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Huschtscha Z, Silver J, Gerhardy M, Urwin CS, Kenney N, Le VH, Fyfe JJ, Feros SA, Betik AC, Shaw CS, Main LC, Abbott G, Tan SY, May A, Smith CM, Kuriel V, Barnard J, Hamilton DL. The Effect of Palmitoylethanolamide (PEA) on Skeletal Muscle Hypertrophy, Strength, and Power in Response to Resistance Training in Healthy Active Adults: A Double-Blind Randomized Control Trial. SPORTS MEDICINE - OPEN 2024; 10:66. [PMID: 38844675 PMCID: PMC11156829 DOI: 10.1186/s40798-024-00732-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 05/20/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Palmitoylethanolamide (PEA) has analgesic/anti-inflammatory properties that may be a suitable alternative to over-the-counter (OTC) non-steroidal analgesics/anti-inflammatories. While OTC pain medications can impair strength training adaptations, the mechanism of action of PEA is distinct from these and it may not negatively affect skeletal muscle adaptations to strength training. METHODS The primary aim of this study was to investigate the effects of daily PEA supplementation (350 mg Levagen + equivalent to 300 mg PEA) combined with 8-weeks of resistance training on lean body mass with secondary aims addressing strength, power, sleep, and wellbeing compared to placebo (PLA) in young, healthy, active adults. In a randomized, controlled, double-blinded trial, 52 untrained, recreationally active participants aged 18-35 y were allocated to either the PEA or PLA groups. Participants consumed either 2 × 175 mg Levagen + PEA or identically matched maltodextrin capsules during an 8-week period of whole-body resistance training. This trial assessed the pre- to post- changes in total and regional lean body mass, muscular strength (1-RM bench, isometric mid-thigh pull), muscular power [countermovement jump (CMJ), bench throw], pain associated with exercise training, sleep, and wellbeing compared with the PEA or PLA condition. RESULTS 48 Participants were included in the final intention to treat (ITT) analysis and we also conducted per protocol (PP) analysis (n = 42). There were no significant between-group differences for total or regional lean muscle mass post-intervention. There was a significantly higher jump height (CMJ) at week 10 in the PEA group compared to the PLA (Adjusted mean difference [95% CI] p-value; ITT: - 2.94 cm [- 5.15, - 0.74] p = 0.010; PP: - 2.93 cm [- 5.31, - 0.55] p = 0.017). The PLA group had higher 1-RM bench press post-intervention compared with the PEA group (ITT: 2.24 kg [0.12, 4.37] p = 0.039; PP: 2.73 kg [0.40, 5.06] p = 0.023). No significant treatment effects were noted for any of the other outcomes. CONCLUSION PEA supplementation, when combined with 8 weeks of strength training, did not impair lean mass gains and it resulted in significantly higher dynamic lower-body power when compared with the PLA condition. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR: ACTRN12621001726842p).
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Affiliation(s)
- Zoya Huschtscha
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Jessica Silver
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Michael Gerhardy
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Charles S Urwin
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Nathan Kenney
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Viet Hung Le
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Jackson J Fyfe
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Simon A Feros
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Andrew C Betik
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Christopher S Shaw
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Luana C Main
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Gavin Abbott
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Sze-Yen Tan
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Anthony May
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
- Respiratory Research@Alfred, Monash University, Melbourne, Australia
| | - Craig M Smith
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, 3216, Australia
| | - Vicky Kuriel
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Jackson Barnard
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - D Lee Hamilton
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia.
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Varela-Margolles D, Milani A, Kamel SI. Percutaneous Interventions for Injuries in Athletes: Implications on Return to Play. Semin Musculoskelet Radiol 2024; 28:146-153. [PMID: 38484767 DOI: 10.1055/s-0043-1778026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
For nonsurgical musculoskeletal (MSK) injuries in athletes, image-guided percutaneous intervention may aid in recovery and decrease return to play (RTP) time. These interventions fall into two major categories: to reduce inflammation (and therefore alleviate pain) or to promote healing. This review describes the risks and benefits of the various percutaneous interventions in MSK athletic injury and surveys the literature regarding the implication of these interventions on RTP.
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Affiliation(s)
- Diana Varela-Margolles
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Ava Milani
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sarah I Kamel
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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Tsai AWW, Kobayashi R, Liu IAW, Fim M, Liggieri AC, Machado ES. Update on Musculoskeletal Pain Management. Rev Bras Ortop 2024; 59:e160-e171. [PMID: 38606122 PMCID: PMC11006528 DOI: 10.1055/s-0043-1776135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/25/2023] [Indexed: 04/13/2024] Open
Abstract
Pain is the most common complaint reported to orthopedists in the outpatient clinic, emergency room, or booth. Numerous publications report the inadequate management of both acute and chronic pain by health professionals. This updated article aims to provide information about musculoskeletal pain, its classification, evaluation, diagnosis, and the multimodal therapeutic approach for each case. For acute pain, adequate control allows for earlier rehabilitation to work and reduces the rates of pain chronification. For chronic pain, the goal is to reduce its intensity and improve the quality of life. Currently, some procedures are increasingly used and aided by imaging tests for diagnostic and therapeutic purposes.
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Affiliation(s)
| | - Ricardo Kobayashi
- Centro de Dor, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | - Márcio Fim
- Cirurgia de Ombro e Cotovelo, Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Belo Horizonte, MG, Brasil
| | - André Cicone Liggieri
- Centro de Dor, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Edilson Silva Machado
- Serviço de Dor e Cuidados Paliativos, Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brasil
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Kamel SI, Rosas HG, Gorbachova T. Local and Systemic Side Effects of Corticosteroid Injections for Musculoskeletal Indications. AJR Am J Roentgenol 2024; 222:e2330458. [PMID: 38117096 DOI: 10.2214/ajr.23.30458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Corticosteroid injections can be associated with a range of potential side effects, which may be classified as local or systemic and further stratified as immediate or delayed in onset. Radiologists performing image-guided musculoskeletal injections should recognize the potential side effects of corticosteroid medication when counseling patients before injection and consider such side effects in planning individual injections. This Review summarizes the available evidence regarding the local and systemic side effects of corticosteroid injections performed for musculoskeletal indications. Local side effects include postinjection flare, skin hypopigmentation and atrophy, infection, tendon rupture, accelerated progression of osteoarthritis, and osseous injury. Systemic side effects include adrenal suppression or insufficiency, facial flushing, hypertension, hyperglycemia, and osteoporosis. Additional targeted counseling is warranted regarding side effects that are specific to certain patient populations (i.e., premenopausal women, patients with diabetes, athletes, and pediatric patients). Corticosteroid injections are contraindicated in the presence of superficial or deep infection, fracture, or a prosthetic joint. Guidelines on the frequency, duration, and maximal lifetime use of corticosteroid injections are currently lacking. Further research is needed regarding the long-term complications of continuous corticosteroid use, particularly with regard to osseous effects.
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Affiliation(s)
- Sarah I Kamel
- Department of Radiology, Thomas Jefferson University Hospital, 111 S 11th St, Philadelphia, PA 19107
| | - Humberto G Rosas
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Read D, Rosenbloom C. What contextual factors influence pain management decision making concerning player availability in professional men's football? A qualitative analysis of practitioner perceptions. SCI MED FOOTBALL 2024:1-12. [PMID: 38341871 DOI: 10.1080/24733938.2024.2316093] [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] [Accepted: 01/31/2024] [Indexed: 02/13/2024]
Abstract
PURPOSE Football practitioners must regularly assess the risk of participation when determining player availability. At present, there is a lack of information detailing the factors that influence risk assessments. Accordingly, the following research question was explored: what contextual factors influence pain management decision-making when determining player availability in professional men's football? METHODS 20 semi-structured interviews were conducted with club doctors (8), physiotherapists (6), and heads of medicine and performance (8) working in professional men's football in the United Kingdom. The methodology is reported using COREQ criteria and data were analysed using thematic analysis. RESULTS Three themes were created that explain how decision-making concerning analgesia was influenced by: (1) access to medical resources, (2) trust between staff and players, and (3) prioritising short-term success. First, the time, resources, and medical information available to staff impacted the ability to assess players and their risk tolerance in relation to analgesia. Second, decision-making was perceived as a multi-stakeholder process and the nature of relationships with players and performance staff could increase or decrease risk tolerance. Third, player decisions are made against a performance and working environment that privileges short term success over long term wellbeing. CONCLUSION The data support that pain management decision-making in professional men's football is influenced by the player and staff's working context. Further, practitioners viewed potential harm to a player from a socio-economic and physical perspective. These findings support the adoption of a patient-centred care approach and can inform clear recommendations from international and national governing bodies.
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Affiliation(s)
- Daniel Read
- Institute for Sport Business, Loughborough University, Loughborough, UK
| | - Craig Rosenbloom
- Sport and Exercise Medicine Department, Queen Mary University of London, London, UK
- Medical Department, Tottenham Hotspur Football Club, London, UK
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Kureshi S, Mendizabal M, Francis J, Djalilian HR. Conservative Management of Acute Sports-Related Concussions: A Narrative Review. Healthcare (Basel) 2024; 12:289. [PMID: 38338173 PMCID: PMC10855441 DOI: 10.3390/healthcare12030289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/09/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
This review explores the application of the conservative management model for pain to sports-related concussions (SRCs), framing concussions as a distinct form of pain syndrome with a pathophysiological foundation in central sensitization. Drawing parallels with proven pain management models, we underscore the significance of a proactive approach to concussion management. Recognizing concussions as a pain syndrome allows for the tailoring of interventions in alignment with conservative principles. This review first covers the epidemiology and controversies surrounding prolonged concussion recovery and persistent post-concussion symptoms (PPCS). Next, the pathophysiology of concussions is presented within the central sensitization framework, emphasizing the need for early intervention to mitigate the neuroplastic changes that lead to heightened pain sensitivity. Five components of the central sensitization process specific to concussion injuries are highlighted as targets for conservative interventions in the acute period: peripheral sensitization, cerebral metabolic dysfunction, neuroinflammation, glymphatic system dysfunction, and pain catastrophizing. These proactive interventions are emphasized as pivotal in accelerating concussion recovery and reducing the risk of prolonged symptoms and PPCS, in line with the philosophy of conservative management.
