1
|
Mann RH, Clift BC, Day J, Barker AR. Co-creation of injury prevention measures for competitive adolescent distance runners: knowledge, behavior, and needs of athletes and coaches enrolled on England Athletics' Youth Talent Programme. Ann Med 2024; 56:2334907. [PMID: 38599225 PMCID: PMC11008313 DOI: 10.1080/07853890.2024.2334907] [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: 10/13/2023] [Accepted: 02/23/2024] [Indexed: 04/12/2024] Open
Abstract
This study assessed the knowledge, behavior, and needs of competitive adolescent (16-18 years) distance runners and distance running coaches enrolled as part of England Athletics' Youth Talent Programme in relation to the prevention of running-related injury (RRI). Two online surveys were developed and distributed to the distance runners (survey one) and coaches (survey two). Both surveys included sections related to: (1) current knowledge; (2) current behavior; (3) need and support for RRI prevention measures; and (4) possible content and form of RRI prevention measures. A total of 39 distance runners (36% of total possible sample) completed survey 1, and 29 coaches (32% of total possible sample) completed survey 2. Key findings included that the majority of distance runners and coaches: (1) agreed that it is 'very important' to try to prevent RRI; (2) are currently implementing something in practice (e.g., strength training) to prevent RRI; and (3) view the creation of RRI prevention measures as an important initiative. Differences between distance runners and coaches were identified in relation to their understanding of the most common causes of RRI. Interestingly, distance runners identified a modifiable cause of RRI (i.e., too much training) as the most common cause of RRI, while coaches selected a non-modifiable cause of RRI (i.e., growth and maturation). These key findings were supplemented by competitive adolescent runners and distance running coaches detailing their delivery preferences for such RRI prevention measures. Results from this study will help inform subsequent steps of the larger co-creation process, with an emphasis on developing multifaceted and context-specific RRI prevention measures that are deemed to be feasible and acceptable for real-world implementation.
Collapse
Affiliation(s)
- Robert H. Mann
- Children’s Health and Exercise Research Centre, Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Bryan C. Clift
- Department for Health, University of Bath, Bath, UK
- Centre for Qualitative Research, University of Bath, Bath, UK
| | - Jo Day
- NIHR Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, UK
| | - Alan R. Barker
- Children’s Health and Exercise Research Centre, Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| |
Collapse
|
2
|
Joachim MR, Heiderscheit BC, Kliethermes SA. Week-to-week changes in training were not prospectively associated with injuries among Wisconsin high school cross-country runners. Inj Prev 2024:ip-2024-045233. [PMID: 39084699 DOI: 10.1136/ip-2024-045233] [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: 01/03/2024] [Accepted: 07/18/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Training characteristics, such as volume and duration, have been studied in relation to running-related injury (RRI) risk, with mixed findings in adult runners. There is a lack of research assessing how training characteristics relate to RRI in youth runners, despite the high RRI rates observed in this population. PURPOSE To prospectively determine associations between (1) total weekly running volume and duration and (2) week-to-week changes in running volume, duration, intensity and training stress with in-season RRI among high school cross-country runners. METHODS Runners completed a preseason demographics and injury history survey and daily surveys regarding training distance, duration, intensity and current RRI. Values were summed weekly and change scores were calculated relative to the prior week. Runners completing ≥75% of daily surveys were analysed; sensitivity analyses for those completing ≥50% and ≥90% were conducted. Generalised estimating equations assessed associations between change in each predictor, including interactions with sex and RRI within the subsequent week, controlling for year in school, prior RRI and repeated observations. RESULTS 434 runners enrolled in the study; 161 (37%) completed ≥75% of daily surveys. No associations between total volume, total duration or week-to-week change in training characteristics and in-season RRI were observed (p≥0.54). Sensitivity analyses did not detect any significant associations. CONCLUSION Total weekly running volume and duration and weekly changes in training were not associated with RRI. RRI are multifactorial and assessing the interaction between training characteristics and other lifestyle factors is likely necessary for determining RRI risk in youth runners.
Collapse
Affiliation(s)
- Mikel Renee Joachim
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Bryan C Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Stephanie A Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
| |
Collapse
|
3
|
Joachim MR, Heiderscheit BC, Kliethermes SA. Changes in Sleep, Stress, and Fatigue Were Not Prospectively Associated With Running-Related Injuries Among High School Cross Country Runners. Sports Health 2024; 16:247-253. [PMID: 38148661 PMCID: PMC10916783 DOI: 10.1177/19417381231217347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Running-related injuries (RRI) are common among adolescent runners; however, our understanding of RRI risk factors in this population is limited. Sleep, stress, and fatigue are risk factors in other youth sports but have not been studied in high school runners. This study prospectively assessed the effect of changes in sleep duration and quality, stress, and fatigue on RRI among high school cross country runners. HYPOTHESIS Less and poorer quality sleep and greater stress and fatigue, compared with the previous week, would be associated with RRI. STUDY DESIGN Prospective, observational study. LEVEL OF EVIDENCE Level 2b. METHODS Runners completed a preseason demographics and injury history survey and daily surveys regarding sleep duration and quality, stress, fatigue, and current RRI. Values were summed within each week, and change scores were calculated relative to the previous week. Runners completing ≥75% of daily surveys were analyzed; sensitivity analyses for those completing ≥50% and ≥90% were also conducted. Generalized estimating equations assessed the association between change in each predictor, including its interaction with sex, and RRI, controlling for year in school, previous RRI, and repeated observations. RESULTS A total of 434 runners enrolled in the study; 161 (37%) completed ≥75% of daily surveys. No associations between change in sleep duration, sleep quality, or fatigue and RRI were observed (P values ≥0.24). A significant change in stress × sex interaction with RRI was observed (P < 0.01). Associations among boys (P = 0.06) and girls (P = 0.07) were marginally significant. Sensitivity results were similar. CONCLUSION Short-term changes in sleep duration, quality, and fatigue were not associated with RRI, but a significant interaction between change in stress and sex suggests that stress may influence RRI risk in high school cross country runners. CLINICAL RELEVANCE Large changes in stress levels should be monitored throughout the season, as these changes may precede RRI occurrence in this population.
Collapse
Affiliation(s)
- Mikel R Joachim
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, Wisconsin
| | - Bryan C Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin
| | - Stephanie A Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, Wisconsin
| |
Collapse
|
4
|
Watkins RA, Guillen RV. Primary Care Considerations for the Pediatric Endurance Athlete. Curr Rev Musculoskelet Med 2024; 17:76-82. [PMID: 38286940 PMCID: PMC10847077 DOI: 10.1007/s12178-024-09883-1] [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: 01/11/2024] [Indexed: 01/31/2024]
Abstract
PURPOSE OF REVIEW This study aimed to provide an overview of some of the medical concerns surrounding the care of the pediatric endurance athletes and add to the limited literature specific to the pediatric endurance athlete. RECENT FINDINGS Endurance athletes are at risk for overtraining, relative energy deficiency in sport (RED-S), overuse injuries, nutritional deficiencies, and sleep dysfunction. Youth runners and female endurance athletes are particularly high-risk populations for RED-S; nutritional deficiencies and their care should involve thoughtful mitigation of modifiable risk factors. The growing endurance athlete may experience slightly different cardiac adaptations than the adult endurance athlete with the long-term implications of these changes still unclear. Endurance sports are common among youth athletes. Multidisciplinary care that includes screening and early intervention for high-risk areas is critical to optimize their care and promote, safe lifelong sport participation.
Collapse
Affiliation(s)
- Rhonda A Watkins
- Department of Orthopaedic Surgery, Division of Pediatric Orthopaedics, University of California, San Francisco, San Francisco, CA, USA.
- Pediatric Orthopedics, UCSF Benioff Children's Hospitals, 747 52nd Street, Oakland, CA, 94609, USA.
| | | |
Collapse
|
5
|
Joachim MR, Kuik ML, Krabak BJ, Kraus EM, Rauh MJ, Heiderscheit BC. Risk Factors for Running-Related Injury in High School and Collegiate Cross-country Runners: A Systematic Review. J Orthop Sports Phys Ther 2024; 54:1-13. [PMID: 37970801 DOI: 10.2519/jospt.2023.11550] [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] [Indexed: 11/19/2023]
Abstract
OBJECTIVE: To summarize and describe risk factors for running-related injuries (RRIs) among high school and collegiate cross-country runners. DESIGN: Descriptive systematic review. LITERATURE SEARCH: Four databases (Scopus, SPORTDiscus, CINAHL, Cochrane) were searched from inception to August 2023. STUDY SELECTION CRITERIA: Studies assessing RRI risk factors in high school or collegiate runners using a prospective design with at least 1 season of follow-up were included. DATA SYNTHESIS: Results across each study for a given risk factor were summarized and described. The NOS and GRADE frameworks were used to evaluate quality of each study and certainty of evidence for each risk factor. RESULTS: Twenty-four studies were included. Overall, study quality and certainty of evidence were low to moderate. Females or runners with prior RRI or increased RED-S (relative energy deficiency in sport) risk factors were most at risk for RRI, as were runners with a quadriceps angle of >20° and lower step rates. Runners with weaker thigh muscle groups had increased risk of anterior knee pain. Certainty of evidence regarding training, sleep, and specialization was low, but suggests that changes in training volume, poorer sleep, and increased specialization may increase RRI risk. CONCLUSION: The strongest predictors of RRI in high school and collegiate cross-country runners were sex and RRI history, which are nonmodifiable. There was moderate certainty that increased RED-S risk factors increased RRI risk, particularly bone stress injuries. There was limited evidence that changes in training and sleep quality influenced RRI risk, but these are modifiable factors that should be studied further in this population. J Orthop Sports Phys Ther 2024;54(2):1-13. Epub 16 November 2023. doi:10.2519/jospt.2023.11550.
