), lower previous vigorous physical activity level (ES = 0.84) and VO2max (ES = 0.61), greater dynamic foot pronation (ES = 0.66), higher soleus peak EMG amplitude during the absorption (ES = 0.60) and propulsion phases (ES = 0.56) of running, and a history of MTSS (OR = 6.38) (p < 0.05). Stepwise logistic regression showed BMI, dynamic foot index, soleus peak EMG amplitude during propulsion, MTSS history and previous vigorous physical activity were predictors of MTSS. The model predicted 96.6% of the healthy participants and 56.5% of the MTSS participants and correctly classified 88.4% of overall cases. Coaches and sports-medicine professionals that screen for injury risk should consider adopting a comprehensive evaluation that includes these parameters.
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Affiliation(s)
- Aynollah Naderi
- School of Sport Science, Shahrood University of Technology , Shahrood, Iran
| | - Maarten H Moen
- Bergman Clinics , Naarden, The Netherlands.,The Sport Physician Group, OLVG West , Amsterdam, The Netherlands.,Department of Elite Sports, National Olympic Committee and National Sports Federation , Arnhem, The Netherlands
| | - Hans Degens
- Department of Life SciencesResearch Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University , Manchester, UK.,Institute of Sport Science & Innovations, Lithuanian Sports University , Kaunas, Lithuania.,University of Medicine & Pharmacy of Targu Mures , Targu Mures, Rumania
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192
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Lullini G, Giangrande A, Caravaggi P, Leardini A, Berti L. Functional Evaluation of a Shock Absorbing Insole During Military Training in a Group of Soldiers: A Pilot Study. Mil Med 2020; 185:e643-e648. [PMID: 32175582 DOI: 10.1093/milmed/usaa032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/01/2019] [Accepted: 02/07/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Soldiers' lower limbs and feet are frequently affected by overload- and overuse-related injuries. In order to prevent or limit the incidence of these injuries, the use of foot orthoses is often recommended. The aim of this study is to assess the effects of shock-absorbing insoles on in-shoe plantar pressure magnitude and distribution in a group of professional infantry soldiers wearing military boots during standard indoor military training. METHODS Twenty male professional soldiers of the Italian Army (age 35.1 ± 6.1 years; BMI 25.2 ± 2.3 kg/m2) were recruited for this study. Each subject underwent clinical examination to assess possible overuse-related diseases of the lower limb and trunk. Subjects with altered foot morphology according to the Foot Posture Index (FPI) were excluded from this study. Twelve subjects were considered eligible and therefore underwent an indoor training routine comprised of marching, running, jumping inside parallel bars and jumping from different heights. Soldiers repeated the training session twice wearing standard military boots along with two types of insoles: the standard prefabricated insole within the boots (STI), and a special shock-absorbing insole (SAI) featuring an elastic medial arch support. A 99-capacitive sensor insole system was used to record plantar pressure distribution in both feet. Analysis of in-shoe pressure parameters at rearfoot, midfoot and forefoot and in the total foot was performed via a custom-software application developed in MATLAB. Perceived foot comfort (VAS 0-15) was also assessed. RESULTS Pressure parameters recorded during walking and running were considered suitable for statistical analysis. In the whole foot region, pressure parameters were 18-22% lower in military boots fitted with the SAI during walking and 14-18% lower during running. SAI resulted in better comfort (+25%) with respect to the prefabricated boot orthotics (median comfort: SAI = 15/15; STI = 12/15; p = 0.0039) both during walking and running. CONCLUSIONS Shock-absorbing insoles can be an effective solution when fitted inside military boots. The present functional evaluation shows that wearing a prefabricated shock-absorbing insole can provide a significant amelioration of perceived foot comfort and plantar pressure parameters. Further studies are now needed with a larger population and more demanding exercises.