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Affiliation(s)
- Sohaib Kureshi
- Neurosurgical Medical Clinic, San Diego, CA 92111, USA
- TBI Virtual, San Diego, CA 92111, USA
| | | | | | - Hamid R. Djalilian
- TBI Virtual, San Diego, CA 92111, USA
- Departments of Otolaryngology, Neurological Surgery, and Biomedical Engineering, University of California, Irvine, CA 92697, USA
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du Toit F, Schwellnus M, Jordaan E, Swanevelder S, Wood P. Clinical characteristics of gradual onset injuries in recreational road cyclists - SAFER XXVII study over 5 years in 62758 race entrants. PHYSICIAN SPORTSMED 2023; 51:564-571. [PMID: 36281474 DOI: 10.1080/00913847.2022.2136984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/10/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Gradual onset injuries (GOIs) in recreational cyclists are common but not well described. The aim of this study is to describe the clinical characteristics of GOIs (main anatomical regions, specific anatomical sites, specific GOIs, tissue type, severity of GOIs, and treatment modalities) of GOIs among entrants participating in a community-based mass participation-cycling event over 5 years. METHODS During the 2016-2020 Cape Town Cycle Tour, 62,758 consenting race entrants completed an online pre-race medical screening questionnaire. 1879 reported GOIs in the previous 12 months. In this descriptive epidemiological study, we report frequency (% entrants) of GOIs by anatomical region/sites, specific GOI, tissue type, GOI severity, and treatment modalities used. RESULTS The main anatomical regions affected by GOIs were lower limb (47.4%), upper limb (20.1%), hip/groin/pelvis (10.0%), and lower back (7.8%). Specifically, GOI were common in the knee (32.1%), shoulder (10.6%), lower back (7.8%) and the hip/buttock muscles (5.2%). The most common specific GOI was anterior knee pain (17.2%). 57.0% of GOIs were in soft tissue. Almost half (43.9%) of cyclists with a GOI reported symptom duration >12 months, and 40.3% of GOIs were severe enough to reduce/prevent cycling. Main treatment modalities used for GOIs were rest (45.9%), physiotherapy (43.0%), stretches (33.2%), and strength exercises (33.1%). CONCLUSION In recreational cyclists, >50% of GOIs affect the knees, shoulders, hip/buttock muscles and lower back, and 40% are severe enough to reduce/prevent cycling. Almost 45% of cyclists with GOIs in the lower back; or hip/groin/pelvis; or lower limbs; or upper limb reported a symptom duration of >12 months. Risk factors associated with GOIs need to be determined and preventative programs for GOIs need to be designed, implemented, and evaluated.
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Affiliation(s)
- François du Toit
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Paola Wood
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Yamashiro K, Shiiya K, Ikarashi K, Anazawa S, Makibuchi T, Baba Y, Fujimoto T, Ochi G, Omori G, Sato D. Reduced somatosensory evoked potentials and paired-pulse inhibition in the primary somatosensory cortex of athletes with chronic pain. Eur J Appl Physiol 2023; 123:2537-2543. [PMID: 37330433 DOI: 10.1007/s00421-023-05224-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 05/07/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Chronic pain impedes athletic training and performance. However, it is challenging to identify the precise causes of chronic pain for effective treatment. To examine possible neuroplastic changes in sensory transmission and cortical processing, we compared somatosensory evoked potentials (SEPs) and paired-pulse inhibition (PPI) in primary sensory cortex (S1) between athletes with chronic pain and control athletes. METHODS Sixty-six intercollegiate athletes (39 males and 27 females) were recruited for this study, 45 control athletes and 21 reporting persistent pain for > 3 months. Sensory-evoked potentials were induced in S1 by constant-current square-wave pulses (0.2-ms duration) delivered to the right median nerve, while PPI was induced by paired stimulation at interstimulus intervals of 30 and 100 ms (PPI-30 and PPI-100 ms, respectively). All participants were randomly presented with total 1,500 (each 500 stimuli) single stimuli and stimulus pairs at 2 Hz. RESULTS Both N20 amplitude and PPI-30 ms were significantly lower in athletes with chronic pain compared to control athletes, while P25 amplitude and PPI-100 ms did not differ significantly between groups. CONCLUSION Chronic pain in athletes is associated with substantially altered excitatory-inhibitory balance within the primary somatosensory cortex, possibly due to reduced thalamocortical excitatory transmission and suppressed cortical inhibitory transmission.
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Affiliation(s)
- Koya Yamashiro
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan.
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan.
| | - Kanako Shiiya
- Field of Health and Sports, Graduate School of Niigata, University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Koyuki Ikarashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Sayaka Anazawa
- Field of Health and Sports, Graduate School of Niigata, University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Taiki Makibuchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
- Field of Health and Sports, Graduate School of Niigata, University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Yasuhiro Baba
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Tomomi Fujimoto
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Genta Ochi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Go Omori
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Daisuke Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
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Holden S, Lee H, van Middelkoop M, Rathleff MS. Exploring the pain and disability continuum in adolescents with non-traumatic anterior knee pain: a mediation analysis using individual participant data of prospective studies. Br J Sports Med 2023; 57:1388-1394. [PMID: 37699655 DOI: 10.1136/bjsports-2023-107177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVE To use individual patient data (IPD) to investigate if the effect of pain on sports-related disability is mediated through physical (lower extremity isometric strength) or psychological (depression/anxiety and knee confidence) factors in adolescents with non-traumatic anterior knee pain. METHODS This study included four datasets from a previously harmonised IPD dataset. Prior to analysis, the protocol and analysis approach were predefined and published on Open Science Framework. Potential mediators were pre-sepcified as isometric knee and hip strengths, self-reported anxiety/depression and confidence in the knee, allmeasured at 12 weeks after baseline evaluation. Mediation analyses were undertaken using the CMAVerse package in RStudio using the regression-based approach to decompose the total effect of the exposure (pain at baseline evaluation) on the outcome (sports-related disability at 6 months) into the 'indirect effect' (the portion of the total effect acting through the mediators) and the 'direct effect'. RESULTS Two-hundred and seventy-nine adolescents with non-traumatic knee pain were included in the analysis. Median age was 13 (range 10-19), and 72% were women. Baseline pain was associated with sports-related disability at 6 months. There was no evidence of the association being mediated by any of the proposed mediators (total natural indirect effect for strength 0.01 (-1.14 to 1.80) and psychological factors 0.00 (-0.66 to 2.02)). CONCLUSION We found an effect of pain on sports-related disability at 6 months which appears to be independent of lower extremity muscle strength, or depression/anxiety and knee confidence in adolescents with non-traumatic anterior knee pain.
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Affiliation(s)
- Sinead Holden
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Hopin Lee
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | | | - Michael Skovdal Rathleff
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Center for General Practice at Aalborg University, Aalborg University, Aalborg, Denmark
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
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Konieczny M, Skorupska E, Domaszewski P, Pakosz P, Skulska M, Herrero P. Relationship between latent trigger points, lower limb asymmetry and muscle fatigue in elite short-track athletes. BMC Sports Sci Med Rehabil 2023; 15:109. [PMID: 37700332 PMCID: PMC10496335 DOI: 10.1186/s13102-023-00719-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Short-track speed skating movement involves asymmetric overloading of the lower left side of the body. The gluteus maximus fatigue limits the physical and mental athletic capacity to perform set tasks. A possible link between the presence of latent trigger points (LTrPs) and muscle fatigue development/persistence has been posited. The aim of the study was to determine whether elite short-track speed skating can result in the impairment of the musculoskeletal system of the lower limbs. METHODS Elite short-track athletes as the experimental group (EXP) = 9, 19.5 ± 1.8 years, and healthy subjects as the control group (CON) = 18, 20.8 ± 1.2 years, were tested for: (i) lower limb loading asymmetry using ground reaction force (GRF) measurements during quiet standing, (ii) gluteus maximus fatigue measured with surface electromyography (sEMG) during the Biering-Sorensen test, and (iii) LTrPs presence in the 14 examined muscles of the pelvic girdle and lower limbs. RESULTS There were between-group differences in the number of LTrPs, with the EXP group (left lower limb (LLL) n = 18, right lower limb (RLL) n = 9) showing more LTrPs compared to the CON group (LLL n = 2, RLL n = 1), (p < 0.001), and within-group differences in the EXP group only (p < 0.001). There were also significant differences in muscle fatigue for the left side (p < 0.001) both between the groups and within the EXP group (p ≤ 0.001). The vertical ground reaction force (GRF) measurement showed a loading rate of 2% (p = 0.013) in the athletes' LLL exclusively. CONCLUSIONS The study confirmed an increased prevalence of LTrPs, increased muscle fatigue and left-sided limb load asymmetry in elite short-track athletes. TRIAL REGISTRATION The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Poznan University of Medical Sciences (Resolution No 110/22 of 10 March 2022). TRIAL REGISTRATION 20/07/2022, Trial Id: ACTRN12622001016729.
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Affiliation(s)
- Mariusz Konieczny
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Prószkowska 76, Opole, 45-068, Poland
| | - Elżbieta Skorupska
- Department of Physiotherapy, Poznan University of Medical Sciences, Poznan, 61-701, Poland.
| | - Przemysław Domaszewski
- Department of Health Sciences, Institute of Health Sciences, University of Opole, Katowicka 68, Opole, 45-060, Poland
| | - Paweł Pakosz
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Prószkowska 76, Opole, 45-068, Poland
| | - Marta Skulska
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Prószkowska 76, Opole, 45-068, Poland
| | - Pablo Herrero
- Faculty of Health Sciences, IIS Aragon, University of Zaragoza, Domingo Miral, s/n, Zaragoza, 50009, Spain
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Zhou X, Imai K, Chen Z, Liu X, Watanabe E, Zeng H. The Characteristics of Badminton-Related Pain in Pre-Adolescent and Adolescent Badminton Players. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1501. [PMID: 37761462 PMCID: PMC10530166 DOI: 10.3390/children10091501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023]
Abstract
Body pain, often considered as an early sign of injury in young players, warrants thorough study. This study aimed to examine the distribution of badminton-related pain and prevalence in pre-adolescent and adolescent badminton players. Profiles of badminton-related pain were surveyed using a questionnaire among 366 pre-adolescent and adolescent badminton players aged 7-12 years. The distribution of badminton-related pain was described, and the pain incidence was calculated. Proportions of pain per 1000-training-hour exposures were the main outcome measures. The analysis considered various age groups (7-8, 9-10, and 11-12 years) and years of badminton experience (≤2, 2-3, and > 3 years). In total, 554 cases of badminton-related pain were reported. The ankle was the most common site, followed by knee, plantar, shoulder, and lower back. The overall pain rate per 1000-training-hour exposure was 3.06. The 11-12-year-old group showed the highest pain rate, significantly greater than the 7-8-year-old group and the 9-10-year-old group. Additionally, the prevalence of pain exhibited an increasing trend with age. Finally, regardless of the age groups, participants with 2-3 years of badminton experience had the highest pain rate. These findings might help inform targeted interventions to reduce the high prevalence of pain in various body regions across pre-adolescent and adolescent badminton players.