Collapse
|
6
|
DeJong Lempke AF, Hunt DL, Willwerth SB, d'Hemecourt PA, Meehan WP, Whitney KE. Biomechanical changes identified during a marathon race among high-school aged runners. Gait Posture 2024; 108:44-49. [PMID: 37980834 DOI: 10.1016/j.gaitpost.2023.11.009] [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: 02/22/2023] [Revised: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Despite the increasing popularity of endurance running competitions among adolescent runners, there is currently limited information regarding expected biomechanical changes across the duration of a long-distance running event, and the relationship between young runners' biomechanics and running performance. Wearable technology offers an ecological means to continuously assess runners' biomechanical data during outdoor running competitions. RESEARCH QUESTION Do adolescent athletes adopt changes in sensor-derived biomechanics throughout a marathon race, and are there relationships between race performance and biomechanical features among young marathoners? METHODS Fourteen high-school aged runners (9 M, 5 F; age: 16 ± 1 years, height: 170.8 ± 7.5 cm; mass: 63.6 ± 9.4 kg) wore lace-mounted sensors to record step-by-step biomechanics during a marathon race. Official race segment completion times were extracted across 5 race segments (5-K, 15-K, Half Marathon [21.1-K], 35-K, Marathon [42.2-K]). Within-participant repeated measures of covariance (pace) were conducted to assess changes in biomechanics across the race, with Bonferroni post-hoc comparisons. Pearson's r correlations were performed to assess the relationship between race finish times and biomechanics. RESULTS Pace was significantly slower (p-range: 0.002-0.005), contact times significantly longer, and stride lengths significantly shorter in the final segment compared to middle segments (p-range: 0.003-0.004). The rate of shock accumulation was significantly higher in the final race segment compared to the first three segments (p-range: 0.001-0.002). Moderate relationships existed between finish times and pace (r = -0.63), stride length (r = -0.62), and contact time (r = 0.51). SIGNIFICANCE Adolescent runners altered their gait patterns in the final marathon segment compared to earlier segments. Spatiotemporal measures were moderately correlated with race finish times, suggesting a link between faster run pace, increased stride lengths, and reduced contact time for improved running performance during an endurance race.
Collapse
Affiliation(s)
| | - Danielle L Hunt
- Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, United States
| | - Sarah B Willwerth
- The Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Pierre A d'Hemecourt
- Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Harvard, MA, United States
| | - William P Meehan
- Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Harvard, MA, United States
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Harvard, MA, United States
| |
Collapse
|
7
|
Brenner JS, Watson A. Overuse Injuries, Overtraining, and Burnout in Young Athletes. Pediatrics 2024; 153:e2023065129. [PMID: 38247370 DOI: 10.1542/peds.2023-065129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 01/23/2024] Open
Abstract
Sports participation can have tremendous physical and mental health benefits for children. Properly implemented progressive training programs can yield a broad range of beneficial physiologic adaptations, but imbalances of training load and recovery can have important negative consequences. Overuse injuries, for example, can result from repetitive stress without sufficient recovery that leads to accumulated musculoskeletal damage. In addition, extended periods of increased training loads that exceed the intervening recovery can have systemic consequences such as overtraining syndrome, which results in decreased performance, increased injury and illness risk, and derangement of endocrine, neurologic, cardiovascular, and psychological systems. Burnout represents one of the primary reasons for attrition in youth sports. Broadly defined as physical or mental exhaustion and a reduced sense of accomplishment that leads to devaluation of sport, burnout represents a direct threat to the goal of lifelong physical activity and the wide-ranging health benefits that it provides. This clinical report is intended to provide pediatricians with information regarding the risk factors, diagnosis, management, and prevention of these conditions to assist in the identification of at-risk children, the treatment of young athletes, and the guidance of families in the promotion of safe and healthy sport participation.
Collapse
Affiliation(s)
- Joel S Brenner
- Sports Medicine Program, Children's Hospital of The King's Daughters; Department of Pediatrics, Eastern Virginia Medical School; Division of Sports Medicine, Children's Specialty Group, PLLC, Norfolk, Virginia
| | - Andrew Watson
- Division of Sports Medicine, Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| |
Collapse
|
8
|
Joachim MR, Kliethermes SA, Heiderscheit BC. Preseason Vertical Center of Mass Displacement During Running and Bone Mineral Density Z-Score Are Risk Factors for Bone Stress Injury Risk in Collegiate Cross-country Runners. J Orthop Sports Phys Ther 2023; 53:761-768. [PMID: 37860857 DOI: 10.2519/jospt.2023.11860] [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] [Indexed: 10/21/2023]
Abstract
OBJECTIVES: To (1) assess relationships between running biomechanics, bone health, and bone stress injuries (BSIs), and (2) determine which variables constitute the most parsimonious BSI risk model among collegiate cross-country runners. DESIGN: Prospective, observational cohort study. METHODS: Running gait and bone mineral density (BMD) data from healthy collegiate cross-country runners were collected at preseason over 6 seasons. A generalized estimating equation model with backward selection was used to develop the most parsimonious model for estimating BSI risk, controlling for sex, running speed, and prior BSI. The variables assessed were spatiotemporal, ground reaction force, and joint kinematics, based on previous literature. Quasi-likelihood under the independence model criterion values and R2 values were used to select the best-fitting model. RESULTS: Data from 103 runners were included in the analysis. The best-fitting model included vertical center of mass (COM) displacement and BMD z-score. Injury risk increased with greater vertical COM displacement (unit = 0.5 cm; relative risk [RR] = 1.14; 95% confidence interval [CI]: 1.01, 1.29; P = .04) and decreased with greater BMD z-score (unit = 0.5; RR = 0.83; 95% CI: 0.72, 0.95; P = .007). The model performed similarly when step rate was included instead of vertical COM displacement. CONCLUSION: Vertical COM displacement and BMD z-score contributed to the best model for estimating risk the risk of bone stress injury in cross-country runners. Step rate was also an important variable for assessing injury risk. J Orthop Sports Phys Ther 2023;53(12):1-8. Epub 20 October 2023. doi:10.2519/jospt.2023.11860.
Collapse
Affiliation(s)
- Mikel R Joachim
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, WI
| | - Stephanie A Kliethermes
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, WI
| | - Bryan C Heiderscheit
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, WI
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI
| |
Collapse
|
9
|
DeJong Lempke AF, Stracciolini A, Willwerth SB, Ackerman KE, d'Hemecourt PA, Meehan WP, Whitney KE. Clinical assessment, treatment, and referral trends for adolescent runners seeking care at an injured runners' clinic. J Pediatr Rehabil Med 2023:PRM220082. [PMID: 38007679 DOI: 10.3233/prm-220082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2023] Open
Abstract
PURPOSE Over a 10-year time frame, this study aimed to evaluate diagnosis, treatment, and referral trends for adolescent runners seeking care for running-related injuries (RRIs) at a clinic that specializes in running medicine. METHODS This study was a retrospective chart review of 392 adolescent runners (2,326 encounters) who sought care for RRIs between the years 2011 and 2021. Descriptive statistics were used to summarize clinical assessments, referrals, assistive devices, and medications prescribed or administered overall and by injury type. Chi-square analyses were used to compare proportions of services rendered across the 10-year time frame. RESULTS Patients most frequently received manual evaluations or special tests during clinic visits. Most visits resulted in at least one referral (91%), primarily for physical therapy or gait-training. Assistive devices and medications/supplements were offered at only 18% of patient visits. The majority of assessments (X2 = 69.7, p = 0.002), treatments (X2: 23.6-43.8, p: < 0.001-0.003), and referrals (X2 = 132, p < 0.001) were for shin injuries. Larger proportions of nutrition assessments (X2 = 40.7, p < 0.001), interventions (X2 = 26.8, p = 0.003), and referrals (X2 = 27.5, p = 0.002) were performed in or after the year 2015. CONCLUSION Clinic visits for shin injuries required the most clinical resources per episode of care. There were observed shifts in clinical assessment and treatment approaches to include more expanded nutritional and physiologic considerations.
Collapse
Affiliation(s)
- Alexandra F DeJong Lempke
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
- Micheli Center for Sports Injury Prevention, Waltham, MA, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
| | - Andrea Stracciolini
- Micheli Center for Sports Injury Prevention, Waltham, MA, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah B Willwerth
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Kathryn E Ackerman
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Wu Tsai Female Athlete Program, Boston Children's Hospital, Boston, MA, USA
| | - Pierre A d'Hemecourt
- Micheli Center for Sports Injury Prevention, Waltham, MA, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - William P Meehan
- Micheli Center for Sports Injury Prevention, Waltham, MA, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, Waltham, MA, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
10
|
DeJong Lempke AF, Whitney KE, Stracciolini A, Ackerman KE, d'Hemecourt PA, Willwerth SB, Meehan WP. Outpatient Runners Clinic Visit Trends and Injury Characteristics Among 392 Child and Adolescent Patients: A 10-year Chart Review. Clin J Sport Med 2023; 33:e166-e171. [PMID: 37432356 DOI: 10.1097/jsm.0000000000001172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/23/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE To evaluate clinic visits and running-related injury (RRI) characteristics among child and adolescent runners seeking care at an outpatient clinic over a 10-year time frame. DESIGN Retrospective chart review. SETTING Outpatient hospital-affiliated Injured Runners Clinic. PATIENTS Children and adolescent runners (6-17 years) with RRIs. INDEPENDENT VARIABLES We examined electronic medical records (EMRs) among child and adolescent patients in the hospital database from 2011 to 2021 to obtain RRI characteristics and key demographic factors. MAIN OUTCOME MEASURES We assessed volume and frequency of patient visits to the clinic by RRI characteristics. Chi square analyses were used to compare the proportion of clinic visits over time and injury trends by body region and diagnosis. RESULTS There were 392 patients (sex: 277 F; mean age: 16.1 ± 1.3 years) and an average of 5 clinic visits per diagnosis (5 ± 4 visits; min: 1 visit, max: 31 visits). Number of visits generally increased over time up to 2016 but declined most drastically during the years of the pandemic (2020-2021; χ 2 = 644, P < 0 .001). Of the 654 new injury diagnoses, 77.68% were attributed to repetitive stress. Bone stress injuries to the tibia were the most common RRI (χ 2 = 1940, P < 0 .001; N = 132; 20.2% of all injuries) and constituted most of the clinic visits (χ 2 = 9271, P < 0 .001; N = 591; 25.4% of all visits). CONCLUSION We identified that adolescents with overuse injuries, particularly bone stress injuries to the tibia, constituted most of the visits to the outpatient healthcare setting. Clinicians should emphasize injury prevention efforts in clinical practice to reduce RRI burden.
