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Nickerson M, Herickhoff P. Femoroacetabular Impingement and Groin Injuries Among Soccer Players. Sports Med Arthrosc Rev 2024; 32:120-124. [PMID: 39087700 DOI: 10.1097/jsa.0000000000000394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Groin injuries and femoroacetabular impingement are common among soccer players and can provide a challenge in diagnosis, as well as treatment. Nonoperative and operative measures are the 2 predominant treatments. This current review investigates the recent literature on groin and femoroacetabular impingement injuries in soccer players, as well as potential treatment modalities.
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Affiliation(s)
- Morgan Nickerson
- Department of Orthopedic Surgery, Penn State Health Milton S. Hershey Medical Center, State College, PA
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Yan S, Jiang Q, Song M. Effect of improving asymmetry through self-myofascial release in adolescent soccer player with hypomobility syndrome hip: A randomized controlled trial. Medicine (Baltimore) 2024; 103:e39223. [PMID: 39121315 PMCID: PMC11315543 DOI: 10.1097/md.0000000000039223] [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: 05/23/2024] [Accepted: 07/17/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Hypomobility syndrome (HMS), or limited hip range of motion (ROM), is often reported in adolescents who train heavily. This study was aimed to investigate the impact of traditional static stretching (STR) and self-myofascial release (MFR) in adolescents with HMS hip. METHODS This study was a randomized controlled trial. Adolescent athletes with HMS hip were grouped as 23 STR and 23 MFR. Foam rolling was employed as the training method for MFR. Both interventions were performed twice a day for 20 minutes in 6 weeks. The training was filmed and distributed via the mobile video. Self-assessed Copenhagen Hip & Groin Outcome Score, ROM, strength, and hop tests were measured before and after the interventions. The healthy side without limitations was designated as non-HMS (nHMS) and taken as reference value. RESULTS The study participants had limitations in flexion (FLX), abduction (ABD), internal rotation (IR), and external rotation (ER). The ROM of STR group was recovered to nHMS level. The FLX and ABD of MFR group was also recovered, however the IR and ER had lower angles compared to nHMS. MFR FLX, ABD, ER strength, and single hop test were restored like that of nHMS, however STR group was substantially lower than nHMS despite the improvements. Both groups depicted lower pre-intervention Copenhagen Hip & Groin Outcome Score subscale activities daily living, sport, and physical activity compared to nHMS. Activities daily living and physical activity were improved to healthy levels after the intervention, however sport was lower than that of nHMS. CONCLUSION Both STR and MFR had impact on hip mobility and hip self-assessment score. Furthermore, MFR had strength improvements in FLX, ABD, and ER. However, the improvements in MFR group regarding triples, crossover hops, and self-assessed sports were limited. Therefore, STR and MFR are effective in improving not only ROM but also muscle function asymmetry in HMS hip.