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Affiliation(s)
- Xiao Zhou
- School of Physical Education, Huazhong University of Science and Technology, Wuhan 430074, China; (X.Z.); (H.Z.)
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Komaba, Meguro-ku, Tokyo 1538902, Japan;
| | - Kazuhiro Imai
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Komaba, Meguro-ku, Tokyo 1538902, Japan;
| | - Zhuo Chen
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Komaba, Meguro-ku, Tokyo 1538902, Japan;
| | - Xiaoxuan Liu
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Eiji Watanabe
- Institute of Sport, Senshu University, Kawasaki 2148580, Japan;
| | - Hongtao Zeng
- School of Physical Education, Huazhong University of Science and Technology, Wuhan 430074, China; (X.Z.); (H.Z.)
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12
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Norman MB, Norman ER, Langer GH, Allen MR, Meller L, Vitale KC. Return to Sport Using Corticosteroid Injections for Knee Pain in Triathletes. Cureus 2023; 15:e39985. [PMID: 37416041 PMCID: PMC10321459 DOI: 10.7759/cureus.39985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Despite the prevalence of corticosteroid injections in athletes, little is known about their efficacy in triathletes. We aim to assess attitudes, use, subjective effectiveness, and time to return to sport with corticosteroid injections compared to alternative methods in triathletes with knee pain. Methods This is an observational study during the COVID-19 pandemic. Triathletes answered a 13-question survey posted to three triathlon-specific websites. Results Sixty-one triathletes responded, 97% of whom experienced knee pain at some point in their triathlete career; 63% with knee pain received a corticosteroid injection as treatment (average age 51 years old). The most popular attitude (44.3%) regarding corticosteroid injections was "tried them, with good improvement". Most found the cortisone injection helpful for two to three months (28.6%), or more than one year (28.6%); of individuals who found the injections useful for more than one year, four-eight (50%) had received multiple injections during that same period. After injection, 80.6% returned to sport within one month. The average age of people using alternative treatment methods was 39 years old; most returned to sport within one month (73.7%). Compared to alternative methods, there was an ~80% higher odds of returning to sport within one month using corticosteroid injections; however, this relationship was not significant (OR=1.786, p=0.480, 95% CI:0.448-7.09). Conclusion This is the first study to examine corticosteroid use in triathletes. Corticosteroid use is more common in older triathletes and results in subjective pain improvement. A strong association does not exist for a quicker return to sport using corticosteroid injections compared to alternative methods. Triathletes should be counseled on the timing of injections, duration of side effects, and be aware of potential risks.
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Affiliation(s)
| | - Emily R Norman
- Physical Medicine and Rehabilitation, Dartmouth Geisel School of Medicine, Hanover, USA
| | | | - Matthew R Allen
- Orthopedic Surgery, University of California San Diego School of Medicine, La Jolla, USA
| | - Leo Meller
- Orthopedic Surgery, University of California San Diego School of Medicine, La Jolla, USA
| | - Kenneth C Vitale
- Orthopedic Surgery, University of California San Diego School of Medicine, La Jolla, USA
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Pain Acceptance Among Retired National Football League Athletes: Implications for Clinical Intervention. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2023; 17:27-40. [PMID: 36919031 PMCID: PMC10010661 DOI: 10.1123/jcsp.2020-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Over 80% of National Football League (NFL) retirees experience daily pain. Pain acceptance is an important psychological construct implicated in the intensity of chronic pain, though these findings have not been extended to NFL retirees. Therefore, the current study examined the association between pain acceptance and pain intensity among former NFL athletes. NFL retirees (N = 90) recruited from 2018 to 2019 completed questionnaires that assessed pain, substance use, and NFL career information. Multiple linear regression examined the association between current pain acceptance and pain intensity while adjusting for other risk factors of pain. NFL retirees reported average scores of 33.31 (SD = 10.00), and 2.18 (SD = 2.40) on measures of pain acceptance and pain intensity, respectively. After covariate adjustment, greater pain acceptance (β = -0.538, p < .001) was associated with lower pain intensity. These findings can further inform the behavioral and mental health care of retired NFL athletes.
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14
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Purcell C, Duignan C, Fullen BM, Ryan S, Ward T, Caulfield B. Comprehensive assessment and classification of upper and lower limb pain in athletes: a scoping review. Br J Sports Med 2023; 57:535-542. [PMID: 36759138 DOI: 10.1136/bjsports-2022-106380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Upper and lower limb (peripheral) pain is prevalent in athletes. Contemporary research prioritises multidimensional pain assessment and classification. This study aims to review comprehensive athlete pain assessment practices against the reference standard (International Olympic Committee, IOC Athlete Pain framework), identifying trends and highlighting gaps. METHODS AND ANALYSIS Six databases were searched using a comprehensive search strategy. This review followed the Joanna Briggs Institute standardised methodology for scoping reviews and is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Title and abstract, full-text screening and data charting were completed by two independent reviewers. INCLUSION CRITERIA Original research, systematic reviews and clinical practice guidelines reporting assessment or classification of pain in athletes of any age with chronic or acute peripheral pain in English on human participants from database inception. RESULTS 470 studies with 175 different pain assessment tools were mapped against the IOC Athlete Pain Framework. Papers included tools from neurophysiological (470/100%), biomechanical (425/90%), affective (103/22%), cognitive (59/13%) and socioenvironmental (182/39%) domains. Pain classification was included in 108 studies (23%). 4 studies (0.85%) defined pain. Athletes with physical disability were included in 13 (3%) studies and no studies included athletes with intellectual disabilities. Socioeconomic factors were addressed in 29 (6%) studies. DISCUSSION Neurophysiological and biomechanical domains are frequently addressed. Affective, socioenvironmental and cognitive tools are under-represented. Potential tools for use by researchers and clinicians are highlighted. Defining and classifying pain and determining predominant pain mechanisms is needed in both research and clinical practice. More work on underrepresented populations is needed. CONCLUSION This review informs researchers and clinicians working with athletes in pain how pain assessment and classification is currently conducted and highlights future priorities.
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Affiliation(s)
- Ciarán Purcell
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland .,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Ciara Duignan
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland.,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Brona M Fullen
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland
| | - Shiofra Ryan
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland.,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Tomas Ward
- Insight Centre for Data Analytics, School of Computing, Dublin City University, Dublin, Ireland
| | - Brian Caulfield
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland.,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
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15
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Short S, Tuttle M, Youngman D. A Clinically-Reasoned Approach to Manual Therapy in Sports Physical Therapy. Int J Sports Phys Ther 2023; 18:262-271. [PMID: 36793565 PMCID: PMC9897024 DOI: 10.26603/001c.67936] [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: 05/31/2022] [Accepted: 11/03/2022] [Indexed: 02/05/2023] Open
Abstract
Symptom modification techniques have been recently dichotomously labeled as either passive or active therapies. Active therapy such as exercise has been rightfully advocated for while "passive" therapies, mainly manual therapy have been regarded as low value within the physical therapy treatment spectrum. In sporting environments where physical activity and exercise are inherent to the athletic experience, the utilization of exercise-only strategies to manage pain and injury can be challenging when considering the demands and qualities of a sporting career which include chronically high internal and external workloads. Participation may be impacted by pain and its influence on related factors such as training and competition performance, career length, financial earning potential, educational opportunity, social pressures, influence of family, friends, and other key stakeholders of their athletic activity. Though highly polarizing viewpoints regarding different therapies create black and white "sides," a pragmatic gray area regarding manual therapy exists in which proper clinical reasoning can serve to improve athlete pain and injury management. This gray area includes both historic positive reported short-term outcomes and negative historical biomechanical underpinnings that have created unfounded dogma and inappropriate overutilization. Applying symptom modification strategies to safely allow the continuation of sport and exercise requires critical thinking utilizing not only the evidence-base, but also the multi-factorial nature of sports participation and pain management. Given the risks associated with pharmacological pain management, the cost of passive modalities like biophysical agents (electrical stimulation, photobiomodulation, ultrasound, etc), and the indications from the evidence-base when combined with active therapies, manual therapy can be a safe and effective treatment strategy to keep athletes active. Level of Evidence 5.
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16
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Assessing the Association of Shoulder Pain Risk with Physical Fitness in Badminton Players at National Tournament Level. Asian J Sports Med 2022. [DOI: 10.5812/asjsm-129916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Shoulder pain which affects sports performance and activities of daily life, is a common musculoskeletal problem experienced by badminton players. Objectives: This study aimed to identify the association of shoulder pain with physical fitness in elite university badminton players participating in the national tournament via medical check-ups. Methods: Physical fitness evaluations were performed among fifty-two 18 - 22 years old university badminton players participating in the national tournament. Handgrip strength, heel buttock distance, angle of straight leg raise, single leg stance, shoulder range of motion, and trunk range of motion were assessed. The prevalence of present shoulder pain was described. Multivariable logistic regression was used to examine the association of present shoulder pain with physical fitness. Results: Sixteen badminton players (30.8%) sustained present shoulder pain related to badminton. Dominant trunk rotation (adjusted OR: 0.91, 95% CI: 0.84 - 0.99, P-value = 0.028) and single leg stance of the nondominant leg (adjusted OR: 0.97, 95% CI: 0.94 - 1.00, P-value = 0.048) were significantly associated with the presence of present shoulder pain. Conclusions: Decreased trunk rotation and deficit in single-leg stance balance might be potential risk factors associated with physical fitness for shoulder pain in university badminton players at national tournament level. These findings can help draw the attention of badminton coaches, players, and team members to facilitate physical fitness promotion for badminton pain/injury prevention.
