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Glazebrook T, Cooke J, Waddington G, Wallwork SB. Lumbar extension peak-torque, muscle endurance and motor imagery in junior-elite basketballers with and without a history of low back pain: a pilot study. PeerJ 2024; 12:e17508. [PMID: 38854796 PMCID: PMC11162610 DOI: 10.7717/peerj.17508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/13/2024] [Indexed: 06/11/2024] Open
Abstract
Objectives Low back pain (LBP) is common in elite athletes. Several peripheral and central factors have been identified to be altered in non-athletic LBP populations, however whether these alterations also exist in elite athletes with LBP is unknown. The aim of this study was to determine whether elite basketballers with a history of persistent LBP perform worse than those without LBP at a lumbar muscle endurance task, a lumbar extension peak-torque task, and a lumbar motor imagery task. Method An observational pilot study. Twenty junior elite-level male basketballers with (n = 11) and without (n = 9) a history of persistent LBP were recruited. Athletes completed a lumbar extensor muscle endurance (Biering-Sorensen) task, two lumbar extensor peak-torque (modified Biering-Sorensen) tasks and two motor imagery (left/right lumbar and hand judgement) tasks across two sessions (48 hours apart). Performance in these tasks were compared between the groups with and without a history of LBP. Results Young athletes with a history of LBP had reduced lumbar extensor muscle endurance (p < 0.001), reduced lumbar extension peak-torque (p < 0.001), and were less accurate at the left/right lumbar judgement task (p = 0.02) but no less accurate at a left/right hand judgement task (p = 0.59), than athletes without a history of LBP. Response times for both left/right judgement tasks did not differ between groups (lumbar p = 0.24; hand p = 0.58). Conclusions Junior elite male basketballers with a history of LBP demonstrate reduced lumbar extensor muscle endurance and lumbar extension peak-torque and are less accurate at a left/right lumbar rotation judgement task, than those without LBP.
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Affiliation(s)
- Tim Glazebrook
- Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
- SportsMed SA, Adelaide, South Australia, Australia
| | - Jennifer Cooke
- Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
| | - Gordon Waddington
- Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Sarah B Wallwork
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australian Capital Territory, Australia
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
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2
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Sengar M, Gupta A, Singh S, Mishra N. Body composition parameters as predictors of low back pain in rural homemakers of North India. J Family Med Prim Care 2024; 13:512-516. [PMID: 38605797 PMCID: PMC11006052 DOI: 10.4103/jfmpc.jfmpc_920_23] [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: 06/04/2023] [Revised: 06/27/2023] [Accepted: 08/09/2023] [Indexed: 04/13/2024] Open
Abstract
Background Homemakers are the backbones of families, but in rural India, females suffer from many musculoskeletal problems due to excessive workload in their houses. The objective of the present study is to compare body composition parameters as predictors of low back pain (LBP) in nonworking rural homemakers of North India. Materials and Methods The study was conducted among 296 homemakers from rural areas of Lucknow district in Uttar Pradesh. Details of LBP and body composition parameters (body mass index, body fat, visceral fat) were taken. Results The prevalence of LBP among homemakers was found to be 15.54%. BMI was found to be a better predictor of LBP than body fat and visceral fat. The risk of LBP is 7.24 times higher in BMI ≥23 than in women with BMI <23. The risk of LBP is 3.67 times more in visceral fat % ≥10% than in women with visceral fat % <10%. Conclusion Age, type of family, socioeconomic status income was identified as risk factors in this population. Maintaining an adequate BMI is essential for the prevention of LBP.
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Affiliation(s)
- Mili Sengar
- Department of Community Medicine, TS Mishra Medical College, Lucknow, Uttar Pradesh, India
| | - Abhishek Gupta
- Department of Community Medicine, Government Medical College, Kannauj, Uttar Pradesh, India
| | - Swati Singh
- Department of Community Medicine, TS Mishra Medical College, Lucknow, Uttar Pradesh, India
| | - Nandini Mishra
- Department of Microbiology, King George Medical University, Lucknow, Uttar Pradesh, India
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3
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Wan ZY, Zhang J, Shan H, Liu TF, Song F, Samartzis D, Wang HQ. Epidemiology of Lumbar Degenerative Phenotypes of Children and Adolescents: A Large-Scale Imaging Study. Global Spine J 2023; 13:599-608. [PMID: 33843321 DOI: 10.1177/21925682211000707] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE Recently, there has been a rise in children and adolescents developing low back pain and/or sciatica. Degenerative lumbar spine MRI phenotypes can occur in this population but reports have been sporadic and the true incidence of such spine changes remains debatable. As such, the study aimed to address the epidemiology of MRI phenotypes of the lumbar spine in this young population. METHODS 597 children and adolescents with lumbar MRIs were included in the study. T1- and T2-weighted lumbar images from L1/2 to L5/S1 were analyzed in axial and sagittal planes. Global phenotype assessment was performed of each level and based on established nomenclature protocols. RESULTS The cohort consisted of 57.3% (342) boys and 42.7% (255) girls, with a mean age of 10.75 ± 5.25 years (range: 0 to 18 years). The prevalence of imaging findings of lumbar disc degeneration (LDD) and lumbar disc herniation (LDH) were 2.2% (95% CI: 0.93-3.43) and 5.8% (95%CI: 2.58-8.99), respectively. There was significant difference between each disc segment from L1/2 to L5/S1 for both LDD and LDH. Schmorl's nodes were noted in 16 cases (2.7%, youngest case as 15 years), with 11 boys (68.8%) and most frequent segment as L3/4. Modic changes and high-intensity zones were absent in this cohort. CONCLUSIONS LDD can emerge as early as the first decade of life with Schmorl's nodes, without additional specific phenotypes, including Modic changes and high-intensity zones. The study provides valuable information of a unique age group that is often under-represented but equally important as adults.
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Affiliation(s)
- Zhong-Yuan Wan
- Department of Orthopedics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Jun Zhang
- Department of Orthopedics, Baoji Central Hospital, Baoji, Shaanxi Province, People's Republic of China
| | - Hua Shan
- Institute of Integrative Medicine, 107652Shaanxi University of Chinese Medicine, Xi'an, Shaanxi Province, People's Republic of China
| | - Tang-Fen Liu
- Institute of Integrative Medicine, 107652Shaanxi University of Chinese Medicine, Xi'an, Shaanxi Province, People's Republic of China
| | - Fang Song
- Department of Stomatology, PLA Rocket Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Dino Samartzis
- Department of Orthopaedic Surgery, 2468Rush University Medical Center, Chicago, IL, USA
| | - Hai-Qiang Wang
- Institute of Integrative Medicine, 107652Shaanxi University of Chinese Medicine, Xi'an, Shaanxi Province, People's Republic of China
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Wall J, Meehan WP, Trompeter K, Gissane C, Mockler D, van Dyk N, Wilson F. Incidence, prevalence and risk factors for low back pain in adolescent athletes: a systematic review and meta-analysis. Br J Sports Med 2022; 56:1299-1306. [PMID: 36150752 DOI: 10.1136/bjsports-2021-104749] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the incidence, prevalence, risk factors and morphological presentations of low back pain (LBP) in adolescent athletes. DESIGN Systematic review with meta-analysis. DATA SOURCES Medline, Embase, CINAHL via EBSCO, Web of Science, Scopus. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies evaluating the incidence and/or prevalence of LBP in adolescent athletes across all sports. RESULTS There were 80 studies included. The pooled incidence estimate of LBP in adolescent athletes was 11% (95% CI 8% to 13%, I2=0%) for 2 years, 36.0% (95% CI 4% to 68%, I2=99.3%) for 12 months and 14% (95% CI 7% to 22%, I2=76%) for 6 months incidence estimates. The pooled prevalence estimate of LBP in adolescent athletes was 42% (95% CI 29% to 55%, I2=96.6%) for last 12 months, 46% (95% CI 41.0% to 52%, I2=56%) for last 3 months and 16% (95% CI 9% to 23%, I2=98.3%) for point prevalence. Potential risk factors were sport participation, sport volume/intensity, concurrent lower extremity pain, overweight/high body mass index, older adolescent age, female sex and family history of LBP. The most common morphology reported was spondylolysis. Methodological quality was deemed high in 73% of cross-sectional studies and in 30% of cohort studies. Common reasons for downgrading at quality assessment were use of non-validated survey instruments and imprecision or absence of LBP definition. SUMMARY/CONCLUSION LBP is common among adolescent athletes, although incidence and prevalence vary considerably due to differences in study methodology, definitions of LBP and data collection. PROSPERO REGISTRATION NUMBER CRD42020157206.
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Affiliation(s)
- Julia Wall
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention, Division of Sports Medicine, Boston Children's Hospital, Waltham, Massachusetts, USA
| | - Katharina Trompeter
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit Bochum, Bochum, Nordrhein-Westfalen, Germany.,Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Conor Gissane
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | - David Mockler
- John Stearne Medical Library, Trinity College Dublin, Dublin, Ireland
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Fiona Wilson
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
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Li N, Amarasinghe S, Boudreaux K, Fakhre W, Sherman W, Kaye A. Spondylolysis. Orthop Rev (Pavia) 2022; 14:37470. [PMID: 36045696 DOI: 10.52965/001c.37470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Spondylolysis is a bony defect of the pars interarticularis and most often results from repetitive stress. Although spondylolysis is usually asymptomatic, symptomatic spondylolysis is the most common cause of identifiable back pain in children and adolescent athletes. A thorough history and physical exam, as well as appropriate imaging studies are helpful in diagnosis. General first-ine therapy for spondylolysis is conservative and consists of rest from sports, core strengthening, as well as spinal bracing. Patients who have failed conservative therapy may consider surgical repair. This article aims to review the epidemiology, pathophysiology, presentation, and treatment options of spondylolysis.
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Affiliation(s)
| | - Sam Amarasinghe
- Louisiana State University Health Sciences Center - Shreveport
| | - Kyle Boudreaux
- Louisiana State University Health Sciences Center - Shreveport
| | - Waddih Fakhre
- Louisiana State University Health Sciences Center - Shreveport
| | | | - Alan Kaye
- Louisiana State University Shreveport
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The influence of spinal position on imaging findings: an observational study of thoracolumbar spine upright MRI in elite gymnasts. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:225-232. [PMID: 34613494 DOI: 10.1007/s00586-021-06997-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 06/18/2021] [Accepted: 09/14/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate whether upright magnetic resonance imaging (MRI) has a role in defining thoracolumbar spine pathology in elite gymnastics. METHODS A prospective cross-sectional observational study of National Senior and Junior Artistic gymnasts in three MRI positions (standard supine, upright flexed and extended positions). Two specialist musculoskeletal radiologists independently analysed images with neutral as a baseline with the effects of flexion and extension reported in line with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. RESULTS Forty (18 males) gymnasts aged 13-24 years with a mean (SD) of 32 (5.3) training hours per week consented with 75% showing MRI abnormalities. Degenerative disc disease (DDD) was evident in 55% participants with vertebral end plate (VEP) changes in 42.5%. Spondylolysis was present in 40% with an additional 17% showing chronic bilateral complete L5 pars defects. 23% participants demonstrated different MRI findings in upright flexion compared to neutral. CONCLUSION Findings suggest a high levels of MRI abnormalities in elite gymnastics including altered disc morphology and posterior element abnormalities. High prevalence of T11/12 DDD and VEP changes reflects the thoracolumbar junction being a transition zone. Upright MRI and varying spine position offer promise for enhanced visualisation of posterior element abnormalities.