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Affiliation(s)
- Giada Lullini
- Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy.,DIBIMNEM-University of Bologna, Via Zamboni 33, 40110 Bologna, Italy
| | - Alessia Giangrande
- Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy
| | - Paolo Caravaggi
- Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy
| | - Alberto Leardini
- Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy
| | - Lisa Berti
- Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy.,DIBIMNEM-University of Bologna, Via Zamboni 33, 40110 Bologna, Italy
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193
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Matos S, Clemente FM, Silva R, Cancela Carral JM. Variations of Workload Indices Prior to Injuries: A Study in Trail Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4037. [PMID: 32517064 PMCID: PMC7312824 DOI: 10.3390/ijerph17114037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to compare the variations of weekly workload indices of internal and external load measures across the three weeks prior to injury occurrences in trail runners. Twenty-five trail runners (age: 36.23 ± 8.30 years old; body mass: 67.24 ± 5.97 kg; height: 172.12 ± 5.12 cm) were monitored daily for 52 weeks using global positioning systems (GPSs) to determine the total distance covered. Additionally, a rate of perceived exertion (RPE) scale was applied to determine session-RPE (sRPE: RPE multiplied by training time). The accumulated load (AL), acute: chronic workload ratio (ACWR), training monotony (TM), and training strain (TS) indices were calculated weekly for each runner. During the period of analysis, the injury occurrences were recorded. The differences were observed in AL and ACWR for sRPE and training time were significantly greater during the injury week when compared to the previous weeks. Similar evidence was found in TM and TS indices for sRPE, training time, and total distance. Furthermore, no meaningful differences were observed in AL and ACWR for total distance in the weeks prior to injury occurrence. Nevertheless, significant between-subjects variability was found, and this should be carefully considered. For that reason, an individualized analysis of the workload dynamics is recommended, avoiding greater spikes in load by aiming to keep a progressive increment of load without consequences for injury risk.
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Affiliation(s)
- Sérgio Matos
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal; (F.M.C.); (R.S.)
- Faculty of Educational Sciences and Sports Sciences, University of Vigo, 36005 Pontevedra, Spain;
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal; (F.M.C.); (R.S.)
- Instituto de Telecomunicações, Delegação da Covilhã, 1049-001 Lisboa, Portugal
| | - Rui Silva
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal; (F.M.C.); (R.S.)
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194
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Vermand S, Duc S, Ferrari FJ, Joly P. Immediate, short and medium-term effects of orthopedic insoles with a metatarsal retro-capital bar on biomechanical variables, plantar pressures and muscle activity in running. J Sports Med Phys Fitness 2020; 60:848-854. [PMID: 32487980 DOI: 10.23736/s0022-4707.20.10471-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of 12 weeks of use of orthopedic insoles equipped with a metatarsal retro-capital bar (MRCB) on plantar pressure under the feet and lower limb kinematic variables during running. METHODS Two groups of 10 runners used for 12 weeks while running orthopedic insoles without correction or equipped with a MRCB. All participants performed successively a standing posture (CoP displacement) test and a running test at 11 km.h-1 (lower limb kinematic variables) using with flat insoles and orthopedic neutral or MRCB insoles at the beginning (T0), after 4 (T4) and 12 weeks (T12) of use. RESULTS For the MRCB group, CoP moved backwards while forefoot plantar pressure was decreased during standing position at T4 and T12 compared to T0. During running, the plantar pressure under the 2nd, 3rd and 4th metatarsal heads was reduced with MRCB at T0, T4 and T12. The one under the 1st metatarsal head was decreased at T4 and T12, when MRCB or flat insoles were used. The maximal extension and the total amplitude of ankle were slightly increased at T4 and T12 with or without wearing MRCB insoles. Similar changes in knee joint kinematics were observed but only at T12. Any significant changes were found in runners that used orthopedic insoles without correction. CONCLUSIONS Orthopedic insoles equipped with MRCB involve lower plantar pressure under the metatarsal heads, which may be of interest to treat forefoot injuries in runners.