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Affiliation(s)
- Shuren Yan
- Department of Physical Education, Luoyang Normal University, Luoyang, Henan, China
| | - Quan Jiang
- Department of Public Physical Education, Luoyang Normal University, Luoyang, Henan, China
| | - Munku Song
- Department of Physical Education, Gangneung-Wonju National University, Gangneung, Korea
- College of Sport Science, Sungkyunkwan University, Suwon, South Korea
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Bell E, Mosler A, Barton C, Jones D, Heerey J, Johnston R, Coburn S, Kemp J. What are participant beliefs regarding physical therapy led treatment? A qualitative study of people living with femoroacetabular impingement syndrome. Braz J Phys Ther 2024; 28:101077. [PMID: 38838417 PMCID: PMC11215951 DOI: 10.1016/j.bjpt.2024.101077] [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: 07/12/2023] [Revised: 04/11/2024] [Accepted: 05/08/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Physical therapist-led treatment programs are recommended for patients with femoroacetabular impingement (FAI) syndrome. Views of people with FAI syndrome regarding such interventions are currently unknown, including perceptions of potential barriers and facilitators to participation and adherence to exercise programs. OBJECTIVES To explore participant perceptions of physical therapist-led programs for FAI syndrome, including barriers and facilitators for accessing physical therapy, and adhering to a rehabilitation program. METHODS Our qualitative study used semi-structured interviews to explore the perceptions of patients with FAI syndrome undertaking physical therapy-led treatment, where treatment was ceased due to Coronavirus Disease 2019 (COVID-19). The interview topic guide was informed by the Theoretical Domain Framework. Interviews were transcribed verbatim and data categories were developed using inductive thematic analysis. Themes were discussed between researchers until consensus was reached. RESULTS Fourteen participants (mean age: 30 years) with a range of physical activity backgrounds undertook interviews. We identified four key themes, 1) Patients believed their hip pain was caused by structural damage worsened through exercise; 2) Barriers and facilitators on the feasibility of physical therapist-led programs; 3) Participants held beliefs regarding the importance of adjunct treatments to exercise; and 4) Impact of FAI syndrome on physical activity participation. CONCLUSION People with FAI syndrome believe they have structural damage which leads to their hip pain and are often afraid to exercise due to fear of causing more damage to their hip. Our findings suggest that people with FAI syndrome want clear education about exercise, imaging, and expectations of cost and duration of treatment.
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Affiliation(s)
- Emily Bell
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Andrea Mosler
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Christian Barton
- La Trobe Sport and Exercise Medicine Research Centre and Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Denise Jones
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Barwon Health, Geelong, Victoria, Australia
| | - Joshua Heerey
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Richard Johnston
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Sally Coburn
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Joanne Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
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Bhatnagar T, Azim FT, Behrouzian M, Davies K, Wickenheiser D, Jahren G, West N, Leveille L, Lauder GR. Assessing changes in range of motion in adolescent patients undergoing myoActivation® for chronic pain related to myofascial dysfunction: a feasibility study. FRONTIERS IN PAIN RESEARCH 2023; 4:1225088. [PMID: 37954067 PMCID: PMC10634437 DOI: 10.3389/fpain.2023.1225088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/06/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction myoActivation® assessment utilizes systemized movement tests to assess for pain and limitations in motion secondary to myofascial dysfunction. myoActivation needling therapy resolves the myofascial components of pain and is associated with immediately observed changes in pain, flexibility, and range of motion. The principal aim of this feasibility study was to objectively characterize the kinematic metrics of upper and lower body motion before and after myoActivation movement tests and therapy. Methods Five consecutive eligible adolescent participants considered appropriate for myoActivation were consented to receive their myoActivation intervention in a motion laboratory. Clinical motion analysis was used to measure the changes in maximum range of motion (maxROM) and maximum angular speed to maximum ROM (speedROM) of movement tests predicted to change. Metrics were analyzed to assess changes over specified time intervals - i) baseline to after initial myoActivation session, and ii) baseline to after complete myoActivation course. Each participant served as their own control. Results We demonstrated objective evidence of improved maxROM and/or speedROM in 63% of the movement tests predicted to change after just one session of myoActivation and in 77% of movement tests predicted to change over the complete course of treatment. The myoActivation clinician observed positive change in 11/19 of movement tests across all patients, that were predicted to change after the initial myoActivation session; 81% of these positive changes were confirmed by the kinematic data. Discussion Clinical motion analysis provides objective support to clinicians evaluating, treating, and teaching myofascial release. A larger, prospective clinical trial is warranted to explore the impact of myoActivation on movement. Refinement of observation techniques and outcome measures established in this feasibility study will strengthen future clinical motion analysis of the myoActivation process.