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Alaiti RK, Reis FJJ. Pain in Athletes: Current Knowledge and Challenges. Int J Sports Phys Ther 2022; 17:981-983. [PMID: 36237643 PMCID: PMC9528677 DOI: 10.26603/001c.37675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/14/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Rafael Krasic Alaiti
- Nucleus of Neuroscience and Behavior and Nucleus of Applied Neuroscience, Universidade de São Paulo; Research, Technology, and Data Science Office, Grupo Superador
| | - Felipe J J Reis
- Department of Physiotherapy, Instituto Federal do Rio de Janeiro; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel
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Bourgonjon B, Vermeylen K, Tytgat N, Forget P. Anaesthesia for elite athletes. Eur J Anaesthesiol 2022; 39:825-834. [PMID: 35943185 DOI: 10.1097/eja.0000000000001719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sports participation has been growing rapidly since the 1960s. Anaesthesiologists are increasingly confronted with athletes in a peri-operative setting. The right choice of type of anaesthesia technique, pain management of injuries, specific physiologic adaptations of the athlete and knowledge of prohibited substances are eminent for a correct approach of this subpopulation. PURPOSE This review aims to give an overview of athletes' specific anaesthetic management in peri-operative and postoperative settings and to guide the nonspecialised anaesthetist. METHODS We comprehensively reviewed the literature, gathered all the information available on, and synthesised it in a narrative way, regarding preoperative evaluation, intraoperative implications and postoperative pain management of the elite athlete undergoing a surgical procedure. RESULTS An anaesthesiologist should recognise the most common benign ECG findings in athletes like bradycardia, isolated left ventricle hypertrophy on voltage criteria and early repolarisation as normal features in the athlete's heart. Isotonic physiology typically produces four-chamber dilation. In contrast, isometric stress creates high intravascular pressure leading to left ventricular hypertrophy. Pre-operative evaluation should also identify possible consumers of performance-enhancing drugs. Intraoperative points of interest for the anaesthesiologist is mainly avoiding drugs on the prohibited list of the World Anti-Doping Agency (WADA). Postoperative and chronic pain management are still developing fields in this population. The International Olympic Committee (IOC) proposed treating acute pain with a combination of paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), topical analgesics, injectable NSAIDs and local anaesthetics. It may be suggested that chronic pain management in elite athletes could benefit from treatment in specialised multidisciplinary pain clinics. CONCLUSION This literature review aims to serve as a guide for the anaesthesiologist taking care of the elite athlete.
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Affiliation(s)
- Bram Bourgonjon
- From the Department of Anaesthesiology, GZA Antwerpen (BB), Department of Anaesthesiology, AZ Turnhout, Turnhout (KV), Department of Anaesthesiology, ASZ Aalst, Aalst, Belgium (NT) and Institute of Applied Health Sciences, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen; Department of Anaesthesia, NHS Grampian, Aberdeen, UK (PF)
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Pedersen JR, Andreucci A, Thorlund JB, Koes B, Møller M, Storm LK, Bricca A. Prevalence, frequency, adverse events, and reasons for analgesic use in youth athletes: A systematic review and meta-analysis of 44,381 athletes. J Sci Med Sport 2022; 25:810-819. [PMID: 36100523 DOI: 10.1016/j.jsams.2022.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To identify the prevalence, frequency, adverse effects, and reasons for analgesic use in youth athletes. DESIGN Systematic review and meta-analysis. METHODS Systematic searches in Embase, Medline, and SPORT-Discus from inception to September 2021, screening of reference lists, and citation tracking were performed to identify observational studies including athletes aged 15-24 years and reporting data on prevalence and/or frequency of analgesic use. Study quality was assessed using the Newcastle-Ottawa Scale. Random-effect proportion meta-analyses, stratified by type of analgesic medication and prevalence measure, estimated the prevalence of analgesic use. Data on usage frequency, adverse events, and reasons for analgesic use was synthesized narratively. RESULTS Forty-nine studies were included (44,381 athletes), of which 19 were good/high quality. Seven categories of analgesics were identified across 10 prevalence time-points. Meta-analyses suggested common use of NSAIDs (point prevalence 48 % [95 % CI 23 % to 73 %], in-season prevalence 92 % [95 % CI 88 % to 95 %]). The lowest prevalence was found for use of local anesthetic injections within the previous 12 months (2 % [95 % CI 1 % to 3 %]). Seven to 50 % of athletes reported weekly analgesics use. The proportion of adverse events ranged from 3.3 % to 19.2 %. Reasons for using analgesics included treatment of sports-related pain or injury, to treat illness, and to enhance performance. CONCLUSIONS Analgesics are commonly used in youth athletes, but estimates vary depending on type of analgesic and prevalence measure. As the majority of studies were of poor methodological quality, future high-quality research should include prospective data collection of analgesic use to understand consumption trajectories.
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Affiliation(s)
- Julie Rønne Pedersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark.
| | - Alessandro Andreucci
- Center for General Practice, Aalborg University, Denmark. https://twitter.com/Andreucci_Ale
| | - Jonas Bloch Thorlund
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Department of Public Health, University of Southern Denmark, Denmark. https://twitter.com/jbthorlund
| | - Bart Koes
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Center for Muscle and Joint Health, University of Southern Denmark, Denmark. https://twitter.com/bartkoes
| | - Merete Møller
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark. https://twitter.com/Merete_Moller
| | - Louise Kamuk Storm
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark. https://twitter.com/StormKamuk
| | - Alessio Bricca
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Denmark. https://twitter.com/a_bricca
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Gijon-Nogueron G, Ortega-Avila AB, Kaldau NC, Fahlstrom M, Felder H, Kerr S, King M, McCaig S, Marchena-Rodriguez A, Cabello-Manrique D. Data Collection Procedures and Injury Definitions in Badminton: A Consensus Statement According to the Delphi Approach. Clin J Sport Med 2022; 32:e444-e450. [PMID: 35588081 DOI: 10.1097/jsm.0000000000001048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/12/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Previous studies involving injury surveillance in badminton players have used nonstandardized injury definitions and data collection methodologies. The purpose of this study was to apply a Delphi method to (1) reach a consensus on an injury definition in badminton and (2) develop a standardized badminton injury report form. An Injury Consensus Group was established under the auspices of the Badminton World Federation, and initial injury definitions and injury report form were developed. An internal panel was formed from the Injury Consensus Group, and an external panel was selected based on a combination of profession, experience in the field, sport-specific knowledge/expertise, and geographical location to obtain a widely representative sample. Through 2 rounds of voting by the external panel, consensus was reached on both the definition of an injury in badminton and a standardized injury report form. The agreed injury definition was "Any physical injury sustained by a player during a match or training regardless if further diagnostic tests were done or if playing time was lost" and the injury report form contained the following 7 sections: Injury record, Diagnosis, Injury mechanism, Regarding pain, Pain and return to play/training after injury, Grade of severity, and Recurrence. We recommend the use of the definitions and methods presented in this consensus statement for the reporting of injury in all international and domestic badminton players. This should make future injury surveillance reports directly comparable and hence more informative in recognizing trends over time and differences between countries.
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Affiliation(s)
- Gabriel Gijon-Nogueron
- Department of Nursing and Podiatry, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Ana Belen Ortega-Avila
- Department of Nursing and Podiatry, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Niels Christian Kaldau
- Sports Orthopedic Research Center-Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager & Hvidovre Hospital, Hvidovre, Denmark
| | - Martin Fahlstrom
- Department of Clinical Science, Professional Development, Umeå University, Umeå, Sweden
| | - Hanno Felder
- Department of Biomechanics, Olympic Training Center, Saarbrücken, Germany
| | - Stewart Kerr
- Life Fit Wellness, Healthcare & Exercise Centre, Falkirk, Scotland, United Kingdom
| | - Mark King
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Steve McCaig
- English Institute of Sport, EIS/L'Boro Performance Centre, Loughborough University, Loughborough, United Kingdom
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Rentz LE, Bryner RW, Ramadan J, Rezai A, Galster SM. Full-Body Photobiomodulation Therapy Is Associated with Reduced Sleep Durations and Augmented Cardiorespiratory Indicators of Recovery. Sports (Basel) 2022; 10:sports10080119. [PMID: 36006085 PMCID: PMC9414854 DOI: 10.3390/sports10080119] [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: 07/01/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022] Open
Abstract
Research is emerging on the use of Photobiomodulation therapy (PBMT) and its potential for augmenting human performance, however, relatively little research exists utilizing full-body administration methods. As such, further research supporting the efficacy of whole-body applications of PBMT for behavioral and physiological modifications in applicable, real-world settings are warranted. The purpose of this analysis was to observe cardiorespiratory and sleep patterns surrounding the use of full-body PBMT in an elite cohort of female soccer players. Members of a women’s soccer team in a “Power 5 conference” of the National Collegiate Athletic Association (NCAA) were observed across one competitive season while wearing an OURA Ring nightly and a global positioning system (GPS) sensor during training. Within-subject comparisons of cardiorespiratory physiology, sleep duration, and sleep composition were evaluated the night before and after PBMT sessions completed as a standard of care for team recovery. Compared to pre-intervention, mean heart rate (HR) was significantly lower the night after a PBMT session (p = 0.0055). Sleep durations were also reduced following PBMT, with total sleep time (TST) averaging 40 min less the night after a session (p = 0.0006), as well as significant reductions in light sleep (p = 0.0307) and rapid eye movement (REM) sleep durations (p = 0.0019). Sleep durations were still lower following PBMT, even when controlling for daily and accumulated training loads. Enhanced cardiorespiratory indicators of recovery following PBMT, despite significant reductions in sleep duration, suggest that it may be an effective modality for maintaining adequate recovery from the high stress loads experienced by elite athletes.
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Affiliation(s)
- Lauren E. Rentz
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV 26506, USA;
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA; (J.R.); (A.R.); (S.M.G.)
- Correspondence:
| | - Randy W. Bryner
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV 26506, USA;
| | - Jad Ramadan
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA; (J.R.); (A.R.); (S.M.G.)
| | - Ali Rezai
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA; (J.R.); (A.R.); (S.M.G.)
| | - Scott M. Galster
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA; (J.R.); (A.R.); (S.M.G.)