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Yokoe T, Tajima T, Sugimura H, Kubo S, Nozaki S, Yamaguchi N, Morita Y, Chosa E. Predictors of Spondylolysis on Magnetic Resonance Imaging in Adolescent Athletes With Low Back Pain. Orthop J Sports Med 2021; 9:2325967121995466. [PMID: 33889645 PMCID: PMC8040580 DOI: 10.1177/2325967121995466] [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: 10/10/2020] [Accepted: 12/14/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Spondylolysis and undiagnosed mechanical low back pain (UMLBP) are the main causes of low back pain (LBP) in adolescent athletes. No studies have evaluated the difference in clinical and radiographic factors between these 2 conditions. Furthermore, it remains unclear which adolescent athletes with LBP should undergo advanced imaging examination for spondylolysis. Purpose: To compare the clinical and radiographic factors of adolescent athletes with spondylolysis and UMLBP who did not have neurological symptoms or findings before magnetic resonance imaging (MRI) evaluation and to determine the predictors of spondylolysis findings on MRI. Study Design: Cohort study, Level of evidence, 3. Methods: The study population included 122 adolescent athletes aged 11 to 18 years who had LBP without neurological symptoms or findings and who underwent MRI. Of these participants, 75 were ultimately diagnosed with spondylolysis, and 47 were diagnosed with UMLBP. Clinical factors and the following radiographic parameters were compared between the 2 groups: spina bifida occulta, lumbar lordosis (LL) angle, and the ratio of the interfacet distance of L1 to that of L5 (L1:L5 ratio, %). A logistic regression analysis was performed to evaluate independent predictors of spondylolysis on MRI scans. Results: Significantly more athletes with spondylolysis were male (82.7% vs 48.9%; P < .001), had a greater LL angle (22.8° ± 8.1° vs 19.3° ± 8.5°; P = .02), and had a higher L1:L5 ratio (67.4% ± 6.3% vs 63.4% ± 6.6%; P = .001) versus athletes with UMLBP. A multivariate analysis revealed that male sex (odds ratio [OR], 4.66; P < .001) and an L1:L5 ratio of >65% (OR, 3.48; P = .003) were independent predictors of positive findings of spondylolysis on MRI scans. Conclusion: The study findings indicated that sex and the L1:L5 ratio are important indicators for whether to perform MRI as an advanced imaging examination for adolescent athletes with LBP who have no neurological symptoms and findings.
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Affiliation(s)
- Takuji Yokoe
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
- Takuji Yokoe, MD, Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan ()
| | - Takuya Tajima
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
| | - Hiroshi Sugimura
- Department of Radiology, Nozaki Higashi Hospital, Murasumi, Miyazaki, Japan
| | - Shinichirou Kubo
- Department of Orthopaedic Surgery, Nozaki Higashi Hospital, Murasumi, Miyazaki, Japan
| | - Shotarou Nozaki
- Department of Orthopaedic Surgery, Nozaki Higashi Hospital, Murasumi, Miyazaki, Japan
| | - Nami Yamaguchi
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
| | - Yudai Morita
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
| | - Etsuo Chosa
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
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Yokoe T, Tajima T, Yamaguchi N, Nagasawa M, Ota T, Morita Y, Chosa E. Orthopaedic medical examination for young amateur athletes: a repeated cross-sectional study from 2014 to 2018. BMJ Open 2021; 11:e042188. [PMID: 33436469 PMCID: PMC7805366 DOI: 10.1136/bmjopen-2020-042188] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Medical examinations for adult elite athletes are performed all over the world, however, no studies in the relevant English literature have reported on orthopaedic medical examinations for young amateur athletes. The purpose of this study was to report the results of orthopaedic medical examinations of the spine and lower extremities in young amateur athletes. METHODS This repeated cross-sectional study from 2014 to 2018 included a total of 323 young amateur athletes (age, 12-18 years) who were active in one of the following four sports: boxing, canoeing, weightlifting and track and field. The orthopaedic medical examination consisted of six assessments (physical examinations, the generalised joint laxity, muscle and joint tightness, static alignment and muscle volume of the lower extremities and the medial longitudinal arch of the foot). Questions regarding pain in the spine and lower extremities were also performed. RESULTS Among 323 young amateur athletes, 17 (5.3%) had received orthopaedic treatment at the time of the medical examination, with spondylolysis being the most common cause (29.4%, 5/17). Among 306 young athletes who had not received orthopaedic treatment, 61 (19.9%) had at least one positive finding in physical examinations or had pain in the spine or lower extremities. Anterior drawer test of the ankle and Kemp test for the spine accounted for 34% and 28% of positive findings, respectively. Low back pain and knee pain accounted for 58% and 16% of pain, respectively. CONCLUSIONS The present study showed that approximately one-fifth of young amateur athletes who had not received orthopaedic treatment had pain in the spine and lower extremities and positive findings in physical examinations that may require orthopaedic treatments. In addition to the early detection of injuries, orthopaedic medical examinations for young amateur athletes provide an opportunity to educate such athletes.
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Affiliation(s)
- Takuji Yokoe
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Takuya Tajima
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Nami Yamaguchi
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Makoto Nagasawa
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Tomomi Ota
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yudai Morita
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Etsuo Chosa
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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Connolly M, Rotstein AH, Roebert J, Grabinski R, Malara F, O'Shea T, Wood T, Omizzolo M, Kovalchik S, Reid M. Lumbar spine abnormalities and facet joint angles in asymptomatic elite junior tennis players. SPORTS MEDICINE-OPEN 2020; 6:57. [PMID: 33237502 PMCID: PMC7688834 DOI: 10.1186/s40798-020-00285-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Lumbar spine abnormalities, in particular stress fractures to the pars interarticularis, are common in elite junior tennis players, though the difference in prevalence between males and females remains unclear. Further, facet joint orientation appears to be a possible option for recognizing which players might go on to present with a pars stress fracture. Given the link between pars stress fractures and low back pain in tennis players, it appears logical to explore the link between facet joint angle and pars abnormalities. Thus, the purpose of this study was to describe the prevalence of lumbar spine abnormalities and explore the relationship between facet joint orientation and pars abnormalities in elite adolescent tennis players. METHODOLOGY Lumbar spine MRI images of 25 elite junior tennis players were obtained and distributed between five radiologists for analysis. Descriptive comparisons and confidence intervals were used to describe the prevalence of the abnormalities. A generalized linear regression model was conducted to investigate the relationship between lumbar pars abnormalities and lumbar facet joint angles. RESULTS Sixteen (64%) of 25 players were found to have at least one lumbar spine abnormality. Pars abnormalities affected 36% of players while bone marrow edema was found in 24% of players. Disc herniation, disc degeneration, and facet joint degeneration were diagnosed in 20%, 44%, and 24% of players respectively. Lastly, one player (4%) was diagnosed with spondylolisthesis. Females had significantly larger facet joint angles across L3/4 L5/S1 compared to males (p < 0.01). Further, those who had pars abnormalities had larger facet joint angles compared to those who did not (p < 0.001). CONCLUSION Disc degeneration, pars abnormalities, including bone marrow edema, and facet joint degeneration were common findings among elite adolescent tennis players. Additionally, this study is the first to discover that pars abnormalities are linked to facet joint angle in elite adolescent tennis players. This finding might assist in identifying tennis players at a greater risk of developing lumbar spine pars abnormalities in the future.
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Affiliation(s)
- Molly Connolly
- Institute for Health and Sport, Victoria University, Melbourne, Australia. .,Performance, Tennis Australia, Melbourne, Australia.
| | - Andrew H Rotstein
- Victoria House Medical Imaging, 435 Malvern Rd, South Yarra, Melbourne, Australia
| | - Justin Roebert
- Victoria House Medical Imaging, 435 Malvern Rd, South Yarra, Melbourne, Australia
| | - Rafal Grabinski
- Victoria House Medical Imaging, 435 Malvern Rd, South Yarra, Melbourne, Australia
| | - Frank Malara
- Victoria House Medical Imaging, 435 Malvern Rd, South Yarra, Melbourne, Australia
| | - Tomas O'Shea
- Victoria House Medical Imaging, 435 Malvern Rd, South Yarra, Melbourne, Australia
| | - Tim Wood
- Glenferrie Private Hospital, Melbourne, Australia
| | | | - Stephanie Kovalchik
- Institute for Health and Sport, Victoria University, Melbourne, Australia.,Game Insight Group, Tennis Australia, Melbourne, Australia
| | - Machar Reid
- Game Insight Group, Tennis Australia, Melbourne, Australia
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LOW BACK PAIN AND INJURY IN BALLET, MODERN, AND HIP-HOP DANCERS: A SYSTEMATIC REVIEW. Int J Sports Phys Ther 2020; 15:671-687. [PMID: 33110686 DOI: 10.26603/ijspt20200671] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Low back pain is believed to be a common complaint among dancers; however, a comparison across recent research is needed to support or disprove this assertion across genres. Purpose To determine the prevalence of low back pain and low back injury in ballet, modern, and hip-hop dancers through a systematic literature review. A secondary goal was to identify trends amongst dance genres, level of mastery, gender, and age, if possible. Study Design Systematic Review of the Literature. Methods PRISMA search strategy of terms relating to dance and low back pain was conducted within the Pubmed, MEDLINE, SPORTDiscus, Web of Science, and the archives of the Journal of Dance Medicine and Science databases between November 2017 and March 2018. Inclusion criteria were published articles that addressed low back pain or injury in ballet, modern, or hip-hop dance population. Exclusion criteria included studies relating to specific pathologies or studies that did not report specific dance genre. All included articles were assessed for quality using a modified grading evaluation and a Modified Newcastle-Ottawa Risk of Bias assessment. Results Twenty-five ballet articles, five modern, and three hip-hop articles met the inclusion criteria, for a total of 33 articles. Twenty-five of the 33 studies relied on a questionnaire to gather data. Risk of bias results ranged from 3-7/10 and quality of studies ranged from Good I to Limited III. Prevalence of low back pain seems relatively high in ballet dance (range: 20.3%-79% of total dancers are affected). Little research exists on the prevalence of back pain in modern or hip-hop dancers, but hip-hop dancers also seem likely to have low back pain (range: 46.6%-85.7% of total dancers are affected). Low back injuries are also present in ballet (range: 2.1%-88% of total injuries), modern (range: 8.6%-21.6% of total injuries), and hip-hop (range: 26.3%-69.6%). Conclusion Ballet dancers seem to be at risk for low back pain or injury independent of gender, age or level of mastery; however, there is not enough evidence to draw any conclusions about modern dancers or hip-hop dancers and their risk for low back pain/injury currently. Future higher-level studies are needed with reduced risk of bias. Level of Evidence 2a.