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Affiliation(s)
- Stéphane Vermand
- Performance, Health, Measurement Society (PSMS), University of Reims Champagne-Ardennes, Reims, France - .,Podiatrist Office and Postural Study, Amiens, France - .,Association of Sport's Podiatrist Podo'kygèm, Tourcoing, France -
| | - Sébastien Duc
- Podiatrist Office and Postural Study, Amiens, France
| | - Frank-Jourdan Ferrari
- Performance, Health, Measurement Society (PSMS), University of Reims Champagne-Ardennes, Reims, France
| | - Philippe Joly
- Performance, Health, Measurement Society (PSMS), University of Reims Champagne-Ardennes, Reims, France
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196
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Maselli F, Storari L, Barbari V, Colombi A, Turolla A, Gianola S, Rossettini G, Testa M. Prevalence and incidence of low back pain among runners: a systematic review. BMC Musculoskelet Disord 2020; 21:343. [PMID: 32493481 PMCID: PMC7271446 DOI: 10.1186/s12891-020-03357-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/20/2020] [Indexed: 12/12/2022] Open
Abstract
Background Running is one of the most popular sports worldwide. Despite low back pain (LBP) represents the most common musculoskeletal disorder in population and in sports, there is currently sparse evidence about prevalence, incidence and risk factors for LBP among runners. The aims of this systematic review were to investigate among runners: prevalence and incidence of LBP and specific risk factors for the onset of LBP. Methods A systematic review has been conducted according to the guidelines of the PRISMA statement. The research was conducted in the following databases from their inception to 31st of July 2019: PubMed; CINAHL; Google Scholar; Ovid; PsycINFO; PSYNDEX; Embase; SPORTDiscus; Scientific Electronic Library Online; Cochrane Library and Web of Science. The checklists of The Joanna Briggs Institute Critical Appraisal tools were used to investigate the risk of bias of the included studies. Results Nineteen studies were included and the interrater agreement for full-text selection was good (K = 0.78; 0.61–0.80 IC 95%). Overall, low values of prevalence (0.7–20.2%) and incidence (0.3–22%) of LBP among runners were reported. Most reported risk factors were: running for more than 6 years; body mass index > 24; higher physical height; not performing traditional aerobics activity weekly; restricted range of motion of hip flexion; difference between leg-length; poor hamstrings and back flexibility. Conclusions: Prevalence and incidence of LBP among runners are low compared to the others running related injuries and to general, or specific population of athletes. View the low level of incidence and prevalence of LBP, running could be interpreted as a protective factor against the onset of LBP. Systematic review registration PROSPERO CRD42018102001.
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Affiliation(s)
- Filippo Maselli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy. .,Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy.
| | - Lorenzo Storari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy
| | - Valerio Barbari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy
| | - Andrea Colombi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy
| | - Andrea Turolla
- IRCCS, San Camillo, Laboratory of Rehabilitation Technologies, Rehabilitation Research Unit, Venice, Italy
| | - Silvia Gianola
- IRCCS, Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milano, Italy
| | - Giacomo Rossettini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy
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197
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Fukusawa L, Stoddard R, Lopes AD. There is no difference in footstrike pattern distribution in recreational runners with or without anterior knee pain. Gait Posture 2020; 79:16-20. [PMID: 32311654 DOI: 10.1016/j.gaitpost.2020.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 03/04/2020] [Accepted: 03/31/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND There are no studies comparing footstrike pattern distribution between recreational runners with or without anterior knee pain. OBJECTIVE The aim of this study was to investigate if there was any difference in footstrike pattern between recreational runners with or without anterior knee pain. METHODS This cross-sectional study involved 62 runners without anterior knee pain and 60 runners with anterior knee pain. We recruited runners in public parks and amateur road running competitions. A 2D record was made using a high-speed camera with an acquisition frequency of 300 Hz and shutter speed of 300s-1. Also, demographic information, running characteristics, knee pain characteristics, and running biomechanics variables were collected. Besides the footstrike pattern, running step length, mean velocity, footstrike angle, and ankle push-off were evaluated. RESULTS The distribution of rearfoot strike pattern was similar between groups, observed in 96.6 % of the subjects with anterior knee pain and in 93.5 % of the subjects without it. In the secondary analysis, a logistic regression was conducted, and none of the demographic information, running training characteristics, and running biomechanics variables evaluated in this study were associated with runners presenting knee pain. CONCLUSION Runners with or without anterior knee pain do not differ in regard to footstrike pattern. Both groups had predominantly rearfoot strike patterns, and none of the collected variables were associated with anterior knee pain on runners.