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22
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Owoeye OBA, Neme JR, Buchanan P, Esposito F, Breitbach AP. Absence of Injury Is Not Absence of Pain: Prevalence of Preseason Musculoskeletal Pain and Associated Factors in Collegiate Soccer and Basketball Student Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159128. [PMID: 35897492 PMCID: PMC9368705 DOI: 10.3390/ijerph19159128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023]
Abstract
Unlike musculoskeletal (MSK) injuries, MSK pain is rarely studied in athletes. In this study, we examined the prevalence of preseason MSK pain in apparently healthy collegiate soccer and basketball players and its relationship with previous injuries (1-year history), among other factors. Ninety-seven eligible student athletes (mean age: 20.1 (SD: 1.6) years; 43% male; 53% soccer players) completed a baseline questionnaire comprising questions related to demographics, medical and 1-year injury history and any current MSK pain and the corresponding body location. The overall prevalence of preseason MSK pain was 26% (95% CI: 17–36%) and it did not differ by sex or sport. The back (6.2%) and knee (5.2%) regions were reported to be the most frequently affected body parts for preseason MSK pain. Athletes with a previous injury and with perception of incomplete healing had 3.5-fold higher odds (OR: 3.50; 95% CI: 1.28–9.36) of baseline MSK pain compared with those without a previous injury. One in four collegiate soccer and basketball players had preseason MSK pain. Collegiate sports medicine professionals should consider conducting routine preseason evaluations of MSK pain in their athletes and initiate appropriate interventions for the prevention of MSK pain and its potential consequences among athletes.
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Affiliation(s)
- Oluwatoyosi B. A. Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, St. Louis, MO 63104, USA;
- Correspondence:
| | - Jamil R. Neme
- Department of Family and Community Medicine, School of Medicine, Saint Louis University, St. Louis, MO 63104, USA;
| | - Paula Buchanan
- Department of Health and Clinical Outcomes Research, School of Medicine, Saint Louis University, St. Louis, MO 63104, USA;
| | - Flavio Esposito
- Department of Computer Science, Saint Louis University, St. Louis, MO 63103, USA;
| | - Anthony P. Breitbach
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, St. Louis, MO 63104, USA;
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23
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de Sire A. Sports-related musculoskeletal injuries: From diagnostics to rehabilitation. J Back Musculoskelet Rehabil 2022; 35:687-689. [PMID: 35662105 DOI: 10.3233/bmr-225002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Otis CL, Hainline B, Harwood C, Jayanthi NA, Jensen R, Keber A, Kroshus E, Livengood T, Stroia K, Quinn A, Vitkova S, Kliethermes SA. Differences in career longevity before and after implementation of the Women's Tennis Association Tour Age Eligibility Rule and Player Development Programmes: a 25-year study. Br J Sports Med 2022; 56:955-960. [PMID: 35396204 DOI: 10.1136/bjsports-2021-104620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To assess differences in career longevity, as a potential marker of athlete well-being, before and after the 1995 implementation of the Women's Tennis Association (WTA) Age Eligibility Rule (AER) and Player Development Programmes (PDP), which focused on organisational, physical and psychosocial education, skill building and support for adolescent athletes (≤17 years). METHODS Career longevity data were collected through 2019 on adolescent players who began professional tournament play between 1970 and 2014 and reached a WTA singles ranking of 1-150 for a minimum of 1 week during their careers. Players were separated into pre-AER/PDP and post-AER/PDP groups, consisting of those who played their first professional events (FPE) before or after 1 January 1995. Measures of career longevity included career duration and premature retirement. RESULTS Eight-hundred and eleven players were included in this study (51% pre-AER/PDP). The median career duration was 14.2 years for the post-AER/PDP group compared with 12.1 years for the pre-AER/PDP group (p<0.001). Moreover, post-AER/PDP players had higher probabilities of 10-year and 15-year careers compared with pre-AER/PDP players. After adjusting for age at FPE, athletes in the pre-AER/PDP group had an increased risk of shorter career duration (HR 1.55; 95% CI 1.31 to 1.83) and increased odds of premature retirement (OR 5.39; 95% CI 2.28 to 12.75) than athletes in the post-AER/PDP group. CONCLUSIONS Adolescent athletes participating on the WTA after the combined AER/PDP initiative had longer career durations, higher probabilities of 10-year and 15-year careers, and decreased risk of premature retirement compared with those participating prior to AER/PDP. Organisational practices that encompass both education and competition regulation can positively affect career longevity related to improving athlete well-being.
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Affiliation(s)
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | | | | | - Rick Jensen
- Rick Jensen's Performance Center, Aliso Viejo, California, USA
| | | | - Emily Kroshus
- Department of Pediatrics, University of Washington, Seattle, Washington, USA.,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | | | | | - Ann Quinn
- Quintessential Edge, Blackburn, Victoria, Australia
| | | | - Stephanie A Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Malmborg JS, Bremander A, Bergman S, Haglund E, Olsson MC. Musculoskeletal pain and its association with health status, maturity, and sports performance in adolescent sport school students: a 2-year follow-up. BMC Sports Sci Med Rehabil 2022; 14:43. [PMID: 35313966 PMCID: PMC8939173 DOI: 10.1186/s13102-022-00437-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Musculoskeletal pain and its risk factors are rarely assessed in studies on adolescent athletes. The aim was to identify risk factors at baseline that were associated with the persistence or development of musculoskeletal pain at a two-year follow-up in adolescent sport school students, and to study cross-sectional associations at follow-up between musculoskeletal pain and sports performance.
Methods Sport school students (79 boys and 52 girls, aged 14 years at baseline) were divided into infrequent (never–monthly) or frequent (weekly–almost daily) pain groups, based on frequency of pain using a pain mannequin. Logistic regression analyses were performed to study longitudinal associations between frequent pain at follow-up and baseline variables: pain group, number of regions with frequent pain, health status by EQ-5D, maturity offset (pre, average, or post peak height velocity), and sports (contact or non-contact). Linear regression analyses were used to study cross-sectional associations between pain groups and 20-m sprint, agility T-test, counter-movement jump, and grip strength at follow-up. Results were stratified by sex. Results A higher percentage of girls than boys reported frequent pain at follow-up (62% vs. 37%; p = 0.005). In boys, frequent pain at follow-up was associated with being pre peak height velocity at baseline (OR 3.884, CI 1.146–13.171; p = 0.029) and participating in non-contact sports (OR 3.429, CI 1.001–11.748; p = 0.050). In girls, frequent pain at follow-up was associated with having frequent pain in two or more body regions at baseline (OR 3.600, CI 1.033–12.542; p = 0.044), having a worse health status at baseline (OR 3.571, CI 1.026–12.434; p = 0.045), and participating in non-contact sports (OR 8.282, CI 2.011–34.116; p = 0.003). In boys, frequent pain was associated with worse performances in 20-m sprint and counter-movement jump, but not in agility T-test and grip strength. Conclusions Baseline risk factors for having frequent pain at follow-up were late maturation in boys, frequent pain and worse health status in girls, and participation in non-contact sports in both sexes. Boys with pain performed worse in sports tests. Coaches and school health-care services should pay attention to the risk factors and work towards preventing pain from becoming persistent.
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Affiliation(s)
- Julia S Malmborg
- Department of Environmental and Biosciences, School of Business, Innovation and Sustainability, Halmstad University, Box 823, 301 18, Halmstad, Sweden. .,Spenshult Research and Development Center, FoU Spenshult, Bäckagårdsvägen 47, 302 74, Halmstad, Sweden.
| | - Ann Bremander
- Department of Environmental and Biosciences, School of Business, Innovation and Sustainability, Halmstad University, Box 823, 301 18, Halmstad, Sweden.,Spenshult Research and Development Center, FoU Spenshult, Bäckagårdsvägen 47, 302 74, Halmstad, Sweden.,Department of Regional Health Research, University of Southern Denmark, Winsløvsparken 19.3, 5000, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Engelshøjgade 9A, 6400, Sønderborg, Denmark.,Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Box 117, 221 00, Lund, Sweden
| | - Stefan Bergman
- Spenshult Research and Development Center, FoU Spenshult, Bäckagårdsvägen 47, 302 74, Halmstad, Sweden.,Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Box 117, 221 00, Lund, Sweden.,Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 454, 405 30, Gothenburg, Sweden
| | - Emma Haglund
- Department of Environmental and Biosciences, School of Business, Innovation and Sustainability, Halmstad University, Box 823, 301 18, Halmstad, Sweden.,Spenshult Research and Development Center, FoU Spenshult, Bäckagårdsvägen 47, 302 74, Halmstad, Sweden.,Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Box 117, 221 00, Lund, Sweden
| | - M Charlotte Olsson
- Department of Environmental and Biosciences, School of Business, Innovation and Sustainability, Halmstad University, Box 823, 301 18, Halmstad, Sweden
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Low Occurrence of Musculoskeletal Symptoms in Swimming? Musculoskeletal Symptoms and Sports Participation in Adolescents: Cross Sectional Study (ABCD—Growth Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063694. [PMID: 35329389 PMCID: PMC8952247 DOI: 10.3390/ijerph19063694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/04/2022]
Abstract
The purpose of this paper was to identify the association between the occurrence of musculoskeletal symptoms (MS) and sports participation in adolescents. The sample included 193 adolescents (11 to 17 years of age; 131 boys and 62 girls). For this cross-sectional study, participants were categorized into four groups: “no-sports”, “repetitive non-impact sports”, “high-impact sports”, and “odd-impact sports”. A questionnaire was used, which defined MS as pain or any musculoskeletal complaint that led to restriction of current normal activities. In the entire sample, 112 adolescents reported at least one episode of MS during the recording, representing 58% of the sample. Our findings highlight that adolescents regularly engaged in odd-impact sports, such as martial arts, report a higher occurrence of MS than swimmers and adolescents who do not participate in any physical activity.
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Retrospective Analysis of Functional Pain among Professional Climbers. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Climbing became one of the official Olympic sports in 2020. The nociplastic pain mechanism is indicated as important in professional sports. Functional pain, which has not been examined in climbers until now, can be an example of nociplastic pain. This study aimed to determine functional pain locations in climbers according to gender and dominant climbing style. Climbers (n = 183) and healthy subjects (n = 160) completed an online survey focused on functional pain occurrence in the head, spine, and upper limbs. The logistic regression showed that climbing predisposes one to functional pain at: Gleno-humeral joint (odds ratio (OR): 3.06; area under the curve (AUC): 0.635), elbow (OR: 2.86; AUC: 0.625), fingers (OR: 7.74; AUC: 0.733), all (p < 0.05). Among the climbers, the female gender predisposed one to pain at: GHJ (OR: 3.34; AUC: 0.638), thoracic spine (OR: 1.95; AUC: 0.580), and lumbosacral spine (OR: 1.96; AUC: 0.578), all (p < 0.05). Climbing predisposes one to functional pain development in the upper limb. While the male climbers mainly suffered from finger functional pain, the female climbers reported functional pain in the GHJ and the thoracic and lumbosacral spine. Further studies on functional pain occurrence are recommended.