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11
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The Prevalence of Abnormalities in the Pediatric Spine on MRI: A Systematic Review and Meta-Analysis. Spine (Phila Pa 1976) 2020; 45:E1185-E1196. [PMID: 32355138 DOI: 10.1097/brs.0000000000003527] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Systematic review and meta-analysis. OBJECTIVE The aim of this study was to provide an overview of the prevalence of reported musculoskeletal abnormalities on magnetic resonance imaging (MRI) of the pediatric spine. SUMMARY OF BACKGROUND DATA Back pain is a common complaint and significant health issue, already in children. Several studies have investigated musculoskeletal abnormalities of the pediatric spine as possible cause of low back pain (LBP). However, it is not clear which abnormalities are the most prevalent among children. METHODS A systematic literature search on the prevalence of musculoskeletal spinal abnormalities on MRI in children was conducted in the Embase, Medline Ovid, and Cochrane CENTRAL databases. Risk of bias (RoB) was assessed using a checklist based on the Downs and Black checklist. General information on study and patient characteristics and the prevalence of spinal abnormalities were extracted from the studies. Prevalence data were presented in three subgroups: nonathletes without LBP, participants with LBP, and athletes. Prevalence data of the most reported abnormalities were pooled using random-effects proportion meta-analysis. The study protocol was prospectively registered in PROSPERO (CRD42017080543). RESULTS The search resulted in 16,783 articles, of which 31 articles (2373 participants) were included in this systematic review. Two-thirds of the studies had a low RoB. The pooled prevalence in nonathletes without LBP, participants with LBP, and athletes without LBP was respectively 22%, 44%, and 22% for disc degeneration, 1%, 38%, and 13% for herniated discs, 5%, 22%, and 11% for endplate changes, and 0%, 30%, and 6% for pars fractures. CONCLUSION Disc degeneration, herniated discs, endplate changes, and spondylolysis are the most reported spinal abnormalities on MRI in children in literature. Spinal abnormalities seen in adults are already prevalent in children with LBP, with the highest prevalence for disc degeneration and herniated discs. LEVEL OF EVIDENCE 2.
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Yokoe T, Tajima T, Sugimura H, Kubo S, Nozaki S, Yamaguchi N, Morita Y, Chosa E. Comparison of symptomatic spondylolysis in young soccer and baseball players. J Orthop Surg Res 2020; 15:378. [PMID: 32883336 PMCID: PMC7469272 DOI: 10.1186/s13018-020-01910-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Spondylolysis is the main cause of low back pain (LBP) in young athletes. There are few studies analyzing the difference of spondylolysis among young athletes with different sports activities. The purpose of this study was to compare the clinical factors and distribution of the lesions of spondylolysis on magnetic resonance imaging (MRI) scans in young soccer and baseball players with symptomatic spondylolysis. METHODS The medical records of 267 young athletes aged 7 to 18 years old who underwent MRI to evaluate the cause of LBP between 2017 and 2020 were retrospectively reviewed to identify patients with spondylolysis. Of the young athletes with symptomatic spondylolysis, clinical factors and MRI findings in soccer and baseball players were retrospectively evaluated. The clinical factors were age, sex, interval from onset of LBP to MRI, and side of the dominant leg in the sports field. MRI findings included number, lumbar level, and side of the lesions. RESULTS A total of 33 soccer players (mean age, 15.4 ± 1.4 years) and 49 baseball players (mean age, 15.4 ± 1.6 years) with symptomatic spondylolysis were enrolled. All patients were male. No significant differences were noted in age and the interval from onset of LBP to MRI between the groups. Soccer players had greater numbers of multiple (p < 0.001) and bilateral (p < 0.001) lesions than baseball players. The dominant side of the hand for pitching or batting was correlated with the contralateral-side lesions in baseball players (p = 0.001). CONCLUSIONS The distribution of the lesions of spondylolysis differed in young soccer and baseball players. Pitching or batting with the dominant-side hand would be associated with contralateral-side lesions in baseball players. Sports-specific movements and the side of the dominant leg should be considered when treating young athletes with symptomatic spondylolysis.
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Affiliation(s)
- Takuji Yokoe
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Takuya Tajima
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Hiroshi Sugimura
- Department of Radiology, Nozaki Higashi Hospital, 2105 Kouso, Murasumi, Miyazaki, 880-0837, Japan
| | - Shinichirou Kubo
- Department of Orthopaedic Surgery, Nozaki Higashi Hospital, 2105 Kouso, Murasumi, Miyazaki, 880-0837, Japan
| | - Shotarou Nozaki
- Department of Orthopaedic Surgery, Nozaki Higashi Hospital, 2105 Kouso, Murasumi, Miyazaki, 880-0837, Japan
| | - Nami Yamaguchi
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yudai Morita
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Etsuo Chosa
- Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
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Perceptions of low back pain in elite gymnastics: A multi-disciplinary qualitative focus group study. Phys Ther Sport 2020; 44:33-40. [PMID: 32375075 DOI: 10.1016/j.ptsp.2020.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To explore the multidisciplinary team experience of Low Back Pain (LBP) in elite gymnastics. DESIGN A qualitative focus group. SETTING British Gymnastics. PARTICIPANTS Ten coaching, sports science and medicine multidisciplinary team members working with British gymnasts. MAIN OUTCOME MEASURES A topic guide informed by literature/expert opinion enabled discussion that was recorded/transcribed verbatim. Initial inductive analytic process developed theoretical insights. Manual coding using constant comparative methods categorised meaningful themes and sub-themes. RESULTS Two key aspects were identified. Emerging themes for LBP presentation included: early identification LBP and influence of multidisciplinary team members on outcomes; factors influencing LBP reporting e.g. coach-athlete relationship; frequent presentations of LBP and accepted norms; athlete history and physical examination e.g. training load. Emerging themes for causation of LBP included: intrinsic risk factors e.g. growth and maturation; extrinsic risk factors e.g. equipment. CONCLUSIONS Individual responses of a gymnast to experiencing LBP were important across all themes. Some LBP was perceived as normal. The coach-athlete relationship and support team are crucial decision-makers around training load and adaptation. Early detection will help minimise time loss from training/performance to expedite healing.
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Abdalkader M, Guermazi A, Engebretsen L, Roemer FW, Jarraya M, Hayashi D, Crema MD, Mian AZ. MRI-detected spinal disc degenerative changes in athletes participating in the Rio de Janeiro 2016 Summer Olympics games. BMC Musculoskelet Disord 2020; 21:45. [PMID: 31959161 PMCID: PMC6972034 DOI: 10.1186/s12891-020-3057-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/09/2020] [Indexed: 12/22/2022] Open
Abstract
Objective To describe the frequency and the distribution of degenerative disc disease (DDD) detected in athletes who underwent spine MRI in the 2016 Summer Olympic Games in Rio de Janeiro. Methods Data on spine MRI examinations from the 2016 Summer Olympics were retrospectively analyzed. We assessed the frequency of DDD of the cervical (Cs), thoracic (Ts), and lumbar (Ls) spine using Pfirrmann’s classification. Grade II and III were considered as mild, grade IV as moderate, and grade V as severe disc degeneration. Data were analyzed according to the location of the degenerative disc, type of sport, age-groups, and gender of the athletes. Results One hundred out of 11,274 athletes underwent 108 spine MRI’s (21 C, 6 T, and 81 L) (53% Females (F), 47% Males (M)). The frequency of DDD was 40% (42% F, 58% M) over the entire spine (28% mild, 9% moderate and 3% severe). There were 58% (12%F, 88%M) of the cervical spine discs that showed some degree of degeneration (44% mild, 13.5% moderate and 1% severe). Athletics, Boxing, and Swimming were the sports most affected by DDD in the Cs. There were 12.5% of the thoracic discs that showed some degree of degeneration, all were mild DDD and were exclusively seen in female athletes. There were 39% (53% F, 47% M) of the lumbar discs with DDD (26% mild, 9% moderate, and 4% severe). Conclusion Athletes who underwent spine MRI during the 2016 Summer Olympic Games show a high frequency of DDD of cervical and lumbar spines. Recognition of these conditions is important to develop training techniques that may minimize the development of degenerative pathology of the spine.
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Affiliation(s)
- Mohamad Abdalkader
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA.
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland.,Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Orthopedic Surgery, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA.,Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mohamed Jarraya
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA.,Department of Radiology, Brigham and Woman Hospital, Boston, MA, USA
| | - Daichi Hayashi
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA.,Department of Radiology, Stony Brook Medicine, Stony Brook, NY, USA
| | - Michel D Crema
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA.,Institute of Sports Imaging, French National Institute of Sports (INSEP), Paris, France
| | - Asim Z Mian
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA
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Abstract
OBJECTIVE To determine the relationship between low back pain (LBP), flexibility, and individual demographic characteristics in competitive adolescent female gymnasts. DESIGN Cross-sectional observational study. SETTING Gymnastics facilities in Colorado. PARTICIPANTS Six- to 18-year-old gymnasts who participate in the USA Gymnastics Women's Artistic Junior Olympic Program levels 3 to 10. INDEPENDENT VARIABLES Demographic data included height, weight, menstrual status, gymnastics level, and participation hours per week. Flexibility measurements were obtained on the gymnasts. Gymnasts also completed a questionnaire documenting LBP in the past 12 months. Univariable (t test and χ) analyses were used to assess between-group differences; multivariable logistic regression model was used to assess the association between LBP, flexibility, and demographics/injury history. MAIN OUTCOME MEASURES Low back pain within the past 12 months. RESULTS Thirty (45%) of 67 gymnasts reported LBP within the past year. Those who reported LBP were older (11.7 vs 13.7 years, P = 0.005), heavier (37.5 vs 43.4 kg, P = 0.049), and participated in gymnastics more often (19.1 vs 22.4 h/wk, P = 0.017). A greater proportion of gymnasts with LBP had experienced menarche compared with those without LBP (47% vs 16%; P = 0.008). On multivariable analysis, gymnasts with LBP were less likely to have left Iliotibial (IT) band tightness compared with those without LBP [adjusted odds ratio (aOR) = 0.186; 95% confidence interval (CI), 0.04-0.82] and more likely to have experienced menarche (aOR = 8.0; 95% CI, 1.2-50.9). CONCLUSIONS Low back pain is more common in gymnasts who experienced menarche, whereas limited joint flexibility does not seem to be associated with LBP in this population.
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Low back pain in female adolescent gymnasts and functional pain scales. Phys Ther Sport 2019; 38:66-70. [DOI: 10.1016/j.ptsp.2019.04.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/18/2022]
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Abstract
OBJECTIVES To identify factors associated with low back pain (LBP) in children and adolescents. MATERIALS AND METHODS A systematic review was conducted (Prospero CRD42016038186). Observational studies analyzing LBP risk factors among participants aged between 9 and 16 were searched for in 13 electronic databases and 8 specialized journals until March 31, 2016, with no language restrictions. In addition, references in the identified studies were manually tracked. All identified studies that included ≥50 participants aged 9 to 16, were reviewed. Their methodological quality was assessed by 2 reviewers separately, using validated tools, which scored, from worst to best, 0 to 100 for cross-sectional and 0 to 12 for cohort studies. A sensitivity analysis only included studies that had adjusted for confounders, had ≥500 participants, and had a methodological score of ≥50%. RESULTS A total of 5142 citations were screened and 61 studies, including 137,877 participants from 5 continents, were reviewed. Their mean (range) methodological scores were 74.56 (50 to 100) for cross-sectional studies and 7.36 (5 to 9) for cohort studies. The studies had assessed 35 demographic, clinical, biological, family, psychological, ergonomic, and lifestyle risk factors. The mean (range) prevalence of LBP ranged between 15.25% (3.20 to 57.00) for point prevalence and 38.98% (11.60 to 85.56) for lifetime prevalence. Results on the association between LBP and risk factors were inconsistent. In the sensitivity analysis, "older age" and "participation in competitive sports" showed a consistent association with LBP. DISCUSSION Future studies should focus on muscle characteristics, the relationship between body and backpack weights, duration of carrying the backpack, characteristics of sport practice, and which are the factors associated with specifically chronic pain.