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Affiliation(s)
- Tim Bhatnagar
- The Motion Lab, Sunny Hill Centre at BC Children’s Hospital, Vancouver, BC, Canada
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Farah T. Azim
- The Motion Lab, Sunny Hill Centre at BC Children’s Hospital, Vancouver, BC, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Mona Behrouzian
- The Motion Lab, Sunny Hill Centre at BC Children’s Hospital, Vancouver, BC, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Karen Davies
- The Motion Lab, Sunny Hill Centre at BC Children’s Hospital, Vancouver, BC, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Diane Wickenheiser
- The Motion Lab, Sunny Hill Centre at BC Children’s Hospital, Vancouver, BC, Canada
| | - Gail Jahren
- Department of Nursing, BC Children’s Hospital, Vancouver, BC, Canada
| | - Nicholas West
- Research Institute, BC Children’s Hospital, Vancouver, BC, Canada
| | - Lise Leveille
- The Motion Lab, Sunny Hill Centre at BC Children’s Hospital, Vancouver, BC, Canada
- Research Institute, BC Children’s Hospital, Vancouver, BC, Canada
- Department of Orthopedics, University of British Columbia, Vancouver, BC, Canada
| | - Gillian R. Lauder
- Research Institute, BC Children’s Hospital, Vancouver, BC, Canada
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
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Enseki KR, Bloom NJ, Harris-Hayes M, Cibulka MT, Disantis A, Di Stasi S, Malloy P, Clohisy JC, Martin RL. Hip Pain and Movement Dysfunction Associated With Nonarthritic Hip Joint Pain: A Revision. J Orthop Sports Phys Ther 2023; 53:CPG1-CPG70. [PMID: 37383013 DOI: 10.2519/jospt.2023.0302] [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] [Indexed: 06/30/2023]
Abstract
The Academy of Orthopaedic Physical Therapy (AOPT), formerly the Orthopaedic Section of the American Physical Therapy Association (APTA), has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). This is an update to the 2014 Clinical Practice Guideline (CPG) for Hip Pain and Movement Dysfunction Associated with Nonarthritic Hip Joint Pain. The goals of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice. This current CPG covers pathoanatomical features, clinical course, prognosis, diagnosis, examination, and physical therapy interventions in the management of nonarthritic hip joint pain. J Orthop Sports Phys Ther 2023;53(7):CPG1-CPG70. doi:10.2519/jospt.2023.0302.
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Beddows TPA, Weir A, Agricola R, Tak IJR, Piscaer TM, Verhaar JAN, Klij PV. Hip and groin pain in male field hockey players: Prevalence, incidence and associations with patient reported outcome scores and hip muscle strength. Phys Ther Sport 2023; 61:66-72. [PMID: 36933477 DOI: 10.1016/j.ptsp.2023.02.010] [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: 12/05/2022] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES Investigate point prevalence (second half season 2018-2019) and incidence (season 2017-2018 and first half season 2018-2019) of non-time-loss and time-loss hip/groin pain in male field hockey players. Secondary aims were to study associations between: current/previous hip/groin pain and hip muscle strength, patient reported outcome measures (PROM) and hip muscle strength, and previous hip/groin pain and PROMs. Additionally we studied normal values for the PROMs (Hip and Groin Outcome Score (HAGOS)). DESIGN Cross-sectional study. SETTING Testing at field hockey clubs. PARTICIPANTS 100 male field hockey players (elite, sub-elite and amateur). MAIN OUTCOME MEASURES Point prevalence and incidence of hip/groin pain, strength: eccentric adduction and abduction, adductor squeeze, HAGOS. RESULTS Hip/groin pain point prevalence was 17% (time-loss: 6%) and incidence was 36% (time-loss: 12%). Presence of current or previous hip/groin and lower HAGOS-values were not associated with lower hip muscle strength. Previous hip/groin pain was associated with a significant lower HAGOS-values in all domains, except for the 'participation in physical activities' domain. CONCLUSIONS Hip/groin pain is common in field hockey. One fifth of players have hip/groin pain and one third had pain in the previous season. Previous hip/groin pain was associated with worse ongoing patient reported outcomes in most domains.
