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Nicolay RW, Hartwell MH, Bigach SD, Fernandez CE, Morgan AM, Cogan CJ, Terry MA, Tjong VK. Injury Risk in Collegiate Football Players With Generalized Joint Hypermobility: A Prospective Cohort Study Over 2 Years. Orthop J Sports Med 2023; 11:23259671231167117. [PMID: 37359974 PMCID: PMC10288402 DOI: 10.1177/23259671231167117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/09/2022] [Indexed: 06/28/2023] Open
Abstract
Background Generalized joint hypermobility (GJH) has been identified as a risk factor for injury in various athletic patient populations. Purpose To evaluate GJH as a predisposing risk factor for injury in a population of National Collegiate Athletic Association (NCAA) Division I football players. Study Design Cohort study; Level of evidence, 2. Methods The Beighton score was collected for 73 athletes during their preseason physical examinations in 2019. GJH was defined as a Beighton score ≥4. Athlete descriptive characteristics, including age, height, weight, and playing position, were recorded. The cohort was evaluated prospectively for 2 years, and the number of musculoskeletal issues, injuries, treatment episodes, days unavailable, and surgical procedures for each athlete during this period were recorded. These measures were compared between the GJH and no-GJH groups. Results The mean Beighton score was 1.4 ± 1.5 for the 73 players; 7 players (9.6%) had a Beighton score indicating GJH. During the 2-year evaluation, there were 438 musculoskeletal issues, including 289 injuries. The mean number of treatment episodes per athlete was 77 ± 71 (range, 0-340), and the mean number of days unavailable was 67 ± 92 days (range, 0-432 days). There were 23 athletes who required 25 operations, the most common procedure being arthroscopic shoulder stabilization (n = 6). The number of injuries per athlete was not significantly different between the GJH and no-GJH groups (3.0 ± 2.1 vs 4.1 ± 3.0; P = .13), nor were there any between-group differences in the number of treatments received (74.6 ± 81.9 vs 77.2 ± 71.5; P = .47), days unavailable (79.6 ± 124.5 vs 65.3 ± 89.3; P = .61), or rates of surgery (43% vs 30%; P = .67). Conclusion A preseason diagnosis of GJH did not place NCAA football players at a greater risk for injury during the 2-year study period. Based on the findings of this study, no specific preparticipation risk counseling or intervention is warranted for football players who are diagnosed with GJH as defined by the Beighton score.
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Affiliation(s)
| | - Matthew H. Hartwell
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Stephen D. Bigach
- Department of Orthopaedic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Claire E. Fernandez
- Department of Orthopaedic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Allison M. Morgan
- Department of Orthopedic Surgery, New York University, New York, New York, USA
| | - Charles J. Cogan
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Michael A. Terry
- Department of Orthopaedic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Vehniah K. Tjong
- Department of Orthopaedic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, USA
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Age and Sex Comparisons in Pediatric Track and Field Hurdle Injuries Seen in Emergency Departments of the US. Sports (Basel) 2023; 11:sports11030065. [PMID: 36976951 PMCID: PMC10052995 DOI: 10.3390/sports11030065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
There is limited literature analyzing pediatric hurdle injuries based on sex and age. This study compares hurdle-related injury types, injured body parts, and injury mechanisms by age and sex in pediatrics. Hurdle-related injury data from the National Electronic Injury Surveillance System were used to retrospectively review the injuries of hurdlers 18 years and under. Differences in injured body parts, injury types, and mechanisms were analyzed by age (pre-high school vs. high school) and sex (male vs. female). A total of 749 cases were extracted. Fractures were more common in pre-high schoolers (34.1% vs. 21.5%, p = 0.001), while more sprains were identified in high schoolers (29.6%) than pre-high schoolers (22.8%, p = 0.036). Males suffered more fractures than females (35.1% vs. 24.3%, p = 0.001). Females sustained more joint sprains (29.1% vs. 21.0%, p = 0.012) and contusions/hematomas (12.7% vs. 7.5%, p = 0.020). Ankle injuries were more common in females (24.0%) than males (12.0%, p = 0.001), while wrist injuries were more prevalent in males (11.7% vs. 7.2%, p = 0.034). The most common injury mechanism was apparatus-related, with no differences based on age or sex. Injury types and injured body parts differed depending on age and sex in pediatric hurdle injuries seen in emergency departments. These findings may be helpful for injury prevention and medical care for pediatric hurdlers.