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Fatty Infiltrate of the Lumbar Multifidus Muscles Predicts Return to Play in Young Athletes With Extension-Based Low Back Pain. Clin J Sport Med 2019; 29:37-42. [PMID: 28817410 DOI: 10.1097/jsm.0000000000000483] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the predictive value of fatty infiltrate of the lumbar multifidus muscles (LMM) for return to play in young athletes with extension-based low back pain (EB LBP). DESIGN Retrospective cohort study. SETTING Hospital-based sports medicine practice. PATIENTS Sixty-two athletes, 61.3% female, and 38.7% male, mean age 14.8 years, with a primary complaint of EB LBP who underwent magnetic resonance imaging (MRI); 46.8% had a pars interarticularis stress reaction or fracture and 53.2% were MRI negative. INTERVENTIONS A musculoskeletal fellowship-trained radiologist reviewed MRI for all subjects and graded the degree of fatty infiltrate of the LMM, using the Goutallier classification system (GCS), at the L4/L5 and L5/S1 levels. MAIN OUTCOME MEASURE Days to return to play after first MD visit were correlated with the amount of fatty infiltrate in the LMM measured on MRI for each subject. RESULTS When the level of fatty infiltrate increased to a 2 or 3 on the GCS (greater than fatty streaks in the muscle), the predicted probability of return to sport decreased significantly. CONCLUSION Our study demonstrated that athletes with EB LBP and fatty infiltrate in the LMM had lower odds of return to sport compared with athletes with normal muscle. LEVEL OF EVIDENCE II B. CLINICAL RELEVANCE This study provides sports medicine clinicians with a prognostic tool to help manage young athletes with EB LBP. Clinicians can make decisions regarding rehabilitation and return to play based on MRI findings.
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Yamashita K, Sugiura K, Manabe H, Ishihama Y, Tezuka F, Takata Y, Sakai T, Maeda T, Sairyo K. Accurate diagnosis of low back pain in adult elite athletes. THE JOURNAL OF MEDICAL INVESTIGATION 2019; 66:252-257. [DOI: 10.2152/jmi.66.252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Kazuta Yamashita
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Kosuke Sugiura
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Hiroaki Manabe
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Yoshihiro Ishihama
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Fumitake Tezuka
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Yoichiro Takata
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Toshinori Sakai
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Toru Maeda
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Koichi Sairyo
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
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20
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Gaddikeri S, Matesan M, Alvarez J, Hippe DS, Vesselle HJ. MDP-SPECT Versus Hybrid MDP-SPECT/CT in the Evaluation of Suspected Pars Interarticularis Fracture in Young Athletes. J Neuroimaging 2018; 28:635-639. [DOI: 10.1111/jon.12533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/01/2018] [Accepted: 06/02/2018] [Indexed: 12/01/2022] Open
Affiliation(s)
| | - Manuela Matesan
- Department of Radiology and Nuclear Medicine; University of Washington; Seattle WA
| | - Jacqueline Alvarez
- Department of Radiology; University of Washington Medical Center; Seattle WA
| | - Daniel S. Hippe
- Department of Radiology; University of Washington; Seattle WA
| | - Hubert J. Vesselle
- Department of Radiology and Nuclear Medicine; University of Washington Medical Center; Seattle WA
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Todd C, Aminoff AS, Agnvall C, Thoreson O, Swärd L, Karlsson J, Baranto A. No difference in prevalence of spine and hip pain in young Elite skiers. Knee Surg Sports Traumatol Arthrosc 2018; 26:1959-1965. [PMID: 29204863 PMCID: PMC6061433 DOI: 10.1007/s00167-017-4733-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 09/25/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate the prevalence between back and hip pain in young Elite skiers. METHODS Sample group (n = 102), consisted of young Elite skiers (n = 75) and age-matched non-athletes (n = 27), all completed a three-part back and hip pain questionnaire, Oswestry Disability Index and EuroQoL to evaluate general health, activity level, back and hip pain prevalence. RESULTS No significant differences were shown for lifetime prevalence of back pain in the skiers (50%) compared with controls (44%) (n.s.). Duration of back pain for the skiers showed (30%) > 1 year, whilst (46%) > 5 years. A significant difference was shown with increased Visual Analogue Scale back pain levels for skiers 5.3 (SD 3.1) compared with controls 2.4 (SD 1.9, p = 0.025). No significant differences were shown for lifetime prevalence of hip pain in skiers (21%) compared with controls (8%) (n.s.). CONCLUSION Young Elite skiers are shown not to have increased lifetime prevalence for back and hip pain compared with a non-athletic control group. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Carl Todd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden.
- The Carl Todd Clinic, 5 Pickwick Park, Park Lane, Corsham, SN13 0HN, UK.
| | - Anna Swärd Aminoff
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden
| | - Cecilia Agnvall
- Sportsmedicine Åre and Åre Ski High School, Göthenburg, Sweden
| | - Olof Thoreson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden
| | - Leif Swärd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden
| | - Jon Karlsson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden
| | - Adad Baranto
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden
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Rossi MK, Pasanen K, Heinonen A, Myklebust G, Kannus P, Kujala UM, Tokola K, Parkkari J. Incidence and risk factors for back pain in young floorball and basketball players: A Prospective study. Scand J Med Sci Sports 2018; 28:2407-2415. [DOI: 10.1111/sms.13237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 12/31/2022]
Affiliation(s)
- M. K. Rossi
- Tampere Research Center of Sports Medicine; Tampere Finland
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - K. Pasanen
- Tampere Research Center of Sports Medicine; Tampere Finland
- UKK Institute for Health Promotion Research; Tampere Finland
- Faculty of Kinesiology; Sport Injury Prevention Research Centre; University of Calgary; Calgary Canada
| | - A. Heinonen
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - G. Myklebust
- Department of Sports Sciences; Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - P. Kannus
- Injury and Osteoporosis Research Center; UKK Institute; Tampere Finland
| | - U. M. Kujala
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - K. Tokola
- Tampere Research Center of Sports Medicine; Tampere Finland
| | - J. Parkkari
- Tampere Research Center of Sports Medicine; Tampere Finland
- UKK Institute for Health Promotion Research; Tampere Finland
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Scheuer R. Wirbelsäule und Sport. MANUELLE MEDIZIN 2018. [DOI: 10.1007/s00337-017-0352-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Winslow JJ, Jackson M, Getzin A, Costello M. Rehabilitation of a Young Athlete With Extension-Based Low Back Pain Addressing Motor-Control Impairments and Central Sensitization. J Athl Train 2018; 53:168-173. [PMID: 29350556 DOI: 10.4085/1062-6050-238-16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To describe the conservative management of a young athlete with extension-based (EB) low back pain (LBP). BACKGROUND We present the case of a 15-year-old female high school gymnast with a 4-year history of EB LBP. Magnetic resonance imaging revealed a healed spondylolysis and significant atrophy with fatty infiltrate of the lumbar multifidi muscles (LMM). She had several courses of outpatient orthopaedic rehabilitation that focused on core muscle strengthening (improving activation and strength of the LMM and transversus abdominus muscle in a neutral pelvic position) without long-lasting improvement. She was unable to tolerate higher levels of training or compete. DIFFERENTIAL DIAGNOSIS The LMM are rich in muscle spindles and provide continuous feedback to the central nervous system about body position. Atrophy and fatty infiltrate of the LMM can compromise neuromuscular function and contribute to dysfunctional movement patterns that place a greater demand on lumbar spine structures. Ongoing motor-control impairments perpetuate nociceptive input, leading to central sensitization. TREATMENT The athlete had difficulty controlling trunk extension during sport-specific activities; she moved early and to a greater extent in the lumbar spine. The aim of the treatment was to teach the athlete how to control her tendency to overload her lumbar spine when bending backward, thus reducing nociceptive input from lumbar spine structures and desensitizing the nervous system. UNIQUENESS Treating EB LBP by addressing motor-control impairments and cognitive-affective factors as opposed to core strengthening. CONCLUSIONS Activity modification, bracing, and traditional core-strengthening exercises may not be the most appropriate treatment for athletes experiencing EB LBP. Addressing cognitive-affective factors in addition to correcting maladaptive motor behavior and moving in a pain-free range reduces nociceptive input, desensitizes the nervous system, and allows athletes to gain control over their pain.
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Witwit WA, Kovac P, Sward A, Agnvall C, Todd C, Thoreson O, Hebelka H, Baranto A. Disc degeneration on MRI is more prevalent in young elite skiers compared to controls. Knee Surg Sports Traumatol Arthrosc 2018; 26:325-332. [PMID: 28409199 PMCID: PMC5754419 DOI: 10.1007/s00167-017-4545-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 04/07/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE Evidence-based facts regarding spine abnormalities and back pain are needed in order to develop rehabilitation programs and prevent spine injuries in young skiers. The aim therefore is to identify MRI changes in the thoraco-lumbar spine and the lifetime prevalence of back pain, as well as the association between them, in young skiers compared to non-athletes. METHODS Seventy-five young elite alpine and mogul skiers, age range 16-20 years, were compared with 27 non-athletic controls. All subjects underwent spinal MRI and answered back pain questionnaires. RESULTS Fifty-six percent of skiers had at least one disc Pfirrmann grade ≥3 compared to 30% of controls (p = 0.027). Schmorl's nodes (46%) and disc height reduction (37%) were significantly more prevalent in skiers compared to controls (0%) (p < 0.001). When all parameters were combined together, skiers had significantly higher rate of radiological changes than controls, 82% compared to 54% (p = 0.007). The mean number of discs with Pfirrmann grade ≥3 was 1.1 per individual in skiers (median 1, range 0-6) versus 0.6 in controls (median 0, range 0-3). There was no significant difference in lifetime prevalence of back pain between skiers (50%) and controls (44%) (n.s.). MRI abnormalities in skiers did not correlate with lifetime prevalence of back pain. Skiers had a better health perception than controls (p = 0.026). CONCLUSION Alpine skiers have more degenerative disc changes compared to non-athletes, but these changes do not correlate with the lifetime prevalence of back pain. Lifetime prevalence of back pain is not significantly different between the groups; however, skiers report more severe pain on VAS score. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Wisam A. Witwit
- Department of Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Peter Kovac
- Department of Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Anna Sward
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Cecilia Agnvall
- Sportsmedicine Åre and Åre Ski High School, Ostersund, Sweden
| | - Carl Todd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Olof Thoreson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanna Hebelka
- Department of Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Adad Baranto
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
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Kędra A, Kolwicz-Gańko A, Kędra P, Bochenek A, Czaprowski D. Back pain in physically inactive students compared to physical education students with a high and average level of physical activity studying in Poland. BMC Musculoskelet Disord 2017; 18:501. [PMID: 29183373 PMCID: PMC5706389 DOI: 10.1186/s12891-017-1858-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 11/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the study was (1) to characterise back pain in physically inactive students as well as in trained (with a high level of physical activity) and untrained (with an average level of physical activity) physical education (PE) students and (2) to find out whether there exist differences regarding the declared incidence of back pain (within the last 12 months) between physically inactive students and PE students as well as between trained (with a high level of physical activity) and untrained (with an average level of physical activity) PE students. METHODS The study included 1321 1st-, 2nd- and 3rd-year students (full-time bachelor degree course) of Physical Education, Physiotherapy, Pedagogy as well as Tourism and Recreation from 4 universities in Poland. A questionnaire prepared by the authors was applied as a research tool. The 10-point Visual Analogue Scale (VAS) was used to assess pain intensity. Prior to the study, the reliability of the questionnaire was assessed by conducting it on the group of 20 participants twice with a shorter interval. No significant differences between the results obtained in the two surveys were revealed (p < 0.05). RESULTS In the group of 1311 study participants, 927 (70.7%) respondents declared having experienced back pain within the last 12 months. Physically inactive students declared back pain frequency similar to the frequency declared by their counterparts studying physical education (p > 0.05). Back pain was more common in the group of trained students than among untrained individuals (p < 0.05). Back pain was mainly located in the lumbar spine. CONCLUSIONS A frequent occurrence of back pain (70.7%) was noted in the examined groups of students. The percentage of students declaring back pain increased in the course of studies (p < 0.05) and, according to the students' declarations, it was located mainly in the lumbar spine. No significant differences regarding the incidence of back pain were found between physically inactive students and physical education students (p > 0.05). The trained students declared back pain more often than their untrained counterparts (p < 0.05).