Collapse
Affiliation(s)
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts; and
| | - Andrea Stracciolini
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts; and
| | - Kathryn E Ackerman
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts; and
- Wu Tsai Female Athlete Program, Boston Children's Hospital, Boston, Massachusetts
| | - Pierre A d'Hemecourt
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts; and
| | - Sarah B Willwerth
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts
| | - William P Meehan
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts; and
| |
Collapse
|
11
|
DeJong Lempke AF, Hunt DL, Dawkins C, Stracciolini A, Kocher MS, d'Hemecourt PA, Whitney KE. Adolescent and young adult hip and knee strength profiles relate to running gait biomechanics. Phys Ther Sport 2023; 64:48-54. [PMID: 37741000 DOI: 10.1016/j.ptsp.2023.09.005] [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: 07/18/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVES Compare and assess relationships between strength and running biomechanics among healthy adolescents and young adult males and females. DESIGN Retrospective cohort. SETTING Clinic. PARTICIPANTS 802 healthy participants (570 F, 232 M; 16.6 ± 2.3 years). MAIN OUTCOME MEASURES Mass-normalized knee flexor and extensor strength, hip adductor and abductor strength, hamstrings-to-quadriceps (H:Q), and abductor-to-adductor (Abd:Add) ratios were obtained using hand-held dynamometry. Mass-normalized peak vertical ground reaction force (vGRF), %stance, cadence, and stride length were obtained using an instrumented treadmill. Multivariate analyses of variance were used to compare strength and biomechanics across ages and sexes. Linear regressions were used to assess the relationships between strength and biomechanics, accounting for speed, age, and sex. Independent t-tests were used to compare strength between strength ratio profiles. RESULTS Strength and running biomechanics significantly differed between sexes (p-range: <0.001-0.05) and age groups (p-range: <0.001-0.02). Strength and strength ratios were significantly associated with increased cadence (p-range:0.001-0.04) and stride lengths (p-range:0.004-0.03), and decreased vGRF (p < 0.001). Lower H:Q ratios had significantly lower strength measures (p < 0.001). Higher Abd:Add ratios had significantly increased abductor strength (p < 0.001). CONCLUSIONS Strength and running biomechanics differed by sexes and ages. Hip and knee strength and strength ratios were related to select spatiotemporal and kinetic biomechanical features.
Collapse
Affiliation(s)
- Alexandra F DeJong Lempke
- School of Kinesiology, University of Michigan, Ann Arbor, 830 N University Ave, Ann Arbor, MI, 48109, USA.
| | - Danielle L Hunt
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA
| | - Corey Dawkins
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA
| | - Andrea Stracciolini
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
| | - Mininder S Kocher
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
| | - Pierre A d'Hemecourt
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
| |
Collapse
|
12
|
Roberts WO, Kucera NS, Miner MH. A Pilot Study: Do Children Who Run Marathons Have More Osteoarthritis in the Lower Extremities as Adults. Clin J Sport Med 2023; 33:618-622. [PMID: 37713165 DOI: 10.1097/jsm.0000000000001190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE To compare self-reported osteoarthritis of the knee and hip in adults who ran at least 1 marathon as a child with adults who ran high-school cross country (HSCC). DESIGN Subject self-recall retrospective survey. SETTING Electronic survey. PARTICIPANTS 319 adults who either ran a marathon under age 18 or ran HSCC recruited from running clubs, marathon participants, and on-line interest groups. INTERVENTIONS Survey. MAIN OUTCOME MEASURES Self-reported history of osteoarthritis (OA), joint pain, anterior cruciate ligament injury, still running or running marathons, and number of marathons as an adult. RESULTS One hundred twenty-three respondents ran a marathon under age 18 (26% female) and were 40 years old (sd 16) and 196 ran HSCC (53% female) and were 36 years old (sd 13). The mean age of first marathon was 15 (sd 2.3, range 5-17); 50% ran 1% and 50% ran >1 marathon. Child marathoners reported a family history of OA in knees or hips (26%) or a joint replacement (30%) compared with 24% and 28% of HSCC runners. 10% of child marathoners and 7% of HSCC reported OA and 24% and 21% reported daily or weekly joint pain. 91% of all respondents are still running; 78% of child marathoners (mean 17, range 1-91) and 80% HSCC ran ≥1 marathons as adults (mean 10, range 1-80). CONCLUSIONS Adults who ran marathons as children compared with adults who ran HSCC self-report similar rates of the knee and hip OA, chose to participate of their own accord, continue to run as adults, played other sports, and did not "specialize" in marathons.
Collapse
Affiliation(s)
- William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Neal S Kucera
- Arizona College of Osteopathic Medicine, Glendale, Arizona
| | - Michael H Miner
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| |
Collapse
|
13
|
Mehta S, Zheng E, Heyworth BE, Rizzone K, Halstead M, Brown N, Stinson Z, Nussbaum ED, Gray A, Segovia N, Kraus E. Tarsal Navicular Bone Stress Injuries: A Multicenter Case Series Investigating Clinical Presentation, Diagnostic Approach, Treatment, and Return to Sport in Adolescent Athletes. Am J Sports Med 2023; 51:2161-2168. [PMID: 37265102 DOI: 10.1177/03635465231170399] [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] [Indexed: 06/03/2023]
Abstract
BACKGROUND Tarsal navicular bone stress injuries (BSIs) are considered "high risk" because of prolonged healing times and higher rates of nonunion in adult populations but, to our knowledge, have not been comprehensively examined in adolescent athletes. PURPOSE To describe the characteristics of tarsal navicular BSIs in adolescents. STUDY DESIGN Case series; Level of evidence, 4. METHODS A retrospective analysis of patients aged 10 to 19 years with a radiographically diagnosed tarsal navicular BSI was performed at 8 academic centers over a 9-year study period. Age, sex, body mass index (BMI), primary sport, physical examination findings, imaging, treatment, surgical technique, return-to-sport time, and complications were analyzed. RESULTS Among 110 patients (mean age, 14.7 ± 2.7 years; 65% female), common primary sports were cross-country/track and field (29/92 [32%]) and gymnastics/dance (25/92 [27%]). Grade 4 BSIs were identified in 44% (48/110) of patients, with fracture lines present on radiography or magnetic resonance imaging. Nonoperative treatment (mean age, 14.4 ± 2.6 years), consisting of protected weightbearing and either a protective boot (69/88 [78%]) or a cast (19/88 [22%]), was trialed in all patients and was successful in 94 patients (85%). Operative treatment (mean age, 17.1 ± 1.4 years) was ultimately pursued for 16 patients (15%). Patients who required surgery had a higher BMI and a higher percentage of fracture lines present on imaging (nonoperative: 36/94 [38%]; operative: 14/16 [88%]). The median time to return to weightbearing, running, and full sport was significantly longer in duration for the operative group than the nonoperative group (P <.05). Complications associated with surgery included 1 case each of delayed union, nonunion, and painful implants, the latter of which required secondary surgery. CONCLUSION Adolescent tarsal navicular BSIs were identified most commonly in female patients in leanness sports. Adolescents who required surgery were more likely to be older, have higher BMIs, and have grade 4 BSIs, and they returned to sport within a median of 5 months after single- or double-screw fixation with a low risk of postoperative complications. A better understanding of the presenting signs and symptoms and appropriate diagnostic imaging of navicular BSIs may lead to an earlier diagnosis and improved outcomes.
Collapse
Affiliation(s)
| | - Evan Zheng
- Boston Children's Hospital, Boston, Massachusetts, USA
| | | | | | - Mark Halstead
- Washington University in St Louis, St Louis, Missouri, USA
| | - Naomi Brown
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | | | - Aaron Gray
- University of Missouri, Columbia, Missouri, USA
| | | | - Emily Kraus
- Stanford University, Stanford, California, USA
| |
Collapse
|
14
|
Kim J, McSweeney SC, Hollander K, Horstman T, Wearing SC. Adolescents running in conventional running shoes have lower vertical instantaneous loading rates but greater asymmetry than running barefoot or in partial-minimal shoes. J Sports Sci 2023; 41:774-787. [PMID: 37571975 DOI: 10.1080/02640414.2023.2240174] [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: 11/21/2022] [Accepted: 07/17/2023] [Indexed: 08/13/2023]
Abstract
Footwear may moderate the transiently heightened asymmetry in lower limb loading associated with peak growth in adolescence during running. This repeated-measures study compared the magnitude and symmetry of peak vertical ground reaction force and instantaneous loading rates (VILRs) in adolescents during barefoot and shod running. Ten adolescents (age, 10.6 ± 1.7 years) ran at self-selected speed (1.7 ± 0.3 m/s) on an instrumented treadmill under three counter-balanced conditions; barefoot and shod with partial-minimal and conventional running shoes. All participants were within one year of their estimated peak height velocity based on sex-specific regression equations. Foot-strike patterns, peak vertical ground reaction force and VILRs were recorded during 20 seconds of steady-state running. Symmetry of ground reaction forces was assessed using the symmetry index. Repeated-measures ANOVAs were used to compare conditions (α=.05). Adolescents used a rearfoot foot-strike pattern during barefoot and shod running. Use of conventional shoes resulted in a lower VILR (P < .05, dz = 0.9), but higher VILR asymmetry (P < .05) than running barefoot (dz = 1.5) or in partial-minimal shoes (dz = 1.6). Conventional running shoes result in a lower VILR than running unshod or in partial-minimal shoes but may have the unintended consequence of increasing VILR asymmetry. The findings may have implications for performance, musculoskeletal development and injury in adolescents.