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Abstract
Flexibility refers to the intrinsic properties of body tissues that determine maximal joint range of motion without causing injury. For many years, flexibility has been classified by the American College of Sports Medicine as a major component of physical fitness. The notion flexibility is important for fitness has also led to the idea static stretching should be prescribed to improve flexibility. The current paper proposes flexibility be retired as a major component of physical fitness, and consequently, stretching be de-emphasized as a standard component of exercise prescriptions for most populations. First, I show flexibility has little predictive or concurrent validity with health and performance outcomes (e.g., mortality, falls, occupational performance) in apparently healthy individuals, particularly when viewed in light of the other major components of fitness (i.e., body composition, cardiovascular endurance, muscle endurance, muscle strength). Second, I explain that if flexibility requires improvement, this does not necessitate a prescription of stretching in most populations. Flexibility can be maintained or improved by exercise modalities that cause more robust health benefits than stretching (e.g., resistance training). Retirement of flexibility as a major component of physical fitness will simplify fitness batteries; save time and resources dedicated to flexibility instruction, measurement, and evaluation; and prevent erroneous conclusions about fitness status when interpreting flexibility scores. De-emphasis of stretching in exercise prescriptions will ensure stretching does not negatively impact other exercise and does not take away from time that could be allocated to training activities that have more robust health and performance benefits.
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Affiliation(s)
- James L Nuzzo
- Neuroscience Research Australia, Barker Street, Randwick, NSW, Australia, 2031.
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
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Reuter PR. Joint hypermobility and musculoskeletal injuries in a university-aged population. Phys Ther Sport 2021; 49:123-128. [PMID: 33676202 DOI: 10.1016/j.ptsp.2021.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/13/2021] [Accepted: 02/16/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To explore the correlation between joint hypermobility and risk of musculoskeletal injuries in a university-aged population. DESIGN Cross-sectional study using an anonymous survey. SETTING Anatomy & Physiology lab. PARTICIPANTS 816 undergraduate Anatomy & Physiology students at a university in the United States. MAIN OUTCOME MEASURES Beighton score, self-reported musculoskeletal injuries. RESULTS Athletically active study respondents reported more musculoskeletal injuries than respondents who indicated not being athletically active. Female respondents had lower rates of self-reported injuries than male respondents (55.4% vs. 65.5%; p = 0.0099; odds ratio: 1.53). The most commonly reported injury type for both women and men were quadriceps, groin and hamstring injuries. Neither male nor female respondents with generalized joint hypermobility (GJH) or localized joint hypermobility (LJH) reported higher rates of musculoskeletal injuries. CONCLUSIONS Athletically active young adults are at greater risk for sustaining musculoskeletal injuries; however, there is no additional increase in injury risk for young people with GJH or LJH.
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Affiliation(s)
- Peter R Reuter
- Department of Rehabilitation Sciences, Marieb College of Health & Human Services, Florida Gulf Coast University, 10501 FGCU Boulevard South, Marieb Hall 419, Fort Myers, 33912, Fort Myers, Florida, USA.
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Risk of Injury in Physically Active Students: Associated Factors and Quality of Life Aspects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072564. [PMID: 32276511 PMCID: PMC7177920 DOI: 10.3390/ijerph17072564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 11/18/2022]
Abstract
Background: The aim of this study was to assess the potential factors of hypermobility and pain threshold on the risk of injury in physically active students and to verify which domains of quality of life are rated lower by young people with a history of injuries. Methods: The study included 278 students (138 women and 140 men) who regularly undertake physical activity. Anthropometric measurements, body composition, pain threshold, incidence of hypermobility syndrome, information on the history of injuries to the locomotor system, and the quality of life of the study participants were collected. Results: In the group studied, hypermobility and pain threshold had a statistically significant related on the risk of injury. Participants with a history of injuries had lower scores for an individual’s overall perception of their own health and the physical domain. There were also significant differences in the psychological domain of the quality of life between males and females with a history of injuries. Conclusion: In the studied group, the risk of injuries was related to diagnosed hypermobility and pain threshold measured on the lower limbs. The study also showed that people with a history of injuries had statistically significantly lower scores in the individual general perception of their own health and in the physical domain. Gender had a significant impact on the quality of life of people with injuries.