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Affiliation(s)
- T P A Beddows
- Afdeling Orthopedie & Sportgeneeskunde, Erasmus Medisch Centrum, Rotterdam, the Netherlands.
| | - A Weir
- Afdeling Orthopedie & Sportgeneeskunde, Erasmus Medisch Centrum, Rotterdam, the Netherlands; Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - R Agricola
- Afdeling Orthopedie & Sportgeneeskunde, Erasmus Medisch Centrum, Rotterdam, the Netherlands; Afdeling Orthopedische Chirurgie, Sport & Orthopedie Eindhoven, St. Anna Ziekenhuis, the Netherlands
| | - I J R Tak
- Fysiotherapie Utrecht Oost, Utrecht, the Netherlands; Amsterdam Collaboration on Health and Safety in Sports (ACHSS) / IOC Research Center of Excellence, Amsterdam, the Netherlands
| | - T M Piscaer
- Afdeling Orthopedie & Sportgeneeskunde, Erasmus Medisch Centrum, Rotterdam, the Netherlands
| | - J A N Verhaar
- Afdeling Orthopedie & Sportgeneeskunde, Erasmus Medisch Centrum, Rotterdam, the Netherlands
| | - P van Klij
- Afdeling Orthopedie & Sportgeneeskunde, Erasmus Medisch Centrum, Rotterdam, the Netherlands; Afdeling Sportgeneeskunde, Isala Ziekenhuis, Zwolle, the Netherlands
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Šarčević Z, Tepavčević A. Association between femoroacetabular impingement syndrome and limited lateral hip rotation in young athletes: A case-control study. J Child Orthop 2022; 16:191-197. [PMID: 35800651 PMCID: PMC9254021 DOI: 10.1177/18632521221106377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/10/2022] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Hip pain is very common in athletes. One of the main disorders causing hip pain is femoroacetabular impingement syndrome. This study aimed to identify a new etiological risk factor for femoroacetabular impingement in the hip. METHODS This case-control study included 88 young athletes, 34 with pains in the hip (supposedly with femoroacetabular impingement) and 54 controls. Femoroacetabular impingement was diagnosed with a flexion, adduction, internal, and rotation test and a particular type of hip pain during sports activities. The medial (internal) and lateral (external) hip ranges of rotation have been measured with an inclinometer. The data were analyzed using a t-test, the Wilcoxon test, the Mann-Whitney U test, and logistic regression. RESULTS There is a statistically significant difference in the external hip rotation range between the athletes with hip pain and controls. Logistic regression analysis showed that external hip range of motion is significantly associated with femoroacetabular impingement. CONCLUSION Limited external hip range of motion was found to be significantly associated with the diagnosis of femoroacetabular impingement in young athletes. A biomechanical explanation of the hypothesis that limited external hip rotation can predict femoroacetabular impingement is given. Based on our results, the hip's lateral range of motion screening can be advised within the regular screening of young athletes. Kinesiotherapeutic procedures for stretching the muscles of the medial hip rotors can be advised to prevent the lateral hip rotation restriction and lower the risk of femoroacetabular impingement in case the limited rotation is due to muscular restriction. LEVEL OF EVIDENCE level III-case-control study.
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Affiliation(s)
- Zoran Šarčević
- Sports Medicine Centre, Novi Sad
Health Care Centre, Novi Sad, Serbia
- Faculty of Medicine, University
of Novi Sad, Novi Sad, Serbia
- Zoran Šarčević, Sports Medicine
Centre, Novi Sad Health Care Centre, Branka Radicevica 51, Novi Sad
21000, Serbia.