Collapse
Affiliation(s)
- Jae Kim
- Complete Rehab Allied Health Clinic, Brisbane, Australia
| | - Simon C McSweeney
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Karsten Hollander
- Institute of Exercise Science & Sports Medicine, Medical School Hamburg, Hamburg, Germany
| | - Thomas Horstman
- Conservative and Rehabilitative Orthopaedics, Technical University Munich, Munich, Germany
| | - Scott C Wearing
- Conservative and Rehabilitative Orthopaedics, Technical University Munich, Munich, Germany
| |
Collapse
|
15
|
Li X, Feng R, Luo S, Li C, Gómez-Ruano MA. The associations of early specialization, sports volume, and maturity status with musculoskeletal injury in elite youth football players. Front Physiol 2023; 14:1183204. [PMID: 37250118 PMCID: PMC10213919 DOI: 10.3389/fphys.2023.1183204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/02/2023] [Indexed: 05/31/2023] Open
Abstract
Background: Youth football in schools has experienced rapid growth in China. Despite the increase of players engaging in more frequent, intensive, and organized sports training at their early ages, the controversy over early specialization (ES) still exists. This study aims to: a) investigate the training situation of players in the Chinese School Football Programme and b) examine the associations of early specialization, sports volume, and maturity status with musculoskeletal injury. Methods: A cross-sectional survey was used. Players who participated in the National School Football Winter Camp were invited to fill out a questionnaire that included the data of maturity, ES, sports volume, and injury history (n = 88 boys and n = 90 girls). Results: The results have shown that 80.3% of the athletes were classified as ES, while 19.7% of them were classified as non-ES. Almost all athletes (96%) participated in a sport for more than 8 months in a year. Most athletes (75.8%) spent more than twice of the time on organized sports than leisure activities. 30.3% of the athletes trained on average more hours per week than the number of their ages. Binomial logistic regression models reflected the significant differences in the odds ratios (OR) of reporting a history of injury among athletes with different levels of specialization (p = 0.024) and the OR of reporting a history of leg injury among players with different weekly sports volumes (p = 0.038). Significant differences were also shown in the OR of players reporting foot injuries between players with different maturity states (p = 0.046), and the Chi-squared test showed significant differences in the OR of reporting acute injuries between players with different levels of specialization (p = 0.048) and weekly activity (p = 0.022). No significant differences were found between the remaining variables. Conclusion: Most school football elite players follow the ES pathway even though ES increases the risk of injury, especially acute injury. Pre-pubertal and early pubertal players have a higher incidence of foot injuries. Players who train more hours per week than their ages have more leg injuries and acute injuries. Therefore, priority protection and intervention should be carried out for populations with a high risk of injury.
Collapse
Affiliation(s)
- Xiang Li
- China Football College, Beijing Sport University, Beijing, China
| | - Runze Feng
- Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Shiyi Luo
- Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Chunman Li
- China Football College, Beijing Sport University, Beijing, China
| | - Miguel A. Gómez-Ruano
- Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| |
Collapse
|
16
|
Mazzella N, Fox A, Saunders N, Trowell D, Vicenzino B, Bonacci J. Australian secondary school principals', parents', and students' attitudes to prescribed school footwear guidelines. J Foot Ankle Res 2023; 16:26. [PMID: 37120547 PMCID: PMC10148548 DOI: 10.1186/s13047-023-00624-0] [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] [Received: 02/15/2023] [Accepted: 04/19/2023] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Adolescents are often required to wear footwear that adheres to uniform guidelines at secondary school. There is a paucity of literature on factors influencing school footwear choice and what drives the development of school footwear guidelines. The aims of this study were to describe (i) current school footwear guidelines in secondary schools across Australia, (ii) factors that influence footwear choice in secondary school students and their parents, and (iii) principals, parents, and students' beliefs on factors which contribute to school footwear guidelines. METHODS An online survey was distributed to principals, secondary school students (aged 14-19 years) and their parents across Australia. The survey included questions on current school footwear guidelines, factors influencing footwear choice (for students and parents), participants beliefs on the effect footwear has on musculoskeletal health, current and previous lower limb pain, and beliefs on factors that contribute to school footwear guidelines. Parent and student responses to factors that influence their footwear choice were compared using proportional odds logistic regression. Students and parents' responses to factors influencing footwear guidelines were compared to principal responses using proportional odds logistic regression. Significance was set at an alpha of < 0.05. RESULTS Eighty principals, 153 parents and 120 secondary school students responded to the survey. 96% (77/80) of principals reported that their schools have set guidelines for school footwear. 88% of principals considered comfort to be important when developing school footwear guidelines. Proportional odds logistics regression showed that parents and students were 3.4 and 4.9 times more likely, respectively, than principals to rate comfort as being important when schools develop footwear guidelines. More than 40% of students reported experiencing musculoskeletal pain, and 70% of these students reported the pain to be exacerbated when in their school shoes. Less than a third of participants considered healthcare recommendations important to the development of footwear guidelines. CONCLUSIONS Nearly all principals that participated in this survey had set guidelines for school footwear. There is a discord between parents, students, and principals on the importance that factors such as comfort, play in the development of school footwear guidelines.
Collapse
Affiliation(s)
- Natalie Mazzella
- Centre for Sports Research, Deakin University, Waurn Ponds, VIC, 3215, Australia
| | - Aaron Fox
- Centre for Sports Research, Deakin University, Waurn Ponds, VIC, 3215, Australia
| | - Natalie Saunders
- Centre for Sports Research, Deakin University, Burwood, VIC, 3125, Australia
| | - Danielle Trowell
- Centre for Sports Research, Deakin University, Burwood, VIC, 3125, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Jason Bonacci
- Centre for Sports Research, Deakin University, Waurn Ponds, VIC, 3215, Australia.
| |
Collapse
|
17
|
Plesek J, Hamill J, Blaschova D, Freedman-Silvernail J, Jandacka D. Acute effects of footwear on running impact loading in the preschool years. Sports Biomech 2023; 22:442-458. [PMID: 35378049 DOI: 10.1080/14763141.2022.2058599] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to assess acute effects of footwear conditions (barefoot, minimalist and standard running shoes) on running impact loading in the preschool years. Fourty-eight habitually shod preschool children (26 males and 22 females) were divided into four age groups (3-, 4-, 5- and 6-year-old). Children performed a simple running game in three different conditions. Three-dimensional biomechanical analysis was carried out during overground running. Statistical parametric mapping was performed on the vertical ground reaction force profiles during the stance phase and one-way repeated measures ANOVA on the vertical instantaneous loading rate. Three-year-old children displayed significantly lower vertical ground reaction force values in the barefoot condition compared to minimalist (3-7% stance) and standard running shoes (7-11% stance). There were also differences in vertical instantaneous loading rate, where 3-year-olds had lower loading when barefoot than in minimalist (p = 0.010, d = 1.19) or running shoes (p = 0.045, d = 0.98), despite no differences in the footstrike pattern (mostly rearfoot-midfoot strike). No differences were found for the older children. Running in minimalist shoes did not imitate barefoot running in 3-year-old children. On the contrary, increased loading was observed in minimalist shoes in early running developmental stages.
Collapse
Affiliation(s)
- Jan Plesek
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic
| | - Joseph Hamill
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic.,Department of Kinesiology, Biomechanics and Motor Control Laboratories, University of Massachusetts, Amherst, MA, USA
| | - Denisa Blaschova
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic
| | - Julia Freedman-Silvernail
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic.,Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Daniel Jandacka
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic
| |
Collapse
|
18
|
Plesek J, Hamill J, Freedman Silvernail J, Skypala J, Jandacka D. Age differences in running biomechanics during footstrike between preschool children and adults. J Sports Sci 2023; 40:2401-2411. [PMID: 36588173 DOI: 10.1080/02640414.2022.2162237] [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: 01/03/2023]
Abstract
This study aimed to compare impact loading between two age groups of preschool children (3-4 and 5-6 years old) and one group of young adults representing mature level of running skill (n = 15 per group). Three-dimensional biomechanical data were collected during running barefoot, in minimalist and running shoes. A two-way mixed ANOVA was performed to assess age and footwear differences in vertical instantaneous loading rate (VILR). An interaction was found in VILR. Older (5-6) preschoolers had 30-31% lower VILR than younger (3-4) (p = 0.012, d = 1.02; p = 0.001, d = 1.18) and adults had 51-77% lower VILR than younger preschoolers (p = 0.001, d = 1.85; p = 0.001, d = 2.82) in minimalist and running shoes, respectively. Additionally, adults had lower VILR than older preschoolers in running shoes (p = 0.001, d = 2.68). No differences were found between older children and adults in barefoot and minimalist shoes. Loading decreased with increasing age, particularly in minimalist and running shoes. Unchanged cadence and running speed did not explain the decrease of VILR during preschool age. The explanation likely underlies in lower limb alignment during footstrike and developmental ontogenetic changes.
Collapse
Affiliation(s)
- Jan Plesek
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic
| | - Joseph Hamill
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic.,Department of Kinesiology, Biomechanics and Motor Control Laboratories, University of Massachusetts, Amherst, MA, USA
| | - Julia Freedman Silvernail
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic.,Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Jiri Skypala
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic
| | - Daniel Jandacka
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic
| |
Collapse
|
19
|
DeJong Lempke AF, Whitney KE, Collins SE, dHemecourt PA, Meehan WP. Intrinsic and extrinsic factors contributing to running-related lower limb injuries among adolescent runners. J Sports Sci 2022; 40:2468-2474. [PMID: 36581607 DOI: 10.1080/02640414.2022.2163353] [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: 12/31/2022]
Abstract
The purpose of this study was to assess which combination of intrinsic and extrinsic factors contribute to running-related injury (RRI)among adolescent cross-country, track, and long-distance runners. We conducted a retrospective study at a hospital-affiliated sports injury prevention centre of 130 adolescent runners (F: 62.1%, M: 37.9%; cross-country: 34.1%, track: 56.1%, long-distance running: 9.8%) who underwent an Injury Prevention Evaluation between 2013 and 2021. The evaluation included a questionnaire on personal and training factors, and standardised physical assessments. We used a binomial logistic regression to assess the influence of demographics, lower extremity strength and alignment, training (running volume and intensity, weight training), and dietary factors on RRIs. There were 38 adolescent runners who reported RRIs (ankle sprains: N = 16, shin splints: N = 9, stress fractures: N = 13). Female sex (odds ratio [OR]: 4.58 [1.37, 15.37]; p = 0.01), reduced weekday hours of sleep (OR: 1.75 [1.04, 2.95]; p = 0.04), reduced hip abduction strength (OR: 1.02 [1.00, 1.04]; p = 0.05), and intention to lose weight to improve athletic performance (OR: 4.58 [1.00, 21.28]; p = 0.05) were associated with RRIs. These intrinsic and extrinsic risk factors may represent targets for injury prevention for adolescent runners.