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Alexander LAJ, Eken MM, Teoh CS, Stuart MC, Derman EW, Blauwet CA. Patterns of Athlete Medication Use at the 2018 PyeongChang Paralympic Games: A Descriptive Cohort Study. Am J Phys Med Rehabil 2022; 101:270-278. [PMID: 33782274 DOI: 10.1097/phm.0000000000001751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Medication use among elite athletes has received growing attention over the past decades. However, only limited studies have focused on para athletes, and trends in medication use among this cohort remain unclear. The aims of this study were (1) to describe the pattern of medication use in elite Paralympic athletes, with a particular focus on analgesics, (2) to analyze whether medications declared by athletes were included in the 2018 World Anti-Doping Agency's prohibited list and monitoring program, (3) to report on a variety of novel supplements, and (4) to review whether athlete analgesic needs will be met by the new Olympic & Paralympic Model Formulary. DESIGN This is a retrospective, descriptive cohort study. RESULTS Of all athletes who underwent doping control, 21% declared the use of an analgesic medication. Athletes with limb deficiency and para snowboarders declared the most analgesic medications in their respective categories. It was determined that 84% of the athletes' analgesic medication needs were provided from the new Olympic & Paralympic Model Formulary. CONCLUSIONS Analgesic use among athletes who participated at the 2018 PyeongChang Winter Paralympics was high. Para snowboarders and athletes with limb deficiency declared the most analgesics. The new Olympic & Paralympic Model Formulary adequately addressed the medication needs of the athletes attending the 2018 games.
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Affiliation(s)
- Laine A J Alexander
- From the Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Department of Surgical Sciences, Stellenbosch University, Cape Town, South Africa (LAJA, MME, EWD); Sports Medicine Centre, Khoo Teck Puat Hospital, Singapore (CST); International Olympic Committee Medical and Scientific Commission Games Group, Lausanne, Switzerland (MCS); Centre for Metabolism and Inflammation, Division of Medicine, University College London, London, United Kingdom (MCS); International Olympic Committee Research Centre, Stellenbosch, South Africa (EWD); and Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (CAB)
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Murofushi K, Yamaguchi D, Katagiri H, Hirohata K, Furuya H, Mitomo S, Oshikawa T, Kaneoka K, Koga H. The relationship between movement self-screening scores and pain intensity during daily training. THE JOURNAL OF MEDICAL INVESTIGATION 2022; 69:204-216. [PMID: 36244771 DOI: 10.2152/jmi.69.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background : Various musculoskeletal screening and functional performance tests are used to evaluate physical condition. However, validated analysis tools that can identify gaps in pain knowledge during athletes' daily training are lacking. This study aimed to investigate the relationship between pain intensity in athletes during their daily training and the KOJI AWARENESS™ test in order to determine whether body dysfunction is related to pain among athletes. Methods : This cross-sectional study was conducted in a fitness center at the authors' affiliated institution. Thirty-five athletes (17 women and 18 men) aged 20-40 years were selected for study participation. KOJI AWARENESS™ self-evaluated test scores and pain intensity during daily training, as assessed on the numerical rating scale (NRS), were recorded. Results : The KOJI AWARENESS™ score showed a strong negative correlation with the NRS score for pain intensity during daily training (r = -0.640, P < 0.001). There was a significant negative correlation between KOJI AWARENESS™ and NRS scores, even when body mass index, sex, and age were entered as control variables. Conclusions : KOJI AWARENESS™ was highly accurate in detecting pain in athletes during their training. J. Med. Invest. 69 : 204-216, August, 2022.
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Affiliation(s)
- Koji Murofushi
- Sports Science Center, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Japan Sports Agency, Tokyo, Japan
| | - Daisuke Yamaguchi
- Sports Science Center, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Department of Orthopedics, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kenji Hirohata
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hidetaka Furuya
- Department of Rehabilitation, Sonoda Third Hospital/Tokyo Medical Institute Tokyo Spine Center, Tokyo, Japan
| | - Sho Mitomo
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | | | - Koji Kaneoka
- Faculty of Sport Science, Waseda University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Purcell C, Duignan C, Fullen B, Caulfield B. Assessment and classification of peripheral pain in athletes: a scoping review protocol. BMJ Open Sport Exerc Med 2021; 7:e001215. [PMID: 35028159 PMCID: PMC8719172 DOI: 10.1136/bmjsem-2021-001215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/04/2022] Open
Abstract
Pain is often presumed to be part of the sport injury experience. The time-loss definition of injury leads to under-reported athletic pain impacting performance and quality of life. Whilst research regarding the assessment and classification of back pain in athletes is emerging, little has been reported regarding how peripheral pain is assessed and classified in research and practice. Six databases will be searched for relevant articles. Title and abstract screening followed by full-text screening will be completed by two independent reviewers. Data charting will be carried out using a modified standardised form. Descriptive results and frequencies will be reported. Pain measures identified in the studies will be mapped against the IOC Athlete Pain Framework alongside a narrative summary. Published peer-reviewed primary research studies alongside systematic reviews and clinical practice guidelines reporting the assessment or classification of pain in athletes of any age with chronic or acute peripheral pain across all study contexts in the English language on human participants from inception of the databases will be included. The results of this study are part of a body of research which will be used to inform the development of a pain assessment framework. The scoping review will be submitted for peer-reviewed journal publication and presented at sports medicine conferences. This review will inform researchers and clinicians working with athletes in pain how pain assessment and classification is currently conducted and positioned against the IOC Athlete Pain Framework.
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Affiliation(s)
- Ciarán Purcell
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Ciara Duignan
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Brona Fullen
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Brian Caulfield
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
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Bedrin MD, Putko RM, Dickens JF. Analgesia in Athletes: A Review of Commonly Used Oral and Injectable Modalities. Sports Med Arthrosc Rev 2021; 29:e71-e76. [PMID: 34730120 DOI: 10.1097/jsa.0000000000000325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Pain is common among athletes at all levels and the treatment of pain can be a challenging and frustrating task. The team physician needs a fundamental knowledge of analgesic strategies as it relates to athletes. It is important to understand the mechanism of action, side effect profile/associated complications, incidence of and indications for use, as well as the controversies associated with the most common analgesic medications used in sports medicine. Several "in vogue" treatment modalities, including cannabidiol, are also becoming more commonly used and are worth discussion.
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de Sire A, Marotta N, Lippi L, Scaturro D, Farì G, Liccardi A, Moggio L, Letizia Mauro G, Ammendolia A, Invernizzi M. Pharmacological Treatment for Acute Traumatic Musculoskeletal Pain in Athletes. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111208. [PMID: 34833426 PMCID: PMC8618079 DOI: 10.3390/medicina57111208] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 12/14/2022]
Abstract
Pain management is a crucial issue for athletes who train and compete at the highest performance levels. There are still evidence gaps for the use of analgesics for sports injuries despite the growing interest in training and competition settings. However, high-quality research is needed to determine the most appropriate and optimal timing and formulations in non-steroidal anti-inflammatory drug and opioid management, particularly given the strictness of anti-doping regulations. Indeed, the role of pharmacological therapy in reducing acute traumatic pain in athletes should still be addressed to minimize the timing of return to sport. Therefore, the aim of this comprehensive review was to summarize the current evidence about pain management in the setting of acute injury in elite athletes, providing the most informed strategy for pain relief and performance recovery.
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Affiliation(s)
- Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (L.M.); (A.A.)
- Correspondence: ; Tel.: +39-0961712819
| | - Nicola Marotta
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (L.M.); (A.A.)
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (M.I.)
| | - Dalila Scaturro
- Physical and Rehabilitative Medicine, Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90100 Palermo, Italy; (D.S.); (G.L.M.)
| | - Giacomo Farì
- Motor and Sports Sciences, Department of Sciences and Biological and Environmental Technologies, Salento University, 73100 Lecce, Italy;
| | - Alfonso Liccardi
- Department of Biomedical Sciences for Health, University of Milan, 20122 Milan, Italy;
| | - Lucrezia Moggio
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (L.M.); (A.A.)
| | - Giulia Letizia Mauro
- Physical and Rehabilitative Medicine, Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90100 Palermo, Italy; (D.S.); (G.L.M.)
| | - Antonio Ammendolia
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (L.M.); (A.A.)
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Sari DM, Rønne Pedersen J, Bloch Thorlund J, Ramer Mikkelsen U, Møller M. Pain medication use in youth athletes: A cross‐sectional study of 466 youth handball players. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Dilara Merve Sari
- Department of Sports Science and Clinical Biomechanics University of Southern Denmark Odense Denmark
| | - Julie Rønne Pedersen
- Department of Sports Science and Clinical Biomechanics University of Southern Denmark Odense Denmark
| | - Jonas Bloch Thorlund
- Department of Sports Science and Clinical Biomechanics University of Southern Denmark Odense Denmark
- Research Unit for General Practice Department of Public Health University of Southern Denmark Odense Denmark
| | - Ulla Ramer Mikkelsen
- Section for Sports Science Department of Public Health Aarhus University Aarhus Denmark
| | - Merete Møller
- Department of Sports Science and Clinical Biomechanics University of Southern Denmark Odense Denmark
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Martin CL, Arundale AJH, Kluzek S, Ferguson T, Collins GS, Bullock GS. Characterization of Rookie Season Injury and Illness and Career Longevity Among National Basketball Association Players. JAMA Netw Open 2021; 4:e2128199. [PMID: 34605914 PMCID: PMC8491104 DOI: 10.1001/jamanetworkopen.2021.28199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE There is limited research investigating injury and illness among professional basketball players during their rookie season. By improving the understanding of injury incidence and risk specific to rookie players, sports medicine clinicians may be able to further individualize injury mitigation programs that address the unique needs of rookie players. OBJECTIVE To compare incidence and rate ratio (RR) of injury and illness among professional National Basketball Association (NBA) players in their rookie season with veteran players and to explore the association of sustaining an injury rookie season with career longevity. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used an online data repository and extracted publicly available data about NBA players between the 2007 and 2008 season to the 2018 and 2019 season. Available data for initial injury and all subsequent injuries were extracted during this time frame. EXPOSURES Injury and illness based on injury status during the rookie season of professional NBA players. MAIN OUTCOMES AND MEASURES Injury and illness incidence and RR. Association of injury during the rookie season with career longevity was assessed via Poisson regressions. RESULTS Of the 12 basketball seasons analyzed, 904 NBA players were included (mean [SD] age, 24.6 [3.9] years; body mass index, 24.8 [1.8]). The injury and illness incidence for rookie players was 14.28 per 1000 athlete game exposures (AGEs). Among all body regions, ankle injuries had the greatest injury incidence among players injured during their rookie season (3.17 [95% CI, 3.15-3.19] per 1000 AGEs). Rookie athletes demonstrated higher RR compared with veterans across multiple regions of the body (ankle: 1.32; 95% CI, 1.12 to 1.52; foot/toe: 1.29; 95% CI, 0.97 to 1.61; shoulder/arm/elbow: 1.43; 95% CI, 1.10 to 1.77; head/neck: 1.21; 95% CI, 0.61 to 1.81; concussions: 2.39; 95% CI, 1.89 to 2.90; illness: 1.14; 95% CI, 0.87 to 1.40), and demonstrated a higher rate of initial injuries compared with veteran players (1.41; 95% CI, 1.29 to 1.53). Players who sustained an injury rookie season demonstrated an unadjusted decrease in total seasons played (-0.4 [95% CI, -0.5 to -0.3] log years; P < .001), but this decrease was not observed within adjusted analysis (0.1 [95% CI, -0.1 to 0.2] log years; P = .36). CONCLUSIONS AND RELEVANCE In this study, rookie athletes demonstrated the highest injury incidence at the ankle and increased RR across multiple regions. These findings may reflect differences in preseason conditioning or load variables impacting rookie athletes and warrant further investigation. Future research is needed to determine the association of cumulative injury burden vs a singular injury event on career longevity.