| | - Andreja Tepavčević
- Faculty of Sciences, University
of Novi Sad, Novi Sad, Serbia
- Mathematical Institute SANU,
Belgrade, Serbia
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Filan D, Mullins K, Carton P. Hip Range of Motion Is Increased After Hip Arthroscopy for Femoroacetabular Impingement: A Systematic Review. Arthrosc Sports Med Rehabil 2022; 4:e797-e822. [PMID: 35494261 PMCID: PMC9042900 DOI: 10.1016/j.asmr.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/08/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose To investigate the impact of arthroscopic correction of symptomatic femoroacetabular impingement on postoperative hip range of motion (ROM), as an objectively measured postoperative clinically reported outcome. Methods A systematic review of the current literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, OVID/MEDLINE, EMBASE, and Cochrane databases were queried in November 2020. Studies not reporting pre- to postoperative ROM measurements were excluded. Methodologic quality was assessed using the MINORS assessment, and certainty of evidence was assessed using the GRADE approach. Effect size using standardized mean differences assessed magnitude of change between pre- and postoperative ROM. Results In total, 23 studies were included evaluating 2,332 patients. Mean age ranged from 18 to 44.2 years. Flexion, internal rotation (IR), and external rotation (ER) were the predominantly measured ROMs reported in 91%, 100% and 65% of studies, respectively. Observed change following hip arthroscopy was considered significant in 57.1% (flexion), 74% (IR), and 20% (ER). Effect size of change in significantly improved ROMs were weak (16.7% flexion, 33.3% ER), moderate (58.3% flexion, 29.4% IR), and large (25% flexion, 64.7% IR, 66.7% ER). For goniometric assessment mean observed changes ranged as follows: flexion: 0.1° to 12.2°; IR: 3.6° to 21.9°; ER: –2.6° to 12.8°. For computed tomography–simulated assessment, the mean observed change ranged as follows: flexion: 3.0° to 8.0°; IR 9.3° to 14.0°. Conclusions Outcome studies demonstrate overall increased range of flexion and IR post-hip arthroscopy, with a moderate and large effect respectively. Change in ER is less impacted following hip arthroscopy. Certainty of evidence to support this observation is low. Current research evaluating changes in this functional ability is limited by a lack of prospective studies and non-standardized measurement evaluation techniques. Level of Evidence Level IV, systematic review of Level II-IV studies.
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Affiliation(s)
- David Filan
- UPMC Whitfield, Waterford, Ireland
- Address correspondence to David Filan, Suite 5, UPMC Whitfield, Butlerstown North, Cork Road, Waterford, Ireland.
| | | | - Patrick Carton
- Hip and Groin Clinic, Waterford, Ireland
- UPMC Whitfield, Waterford, Ireland
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Cause-Effect Relationships between Painful TMD and Postural and Functional Changes in the Musculoskeletal System: A Preliminary Report. Pain Res Manag 2022; 2022:1429932. [PMID: 35265232 PMCID: PMC8901334 DOI: 10.1155/2022/1429932] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/04/2022] [Accepted: 01/28/2022] [Indexed: 12/23/2022]
Abstract
Introduction. Temporomandibular disease (TMD) is a general term including a group of conditions that cause pain and dysfunction in the masticatory muscles, the temporomandibular joint (TMJ), and their related structures. The painful forms of these dysfunctions have become an increasing phenomenon among dental patients. A number of scientific publications indicated the relationship between the presence of postural dysfunctions and functional disorders of the masticatory system in humans. Nevertheless, dental procedures still very rarely include comprehensive diagnostics and procedures aimed at the normalization of the locomotor system related to TMD. Scientific literature usually refers to and describes the coexistence of postural disorders in patients with TMD in the context of anatomical connections, the so-called biokinematic chains, indicating specific types of postures that correlate with different positions of the mandible and/or teeth. Objective. The aim of the study was to investigate the effect of painless positioning of the mandibular head in the articular fossa on postural and functional changes in the musculoskeletal system. Materials and Methods. The study was conducted on a group of 30 randomly selected patients who reported to the Department of Propaedeutic, Physical Diagnostics and Dental Physiotherapy of the Pomeranian Medical University in Szczecin (Poland). Before the examination, the dentists and the physiotherapist were calibrated by an examiner who had previously