Collapse
Affiliation(s)
- Alexandra F DeJong Lempke
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, United States.,Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, United States.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, United States.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, United States.,Harvard Medical School, Boston, Massachusetts, United States
| | - Sara E Collins
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, United States.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Pierre A dHemecourt
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, United States.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, United States.,Harvard Medical School, Boston, Massachusetts, United States
| | - William P Meehan
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, United States.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, United States.,Harvard Medical School, Boston, Massachusetts, United States
| |
Collapse
|
20
|
Mishra R, Aranha VP, Samuel AJ. Reliability and Reference Norms of Single Heel-Rise Test Among Children: A Cross-sectional Study. J Foot Ankle Surg 2022; 62:426-431. [PMID: 36396548 DOI: 10.1053/j.jfas.2022.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 08/31/2022] [Accepted: 10/16/2022] [Indexed: 11/16/2022]
Abstract
There is a lack of data regarding the single heel-rise test (SHRT) among children. Hence, we aimed to establish reliability and reference norms of SHRT among children aged 8 to 12 years. About 500 healthy children were randomly selected from the recognized school and community settings. After demographic measurements, SHRT was conducted to evaluate the strength of each plantar flexors. SHRT repetitions were assessed by the same rater on 2 occasions for intrarater (on the same day) and test-retest reliability (on different days) and by 2 raters for inter-rater reliability. Relative reliability was described in terms of the intraclass correlation coefficient (ICC) and Pearson correlation coefficient (r). Absolute reliability was indicated by the standard error of measurement (SEm), minimal detectable change (MDC), and Bland-Altman graph. The mean of the number of repetitions of SHRT was calculated to derive the reference norm of SHRT. The anthropometric parameters were correlated with SHRT for multiple regression analysis. Intrarater, test-retest, and inter-rater reliability of SHRT were, ICC = 0.81, ICC = 0.70, and ICC = 0.57, respectively. The Bland-Altman graph confirmed limits of agreement for intrarater, test-retest, and inter-rater reliability. The reference norm of SHRT is documented to be 20.6 ± 4.8. SEm and MDC are found to be 2 and 3, respectively. Multiple regression analysis predicted a correlation of age, weight, and calf muscle girth with SHRT. SHRT is moderate to good reliable in assessing the strength of plantar flexors. The reference norms of SHRT have been derived for healthy children aged 8 to 12 years.
Collapse
Affiliation(s)
- Rajnee Mishra
- Department of Pediatric and Neonatal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Haryana, India; Department of Physiotherapy and Rehabilitation, Bengal Cancer Foundation, Bardhaman Institute of Medical Science Hospital, Burdwan, West Bengal, India
| | - Vencita Priyanka Aranha
- Department of Pediatric and Neonatal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Haryana, India; Aikya Physiotherapy and Rehabilitation Centre, Karkala, Karnataka, India
| | - Asir John Samuel
- Department of Pediatric and Neonatal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Haryana, India; Yenepoya Physiotherapy College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India.
| |
Collapse
|
21
|
Abstract
This Viewpoint examines youth marathon participation through the collective perspectives of clinicians and researchers invested in optimizing health, safety, and performance in young runners.
Collapse
Affiliation(s)
- James M Smoliga
- Department of Physical Therapy, High Point University, High Point, North Carolina
| | - William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
| |
Collapse
|
22
|
DeJong Lempke AF, Collins SE, Whitney KE, D'Hemecourt PA, Meehan WP. A Comparison of Factors Associated with Running-Related Injuries between Adult and Adolescent Runners. Int J Sports Phys Ther 2022; 17:1033-1042. [PMID: 36237652 PMCID: PMC9528711 DOI: 10.26603/001c.38045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
Background There are multiple personal and environmental factors that influence the risk of developing running-related injuries (RRIs). However, it is unclear how these key clinical factors differ between adult and adolescent runners. Purpose The purpose of this study was to compare anthropometric, training, and self-reported outcomes among adult and adolescent runners with and without lower extremity musculoskeletal RRIs. Study Design Cross-sectional study. Methods Questionnaire responses and clinical assessment data were extracted from 38 adult runners (F: 25, M: 13; median age: 23 [range 18-36]) and 91 adolescent runners (F: 56, M: 35; median age: 15 [range 14-16]) who underwent a physical injury prevention evaluation at a hospital-affiliated sports injury prevention center between 2013 and 2021. Participants were sub-grouped into those with (adults: 25; adolescents: 38) and those without (adults: 13; adolescents: 53) a history of self-reported RRIs based on questionnaire responses. Multivariate analyses of covariance (MANCOVA) covarying for gender were conducted to compare outcomes across groups. Results Adult runners had lower Functional Movement Screen™ (FMS™) scores (mean differences [MD]: -1.4, p=0.01), were more likely to report intentional weight-loss to improve athletic performance (% difference: 33.0%; p:<.001), and more frequently included resistance training into their training routines (% difference: 21.0%, p=0.01) compared to adolescents. Those with a history of RRIs were more likely to report intentional weight-loss compared to uninjured runners (% difference: 21.3; p=0.02) and had shorter single leg bridge durations than those without RRIs (RRI: 57.9±30, uninjured: 72.0±44, p=0.01). Conclusion The findings indicate that addressing aspects of biomechanics identified by the FMS™ and behaviors of weight loss as an effort to improve performance may represent targets for the prevention of RRIs for adult and adolescent runners, given the association with history of RRIs. Level of Evidence 3.
Collapse
Affiliation(s)
- Alexandra F DeJong Lempke
- School of Kinesiology, University of Michigan; Micheli Center for Sports Injury Prevention; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital
| | - Sara E Collins
- Micheli Center for Sports Injury Prevention; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital
| | - Kristin E Whitney
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital; Harvard Medical School
| | - Pierre A D'Hemecourt
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital; Harvard Medical School
| | - William P Meehan
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital; Harvard Medical School
| |
Collapse
|
23
|
Stürznickel J, Hinz N, Delsmann MM, Hoenig T, Rolvien T. Impaired Bone Microarchitecture at Distal Radial and Tibial Reference Locations Is Not Related to Injury Site in Athletes With Bone Stress Injury. Am J Sports Med 2022; 50:3381-3389. [PMID: 36053067 PMCID: PMC9527365 DOI: 10.1177/03635465221120385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Bone stress injuries (BSIs) are common sports injuries that occur because of an imbalance between microdamage accumulation and removal through bone remodeling. The underlying bone phenotype has been assumed to be a contributing factor. However, the bone microarchitecture of athletes with BSI is not well characterized, and no study has investigated whether impaired bone microarchitecture is associated with bone composition or anatomic site of injury. PURPOSE/HYPOTHESIS This cross-sectional study characterizes the bone microarchitecture at distal radial and tibial reference locations in athletes with BSI. Based on previous dual-energy X-ray absorptiometry (DXA) findings, the aim was to compare anatomic injury sites, hypothesizing that athletes with BSIs in bones with greater trabecular composition show impaired bone microarchitecture parameters compared with those with BSIs in bones with greater cortical composition. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Athletes who had presented to our outpatient clinic because of a high-grade BSI (ie, stress fracture) were retrospectively included. Blood and urine samples were collected. Areal bone mineral density (aBMD) was assessed by DXA at the lumbar spine and both hips. Bone microarchitecture was analyzed by high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and tibia. HR-pQCT parameters were expressed in relation to available sex-, age-, and device-adjusted reference values and compared with a cohort of 53 age- and sex-matched controls. RESULTS In total, 53 athletes had a BSI of the foot (n = 20), tibia/fibula (n = 18), pelvis (n = 9), femur (n = 5), or sternum (n = 1). Based on DXA measurements, a Z-score of -1.0 or lower was found in 32 of 53 (60.4%) of the athletes, of whom 16 of 53 (30.2%) had a Z score -2.0 or lower. While an impairment of cortical area (P = .034 and P = .001) and thickness (P = .029 and P < .001) was detected at the distal radius and tibia in the BSI cohort compared with controls, no differences in BMD or bone microarchitecture were observed between anatomic injury sites. Furthermore, no difference was revealed when BSIs were grouped into cortical- and trabecular-rich sites. CONCLUSION Reduced aBMD and impaired cortical bone microarchitecture were present in a considerable number of athletes with BSI. Neither aBMD nor bone microarchitecture was related to the injury site, highlighting the multifactorial etiology of BSI.
Collapse
Affiliation(s)
- Julian Stürznickel
- Department of Osteology and
Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Department of Trauma and Orthopaedic
Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Julian Stürznickel, MD,
Department of Osteology and Biomechanics, University Medical Center
Hamburg-Eppendorf, Lottestraße 59, 22529 Hamburg, Germany (
); or Tim Rolvien, MD, PhD, MBA,
Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery,
University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg,
Germany ()
| | - Nico Hinz
- Department of Trauma and Orthopaedic
Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Department of Trauma Surgery,
Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany
| | - Maximilian M. Delsmann
- Department of Osteology and
Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Department of Trauma and Orthopaedic
Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim Hoenig
- Department of Trauma and Orthopaedic
Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim Rolvien
- Department of Trauma and Orthopaedic
Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Julian Stürznickel, MD,
Department of Osteology and Biomechanics, University Medical Center
Hamburg-Eppendorf, Lottestraße 59, 22529 Hamburg, Germany (
); or Tim Rolvien, MD, PhD, MBA,
Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery,
University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg,
Germany ()
| |
Collapse
|
24
|
Garcia MC, Heiderscheit BC, Murray AM, Norte GE, Kraus E, Bazett-Jones DM. One size does not fit all: Influence of sex and maturation on temporal-spatial parameters for adolescent long-distance runners. J Sports Sci 2022; 40:2153-2158. [PMID: 36352559 DOI: 10.1080/02640414.2022.2142743] [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: 11/11/2022]
Abstract
Runners and coaches are often interested in identifying the "ideal" running form to reduce the risk of injury and improve performance. While differences in pelvis and hip motion have been reported among adolescent female and male long-distance runners of different stages of physical maturation, the influence of sex and/or maturation on temporal-spatial parameters is unknown for adolescent runners. Adolescent runners of different stages of physical maturation (pre-, mid-, post-pubertal) completed an overground running analysis at a self-selected speed. We performed 2 × 3 ANCOVAs (covariate = running speed) to compare temporal-spatial parameters among sex and maturation groups. Pre-adolescents ran with higher cadences and shorter step lengths than mid- (p ≤ .01) and post-pubertal adolescents (p ≤ .01), respectively. Mid-pubertal males and post-pubertal females also ran with higher cadences and shorter step lengths than post-pubertal males (p ≤ .01). When step length was normalized to leg length, less physically mature runners demonstrated longer normalized step lengths (p ≤ .01). Caution is advised when using a "one-size-fits-all" approach for recommending an "ideal" cadence and/or step length for adolescent long-distance runners. A runner's sex, stage of physical maturation and leg length should be considered when assessing and prescribing cadence and/or step length.