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Affiliation(s)
| | - Amelia J. H. Arundale
- Icahn School of Medicine at Mount Sinai Health System, New York, New York
- Red Bull Athlete Performance Center, Red Bull GmBH, Thalgau, Austria
| | - Stefan Kluzek
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, United Kingdom
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- University of Nottingham, Nottingham, United Kingdom
| | - Tyler Ferguson
- Big Data Institute, University of Oxford, United Kingdom
| | - Gary S. Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Garrett S. Bullock
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, United Kingdom
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Rojas-Valverde D. Potential Role of Cannabidiol on Sports Recovery: A Narrative Review. Front Physiol 2021; 12:722550. [PMID: 34413793 PMCID: PMC8369499 DOI: 10.3389/fphys.2021.722550] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/09/2021] [Indexed: 12/12/2022] Open
Abstract
The use of cannabidiol (CBD) among athletes is becoming extensive and frequent. This could be due to the elimination of CBD from the list of prohibited substances by federations and international institutions of sport. The legalization and resulting production, and commercialization of CBD, could increase its intake in sports professionals. This commercialization of cannabinoids has fueled a race to study their properties, benefits, and risks for health and performance in athletes. Although there is evidence that suggests some beneficial properties such as anxiolytics, antidepressants, anti-inflammatory, and antioxidants among others, the evidence presented so far is neither clear nor conclusive. There are significant gaps in knowledge of the physiological pathways that explain the role of CBD in sports performance. This mini-review examines evidence suggesting that CBD has the potential to be used as a part of the strategies to recover from fatigue and muscle damage related to physical and cognitive exertion in sports.
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Affiliation(s)
- Daniel Rojas-Valverde
- Clínica de Lesiones Deportivas (Rehabilitation and Readaptation), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia, Costa Rica.,Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia, Costa Rica.,Núcleo de Estudios para el Alto Rendimiento y la Salud (NARS), Escuela Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia, Costa Rica
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Doheny MC, Bury G. Pitch-side Acute Severe Pain Management Decisions in European Elite football. Int J Sports Med 2021; 43:567-573. [PMID: 34399429 DOI: 10.1055/a-1588-7931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This is the first study on acute severe pain management involving sport and exercise medicine Doctors who are leaders in football medicine in their respective countries. An online survey was designed describing the management of acute severe pain in this expert cohort. The survey captured participant sex, age, years working in sports medicine, core specialty and use of clinical practice guidelines (CPGs). Finally, three clinical vignettes exploring the management of acute pain were presented. Forty-four senior team doctors across 55 European countries completed the survey. There were no consistent guidelines proposed, with 33 (75%) participants indicating they did not use any. Methoxyflurane was proposed by 14 (32%) and 13 (30%) participants for female anterior cruciate ligament rupture and male ankle fracture, respectively. Strong opioids were not used in 17 (39%) and 6 (14%) participants regarding female cruciate injuries and male fractures, respectively. Despite 75% of participants having paediatric life support training, eight (18%) participants expressed uncertainty administering medications in this population, and 15 (34%) would avoid using strong opioids altogether. There is a tendency to undertreat pain and avoid strong opioids for reasons including lack of monitoring equipment, anti-doping concerns and lack of comfort treating paediatric patients with opioids.
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Affiliation(s)
| | - Gerard Bury
- General Practice, University College Dublin, Dublin, Ireland
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Zandonai T, Escorial M, Peiró AM. Codeine and Tramadol Use in Athletes: A Potential for Abuse. Front Pharmacol 2021; 12:661781. [PMID: 34177579 PMCID: PMC8222773 DOI: 10.3389/fphar.2021.661781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/19/2021] [Indexed: 02/03/2023] Open
Affiliation(s)
- Thomas Zandonai
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Elche, Spain.,Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernández University of Elche, Elche, Spain
| | - Mónica Escorial
- Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernández University of Elche, Elche, Spain.,Neuropharmacology on Pain and Functional Diversity (NED), Institute of Health and Biomedical Research of Alicante (ISABIAL Foundation), Alicante, Spain
| | - Ana M Peiró
- Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernández University of Elche, Elche, Spain.,Neuropharmacology on Pain and Functional Diversity (NED), Institute of Health and Biomedical Research of Alicante (ISABIAL Foundation), Alicante, Spain.,Pain Unit, Department of Health of Alicante-General Hospital, Alicante, Spain
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38
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Bascour-Sandoval C, Norambuena-Noches Y, Monrroy-Uarac M, Flández-Valderrama J, Gálvez-García G, Gajardo-Burgos R. ASSOCIATION BETWEEN SLEEP QUALITY AND PAIN IN YOUNG AMATEUR ATHLETES. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127022019_0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: It has been shown that there is a close association between sleep quality and pain. In young athletes, sleep disorders and pain have a particularly high prevalence; however, the relationship between them has not been widely studied. Objective: To study the association between sleep quality and pain in young athletes. Methods: A cross-sectional study was conducted in which 71 young amateur athletes (39 males) were included. The mean age was 16.9 ± 1.2 years, with 6.5 ± 3.2 years of sports practice and 5.2 ± 1.2 hours of training per week. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The participants were classified according to sleep quality, as PSQI-I = without sleep disorders, PSQI-II = requiring medical assistance and PSQI-III = requiring medical assistance and treatment. Also, pain intensity was assessed on the Numerical Rating Scale, both at rest (NRSr) and during sports activity (NRSs), along with pain duration. Results: The individuals classified as PSQI-III presented higher NRSr (Mdn = 2.0; IQR = 4.0 vs. Mdn = 0.0; IQR = 2.0; p = 0.04) and higher NRSs (Mdn = 4.0; IQR = 5.0 vs. Mdn = 0.0; IQR = 2.0; p = 0.03) than the individuals classified as PSQI-I. No differences were observed in relation to pain duration. The PSQI score was positively but weakly associated with NRSr (rs = 0.24, p=0.046) and NRSs (rs = 0.27, p = 0.03) but not with pain duration. Conclusion: Young athletes with lower levels of sleep quality show higher levels of pain at rest and during sports practice. Therefore, sleep quality and pain should be considered in the routine assessment of young athletes, by technical and health teams. Level of evidence III; type of study: Cross-sectional .
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Abstract
CONTEXT Injections are commonly used by health care practitioners to treat foot and ankle injuries in athletes despite ongoing questions regarding efficacy and safety. EVIDENCE ACQUISITION An extensive literature review was performed through MEDLINE, Google Scholar, and EBSCOhost from database inception to 2021. Keywords searched were injections, athletes, sports, foot and ankle, corticosteroids, platelet-rich plasma, and placental tissue. Search results included articles written in the English language and encompassed reviews, case series, empirical studies, and basic science articles. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS Corticosteroids, platelet-rich plasma/autologous blood, anesthetic, and placental tissue injections are commonly used in the treatment of foot and ankle injuries. Primary indications for injections in athletes include plantar fasciitis, Achilles tendinosis, isolated syndesmotic injury, and ankle impingement with varying clinical results. CONCLUSIONS Despite promising results from limited case series and comparative studies, the data for safety and efficacy of injections for foot and ankle injuries in athletes remain inconclusive.
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Affiliation(s)
- Jonathan K Ochoa
- Department of Orthopaedic Surgery, University of California-Irvine, Orange, California
| | - Christopher E Gross
- Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina
| | - Robert B Anderson
- Bellin Health Titletown Sports Medicine and Orthopedics, Green Bay, Wisconsin
| | - Andrew R Hsu
- Department of Orthopaedic Surgery, University of California-Irvine, Orange, California
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40
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Spotlight on the link between imagery and empathy in sport. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-020-00722-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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41
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Yargiç MP, Torgutalp ŞŞ, Erdagi K. Nonsteroidal anti-inflammatory drugs and paracetamol use in elite-level Olympic-style weightlifters: a survey study. J Sports Med Phys Fitness 2021; 61:991-996. [PMID: 33586925 DOI: 10.23736/s0022-4707.21.11604-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although the high prevalence of analgesic use in various sports disciplines is well-known, it has not been reported among Olympic-style weightlifters yet. We aimed to determine the frequency of the nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol use in elite-level Olympic-style weightlifters, the weightlifters' attitudes towards NSAIDs and paracetamol use, and the total daily, weekly and monthly doses of NSAIDs and paracetamol. METHODS A total of 166 (46 female, 120 male) Olympic-style weightlifters enrolled for this study. Data was collected through an interviewer-administered questionnaire distributed during national championships. The Assessment of Spondyloarthritis International Society-NSAID equivalent score, total doses of acetylsalicylic acid and paracetamol were calculated daily, weekly, and monthly. RESULTS The mean age of participants was 18.9±4.7 years. Only 11.4% of athletes stated that they used the drug only when the physician prescribed it. More than half of the athletes (57.2%) stated that they used at least one of the analgesics the day before the competition day. The most common form reported by the athletes was the concomitant use of medications (31.3%). The mean total acetylsalicylic acid, NSAID and paracetamol doses of 95 athletes using analgesics were daily: 500.0±95.0 mg/105.0±71.4 mg/555.6±160.1 mg, weekly: 1166.0±899.4 mg/145.2±176.6 mg/1166.7±892.8 mg, and monthly: 3461.1±4940.7 mg/201.5±274.0 mg/2750.0±3841.9 mg, respectively. CONCLUSIONS The frequency of analgesic and anti-inflammatory medication use among the elite-level Olympic-style weightlifters is very high.