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Affiliation(s)
- Leandro Fukusawa
- Master and Doctoral Program of Physiotherapy of Universidade Cidade de São Paulo, Sāo Paulo, SP, Brazil.
| | - Ryan Stoddard
- Department of Physical Therapy & Kinesiology, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Alexandre Dias Lopes
- Master and Doctoral Program of Physiotherapy of Universidade Cidade de São Paulo, Sāo Paulo, SP, Brazil; Department of Physical Therapy & Kinesiology, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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198
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Wei RXY, Chan ZYS, Zhang JHW, Shum GL, Chen CY, Cheung RTH. Difference in the running biomechanics between preschoolers and adults. Braz J Phys Ther 2020; 25:162-167. [PMID: 32507484 DOI: 10.1016/j.bjpt.2020.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 05/12/2020] [Accepted: 05/17/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND High vertical loading rate is associated with a variety of running-related musculoskeletal injuries. There is evidence supporting that non-rearfoot footstrike pattern, greater cadence, and shorter stride length may reduce the vertical loading rate. These features appear to be common among preschoolers, who seem to experience lower running injury incidence, leading to a debate whether adults should accordingly modify their running form. OBJECTIVE This study sought to compare the running biomechanics between preschoolers and adults. METHODS Ten preschoolers (4.2±1.6 years) and ten adults (35.1±9.5 years) were recruited and ran overground with their usual shoes at a self-selected speed. Vertical average (VALR) and vertical instantaneous loading rate (VILR) were calculated based on the kinetic data. Footstrike pattern and spatiotemporal parameters were collected using a motion capture system. RESULTS There was no difference in normalized VALR (p=0.48), VILR (p=0.48), running speed (p=0.85), and footstrike pattern (p=0.29) between the two groups. Preschoolers demonstrated greater cadence (p<0.001) and shorter normalized stride length (p=0.01). CONCLUSION By comparing the kinetic and kinematic parameters between children and adults, our findings do not support the notion that adults should modify their running biomechanics according to the running characteristics in preschoolers for a lower injury risk.
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Affiliation(s)
- Rachel X Y Wei
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - Zoe Y S Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Janet H W Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Gary L Shum
- School of Sport, Health and Wellbeing, Plymouth Marjon University, Derriford, Plymouth, United Kingdom
| | - Chao-Ying Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Roy T H Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China; School of Health Sciences, Western Sydney University, Campbelltown Campus, Australia
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Franettovich Smith MM, Collins NJ, Mellor R, Grimaldi A, Elliott J, Hoggarth M, Weber Ii KA, Vicenzino B. Foot exercise plus education versus wait and see for the treatment of plantar heel pain (FEET trial): a protocol for a feasibility study. J Foot Ankle Res 2020; 13:20. [PMID: 32384905 PMCID: PMC7206811 DOI: 10.1186/s13047-020-00384-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022] Open
Abstract
Background Plantar heel pain (PHP) is present in a wide range of individuals and creates significant burden to quality of life and participation in physical activity. The high recurrence rates and persistence of PHP suggests current management options may not address all potentially modifiable factors associated with the condition. Reports of intrinsic foot muscle (IFM) atrophy in individuals with PHP, together with biomechanical evidence of their important contribution to optimal foot function, suggests that an intervention focused on IFM training may be beneficial in managing PHP. We will test the feasibility of a prospective, assessor-blinded, parallel-group, randomised clinical trial that compares foot exercise plus education to brief advice in individuals with PHP. Methods Twenty participants with PHP will be randomly allocated to one of two groups for a 12-week intervention period: (i) foot exercise plus education, or (ii) brief advice. The foot exercise plus education