Collapse
Affiliation(s)
- Micah C Garcia
- Motion Analysis and Integrative Neurophysiology Lab, College of Health and Human Services, the University of Toledo, Toledo, OH, USA
| | - Bryan C Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
| | - Amanda M Murray
- Motion Analysis and Integrative Neurophysiology Lab, College of Health and Human Services, the University of Toledo, Toledo, OH, USA
| | - Grant E Norte
- Motion Analysis and Integrative Neurophysiology Lab, College of Health and Human Services, the University of Toledo, Toledo, OH, USA
| | - Emily Kraus
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA
| | - David M Bazett-Jones
- Motion Analysis and Integrative Neurophysiology Lab, College of Health and Human Services, the University of Toledo, Toledo, OH, USA
| |
Collapse
|
25
|
Tenforde AS, DeLuca S, Wu AC, Ackerman KE, Lewis M, Rauh MJ, Heiderscheit B, Krabak BJ, Kraus E, Roberts W, Troy KL, Barrack MT. Prevalence and factors associated with bone stress injury in middle school runners. PM R 2022; 14:1056-1067. [PMID: 34251763 DOI: 10.1002/pmrj.12673] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 06/22/2021] [Accepted: 07/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Bone stress injury (BSI) in youth runners is clinically important during times of skeletal growth and is not well studied. OBJECTIVE To evaluate the prevalence, anatomical distribution, and factors associated with running-related BSI in boy and girl middle school runners. DESIGN Retrospective cross-sectional study. SETTING Online survey distributed to middle school runners. METHODS Survey evaluated BSI history, age, grade, height, weight, eating behaviors, menstrual function, exercise training, and other health characteristics. MAIN OUTCOME MEASUREMENTS Prevalence and characteristics associated with history of BSI, stratified by cortical-rich (eg, tibia) and trabecular-rich (pelvis and femoral neck) locations. PARTICIPANTS 2107 runners (n = 1250 boys, n = 857 girls), age 13.2 ± 0.9 years. RESULTS One hundred five (4.7%) runners reported a history of 132 BSIs, with higher prevalence in girls than boys (6.7% vs 3.8%, p = .004). The most common location was the tibia (n = 51). Most trabecular-rich BSIs (n = 16, 94% total) were sustained by girls (pelvis: n = 6; femoral neck: n = 6; sacrum: n = 4). In girls, consuming <3 daily meals (odds ratio [OR] = 18.5, 95% confidence interval [CI] = 7.3, 47.4), eating disorder (9.8, 95% CI = 2.0, 47.0), family history of osteoporosis (OR = 6.9, 95% CI = 2.6, 18.0), and age (OR = 1.6, 95% CI = 1.0, 2.6) were associated with BSI. In boys, family history of osteoporosis (OR = 3.2, 95% CI = 1.2, 8.4), prior non-BSI fracture (OR = 3.2, 95% CI = 1.6, 6.7), and running mileage (OR = 1.1, 95% CI = 1.0, 1.1) were associated with BSI. Participating in soccer or basketball ≥2 years was associated with lower odds of BSI for both sexes. CONCLUSION Whereas family history of osteoporosis and prior fracture (non-BSI) were most strongly related to BSI in the youth runners, behaviors contributing to an energy deficit, such as eating disorder and consuming <3 meals daily, also emerged as independent factors associated with BSI. Although cross-sectional design limits determining causality, our findings suggest promoting optimal skeletal health through nutrition and participation in other sports including soccer and basketball may address factors associated with BSI in this population.
Collapse
Affiliation(s)
- Adam S Tenforde
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Stephanie DeLuca
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Alexander C Wu
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
| | - Kathryn E Ackerman
- Harvard Medical School, Boston, Massachusetts, USA
- Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Margo Lewis
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
| | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, California, USA
| | - Bryan Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, Wisconsin, USA
| | - Brian J Krabak
- Rehabilitation, Orthopedics and Sports Medicine, University of Washington, Seattle, Washington, USA
| | - Emily Kraus
- Stanford Children's Orthopedic and Sports Medicine Center, Stanford University, Stanford, California, USA
| | - William Roberts
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Karen L Troy
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - Michelle T Barrack
- Department of Family and Consumer Sciences, California State University, Long Beach, California, USA
| |
Collapse
|
26
|
Global Positioning System Watches and Electronic Journals: Are Training-Load Measures Similar in High School Cross-Country Runners? Int J Sports Physiol Perform 2022; 17:1132-1139. [PMID: 35606093 DOI: 10.1123/ijspp.2021-0563] [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: 12/20/2021] [Revised: 04/01/2022] [Accepted: 04/01/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Running programs are designed to progress training loads by manipulating the duration, frequency, and/or intensity of running sessions. While some studies use journals to monitor training load, others have used wearable technology. The purpose of this study was to compare the validity of self-reported and global positioning system (GPS)-watch-derived measures of external and internal loads in high school cross-country runners. METHODS Twenty-two high school cross-country runners participated in the study during fall 2020. Participants recorded running sessions using a GPS watch and self-reported the running session using an electronic journal. External (distance and duration) and internal loads (session rating of perceived exertion [sRPE], average, and maximum heart rate) were retrieved from the GPS watch and electronic journal. Correlations compared relationships, and Bland-Altman plots compared agreements between GPS-watch-derived and self-reported measures of training loads. RESULTS We found moderate relationships between self-reported and GPS-watch-derived measures of external loads (distance: r = .76, moving duration: r = .74, and elapsed duration: r = .70) and poor relationships between internal loads (sRPE vs average heart rate: ρ = .11, sRPE vs maximal heart rate: ρ = .13). We found mean differences of -0.8 km (95% = -6.3 to +4.8 km) for distance, -4.5 minutes (95% = -27.8 to +33.2 min) for moving duration, and 2.7 minutes (95% = -27.8 min to +33.2 min) for elapsed duration. CONCLUSIONS High school runners overreported running distance and duration using self-reports, and self-reported and GPS-watch-derived measures of internal loads demonstrated poor agreement. Coaches and clinicians should use caution when comparing results from studies using different methods of monitoring training loads.
Collapse
|
27
|
Body Height Trajectories in Pediatric Competitive Athletes from 46 Different Sport Types. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12105033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
There is some concern that competitive sports in children and adolescents might hinder their growth. This study’s purpose was to examine height changes in pediatric competitive athletes from 46 different sports. Clinical data from athletes aged <18 years that underwent annual preparticipation examinations at a single sports medicine center were extracted from computerized medical records. Height was transformed into standard deviation scores (SDS). Generalized estimating equations were used to analyze height SDS changes over time in the total cohort and in subgroups of age, sex and several sport types. Data on 2276 athletes were available (71.3% males, age: 12.3 ± 2.6 years), of which 688 had repeated measurements. The median duration between examinations was 1.9 years (interquartile range: 1.0–2.9, maximum: 9.3 years). Height SDS neither significantly changed throughout follow up in the total cohort (−0.01 per year, 95%CI = −0.48–0.03, p = 0.62) nor in subgroups of age and sex. However, height SDS was significantly reduced by −0.12 to −0.23 per year in athletes engaged in endurance sports (i.e., swimming, cycling and triathlon) but not in gymnastics, tennis, basketball or football. We conclude that competitive sports in youth are generally not associated with significant changes in body height relative to age. However, this might occur in endurance sports, possibly due to low energy availability.
Collapse
|
28
|
Johnson DM, Cumming SP, Bradley B, Williams S. The influence of exposure, growth and maturation on injury risk in male academy football players. J Sports Sci 2022; 40:1127-1136. [DOI: 10.1080/02640414.2022.2051380] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- David M. Johnson
- Department for Health, University of Bath, Bath, UK
- Academy Sports Science and Medicine Department, AFC Bournemouth, Bournemouth, UK
| | | | - Ben Bradley
- Academy Sports Science and Medicine Department, AFC Bournemouth, Bournemouth, UK
| | | |
Collapse
|
29
|
Garcia MC, Lennon A, Bazett-Jones DM, Ford KR, Long JT, Taylor-Haas JA. Influence of hamstring flexibility on running kinematics in adolescent long-distance runners. Gait Posture 2022; 93:107-112. [PMID: 35124517 DOI: 10.1016/j.gaitpost.2022.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Studies have found no or minimal differences in running kinematics between flexible and inflexible adult runners. The interaction between hamstring flexibility and running kinematics has not been reported in adolescent long-distance runners. RESEARCH QUESTION Does hamstring flexibility influence running kinematics in adolescent long-distance runners? METHODS Adolescent long-distance runners (n = 140, ages 9-19) were enrolled in our cross-sectional study. Hamstring flexibility was assessed with the forward bending Beighton task. Runners were categorized if they tested positive or negative on the forward bending task. Participants ran at a comfortable self-selected speed on a treadmill. Runners who tested positive on the forward bending task (n = 17) were matched with runners who tested negative on the task (n = 17) according to sex, physical maturation, and running speed. Statistical parametric mapping compared trunk, pelvis, hip, and knee kinematic waveforms throughout the gait cycle and independent sample t tests compared temporal-spatial parameters between the groups. RESULTS Runners who tested positive on the forward bending task demonstrated significantly greater anterior pelvic tilt during stance (average difference = 4.8° ± 0.4°, p < .001) and swing (average difference = 4.3° ± 0.2°, p < .01) compared to runners who tested negative on the forward bending task. No significant differences were found between groups for the remaining kinematic waveforms or for any temporal-spatial parameters (p > .05). SIGNIFICANCE This is the first study to report the interaction between hamstring flexibility and running kinematics in adolescent long-distance runners. The greater anterior pelvic tilt demonstrated by runners with greater hamstring flexibility may place more eccentric demands on the hamstring musculature. However, as there were no other differences in joint kinematics or temporal-spatial parameters between groups, greater hamstring flexibility does not appear to have a significant interaction with running kinematics when running at sub-maximal speeds. Our results suggest hamstring flexibility does not predispose adolescent long-distance runners to sub-optimal segment positions associated with running-related injuries.