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Affiliation(s)
- Agnieszka Kędra
- Jozef Pilsudski University of Physical Education in Warsaw, Faculty of Physical Education and Sport, ul. Akademicka 2, 21-500, Biala Podlaska, Poland.
| | - Aleksandra Kolwicz-Gańko
- Jozef Rusiecki University College in Olsztyn, Faculty of Physiotherapy, ul. Bydgoska 33, 10-243, Olsztyn, Poland
| | - Przemysław Kędra
- Jozef Pilsudski University of Physical Education in Warsaw, Faculty of Tourism and Sport, ul. Akademicka 2, 21-500, Biala Podlaska, Poland
| | - Anna Bochenek
- Jozef Pilsudski University of Physical Education in Warsaw, Faculty of Physical Education and Sport, ul. Akademicka 2, 21-500, Biala Podlaska, Poland
| | - Dariusz Czaprowski
- Jozef Rusiecki University College in Olsztyn, Faculty of Physiotherapy, ul. Bydgoska 33, 10-243, Olsztyn, Poland
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Prevalence and Risk Factors for Low Back Pain in 1,355 Young Adults: A Cross-Sectional Study. Asian Spine J 2017; 11:610-617. [PMID: 28874980 PMCID: PMC5573856 DOI: 10.4184/asj.2017.11.4.610] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 12/18/2016] [Accepted: 01/10/2017] [Indexed: 02/01/2023] Open
Abstract
Study Design Cross-sectional study. Purpose To evaluate the prevalence and various risk factors for low back pain (LBP) in young adults in India. Overview of Literature LBP is an emerging problem in adolescents, with an incidence that is the highest in the third decade of life worldwide. Various risk factors such as obesity, smoking, family history, stress, and exercise have been described in the literature. This study was conducted because of paucity of data in the Indian literature. Methods A total of 1,355 (741 males and 641 females) young Indian Administrative Service aspirants and medical postgraduate aspirants aged 18–35 years were enrolled in the study. The subjects completed a detailed, semi-structured questionnaire that gathered data regarding their sociodemographic profile and factors considered to be risk factors for LBP. Anthropometric measurements, including height and weight, were measured and body mass index was calculated. Results Most subjects (90.6%) were aged 20–29 years (mean, 24.49; range, 18–35 years). Results indicated that the following factors were associated with LBP in young adults: marital status, previous history of spine problems, strenuous exercise, job satisfaction, monotony, stress, daily number of studying hours, and family history of spine problems (p<0.05). However, age, sex, smoking, alcoholism, coffee intake, mode and duration of travel, diet, frequency of weightlifting, wearing heels, studying posture, and frequency and type of sports activities were not associated with LBP. Conclusions The study identified various modifiable and non-modifiable risk factors that precipitated LBP in young adult Indians. Identifying these risk factors at an early stage will prevent LBP progression to a chronic disease state, thereby improving an individual's quality of life and increasing productivity.
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Spörri J, Kröll J, Fasel B, Aminian K, Müller E. The Use of Body Worn Sensors for Detecting the Vibrations Acting on the Lower Back in Alpine Ski Racing. Front Physiol 2017; 8:522. [PMID: 28775695 PMCID: PMC5517454 DOI: 10.3389/fphys.2017.00522] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/06/2017] [Indexed: 01/09/2023] Open
Abstract
This study explored the use of body worn sensors to evaluate the vibrations that act on the human body in alpine ski racing from a general and a back overuse injury prevention perspective. In the course of a biomechanical field experiment, six male European Cup-level athletes each performed two runs on a typical giant slalom (GS) and slalom (SL) course, resulting in a total of 192 analyzed turns. Three-dimensional accelerations were measured by six inertial measurement units placed on the right and left shanks, right and left thighs, sacrum, and sternum. Based on these data, power spectral density (PSD; i.e., the signal's power distribution over frequency) was determined for all segments analyzed. Additionally, as a measure expressing the severity of vibration exposure, root-mean-square (RMS) acceleration acting on the lower back was calculated based on the inertial acceleration along the sacrum's longitudinal axis. In both GS and SL skiing, the PSD values of the vibrations acting at the shank were found to be largest for frequencies below 30 Hz. While being transmitted through the body, these vibrations were successively attenuated by the knee and hip joint. At the lower back (i.e., sacrum sensor), PSD values were especially pronounced for frequencies between 4 and 10 Hz, whereas a corresponding comparison between GS and SL revealed higher PSD values and larger RMS values for GS. Because vibrations in this particular range (i.e., 4 to 10 Hz) include the spine's resonant frequency and are known to increase the risk of structural deteriorations/abnormalities of the spine, they may be considered potential components of mechanisms leading to overuse injuries of the back in alpine ski racing. Accordingly, any measure to control and/or reduce such skiing-related vibrations to a minimum should be recognized and applied. In this connection, wearable sensor technologies might help to better monitor and manage the overall back overuse-relevant vibration exposure of athletes in regular training and or competition settings in the near future.
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Affiliation(s)
- Jörg Spörri
- Department of Sport Science and Kinesiology, University of SalzburgHallein-Rif, Austria.,Department of Orthopedics, Balgrist University Hospital, Zurich, University of ZurichZurich, Switzerland
| | - Josef Kröll
- Department of Sport Science and Kinesiology, University of SalzburgHallein-Rif, Austria
| | - Benedikt Fasel
- Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de LausanneLausanne, Switzerland
| | - Kamiar Aminian
- Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de LausanneLausanne, Switzerland
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of SalzburgHallein-Rif, Austria
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Fett D, Trompeter K, Platen P. Back pain in elite sports: A cross-sectional study on 1114 athletes. PLoS One 2017; 12:e0180130. [PMID: 28662110 PMCID: PMC5491135 DOI: 10.1371/journal.pone.0180130] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 06/10/2017] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To establish the prevalence of back pain in German elite athletes; examine the influence of age, sex, sports discipline and training volume; and compare elite athletes with a physically active control group. METHODS A standardized and validated online back pain questionnaire was sent by the German Olympic Sports Confederation to approximately 4,000 German national and international elite athletes, and a control group of 253 physically active but non-elite sports students. RESULTS We received responses from 1,114 elite athletes (46.5% male and 53.1% female, mean age 20.9 years ± 4.8 years, mean height 176.5 ± 11.5 cm, mean weight 71.0 ± 10.3 kg) and 166 physically active sports students (74.7% male and 24.1 female, mean age 21.2 ± 2.0 years, mean height 180.0 ± 8.0 cm, mean weight 74.0 ± 14.5 kg). In elite athletes, the lifetime prevalence of back pain was 88.5%, the 12-month prevalence was 81.1%, the 3-month prevalence was 68.3% and the point prevalence was 49.0%, compared with 80.7%, 69.9%, 59.0% and 42.8%, respectively in the control group. The lifetime, 12-month and 3-month prevalences in elite athletes were significantly higher than in the control group. Regarding the individual sports disciplines, the prevalence of back pain was significantly higher in elite rowers, dancers, fencers, gymnasts, track and field athletes, figure skaters and marksmen, and those who play underwater rugby, water polo, basketball, hockey and ice hockey compared with the control group. The prevalence of back pain was significantly lower in elite triathletes. CONCLUSIONS Back pain is a common complaint in German elite athletes. Low back pain seems to be a problem in both elite athletes and physically active controls. A high training volume in elite athletes and a low training volume in physically active individuals might increase prevalence rates. Our findings indicate the necessity for specific prevention programs, especially in high-risk sports. Further research should investigate the optimal dose-effect relationship of sporting activity for the general population to prevent back pain.
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Affiliation(s)
- Daniela Fett
- Department of Sports Medicine and Sports Nutrition, Ruhr-University Bochum, Bochum, Germany
- * E-mail: (DF); (KT)
| | - Katharina Trompeter
- Department of Sports Medicine and Sports Nutrition, Ruhr-University Bochum, Bochum, Germany
- * E-mail: (DF); (KT)
| | - Petra Platen
- Department of Sports Medicine and Sports Nutrition, Ruhr-University Bochum, Bochum, Germany
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Thoreson O, Ekström L, Hansson HA, Todd C, Witwit W, Swärd Aminoff A, Jonasson P, Baranto A. The effect of repetitive flexion and extension fatigue loading on the young porcine lumbar spine, a feasibility study of MRI and histological analyses. J Exp Orthop 2017; 4:16. [PMID: 28500483 PMCID: PMC5429315 DOI: 10.1186/s40634-017-0091-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 05/05/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The biomechanical mechanisms of failure of FSUs have been studied but the correlation of repetitive flexion and extension loadings to the initial phase of fatigue in young FSUs are still not known. The purpose of the study was to examine the fatigue results of low magnitude repetitive flexion and extension loading on porcine lumbar Functional Spinal Units (FSUs) with Magnetic Resonance Imaging (MRI) and histology. METHODS Eight FSUs were subject to repetitive pivot flexion and eight to extension loading by a protocol of 20 000 cycles at 1 Hz with a load of 700 N. All loaded FSUs (N = 16) were examined with MRI and histology post loading. Three FSUs were examined with MRI as controls. Further three FSUs were non loaded histology controls. RESULTS Fifteen (94%) of the loaded FSUs have decreased MRI signal in the growth zone of the superior vertebra and 12 (75%) in the inferior vertebrae. Fourteen (88%) FSUs have increased signal in the superior vertebral body. Fourteen (88%) FSUs have a reduced signal in all or any endplate. The histology morphometry displayed that the unstained parts of the epiphyseal growth zone were larger among the loaded FSUs (mean 29% vs 4%) and that the chondrocytes in the endplate and growth zones had abnormal structure and deformed extracellular matrix. CONCLUSION Repetitive loading of young porcine FSUs in both extension and flexion causes concurrent MRI and histological changes in the growth zones and endplates, which could be a first sign of fatigue and an explanation for the disc, apophyseal and growth zone injuries seen among adolescent athletes.