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Morphological characteristics, assessment of hypermobility and pain threshold of rugby players. CENTRAL EUROPEAN JOURNAL OF SPORT SCIENCES AND MEDICINE 2020. [DOI: 10.18276/cej.2020.3-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Paul Johnson A, Ward S, Simmonds J. The Lower Limb Assessment Score: A valid measure of hypermobility in elite football? Phys Ther Sport 2019; 37:86-90. [PMID: 30904749 DOI: 10.1016/j.ptsp.2019.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/12/2019] [Accepted: 03/12/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study aims to validate the Lower Limb Assessment Score against the current gold standard Beighton Scale within an adult elite footballing population to allow for future research to explore the influence of lower limb specific hypermobility on injury incidence. DESIGN Observational cohort study. SETTING Thirty-six male, professional footballers aged between 18 and 37 years old. MAIN OUTCOME MEASURES The Sensitivity, specificity, positive predictive value, negative predictive value and Spearman's rank correlation between the LLAS and Beighton Scale. RESULTS There was significant strong correlation between LLAS and Beighton Scale scores (ρ = 0.732; p < 0.001). The LLAS displayed a sensitivity of 67% and specificity of 94% when a cut off of ≥4/12 was applied to the screening data. This cut off point also yielded moderate Positive Predictive Validity (50%) and excellent Negative Predictive Validity (97%). CONCLUSIONS The present study suggests that the LLAS is a valid test for identifying lower limb hypermobility within an adult male footballing population when a cut off of ≥4/12 is used.
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Affiliation(s)
- Adam Paul Johnson
- Brighton & Hove Albion Football Club, American Express Elite Football Performance Centre, 60 Mash Barn Lane, Lancing, BN15 9FP, UK; Department for Health, University of Bath, Claverton Down, Bath, UK.
| | - Sarah Ward
- Department for Health, University of Bath, Claverton Down, Bath, UK; School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Jane Simmonds
- Great Ormond Street Institute of Child Health, University College London, UK
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Klein C, Henke T, Platen P. Injuries in football (soccer)—a systematic review of epidemiology and aetiological aspects. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2018. [DOI: 10.1007/s12662-018-0530-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Toivo K, Kannus P, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Savonen K, Selänne H, Vasankari T, Kannas L, Kujala UM, Villberg J, Parkkari J. Musculoskeletal examination in young athletes and non-athletes: the Finnish Health Promoting Sports Club (FHPSC) study. BMJ Open Sport Exerc Med 2018; 4:e000376. [PMID: 29955377 PMCID: PMC6018865 DOI: 10.1136/bmjsem-2018-000376] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 04/04/2018] [Accepted: 04/04/2018] [Indexed: 12/26/2022] Open
Abstract
Objectives To determine the inter-rater repeatability of a musculoskeletal examination and to compare findings between adolescent athletes and non-athletes in Finland. Methods In this cross-sectional study, a musculoskeletal examination assessing posture, mobility and movement control was carried out by a sports and exercise medicine physician on 399 athletes aged 14–17 years and 177 non-athletes. Within 2 weeks another sports and exercise medicine physician repeated the examination for 41 adolescents to test the inter-rater repeatability. Results In total, 10 of the 11 tests performed had at least moderate inter-rater reliability (κ ≥0.4 or percentage agreement >80%). Athletes more often than non-athletes had one shoulder protruded (8.0% vs 4.0%, OR 2.81, 95% CI 1.16 to 6.81). Forty-six per cent of athletes had good knee control in the two-legged vertical drop jump test compared with 32% of non-athletes (OR 1.99, 95% CI 1.29 to 3.06). Athletes had better core muscle control with 86.3% being able to remain in the correct plank position for 30 s compared with 68.6% of non-athletes (OR 2.70, 95% CI 1.67 to 4.36). In the deep squat test, good lumbar spine control was maintained only by 35.8% of athletes and 38.4% of non-athletes. Conclusion A basic musculoskeletal examination is sufficiently reliable to be performed by trained physicians as a part of a periodic health evaluation. Shortfalls in mobility, posture and movement control are common in both athletes and non-athletes. These deficits could have been caused by sedentary behaviour, monotonous training, or both.