Collapse
Affiliation(s)
- Micah C Garcia
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; College of Health and Human Services, University of Toledo, Toledo, OH, USA.
| | - Anne Lennon
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | | | - Kevin R Ford
- Department of Physical Therapy, High Point University, High Point, NC, USA.
| | - Jason T Long
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Jeffery A Taylor-Haas
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| |
Collapse
|
30
|
Chan ZYS, Peeters R, Cheing G, Ferber R, Cheung RTH. Evaluation of COVID-19 Restrictions on Distance Runners' Training Habits Using Wearable Trackers. Front Sports Act Living 2022; 3:812214. [PMID: 35098124 PMCID: PMC8790471 DOI: 10.3389/fspor.2021.812214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/13/2021] [Indexed: 11/22/2022] Open
Abstract
The COVID-19 pandemic caused widespread disruption to many individuals' lifestyles. Social distancing restrictions implemented during this global pandemic may bring potential impact on physical activity habits of the general population. However, running is one of the most popular forms of physical activity worldwide and one in which it could be maintained even during most COVID-19 restrictions. We aimed to determine the impact of COVID-19 restrictions on runners' training habits through analyzing the training records obtained from their GPS enabled wearable trackers. Retrospective and prospective data were collected from an online database (https://wetrac.ucalgary.ca). Runners' training habits, including frequency, intensity and duration of training, weekly mileage and running locations were analyzed and compared 9 months before and after the start of COVID-19 restrictions in March 2020. We found that runners ran 3 km per week more (p = 0.05, Cohen's d = 0.12) after the start of COVID-19 restrictions, and added 0.3 training sessions per week (p = 0.03, Cohen's d = 0.14). Moreover, runners ran an additional 0.4 sessions outdoors (p < 0.01, Cohen's d = 0.21) but there was no significant change in the intensity or duration of training sessions. Our findings suggested that runners adopted slightly different training regimen as a result of COVID-19 restrictions. Our results described the collective changes, irrespective of differences in response measures adopted by various countries or cities during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Zoe Y. S. Chan
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Rhys Peeters
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Gladys Cheing
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Reed Ferber
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Roy T. H. Cheung
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
- *Correspondence: Roy T. H. Cheung
| |
Collapse
|
31
|
Garcia MC, Pexa BS, Ford KR, Rauh MJ, Bazett-Jones DM. Quantification method influences training load change in high school cross-country runners across a competitive season. J Athl Train 2021; 57:672-677. [PMID: 34902855 DOI: 10.4085/1062-6050-523-21] [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: 11/09/2022]
Abstract
CONTEXT Running programs traditionally monitor external loads (e.g., time, distance). There has been a recent movement to encompass a more comprehensive approach to also monitor training loads that account for internal loads (e.g., intensity, measured as session rating of perceived exertion [sRPE]). The combination of an external and internal load accounts for the potential interaction between these loads. While differences in weekly change in training loads have been reported between external loads and the combination of an external and internal load during 2- and 4-week training cycles, there are no reports whether these differences are apparent during an entire cross-country season in high school runners. OBJECTIVE To compare change in training loads, as measured by external loads and combinations of an external and internal load, in high school runners during an interscholastic cross-country season. DESIGN Case-series. SETTING Community-based with daily online surveys. PARTICIPANTS Twenty-four high school cross-country runners (female=14, male=10, age=15.9±1.1 years, running experience=9.9±3.2 years). MAIN OUTCOME MEASURE(S) Week-to-week percent change in training load when measured by external loads (time, distance) and the combination of an external and internal load (timeRPE, distanceRPE). RESULTS Overall, the average weekly change was 7.1% greater for distanceRPE compared to distance (p=.04, d=0.18). When decreasing weekly running duration, the average weekly change was 5.2% greater for distanceRPE compared to timeRPE (p=.03, d=0.24). When maintaining or increasing weekly running duration, the average weekly change was 10-15% greater when an external load was combined with an internal load compared to external loads alone, but these differences were non- significant (p=.11-.22, d=0.19-0.34). CONCLUSIONS Our results demonstrate that progression in training load may be underestimated when relying solely on external loads. The interaction between internal loads (sRPE) and external loads (distance or time) appears to provide a different measure of training stresses experienced by runners than external loads alone.
Collapse
Affiliation(s)
- Micah C Garcia
- † College of Health and Human Services, Motion Analysis and Integrative Neurophysiology Lab, University of Toledo, Toledo, OH, , , Twitter: @run_mcg, @DrBazettJones
| | - Brett S Pexa
- ‡ Cogdon School of Health Sciences, Department of Athletic Training, High Point University, High Point, North Carolina, , Twitter: brexa17
| | - Kevin R Ford
- § Cogdon School of Health Sciences, Department of Physical Therapy, High Point University, High Point, North Carolina, , Twitter: @ford_kr
| | - Mitchell J Rauh
- ‖ Doctor of Physical Therapy Program, San Diego State University, San Diego, CA,
| | - David M Bazett-Jones
- † College of Health and Human Services, Motion Analysis and Integrative Neurophysiology Lab, University of Toledo, Toledo, OH, , , Twitter: @run_mcg, @DrBazettJones
| |
Collapse
|
32
|
McSweeney SC, Grävare Silbernagel K, Gruber AH, Heiderscheit BC, Krabak BJ, Rauh MJ, Tenforde AS, Wearing SC, Zech A, Hollander K. Adolescent Running Biomechanics - Implications for Injury Prevention and Rehabilitation. Front Sports Act Living 2021; 3:689846. [PMID: 34514384 PMCID: PMC8432296 DOI: 10.3389/fspor.2021.689846] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/23/2021] [Indexed: 12/28/2022] Open
Abstract
Global participation in running continues to increase, especially amongst adolescents. Consequently, the number of running-related injuries (RRI) in adolescents is rising. Emerging evidence now suggests that overuse type injuries involving growing bone (e.g., bone stress injuries) and soft tissues (e.g., tendinopathies) predominate in adolescents that participate in running-related sports. Associations between running biomechanics and overuse injuries have been widely studied in adults, however, relatively little research has comparatively targeted running biomechanics in adolescents. Moreover, available literature on injury prevention and rehabilitation for adolescent runners is limited, and there is a tendency to generalize adult literature to adolescent populations despite pertinent considerations regarding growth-related changes unique to these athletes. This perspective article provides commentary and expert opinion surrounding the state of knowledge and future directions for research in adolescent running biomechanics, injury prevention and supplemental training.
Collapse
Affiliation(s)
- Simon C McSweeney
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Allison H Gruber
- Department of Kinesiology, School of Public Health - Bloomington, Indiana University, Bloomington, IN, United States
| | - Bryan C Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, WI, United States
| | - Brian J Krabak
- Department of Rehabilitation, Orthopedics and Sports Medicine, University of Washington and Seattle Childrens Hospital, Seattle, WA, United States
| | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, CA, United States
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Scott C Wearing
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Jena, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Faculty of Medicine, MSH Medical School Hamburg, Hamburg, Germany
| |
Collapse
|
33
|
Barrack MT, Sassone J, Dizon F, Wu AC, DeLuca S, Ackerman KE, Tenforde AS. Dietary Supplement Intake and Factors Associated with Increased Use in Preadolescent Endurance Runners. J Acad Nutr Diet 2021; 122:573-582. [DOI: 10.1016/j.jand.2021.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 01/09/2023]
|
34
|
Raghunandan A, Charnoff JN, Matsuwaka ST. The Epidemiology, Risk Factors, and Nonsurgical Treatment of Injuries Related to Endurance Running. Curr Sports Med Rep 2021; 20:306-311. [PMID: 34099608 DOI: 10.1249/jsr.0000000000000852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Running is a popular form of exercise that is easily accessible to various populations; endurance running, defined as distances beyond 5 km, continues to grow within the sport. Endurance running-related injuries are common in the lower extremities and are primarily overuse related. A multitude of risk factors for injury exist, including extrinsic factors, such as running distance and frequency, and intrinsic factors, such as biomechanics and nutrition status. Training and rehabilitation techniques vary with a general focus on strengthening and gradual increase in activity, but evidence is mixed, and it is difficult to generalize programs across different running populations. Management of specific running groups, including youth runners, is an area in which additional research is needed. New treatments, such as orthobiologics and wearable technology, have promising potential to optimize performance and recovery and minimize injury. However, they need to be further evaluated with high-quality studies.