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Affiliation(s)
- Melda P Yargiç
- Department of Sports Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Şerife Ş Torgutalp
- Clinic of Sports Medicine, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey -
| | - Kenan Erdagi
- Department of Physical Education and Sport, Ahmet Kelesoglu Faculty of Education, Necmettin Erbakan University, Konya, Turkey
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Jędrejko K, Lazur J, Muszyńska B. Risk Associated with the Use of Selected Ingredients in Food Supplements. Chem Biodivers 2021; 18:e2000686. [PMID: 33410585 DOI: 10.1002/cbdv.202000686] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/05/2021] [Indexed: 12/30/2022]
Abstract
This review focuses on four new product categories of food supplements: pre-workout, fat burner/thermogenic, brain/cognitive booster, and hormone/testosterone booster. Many food supplements have been shown to be contaminated with unauthorized substances. In some cases, the ingredients in the new categories of dietary supplements were medicinal products or new synthetic compounds added without performing clinical trials. Some of the new ingredients in dietary supplements are plant materials that are registered in the pharmacopoeia as herbal medicines. In other cases, dietary supplements may contain plant materials that have no history of human use and are often used as materials to 'camouflage' stimulants. In the European Union, new ingredients of dietary supplements, according to European Food Safety Authority or unauthorized novel food. Furthermore, selected ingredients in dietary supplements may be prohibited in sports and are recognized as doping agents by World Anti-Doping Agency.
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Affiliation(s)
- Karol Jędrejko
- Jagiellonian University Medical College, Faculty of Pharmacy, Department of Pharmaceutical Botany, Medyczna 9 Street, PL, 30-688, Kraków, Poland
| | - Jan Lazur
- Jagiellonian University Medical College, Faculty of Pharmacy, Department of Pharmaceutical Botany, Medyczna 9 Street, PL, 30-688, Kraków, Poland
| | - Bożena Muszyńska
- Jagiellonian University Medical College, Faculty of Pharmacy, Department of Pharmaceutical Botany, Medyczna 9 Street, PL, 30-688, Kraków, Poland
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Thornton JS, Caneiro JP, Hartvigsen J, Ardern CL, Vinther A, Wilkie K, Trease L, Ackerman KE, Dane K, McDonnell SJ, Mockler D, Gissane C, Wilson F. Treating low back pain in athletes: a systematic review with meta-analysis. Br J Sports Med 2020; 55:656-662. [PMID: 33355180 DOI: 10.1136/bjsports-2020-102723] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To summarise the evidence for non-pharmacological management of low back pain (LBP) in athletes, a common problem in sport that can negatively impact performance and contribute to early retirement. DATA SOURCES Five databases (EMBASE, Medline, CINAHL, Web of Science, Scopus) were searched from inception to September 2020. The main outcomes of interest were pain, disability and return to sport (RTS). RESULTS Among 1629 references, 14 randomised controlled trials (RCTs) involving 541 athletes were included. The trials had biases across multiple domains including performance, attrition and reporting. Treatments included exercise, biomechanical modifications and manual therapy. There were no trials evaluating the efficacy of surgery or injections. Exercise was the most frequently investigated treatment; no RTS data were reported for any exercise intervention. There was a reduction in pain and disability reported after all treatments. CONCLUSIONS While several treatments for LBP in athletes improved pain and function, it was unclear what the most effective treatments were, and for whom. Exercise approaches generally reduced pain and improved function in athletes with LBP, but the effect on RTS is unknown. No conclusions regarding the value of manual therapy (massage, spinal manipulation) or biomechanical modifications alone could be drawn because of insufficient evidence. High-quality RCTs are urgently needed to determine the effect of commonly used interventions in treating LBP in athletes.
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Affiliation(s)
- Jane S Thornton
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - J P Caneiro
- Physiotherapy, Curtin University, Perth, Western Australia, Australia
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Clare L Ardern
- Division of Physiotherapy, Karolinska Institute, Huddinge, Sweden
- Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Anders Vinther
- Physiotherapy and Occupational Therapy and QD research-unit, Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
| | - Kellie Wilkie
- Tasmania Institute of Sport, Hobart, Tasmania, Australia
| | - Larissa Trease
- Heathcare in remote and extreme environments, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Orthopedics ACT, Canberra, New South Wales, Australia
| | - Kathryn E Ackerman
- Sports Medicine Division, Boston Children's Hospital, Boston, Massachusetts, USA
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kathryn Dane
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - David Mockler
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Conor Gissane
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Fiona Wilson
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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Ferraresi C. Use of Photobiomodulation Therapy in Exercise Performance Enhancement and Postexercise Recovery: True or Myth? Photobiomodul Photomed Laser Surg 2020; 38:705-707. [DOI: 10.1089/photob.2020.4948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Cleber Ferraresi
- Laboratory of Biophotonics and Exercise Performance, Post-graduation program in Biomedical Engineering, Universidade Brasil, Sao Paulo, Brazil
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45
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THE GAP BETWEEN RESEARCH AND CLINICAL PRACTICE FOR INJURY PREVENTION IN ELITE SPORT: A CLINICAL COMMENTARY. Int J Sports Phys Ther 2020; 15:1229-1234. [PMID: 33344038 DOI: 10.26603/ijspt20201229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
As clinicians strive to apply evidence-based principles, team-based practitioners have identified a large gap as it relates to published research, ideal applications of evidence-based practice, and actual clinical practice related to injury prevention in elite sport within the United States. For rehabilitation professionals, especially those intimately involved in the research of injury prevention, the solution often seems quite clear and defined. However, preventing injury by implementing the latest recommendation from the most recent prospective study on the using the FIFA 11 + warm-up, a Copenhagen Adduction exercise, or a plyometric drill with elite athletes may not be as effective as was seen among the cohort used in the study. In addition to extrapolating research, clinicians face additional challenges such as variance among professions, schedule density, and off-season contacts with athletes. There is an inherent difficulty in the application of research to practice in elite sport as it relies on the teamwork of not only the practitioner and athlete, but the entire sporting organizational structure and those involved in athlete participation. The purpose of this clinical commentary is to explore the difficulty with application of research in clinical practice and to discuss potential strategies for improving carry over from research to clinical practice.
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Abstract
Patellofemoral pain (PFP) is among the most common injuries in recreational runners. Current evidence does not identify alignment, muscle weakness, and patellar maltracking or a combination of these as causes of PFP. Rather than solely investigating biomechanics, we suggest a holistic approach to address the causes of PFP. Both external loads, such as changes in training parameters and biomechanics, and internal loads, such as sleep and psychological stress, should be considered. As for the management of runners with PFP, recent research suggested that various interventions can be considered to help symptoms, even if these interventions target biomechanical factors that may not have caused the injury in the first place. In this Current Concepts article, we describe how the latest evidence on education about training modifications, strengthening exercises, gait and footwear modifications, and psychosocial factors can be applied when treating runners with PFP. The importance of maintaining relative homeostasis between load and capacity will be emphasized. Recommendations for temporary or longer-term interventions will be discussed. A holistic, evidence-based approach should consist of a graded exposure to load, including movement, exercise, and running, while considering the capacity of the individual, including sleep and psychosocial factors. Cost, accessibility, and the personal preferences of patients should also be considered.
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Affiliation(s)
- Jean-Francois Esculier
- The Running Clinic, Lac Beauport, QC, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- MoveMed Physiotherapy, Kelowna, BC, Canada
| | - Kevin Maggs
- The Running Clinic, Lac Beauport, QC, Canada
- Lively Health Clinic, Gainesville, VA
| | - Ellora Maggs
- The Running Clinic, Lac Beauport, QC, Canada
- Peak Performance Care Physical Therapy, Sonora, CA
| | - Blaise Dubois
- The Running Clinic, Lac Beauport, QC, Canada
- Physiothérapie et médecine du sport PCN, Quebec City, QC, Canada
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47
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Epidemiology, clinical characteristics and severity of gradual onset injuries in recreational road cyclists: A cross-sectional study in 21,824 cyclists - SAFER XIII. Phys Ther Sport 2020; 46:113-119. [DOI: 10.1016/j.ptsp.2020.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 11/17/2022]
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48
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History of chronic disease is a novel intrinsic risk factor associated with gradual onset injuries in recreational road cyclists: A cross-sectional study in 21,824 cyclists - SAFER XIV. Phys Ther Sport 2020; 46:137-144. [DOI: 10.1016/j.ptsp.2020.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/25/2022]
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49
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Caneiro JP, Alaiti RK, Fukusawa L, Hespanhol L, Brukner P, O'Sullivan PP. There is more to pain than tissue damage: eight principles to guide care of acute non-traumatic pain in sport. Br J Sports Med 2020; 55:75-77. [PMID: 32907798 DOI: 10.1136/bjsports-2019-101705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2020] [Indexed: 11/04/2022]
Affiliation(s)
- J P Caneiro
- Curtin University, School of Physiotherapy and Exercise Science, Perth, Western Australia, Australia .,Body Logic Physiotherapy, Perth, Western Australia, Australia
| | - Rafael Krasic Alaiti
- Universidade de São Paulo, Nucleus of Neuroscience and Behavior and Nucleus of Applied Neuroscience, São Paulo, Brazil.,Projeto Superador, Research and Data Science Unit, São Paulo, Brazil
| | - Leandro Fukusawa
- Projeto Superador, Research and Data Science Unit, São Paulo, Brazil.,Faculdade de Ciências Médicas Santa Casa de São Paulo, Masters and Doctoral Programs in Medical Science, São Paulo, Brazil
| | - Luiz Hespanhol
- Universidade Cidade de São Paulo (UNICID), Masters and Doctoral Programs in Physical Therapy, São Paulo, Brazil.,VU University Medical Center Amsterdam (VUmc), Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam Movement Sciences, Amsterdam Universities Medical Centers, Amsterdam, Netherlands
| | - Peter Brukner
- La Trobe Sport & Exercise Medicine Research Centre at La Trobe University, Melbourne, Victoria, Australia
| | - Peter Pb O'Sullivan
- Curtin University, School of Physiotherapy and Exercise Science, Perth, Western Australia, Australia.,Body Logic Physiotherapy, Perth, Western Australia, Australia
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