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Affiliation(s)
- Kerttu Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, Helsinki, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit of Health and Physical Activity, University of Turku, Turku, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Clinic, Oulu Deaconess Institute, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Harri Selänne
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Lasse Kannas
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
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10
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Armstrong R, Greig DM. The Beighton score as a predictor of Brighton criteria in sport and dance. Phys Ther Sport 2018; 32:145-154. [PMID: 29793123 DOI: 10.1016/j.ptsp.2018.04.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 03/08/2018] [Accepted: 04/18/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To determine the efficacy of using the Beighton joint hypermobility score as a predictor of Brighton criteria components, considering the influence of gender and sports participation. DESIGN Cross sectional study design. SETTING A University. PARTICIPANTS Sixty-five female rugby players, 38 male rugby players, 61 netball players, 42 female dancers, 40 male controls and 40 female controls. MAIN OUTCOME MEASURES The Beighton score was assessed using the Beighton and Horan Joint Mobility Index. The Brighton criteria was used to assess joint hypermobility syndrome. A binary logistic regression was performed for a pooled sample (n = 286), and subsequently for gender and sport to assess the Beighton score as a predictor of Brighton criteria. RESULTS Beighton scores were found to be a predictor of arthralgia (P = 0.002), dislocation and subluxation (P = 0.048) in the pooled analysis; a predictor of dislocation and subluxation (P = 0.047) in males and arthralgia (P = 0.001) in females. Beighton scores were a predictor of arthralgia in female rugby (P = 0.003) and in female controls (P = 0.012). CONCLUSIONS The potential of the Beighton score to predict joint arthralgia and dislocation/subluxation may allow clinicians to implement effective injury prevention strategies.
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Affiliation(s)
- Ross Armstrong
- Department of Sport and Physical Activity, Sports Injuries Research Group, Edge Hill University, Ormskirk, Lancashire L39 4QP, England, United Kingdom.
| | - Dr Matt Greig
- Department of Sport and Physical Activity, Sports Injuries Research Group, Edge Hill University, Ormskirk, Lancashire L39 4QP, England, United Kingdom
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Błażkiewicz A, Grygorowicz M, Białostocki A, Czaprowski D. Characteristics of goalkeeping injuries: a retrospective, self-reported study in adolescent soccer players. J Sports Med Phys Fitness 2018; 58:1823-1830. [PMID: 29479994 DOI: 10.23736/s0022-4707.18.07849-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Characteristic types of actions and training/matches loads of soccer goalkeepers show that goalkeeper's performance differs from other soccer's formations. Such situation may predispose to the occurrence of other kinds of injuries in this position. The aim of this study was to analyze epidemiology of injuries in young soccer goalkeepers. METHODS Forty-eight soccer goalkeepers (aged:15.2±1.9 years) filled the questionnaire aimed at collecting information about all injuries sustained within 12 months before the data collection. The anthropometric data, soccer experience and information regarding the injury types and occurrence were analyzed. The injury rate proportion for acute and overuse injuries and values of injuries including the burden of the match game and training were evaluated. The level of significance was set at P<0.05. RESULTS Thirty-three (68.8%) questionnaires were given back. Twenty-four (72.7%) goalkeepers reported the history of soccer related injury within a year before the survey. 52 injuries were reported. Significantly higher number of acute (76.9%) vs. overuse (23.1%) injuries was described (P=0.0012). Acute injuries involved fractures/subluxations of the fingers and thigh muscle strain/tears. The group of overuse injuries was dominated by trauma of the knee and pelvic girdle muscles. Majority of injuries occurred during training (88.5% of all injuries), and there was significant higher number of injuries sustained on artificial vs. natural grass for all, acute and overuse types of injuries (P<0.0001). CONCLUSIONS Young soccer goalkeepers suffer mostly acute injuries (within the fingers of hands and muscles of thighs). It might be associated with specific characteristic of performance related to goalkeeper's position.