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Affiliation(s)
- Olof Thoreson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Department of Orthopaedics, Sahlgrenska University Hospital/Sahlgrenska, SE-413 45, Gothenburg, Sweden.
| | - Lars Ekström
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hans-Arne Hansson
- Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Todd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,The Carl Todd Clinic, 5 Pickwick Park, Park Lane, Corsham, SN13 0HN, UK
| | - Wisam Witwit
- Department of Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Swärd Aminoff
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Adad Baranto
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Cauci S, Migliozzi F, Trombetta CS, Venuto I, Saccheri P, Travan L, Chiriacò G. Low back pain and FokI (rs2228570) polymorphism of vitamin D receptor in athletes. BMC Sports Sci Med Rehabil 2017; 9:4. [PMID: 28184307 PMCID: PMC5294822 DOI: 10.1186/s13102-017-0069-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 01/23/2017] [Indexed: 12/22/2022]
Abstract
Background Low back pain (LBP) is common in athletes. LBP can be detrimental to athletic performance and health. Factors predisposing to LBP in athletes remain elusive and require further studies. We investigated whether carriage of a specific genotype and/or allele of vitamin D receptor gene (VDR) FokI polymorphism (rs2228570) was a risk factor for LBP in athletes of different sports disciplines. Methods This genotype/phenotype association case-control study included 60 Italian athletes (25 females and 35 males; mean age 33.9 ± 13.3 years; body-mass-index 23.5 ± 3.5 kg/m2) of which 16.7% were swimmers, 11.7% soccer players, 11.7% volleyball players, 10.0% rugby players and other disciplines. VDR-FokI polymorphism was measured by PCR-RFLP in 24 athletes with LBP and 36 athletes without LBP episodes. Absence or presence of the FokI restriction site was denoted “F” and “f”, respectively. Other risk factors were evaluated by a questionnaire. Results The homozygous FF genotype was found in 58.3% (14/24) of athletes with LBP versus 27.8% (10/36) of athletes without LBP, adjusted OR = 5.78, 95% CI 1.41–23.8, P = 0.015. The F allele was a 2-fold risk factor to develop LBP, adjusted OR = 2.55, 95% CI 1.02–6.43, P = 0.046, while f allele was protective. Exposure to vehicle vibrations ≥2 h daily, and family history of lumbar spine pathology were significant risk factors for LBP with OR = 3.54, and OR = 9.21, respectively. Conclusions This is the first study in which an association between VDR-FokI polymorphism and LBP in athletes was found. Further research is needed to extend our results, and to clarify the biochemical pathways associated with how vitamin D modulates LBP in athletes. The VDR-FokI polymorphism should be considered when developing genetic focused studies of precision medicine on health in athletes. Electronic supplementary material The online version of this article (doi:10.1186/s13102-017-0069-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sabina Cauci
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, 33100 Italy.,Clinical Biochemistry and Molecular Biology, Department of Medical and Biological Sciences, Piazzale Kolbe 4, 33100 Udine, Italy
| | - Francesca Migliozzi
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, 33100 Italy.,Department of Medicine, Surgery and Health Sciences, School of Medicine, University of Trieste, Trieste, 34100 Italy
| | - Carlo Simone Trombetta
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, 33100 Italy
| | - Ilaria Venuto
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, 33100 Italy
| | - Paola Saccheri
- Department of Experimental and Clinical Medical Sciences, School of Medicine, University of Udine, Udine, 33100 Italy
| | - Luciana Travan
- Department of Experimental and Clinical Medical Sciences, School of Medicine, University of Udine, Udine, 33100 Italy
| | - Giovanni Chiriacò
- Department of Medicine, Surgery and Health Sciences, School of Medicine, University of Trieste, Trieste, 34100 Italy
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Mueller S, Mueller J, Stoll J, Prieske O, Cassel M, Mayer F. Incidence of back pain in adolescent athletes: a prospective study. BMC Sports Sci Med Rehabil 2016; 8:38. [PMID: 27980790 PMCID: PMC5142377 DOI: 10.1186/s13102-016-0064-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/30/2016] [Indexed: 11/10/2022]
Abstract
Background Recently, the incidence rate of back pain (BP) in adolescents has been reported at 21%. However, the development of BP in adolescent athletes is unclear. Hence, the purpose of this study was to examine the incidence of BP in young elite athletes in relation to gender and type of sport practiced. Methods Subjective BP was assessed in 321 elite adolescent athletes (m/f 57%/43%; 13.2 ± 1.4 years; 163.4 ± 11.4 cm; 52.6 ± 12.6 kg; 5.0 ± 2.6 training yrs; 7.6 ± 5.3 training h/week). Initially, all athletes were free of pain. The main outcome criterion was the incidence of back pain [%] analyzed in terms of pain development from the first measurement day (M1) to the second measurement day (M2) after 2.0 ± 1.0 year. Participants were classified into athletes who developed back pain (BPD) and athletes who did not develop back pain (nBPD). BP (acute or within the last 7 days) was assessed with a 5-step face scale (face 1–2 = no pain; face 3–5 = pain). BPD included all athletes who reported faces 1 and 2 at M1 and faces 3 to 5 at M2. nBPD were all athletes who reported face 1 or 2 at both M1 and M2. Data was analyzed descriptively. Additionally, a Chi2 test was used to analyze gender- and sport-specific differences (p = 0.05). Results Thirty-two athletes were categorized as BPD (10%). The gender difference was 5% (m/f: 12%/7%) but did not show statistical significance (p = 0.15). The incidence of BP ranged between 6 and 15% for the different sport categories. Game sports (15%) showed the highest, and explosive strength sports (6%) the lowest incidence. Anthropometrics or training characteristics did not significantly influence BPD (p = 0.14 gender to p = 0.90 sports; r2 = 0.0825). Conclusions BP incidence was lower in adolescent athletes compared to young non-athletes and even to the general adult population. Consequently, it can be concluded that high-performance sports do not lead to an additional increase in back pain incidence during early adolescence. Nevertheless, back pain prevention programs should be implemented into daily training routines for sport categories identified as showing high incidence rates.
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Affiliation(s)
- Steffen Mueller
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10 - House 12, D-14469 Potsdam, Germany
| | - Juliane Mueller
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10 - House 12, D-14469 Potsdam, Germany
| | - Josefine Stoll
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10 - House 12, D-14469 Potsdam, Germany
| | - Olaf Prieske
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
| | - Michael Cassel
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10 - House 12, D-14469 Potsdam, Germany
| | - Frank Mayer
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10 - House 12, D-14469 Potsdam, Germany
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Haag TB, Mayer HM, Schneider AS, Rumpf MC, Handel M, Schneider C. Risk assessment of back pain in youth soccer players. Res Sports Med 2016; 24:395-406. [PMID: 27537067 PMCID: PMC5152550 DOI: 10.1080/15438627.2016.1222275] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study is to identify several responsible parameters for back pain (BP) in youth soccer players to create a risk assessment tool for early prevention. An iPad-based survey was used to screen for parameters in a cross-sectional study. This questionnaire includes items regarding anthropometric data, training habits and sports injuries and was put into practice with 1110 athletes. Sex (odds ratio (OR): 1.84), age group (1.48) and playing surface (1.56) were significantly associated with BP. A history of injuries especially to the spine and hip/groin increased the likelihood for evolving recurrent BP (1.74/1.40). Overall 15 factors seem to influence the appearance of pain and were integrated into a feasible nomogram. The nomogram provides a practical tool to identify the risks of developing BP for youth soccer players. Although most factors we identified are non-modifiable, this method allows to rank the importance of factors and especially their prevention treatments for athletes.
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Affiliation(s)
- Thore-Björn Haag
- a Sportorthopaedic Institute, FIFA MCE , Schön Klinik München Harlaching , Munich , Germany.,b Academic Teaching Hospital and Spine Research Institute of the Paracelsus Private Medical University Salzburg (PMU) , Austria
| | - H Michael Mayer
- a Sportorthopaedic Institute, FIFA MCE , Schön Klinik München Harlaching , Munich , Germany.,b Academic Teaching Hospital and Spine Research Institute of the Paracelsus Private Medical University Salzburg (PMU) , Austria
| | - Alexandra S Schneider
- a Sportorthopaedic Institute, FIFA MCE , Schön Klinik München Harlaching , Munich , Germany
| | - Michael C Rumpf
- a Sportorthopaedic Institute, FIFA MCE , Schön Klinik München Harlaching , Munich , Germany.,c Sport Performance Research Institute New Zealand , Auckland University of Technology , Auckland , New Zealand
| | - Martin Handel
- a Sportorthopaedic Institute, FIFA MCE , Schön Klinik München Harlaching , Munich , Germany
| | - Christian Schneider
- a Sportorthopaedic Institute, FIFA MCE , Schön Klinik München Harlaching , Munich , Germany.,b Academic Teaching Hospital and Spine Research Institute of the Paracelsus Private Medical University Salzburg (PMU) , Austria
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Rossi M, Pasanen K, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Savonen K, Selänne H, Vasankari T, Kannas L, Kujala U, Villberg J, Parkkari J. Low back and neck and shoulder pain in members and non-members of adolescents' sports clubs: the Finnish Health Promoting Sports Club (FHPSC) study. BMC Musculoskelet Disord 2016; 17:263. [PMID: 27370945 PMCID: PMC4930616 DOI: 10.1186/s12891-016-1114-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 06/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to investigate the prevalence of self-reported low back pain (LBP) and neck and shoulder pain (NSP), and the related factors in members and non-members of adolescents' sports clubs. METHODS This cross-sectional study was based on surveys of 14-16-year-olds as a part of the Finnish Health Promoting Sports Club (FHPSC) Study. The surveys on self-reported health behaviours, injuries, and musculoskeletal health were conducted among sports club members (n = 962) and non-members (n = 675). Binary logistic regression analysis was applied to study the associations between dependent variables of LBP and NSP, and the independent factors. RESULTS The prevalence of LBP during the preceding 3 months was 35.0 % in girls and 24.5 % in boys (p < 0.05 for sex difference). The prevalence of NSP was 55.9 % in girls and 27.3 % in boys (p < 0.001 for sex difference). Being a sports club member increased the odds for LBP in boys (odds ratio [OR] 2.35, 95 % CI 1.48-3.72). On the other hand, sports club participation was associated with lower odds of frequent NSP in girls (OR 0.52, 95 % CI 0.33-0.82). No associations were found between other leisure-time physical activity and LBP or NSP. Higher screen time (computer games, TV/DVD, phone, Internet) during leisure-time increased the odds of NSP in boys and LBP in boys and girls. CONCLUSIONS In this study, self-reported LBP and NSP were already relatively common among adolescents. Girls have a higher risk for reporting LBP and NSP. Measures that are more effective in the prevention of LBP in male sports club members are needed. Excessive screen time is weakly associated with LBP and NSP, which should be taken into account in health promotion among adolescents.
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Affiliation(s)
- M Rossi
- Tampere Research Center of Sports Medicine, P.O. Box 30, FI-33501, Tampere, Finland.
| | - K Pasanen
- Tampere Research Center of Sports Medicine, P.O. Box 30, FI-33501, Tampere, Finland.,UKK Institute for Health Promotion Research, P.O. Box 30, FI-33501, Tampere, Finland
| | - S Kokko
- Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - L Alanko
- Clinic for Sports and Exercise Medicine, Alppikatu 2, FI-00530, Helsinki, Finland
| | - O J Heinonen
- Paavo Nurmi Centre & Department of Health and Physical Activity, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland
| | - R Korpelainen
- Department of Sports and Exercise Clinic, Oulu Deaconess Institute, Albertinkatu 18, FI-90100, Oulu, Finland.,University of Oulu, Center for Life Course Health Research, Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - K Savonen
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100, Kuopio, Finland
| | - H Selänne
- LIKES Foundation for Sports and Health Sciences and Mehiläinen Physical Activity Clinic, P.O. Box 35, FI-40720, Jyväskylä, Finland
| | - T Vasankari
- UKK Institute for Health Promotion Research, P.O. Box 30, FI-33501, Tampere, Finland
| | - L Kannas
- Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - U Kujala
- Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - J Villberg
- Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - J Parkkari
- Tampere Research Center of Sports Medicine, P.O. Box 30, FI-33501, Tampere, Finland.,UKK Institute for Health Promotion Research, P.O. Box 30, FI-33501, Tampere, Finland
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Thoreson O, Kovac P, Swärd A, Agnvall C, Todd C, Baranto A. Back pain and MRI changes in the thoraco-lumbar spine of young elite Mogul skiers. Scand J Med Sci Sports 2016; 27:983-989. [PMID: 27367529 DOI: 10.1111/sms.12710] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 11/30/2022]
Abstract
Athletes have a higher prevalence of LBP and spinal abnormalities on Magnetic Resonance Imaging (MRI) compared to non-athletes. The objective of this study was to investigate the amount of spinal MRI abnormalities and the lifetime prevalence of low back pain (LBP) in 16 young elite Mogul skiers compared to 28 non-athletes in the corresponding age in a cross-sectional design. LBP was assessed by a questionnaire consisting of a part regarding previous or present back pain, the Oswestry disability index, and the EuroQol questionnaire. MRI examinations from Th5 to sacrum were conducted to evaluate spinal pathologies. The Mogul skiers had significantly more MRI abnormalities (like disc degeneration) in mean (7.25 vs 3.78, P < 0.023) compared to the controls. No significant difference was seen regarding the lifetime LBP prevalence between the groups (50% vs 42%, P = 0.555). No correlation could be found between disc degeneration and back pain in this study. Young elite Mogul skiers, compared to an age-matched control group of non-athletes, have an increased risk of developing spinal abnormalities potentially due to the different high loads that they are subjected to in their sport. Future relationship between the MRI abnormalities and LBP cannot be verified by this study design.