group will attend eight sessions with a physiotherapist and receive detailed education on self-management strategies as well as a progressive exercise program for the IFMs. The brief advice group will attend one session with a physiotherapist and receive brief information about self-management strategies and reassurance. Outcome measures will be obtained at baseline and the primary end-point of 12 weeks. Primary outcomes will be the feasibility of conducting a full-scale randomised clinical trial (RCT), and the credibility and acceptability of the foot exercise plus education intervention. Secondary outcomes will explore treatment effects, which will consist of pain, physical function, physical activity level, pain self-efficacy, perceived treatment effect, magnetic resonance and ultrasound image measurement of IFM morphology, ultrasound imaging measurement of plantar fascia thickness, IFM motor performance, foot posture, foot mobility, ankle dorsiflexion range of motion, toe flexor and plantar flexor strength/endurance. Discussion To reduce the burden of PHP on individuals and society, there is a need to establish effective treatments that are feasible and accepted by patients and health professionals. This trial will be the first to evaluate the feasibility of conducting a full-scale RCT, as well as the credibility, acceptability, and treatment effects, of education and foot exercise for PHP. The findings of this study will inform the development of a full-scale RCT. Trial registration The trial protocol was prospectively registered with the Australia and New Zealand Clinical Trial Registry (ACTRN12619000987167) on 11th July 2019.
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Affiliation(s)
- Melinda M Franettovich Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Natalie J Collins
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, 3086, Australia
| | - Rebecca Mellor
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Alison Grimaldi
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.,PhysioTec Physiotherapy, Brisbane, Queensland, 4121, Australia
| | - James Elliott
- Faculty of Medicine and Health and The Kolling Research Institute, The University of Sydney, Sydney, New South Wales, 2006, Australia.,Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Mark Hoggarth
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Kenneth A Weber Ii
- Systems Neuroscience and Pain Lab, Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia
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Liu L, Gisselman AS, Tumilty S. Thermal profiles over the Patella tendon in a cohort of non-injured collegiate athletes over the course of a cross-country season. Phys Ther Sport 2020; 44:47-52. [PMID: 32416581 DOI: 10.1016/j.ptsp.2020.04.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To determine normal temperatures over the Patella tendon over eleven weeks. DESIGN A prospective cohort study with eleven weeks of observation. SETTING University's Human Biomechanics and Physiology Laboratory. PARTICIPANTS Male or female collegiate runners running at least 25 miles per week who did not report pain in the region of the Patella tendon over 11 weeks of data collection. MAIN OUTCOME MEASURES Thermal images taken at the same time and day of the week, were used to measure the temperature of the skin over the Patella tendon. RESULTS Eighteen athletes were eligible for analysis. The mean temperature of the Patella tendon was 30.13 °C (SD = 1.51 °C). Patella tendon temperature changes over time were insignificant (right p = 0.66, left p = 0.90) with ICC right = 0.92, left = 0.94. Mean temperature difference side to side was 0.14 °C (SD = 0.60 °C). Mixed-model Linear regression for mean temperature differences found the effect of (i) time (t = 0.39, p = 0.70, df = 361) and (ii) side (t = -0.89, p = 0.38, df = 361) to be insignificant. CONCLUSIONS This is the first report of normal thermal profiles of collegiate runners over an extended period. Temperature variation above 1.20 °C may represent an abnormal asymmetry in the running population. Variations in Patella tendon temperatures left to right, and over time were not significant.
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Affiliation(s)
- Lizhou Liu
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | | | - Steve Tumilty
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
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