Collapse
|
35
|
Plesek J, Freedman Silvernail J, Hamill J, Jandacka D. Running Footstrike Patterns and Footwear in Habitually Shod Preschool Children. Med Sci Sports Exerc 2021; 53:1630-1637. [PMID: 34261993 DOI: 10.1249/mss.0000000000002629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Running skill develops during the preschool age. There is little research evidence as to how footstrike patterns are affected by footwear during this important developmental period. PURPOSE The aim of this study was to compare footstrike patterns among different age groups of preschool children running in different footwear conditions. METHODS Three-dimensional kinetics and kinematics were collected while 48 typically developing children age 3 to 6 yr ran overground at self-selected speed in a barefoot condition and in minimalist and standard running shoes. Children were divided into four age groups (n = 12 per group). The key dependent variables for this study included strike index and sagittal plane ankle angle at footstrike. A two-way mixed ANOVA (3 × 4) was performed to determine possible footwear and age differences in footstrike patterns. RESULTS An interaction between footwear condition and age group was found in the ankle angle at footstrike (P = 0.030, η2 = 0.145). There was a main effect within the footwear condition across all age groups for strike index (P = 0.001, η2 = 0.337). The ankle was more plantar flexed in the barefoot and minimalist conditions compared with standard running shoes only in 6-yr-old children (P < 0.05, d > 0.8). In addition, 6-yr-old children had a more plantar flexed ankle than did 3-yr-old children when they ran barefoot (P = 0.008, d = 1.24). CONCLUSIONS Footstrike pattern is affected by footwear in preschool children. As children get older, their footstrike pattern becomes more non-rearfoot with a more plantar flexed ankle in barefoot and minimalist shoes. On the contrary, the rearfoot-midfoot strike pattern did not change over preschool age when they wore standard running shoes.
Collapse
Affiliation(s)
- Jan Plesek
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, CZECH REPUBLIC
| | | | | | - Daniel Jandacka
- Department of Human Movement Studies, Human Motion Diagnostic Centre, University of Ostrava, Ostrava, CZECH REPUBLIC
| |
Collapse
|
36
|
Mann RH, McKay CD, Clift BC, Williams CA, Barker AR. Injuries and Training Practices in Competitive Adolescent Distance Runners: A Retrospective Cross-Sectional Study. Front Sports Act Living 2021; 3:664632. [PMID: 34250468 PMCID: PMC8264289 DOI: 10.3389/fspor.2021.664632] [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: 02/05/2021] [Accepted: 05/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Distance running is one of the most popular sports around the world. The epidemiology of running-related injury (RRI) has been investigated in adults, but few studies have focused on adolescent distance runners. Objectives: (1) To provide descriptive epidemiology of RRI (risks, rates, body regions/areas, and severity) and examine the training practices (frequency, volume, and intensity) of competitive adolescent distance runners (13-18 years) in England, and (2) to describe potential risk factors of RRI. Methods: A cross-sectional study design was used. Adolescent distance runners (n = 113) were recruited from England Athletics affiliated clubs. Participants voluntarily completed an online questionnaire between April and December 2018. At the time of completion, responses were based on the participant's previous 12-months of distance running participation. Incidence proportions (IP) and incidence rates (IR) were calculated. Results: The IP for "all RRI" was 68% (95% CI: 60-77), while the IR was 6.3/1,000 participation hours (95% CI: 5.3-7.4). The most commonly injured body areas were the knee, foot/toes, and lower leg; primarily caused by overuse. The number of training sessions per week (i.e., frequency) significantly increased with chronological age, while a large proportion of participants (58%) self-reported a high level of specialisation. Conclusions: RRI is common in competitive adolescent distance runners. These descriptive data provide guidance for the development of RRI prevention measures. However, analytical epidemiology is required to provide better insight into potential RRI risk factors in this specific population.
Collapse
Affiliation(s)
- Robert H Mann
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| | - Carly D McKay
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, United Kingdom
| | - Bryan C Clift
- Centre for Qualitative Research, University of Bath, Bath, United Kingdom.,Department for Health, University of Bath, Bath, United Kingdom
| | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| |
Collapse
|
37
|
Scheer V, Costa RJS, Doutreleau S, Knechtle B, Nikolaidis PT, Roberts WO, Stoll O, S Tenforde A, Krabak B. Recommendations on Youth Participation in Ultra-Endurance Running Events: A Consensus Statement. Sports Med 2021; 51:1123-1135. [PMID: 33704697 DOI: 10.1007/s40279-021-01441-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2021] [Indexed: 12/28/2022]
Abstract
Participation in ultra-endurance running (UER) events continues to grow across ages, including youth athletes. The 50- and 100-km are the most popular distances among youth athletes. Most youth athletes are between 16-18 years; however, some runners younger than 12 years have successfully completed UER events. Parents, athletes, coaches, race directors, and medical professionals often seek advice regarding the safety of youth athletes participating in these events, especially with regard to potential short and long-term health consequences. UER may impact key organ systems during growth and development. We propose a decision-making process, based on current knowledge and the experience of the consensus group that addresses age regulations, medical and psychological well-being, training status and race-specific factors (such as distance, elevation change, remoteness, ambient temperatures, level of medical assistance, and type of provisions provided by the race organizers) to use until evidence of long-term consequences of UER in youth athletes is available. These recommendations are aimed at safe participation in UER events for youth athletes with a proper and individualized assessment.
Collapse
Affiliation(s)
- Volker Scheer
- Ultra Sports Science Foundation, 109 Boulevard de l'Europe, 69310, Pierre-Benite, France. .,Health Science Department, Universidad a Distancia de Madrid (UDIMA), Madrid, Spain.
| | - Ricardo J S Costa
- Department of Nutrition Dietetics and Food, Monash University, Melbourne, Australia
| | | | - Beat Knechtle
- Medbase St. Gallen am Vadianplatz, St. Gallen, Switzerland.,Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | | | - William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Oliver Stoll
- Institute of Sport Science, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Adam S Tenforde
- Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Brian Krabak
- University of Washington and Seattle Children's Sports Medicine, Seattle, WA, USA
| |
Collapse
|
38
|
Hollander K, Hamacher D, Zech A. Running barefoot leads to lower running stability compared to shod running - results from a randomized controlled study. Sci Rep 2021; 11:4376. [PMID: 33623054 PMCID: PMC7902604 DOI: 10.1038/s41598-021-83056-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 01/28/2021] [Indexed: 12/24/2022] Open
Abstract
Local dynamic running stability is the ability of a dynamic system to compensate for small perturbations during running. While the immediate effects of footwear on running biomechanics are frequently investigated, no research has studied the long-term effects of barefoot vs. shod running on local dynamic running stability. In this randomized single-blinded controlled trial, young adults novice to barefoot running were randomly allocated to a barefoot or a cushioned footwear running group. Over an 8-week-period, both groups performed a weekly 15-min treadmill running intervention in the allocated condition at 70% of their VO2 max velocity. During each session, an inertial measurement unit on the tibia recorded kinematic data (angular velocity) which was used to determine the short-time largest Lyapunov exponents as a measure of local dynamic running stability. One hundred running gait cycles at the beginning, middle, and end of each running session were analysed using one mixed linear multilevel random intercept model. Of the 41 included participants (48.8% females), 37 completed the study (drop-out = 9.7%). Participants in the barefoot running group exhibited lower running stability than in the shod running group (p = 0.037) with no changes during the intervention period (p = 0.997). Within a single session, running stability decreased over the course of the 15-min run (p = 0.012) without differences between both groups (p = 0.060). Changing from shod to barefoot running reduces running stability not only in the acute phase but also in the longer term. While running stability is a relatively new concept, it enables further insight into the biomechanical influence of footwear.
Collapse
Affiliation(s)
- Karsten Hollander
- Faculty of Medicine, MSH Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
| | - Daniel Hamacher
- Department of Sport Science, Friedrich Schiller University Jena, Jena, Germany
| | - Astrid Zech
- Department of Sport Science, Friedrich Schiller University Jena, Jena, Germany
| |
Collapse
|
39
|
Hollander K, Rahlf AL, Wilke J, Edler C, Steib S, Junge A, Zech A. Sex-Specific Differences in Running Injuries: A Systematic Review with Meta-Analysis and Meta-Regression. Sports Med 2021; 51:1011-1039. [PMID: 33433864 PMCID: PMC8053184 DOI: 10.1007/s40279-020-01412-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Running is a popular sport with high injury rates. Although risk factors have intensively been investigated, synthesized knowledge about the differences in injury rates of female and male runners is scarce. OBJECTIVE To systematically investigate the differences in injury rates and characteristics between female and male runners. METHODS Database searches (PubMed, Web of Science, PEDro, SPORTDiscus) were conducted according to PRISMA guidelines using the keywords "running AND injur*". Prospective studies reporting running related injury rates for both sexes were included. A random-effects meta-analysis was used to pool the risk ratios (RR) for the occurrence of injuries in female vs. male runners. Potential moderators (effect modifiers) were analysed using meta-regression. RESULTS After removal of duplicates, 12,215 articles were screened. Thirty-eight studies were included and the OR of 31 could be pooled in the quantitative analysis. The overall injury rate was 20.8 (95% CI 19.9-21.7) injuries per 100 female runners and 20.4 (95% CI 19.7-21.1) injuries per 100 male runners. Meta-analysis revealed no differences between sexes for overall injuries reported per 100 runners (RR 0.99, 95% CI 0.90-1.10, n = 24) and per hours or athlete exposure (RR 0.94, 95% CI 0.69-1.27, n = 6). Female sex was associated with a more frequent occurrence of bone stress injury (RR (for males) 0.52, 95% CI 0.36-0.76, n = 5) while male runners had higher risk for Achilles tendinopathies (RR 1. 86, 95% CI 1.25-2.79, n = 2). Meta-regression showed an association between a higher injury risk and competition distances of 10 km and shorter in female runners (RR 1.08, 95% CI 1.00-1.69). CONCLUSION Differences between female and male runners in specific injury diagnoses should be considered in the development of individualised and sex-specific prevention and rehabilitation strategies to manage running-related injuries.
Collapse
Affiliation(s)
- Karsten Hollander
- Medical School Hamburg, Hamburg, Germany.
- Department of Physical Medicine and Rehabilitation, Spaulding National Running Center, Harvard Medical School, Cambridge, MA, USA.
| | - Anna Lina Rahlf
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Jena, Germany
| | - Jan Wilke
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Christopher Edler
- Prevention, Rehabilitation and Interdisciplinary Sports Medicine, BG Trauma Hospital of Hamburg, Hamburg, Germany
| | - Simon Steib
- Department of Human Movement, Training and Active Aging, Institute of Sports and Sports Science, Heidelberg University, Heidelberg, Germany
| | - Astrid Junge
- Medical School Hamburg, Hamburg, Germany
- Swiss Concussion Center, Schulthess Klinik, Zürich, Switzerland
| | - Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Jena, Germany
| |
Collapse
|