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Affiliation(s)
- O Thoreson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - P Kovac
- Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - A Swärd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.,Sportsmedicine Åre and Åre Ski High School, Åre, Sweden
| | - C Agnvall
- Sportsmedicine Åre and Åre Ski High School, Åre, Sweden
| | - C Todd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.,The Carl Todd Clinic, Corsham, UK
| | - A Baranto
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
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Spörri J, Kröll J, Fasel B, Aminian K, Müller E. Course Setting as a Prevention Measure for Overuse Injuries of the Back in Alpine Ski Racing: A Kinematic and Kinetic Study of Giant Slalom and Slalom. Orthop J Sports Med 2016; 4:2325967116630719. [PMID: 26977419 PMCID: PMC4772347 DOI: 10.1177/2325967116630719] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: A combination of frontal bending, lateral bending, and torsion in the loaded trunk has been suggested to be a mechanism leading to overuse injuries of the back in Alpine ski racing. However, there is limited knowledge about the effect of course setting on the aforementioned back-loading patterns. Purpose: To investigate the effect of increased gate offset on the skier’s overall trunk kinematics and the occurring ground-reaction forces and to compare these variables between the competition disciplines giant slalom (GS) and slalom (SL). Study Design: Controlled laboratory study. Methods: Ten top-level athletes were divided into GS and SL groups. Both groups performed a total of 240 GS and 240 SL turns at 2 different course settings. The overall trunk movement components (frontal bending, lateral bending, and torsion angle) were measured using 2 inertial measurement units fixed on the sacrum and sternum. Total ground-reaction forces were measured by pressure insoles. Results: In SL, ground-reaction force peaks were significantly lower when the gate offset was increased, while in GS, no differences between course settings were observed. During the turn phase in which the highest spinal disc loading is expected to occur, the back-loading patterns in both GS and SL included a combination of frontal bending, lateral bending, and torsion in the loaded trunk. SL was characterized by shorter turns, lower frontal and lateral bending angles after gate passage, and a trend toward greater total ground-reaction force peaks compared with GS. Conclusion: Course setting is a reasonable measure to reduce the skier’s overall back loading in SL but not in GS. The distinct differences observed between GS and SL should be taken into account when defining discipline-specific prevention measures for back overuse injuries. Clinical Relevance: To reduce the magnitude of the overall back loading, in SL, minimal gate offsets should be avoided. Prevention measures in GS might particularly need to control and/or reduce the magnitude of frontal and lateral bending in the loaded trunk, whereas prevention measures in SL might especially need to mitigate the short and high total ground-reaction force peaks.
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Affiliation(s)
- Jörg Spörri
- Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Rif, Austria
| | - Josef Kröll
- Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Rif, Austria
| | - Benedikt Fasel
- Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Kamiar Aminian
- Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Rif, Austria
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Müller J, Müller S, Stoll J, Fröhlich K, Otto C, Mayer F. Back pain prevalence in adolescent athletes. Scand J Med Sci Sports 2016; 27:448-454. [DOI: 10.1111/sms.12664] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2016] [Indexed: 11/28/2022]
Affiliation(s)
- J. Müller
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
| | - S. Müller
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
| | - J. Stoll
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
| | - K. Fröhlich
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
| | - C. Otto
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
| | - F. Mayer
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
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38
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Castillo-Lozano R, Casuso-Holgado M. A comparison musculoskeletal injuries among junior and senior paddle-tennis players. Sci Sports 2015. [DOI: 10.1016/j.scispo.2015.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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39
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Severe back pain in elite athletes: a cross-sectional study on 929 top athletes of Germany. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:1204-10. [DOI: 10.1007/s00586-015-4210-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 08/22/2015] [Accepted: 08/22/2015] [Indexed: 10/23/2022]
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Spörri J, Kröll J, Haid C, Fasel B, Müller E. Potential Mechanisms Leading to Overuse Injuries of the Back in Alpine Ski Racing: A Descriptive Biomechanical Study. Am J Sports Med 2015; 43:2042-8. [PMID: 26109612 DOI: 10.1177/0363546515588178] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Overuse injuries of the back are a common complaint among top athletes and of competitive alpine skiers in particular. However, there is limited understanding about the sport-specific causes of these injuries that is essential for their prevention. PURPOSE/HYPOTHESIS This study was undertaken to describe the sport-specific, overall trunk kinematics and skiers' loading during giant slalom turns and to assess the plausibility of the hypothesis that a combination of frontal bending, lateral bending, and/or torsion in the loaded trunk might be a potential mechanism leading to overuse injuries of the back in alpine ski racing. STUDY DESIGN Descriptive laboratory study. METHODS Eight European Cup-level athletes performed giant slalom runs with 2 different pairs of skis (varying in length, width, and sidecut). They were analyzed with respect to selected kinematic variables related to spinal disc loading. The overall trunk movement components (frontal bending, lateral bending, and torsion) were measured using 2 inertial measurement units fixed on the sacrum and sternum. Total ground-reaction forces were measured by pressure insoles. RESULTS During the turn phase in which the total ground-reaction forces were the greatest (up to 2.89 times the body weight), the highest average values of frontal bending (38.7°), lateral bending (14.7°), and torsion (7.7°) in the trunk occurred. Similar magnitudes were observed when skiing on longer, giant slalom skis with less width and sidecut. CONCLUSION The typical loading patterns of the back in alpine ski racing include a combined occurrence of frontal bending, lateral bending, and torsion in the loaded trunk. Because these factors are known to be related to high spinal disc loading, they may be considered important components of mechanisms leading to overuse injuries of the back in alpine ski racing. CLINICAL RELEVANCE Prevention measures should aim to control and/or reduce the magnitude of frontal bending, lateral bending, and torsion in the trunk, as well as the peak loads, while skiing.
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Affiliation(s)
- Jörg Spörri
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Josef Kröll
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Christian Haid
- Department of Orthopaedic Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Benedikt Fasel
- Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
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Abstract
CONTEXT Low Back Pain (LBP) in athletes is common and has a broad spectrum of differential diagnoses that must be taken in to account when a clinician approaches the patient with LBP. The physicians should take into account spinal and extra spinal causes of low back pain in athletes. EVIDENCE ACQUISTION A literature review was performed for the years 1951 through 2013. Keywords used were Low Back Pain and Athletes. We searched MEDLINE, EMBASE, OVID, PUBMED, the Cochrane Library, ELSEVIER, and the references of reviewed articles, for English-language of Low Back Pain in Athletes. RESULTS The two most common causes of LBP arising from spine in athletes are degenerative disc disease and spondylolysis with or without listhesis. Although most athletes, respond well to conservative treatment, surgical treatment is indicated when conservative treatment failes. CONCLUSIONS The major concern in athletes with LBP is return to play and previous level of their activity after treatment. There is insufficient evidence regarding this issue in literature to define the optimal time of return to play following treatment.
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Affiliation(s)
- Javad Mortazavi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Jayran Zebardast
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Babak Mirzashahi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
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42
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Leppänen M, Pasanen K, Kujala UM, Parkkari J. Overuse injuries in youth basketball and floorball. Open Access J Sports Med 2015; 6:173-9. [PMID: 26045679 PMCID: PMC4447174 DOI: 10.2147/oajsm.s82305] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The popularity of team sports is growing among young people. High training volume and intensity may predispose young athletes to overuse injuries. Research to date has tended to focus on acute injuries rather than overuse injuries. The purpose of this study was to examine the occurrence, nature, and severity of overuse injuries in youth basketball and floorball, with the hypothesis that overuse injuries are frequent in youth team sports. Methods The study comprised a total of 401 Finnish team sports athletes (207 basketball and 194 floorball players). The data were collected using a detailed questionnaire. The participants (mean age 15.8±1.9 years) responded to the questionnaire covering information on overuse injuries during the previous 12 months. Results A total of 190 overuse injuries was reported (97 in basketball and 93 in floorball). In both sports, most of the injuries involved the lower extremities (66% and 55% of all injuries in basketball and floorball, respectively). In basketball, the most commonly injured site was the knee (44 cases, 45%). In floorball, the most commonly injured sites were the lower back/pelvis (36 cases, 39%) and knee (32 cases, 34%). Overuse injuries caused an average time loss from full participation of 26±50 (median 7) days in basketball and 16±37 (median 5) days in floorball. Conclusion Overuse injuries are a common problem in youth team sports, and often cause long-term absence from full participation. The findings suggest that injury reduction and training load monitoring strategies are needed in the field. More research using explicit prospective data collection is needed to better understand the problem.
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Affiliation(s)
- Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Urho M Kujala
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
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43
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Schroeder GD, Lynch TS, Gibbs DB, Chow I, LaBelle M, Patel AA, Savage JW, Hsu WK, Nuber GW. Pre-existing lumbar spine diagnosis as a predictor of outcomes in National Football League athletes. Am J Sports Med 2015; 43:972-8. [PMID: 25617402 DOI: 10.1177/0363546514562548] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND It is currently unknown how pre-existing lumbar spine conditions may affect the medical evaluation, draft status, and subsequent career performance of National Football League (NFL) players. PURPOSE To determine if a pre-existing lumbar diagnosis affects a player's draft status or his performance and longevity in the NFL. STUDY DESIGN Cohort study; Level 3. METHODS The investigators evaluated the written medical evaluations and imaging reports of prospective NFL players from a single franchise during the NFL Scouting Combine from 2003 to 2011. Players with a reported lumbar spine diagnosis and with appropriate imaging were included in this study. Athletes were then matched to control draftees without a lumbar spine diagnosis by age, position, year, and round drafted. Career statistics and performance scores were calculated. RESULTS Of a total of 2965 athletes evaluated, 414 were identified as having a pre-existing lumbar spine diagnosis. Players without a lumbar spine diagnosis were more likely to be drafted than were those with a diagnosis (80.2% vs. 61.1%, respectively, P < .001). Drafted athletes with pre-existing lumbar spine injuries had a decrease in the number of years played compared with the matched control group (4.0 vs. 4.3 years, respectively, P = .001), games played (46.5 vs. 50.8, respectively, P = .0001), and games started (28.1 vs. 30.6, respectively, P = .02) but not performance score (1.4 vs. 1.8, respectively, P = .13). Compared with controls, players were less likely to be drafted if they had been diagnosed with spondylosis (62.37% vs. 78.55%), a lumbar herniated disc (60.27% vs. 78.43%), or spondylolysis with or without spondylolisthesis (64.44% vs. 78.15%) (P < .001 for all), but there was no appreciable effect on career performance; however, the diagnosis of spondylolysis was associated with a decrease in career longevity (P < .05). Notably, 2 athletes who had undergone posterior lateral lumbar fusion were drafted. One played in 125 games, and the other is still active and has played in 108 games. CONCLUSION The data in this study suggest that athletes with pre-existing lumbar spine conditions were less likely to be drafted and that the diagnosis is associated with a decrease in career longevity but not performance. Players with lumbar fusion have achieved successful careers in the NFL.