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Affiliation(s)
- Aleksander Błażkiewicz
- Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland - .,Rehasport Clinic, FIFA Medical Center of Excellence, Poznań, Poland -
| | - Monika Grygorowicz
- Rehasport Clinic, FIFA Medical Center of Excellence, Poznań, Poland.,Department of Spondylo-orthopedics and Biomechanics of the Spine, Karol Marcinkowski Poznań University of Medical Sciences, Poznań, Poland
| | | | - Dariusz Czaprowski
- Department of Physiotherapy, Józef Rusiecki University College, Olsztyn, Poland.,Center of Body Posture, Olsztyn, Poland
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Oddy C, Johnson MI, Jones G. The effect of generalised joint hypermobility on rate, risk and frequency of injury in male university-level rugby league players: a prospective cohort study. BMJ Open Sport Exerc Med 2017; 2:e000177. [PMID: 28890803 PMCID: PMC5566262 DOI: 10.1136/bmjsem-2016-000177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2016] [Indexed: 11/12/2022] Open
Abstract
Background Rugby league is a collision sport where musculoskeletal injuries are common. There has been little research on generalised joint hypermobility (GJH) as a risk factor for injury in rugby league. The aim of this study was to investigate the role of GJH on the incidence of injuries in first and second team rugby league players from one British university. Methods We conducted a prospective cohort study of 45 student players from one British university first and second team rugby league squads (mean age 20.93±1.57 years). At the beginning of the season, GJH was determined using a 9-point Beighton scale, and injury and exposure data were collected on a weekly basis throughout the 2013–2014 season. Results The prevalence of GJH was 20%. There was no statistically significant difference in the frequency of injuries between GJH and non-GJH participants (p=0.938, Mann-Whitney U test).Participants categorised as having GJH did not experience a higher fequency of injury (p=0.722, Fisher's exact test) and there was no tendency to demonstrate a higher risk of injury for participants categorised as GJH (OR=0.64, 95% CI 0.15 to 2.78; relative risk (RR)=1.188, 95% CI 0.537 to 2.625). The most common site of injury was the ankle, but this was not statistically significant (OR=0.152, 95% CI 0.008 to 2.876; RR=0.195, CI 0.012 to 3.066). Conclusion British university rugby league players with GJH did not demonstrate a greater risk of injury than those without GJH.
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Affiliation(s)
- Cassie Oddy
- Faculty of Health & Social Sciences, Leeds Beckett University, Leeds, UK
| | - Mark I Johnson
- Faculty of Health & Social Sciences, Leeds Beckett University, Leeds, UK
| | - Gareth Jones
- Faculty of Health & Social Sciences, Leeds Beckett University, Leeds, UK
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Tinkle B, Castori M, Berglund B, Cohen H, Grahame R, Kazkaz H, Levy H. Hypermobile Ehlers-Danlos syndrome (a.k.a. Ehlers-Danlos syndrome Type III and Ehlers-Danlos syndrome hypermobility type): Clinical description and natural history. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2017; 175:48-69. [PMID: 28145611 DOI: 10.1002/ajmg.c.31538] [Citation(s) in RCA: 237] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The hypermobile type of Ehlers-Danlos syndrome (hEDS) is likely the most common hereditary disorder of connective tissue. It has been described largely in those with musculoskeletal complaints including joint hypermobility, joint subluxations/dislocations, as well as skin and soft tissue manifestations. Many patients report activity-related pain and some go on to have daily pain. Two undifferentiated syndromes have been used to describe these manifestations-joint hypermobility syndrome and hEDS. Both are clinical diagnoses in the absence of other causation. Current medical literature further complicates differentiation and describes multiple associated symptoms and disorders. The current EDS nosology combines these two entities into the hypermobile type of EDS. Herein, we review and summarize the literature as a better clinical description of this type of connective tissue disorder. © 2017 Wiley Periodicals, Inc.
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