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Affiliation(s)
- Gregory D Schroeder
- Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois, USA
| | - T Sean Lynch
- Department of Orthopaedic Surgery, Columbia University, New York, New York, USA
| | - Daniel B Gibbs
- Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois, USA
| | - Ian Chow
- Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois, USA
| | - Mark LaBelle
- Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois, USA
| | - Alpesh A Patel
- Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois, USA
| | - Jason W Savage
- Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois, USA
| | - Wellington K Hsu
- Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois, USA
| | - Gordon W Nuber
- Department of Orthopaedic Surgery, NorthShore University, Chicago, Illinois, USA
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Betsch M, Furian T, Quack V, Rath B, Wild M, Rapp W. Effects of athletic training on the spinal curvature in child athletes. Res Sports Med 2015; 23:190-202. [PMID: 25669887 DOI: 10.1080/15438627.2015.1005297] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to examine the spinal posture in young athletes depending on training intensity. The spinal curvature of 245 children, age 8 to 12 years, was evaluated using rasterstereography. According to their weekly training time group 1 (mean age: 9.54 ± 1.18) did 2-6, group 2 (mean age: 9.49 ± 0.87) did 6-15 and group 3 (mean age: 9.68 ± 0.87) did over 15 hours of training. Group 1 had a significantly higher weight (p = 0.028) (33.86 ± 7. kg) than those of the more active groups (30.67 ± 6.49 kg and 29.46 ± 4.33 kg). The mean kyphotic angle decreased significantly (p < 0.001) with the amount of training per week from 46.86 ± 8.2° in group 1 to 40.08 ± 8° in group 3. We also found a significant decrease (p = 0.047) in lateral deviation with training from group 1 with 5.3 ± 3 mm to group 2 with 4.1 ± 1.6 mm. The results of our study suggest that higher training time can be associated with lower weight and decreases in thoracic kyphosis and lateral deviation of the spine.
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Affiliation(s)
- Marcel Betsch
- a Department of Orthopaedics , University Hospital RWTH Aachen , Germany
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45
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Ramadorai U, Hire J, DeVine JG, Brodt ED, Dettori JR. Incidental findings on magnetic resonance imaging of the spine in the asymptomatic pediatric population: a systematic review. EVIDENCE-BASED SPINE-CARE JOURNAL 2014; 5:95-100. [PMID: 25278883 PMCID: PMC4174226 DOI: 10.1055/s-0034-1386753] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 06/03/2014] [Indexed: 11/23/2022]
Abstract
Study Design Systematic review. Clinical Question What is the prevalence of incidental magnetic resonance imaging (MRI) findings of the spine in asymptomatic pediatric patients? Methods Electronic databases and reference lists of key articles were searched up to December 15, 2013, to identify studies reporting the incidence or prevalence of incidental findings on MRI in asymptomatic pediatric patients. Athletes or children with a known history of trauma, infection, or congenital abnormalities were excluded. Results Seven publications, one prospective cohort, and six cross-sectional studies met the inclusion criteria. The most commonly reported findings on MRI were disc-related and included degenerative disc disease (seven studies, prevalence 19.6%), disc herniation/protrusion (four studies, 2.9%), disc height/narrowed disc space (two studies, 33.7%), and endplate changes (two studies, 5.3%). Other disc-related findings, reported by one study each, included bulging disc, abnormal nucleus shape, annular tear, high intensity zone, and nerve root compression, with prevalences ranging from 4.5 to 51.6%. Spondylolisthesis and spondylolysis were reported by one study each with a prevalence of 2.3 and 0%, respectively. Other findings reported included tumors and infections (one study, 0% for both) and Scheuermann-type changes (one study, 7.7%). Conclusions The prevalence of positive MRI findings in the asymptomatic pediatric population is higher than previously assumed, particularly in regard to disc morphology, highlighting the importance of correlating the history and physical examination to the MRI findings to avoid misdiagnosis or over-treatment in the pediatric population.
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Affiliation(s)
- Uma Ramadorai
- Department of Orthopaedics and Rehabilitation, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia, United States
| | - Justin Hire
- Department of Orthopaedics and Rehabilitation, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia, United States
| | - John G DeVine
- Department of Orthopaedic Surgery, Georgia Regents University, Augusta, Georgia, United States
| | - Erika D Brodt
- Spectrum Research, Inc., Tacoma, Washington, United States
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46
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Abstract
Clinicians must have knowledge of the growth and development of the adolescent spine and the subsequent injury patterns and other spinal conditions common in the adolescent athlete. The management and treatment of spinal injuries in adolescent athletes require a coordinated effort between the clinician, patients, parents/guardians, coaches, therapists, and athletic trainers. Treatment should not only help alleviate the current symptoms but also address flexibility and muscle imbalances to prevent future injuries by recognizing and addressing risk factors. Return to sport should be a gradual process once the pain has resolved and the athlete has regained full strength.
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Affiliation(s)
- Arthur Jason De Luigi
- Department of Rehabilitation Medicine, Georgetown University School of Medicine, 3800 Reservoir Road, Washington, DC 20007, USA.
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47
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Espondiloptose em atleta. REVISTA BRASILEIRA DE REUMATOLOGIA 2014. [DOI: 10.1016/j.rbr.2012.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Selanne H, Ryba TV, Siekkinen K, Kyröläinen H, Kautiainen H, Hakonen H, Mikkelsson M, Kujala UM. The prevalence of musculoskeletal pain and use of painkillers among adolescent male ice hockey players in Finland. Health Psychol Behav Med 2014; 2:448-454. [PMID: 25750794 PMCID: PMC4345898 DOI: 10.1080/21642850.2014.884463] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 01/14/2014] [Indexed: 02/04/2023] Open
Abstract
Participating in competitive sport increases the risk for injuries and musculoskeletal pain among adolescent athletes. There is also evidence that the use of prescription drugs has increased among sport club athletes. The purpose of this study was to evaluate the use of painkillers among young male ice hockey players (IHP) in comparison to schoolboys (controls) and its relation to the prevalence of musculoskeletal pain and problems during activities and sleeping. Information was gathered through a questionnaire, completed by 121 IHP and compared to the responses of 618 age-matched controls. Results showed that monthly existing pain was at 82% for IHP, and 72% for controls, though IHP had statistically more musculoskeletal pain in their lower limbs (56% vs. 44%), lower back (54% vs. 35%), and buttocks (26% vs. 11%). There were no group differences in the neck, upper back, upper limb, or chest areas. The disability index was statistically similar for both groups, as musculoskeletal pain causing difficulties in daily activities and sleeping was reported by a minority of subjects. Despite this similarity, IHP used more painkillers than controls (18% vs. 10%). Further nuanced research is encouraged to compare athletes and non-athletes in relation to painkillers.
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Affiliation(s)
| | - Tatiana V Ryba
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark , Odense , Denmark
| | | | - Heikki Kyröläinen
- Department of Biology of Physical Activity, University of Jyväskylä , Jyväskylä , Finland
| | | | | | | | - Urho M Kujala
- Department of Health Sciences, University of Jyväskylä , Jyväskylä , Finland
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Külling FA, Florianz H, Reepschläger B, Gasser J, Jost B, Lajtai G. High Prevalence of Disc Degeneration and Spondylolysis in the Lumbar Spine of Professional Beach Volleyball Players. Orthop J Sports Med 2014; 2:2325967114528862. [PMID: 26535316 PMCID: PMC4555589 DOI: 10.1177/2325967114528862] [Citation(s) in RCA: 27] [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] [Indexed: 11/15/2022] Open
Abstract
Background: Beach volleyball is an intensive sport with high impact on the lumbar spine. Low back pain (LBP) is frequent among elite players. Increased prevalence of pathological changes on magnetic resonance imaging (MRI) in the lumbar spine of elite athletes has been reported. Hypothesis: There is an increased prevalence of disc degeneration and spondylolysis in the MRI of the lumbar spine of professional beach volleyball players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Twenty-nine fully competitive professional male volleyball players (mean age, 28 years) completed outcomes questionnaires and underwent a complete clinical examination and an MRI of their lumbar spine. Results: Whereas 86% of players suffered from LBP during their career, the incidence of LBP in the last 4 weeks was 35%. Pain rated using a visual analog scale (VAS) averaged 3 points (range, 0-8). Twenty-three of 29 players (79%) had at least 1 degenerated disc of Pfirrmann grade ≥3. The most affected spinal levels were L4-5 in 14 (48%) and L5-S1 in 15 players (52%); both levels were involved in 5 players (17%). Six of 29 (21%) players showed a spondylolysis grade 4 according to the Hollenburg classification; there was evidence of spondylolisthesis in 2 players. There was no significant correlation between LBP and MRI abnormalities. Conclusion: In the lumbar spine MRI of professional beach volleyball players, the prevalence of disc degeneration is 79%. Spondylolysis (21%) is up to 3 times higher compared with the normal population. Abnormal MRI findings did not correlate with LBP, thus MRIs have to be interpreted with caution.
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Affiliation(s)
- Fabrice A Külling
- Department of Orthopaedics and Traumatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Hannes Florianz
- Orthopaedic Department, Private Hospital Maria Hilf, Klagenfurt, Austria
| | - Bastian Reepschläger
- Department of Orthopaedics and Traumatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Johann Gasser
- Radiology Department, Private Hospital Maria Hilf, Klagenfurt, Austria
| | - Bernhard Jost
- Department of Orthopaedics and Traumatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Georg Lajtai
- Orthopaedic Department, Private Hospital Maria Hilf, Klagenfurt, Austria
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50
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Schroeder GD, McCarthy KJ, Micev AJ, Terry MA, Hsu WK. Performance-based outcomes after nonoperative treatment, discectomy, and/or fusion for a lumbar disc herniation in National Hockey League athletes. Am J Sports Med 2013; 41:2604-8. [PMID: 23956134 DOI: 10.1177/0363546513499229] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Ice hockey players have a high incidence of lumbar spine disorders; however, there is no evidence in the literature to guide the treatment of an ice hockey player with a herniated lumbar disc. PURPOSE To determine the performance-based outcomes in professional National Hockey League (NHL) athletes with a lumbar disc herniation after either nonsurgical or surgical treatment. STUDY DESIGN Descriptive epidemiological study. METHODS Athletes in the NHL with a lumbar disc herniation were identified through team injury reports and archives on public record. The return-to-play rate, games played per season, points per game, and performance score for each player were determined before and after the diagnosis of a lumbar disc herniation. Statistical analysis was used to compare preinjury and postinjury performance measures for players treated with either nonsurgical or surgical treatment. RESULTS A total of 87 NHL players met the inclusion criteria; 31 underwent nonoperative care, 48 underwent a discectomy, and 8 underwent a single-level fusion. The return-to-play rate for all players was 85%. There was a significant decrease in performance in all players after a lumbar disc herniation in games played per season, points scored per game, and performance score. A comparison of the posttreatment results for the nonsurgical and surgical patient groups revealed no significant difference in performance measures. Notably, the lumbar fusion group did not show a decrease in games played per season or performance score after surgery, likely secondary to a small sample size. CONCLUSION National Hockey League players with a lumbar disc herniation have a high return-to-play rate regardless of the type of treatment; however, performance-based outcomes may decrease compared with preinjury levels. The study data suggest that a lumbar fusion is compatible with a return to play in the NHL, which is in contrast to other professional sports.
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Affiliation(s)
- Gregory D Schroeder
- Gregory D. Schroeder, Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 North St Clair, Suite 1350, Chicago, IL 60611.
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