been calibrated and had three years of experience in the management of patients with TMD. Training of the appropriate palpation strength was performed, and then the results were discussed. In the study group, painful disorders in the temporomandibular joint with an abnormal position of the mandibular head in the articular fossa and individual posture defects were found. The patients complained of pain in the area of the TMJ, episodes of locked joints, and difficulty biting. None of them was treated for these disorders, previously rehabilitated or participated in any body posture examination. The patients were examined by an interdisciplinary team who also performed a preliminary test. The inclusion criterion for the study group was the presence of TMD symptoms in the past. Myofascial pain was diagnosed on the basis of diagnostic criteria for temporomandibular disorders (RDC/TMD Ia and Ib). On the other hand, the displacement of the articular disc was diagnosed on the basis of the diagnostic criteria of temporomandibular disorders (RDC/TMD IIa)—displacement of the articular disc without reduction. At the same time, the body posture was assessed by inspection and using computer techniques while standing and during motion. The examinations were repeated after positioning the mandibular heads in the articular fossa and stabilizing the condylar process using a temporary silicone occlusal splint. Since there is no DC/TMD protocol in Polish to date, RDC/TMD was used in the study. Results. Initial pilot studies and the authors’ observations indicated that the positioning of the mandibular heads in the articular pits and stabilization of the condylar process by providing the oral cavity with a temporary, silicone occlusive splint significantly influenced the posture of the examined patients, both while standing and during locomotion. This correlation also applies to the corrective effect on the foot architecture during standing and patient gait. Conclusions. Diagnostic and therapeutic management in the course of TMD should be holistic. Nevertheless, the observed changes are often varied and largely dependent on individual posture defects, which is an important postulate for further research on a larger study group.
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Sánchez-Migallón V, López-Samanes Á, Del Coso J, Navandar A, Aagaard P, Moreno-Pérez V. Effects of consecutive days of matchplay on maximal hip abductor and adductor strength in female field hockey players. BMC Sports Sci Med Rehabil 2022; 14:3. [PMID: 34980243 PMCID: PMC8725242 DOI: 10.1186/s13102-021-00394-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/22/2021] [Indexed: 12/04/2022] Open
Abstract
Background The purpose of this study was to examine the effects of two competitive field hockey matches, played on consecutive days, on maximal isometric hip adductor and abductor strength, wellness and fatigue.
Methods Fourteen professional female field hockey players (age: 20.4 ± 5.4 years; body mass: 60.7 ± 7.2 kg; height: 167.0 ± 1.0 cm) volunteered to participate in this investigation. Maximal isometric hip adductor and abductor strength were obtained before (pre-match 1) and after the first match (post-match 1), after the second match (post-match 2), and 48 h after the second match. Locomotion patterns during the matches were obtained with portable Global Positioning System (GPS) and perceived exertion (RPE) was assessed after each match. In addition, Wellness Questionnaire (5-WQ) and the Total Quality Recovery Scale (TQR) were employed before the matches and 48 h after the second match. Results For the non-dominant limb, the maximal isometric hip adductor and abductor strength were lower after post-match 2 when compared to pre-match 1 (p = 0.011). Hip abductor strength in the non-dominant limb remained reduced 48 h after post-match 2 (p < 0.001). There were no differences in the total distance covered when comparing match 1 and match 2. Players reported more acute fatigue (5-WQ, p = 0.009) and increased muscle soreness on pre-match 2 compared to pre-match 1 (p = 0.015), while fatigue returned to pre-competition levels 48 h after post-match 2 (p = 0.027). No changes were observed in the TQR. Conclusion The assessment of maximal adductor and abductor strength before and after competitive matches, in addition to evaluating self-perceived fatigue by a wellness questionnaire can help to identify field hockey players with excessive fatigue responses during tournaments with a congested match program.
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Affiliation(s)
- Violeta Sánchez-Migallón
- Exercise Physiology Group, School of Physiotherapy, School of Health Sciences, Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223, Madrid, Spain
| | - Álvaro López-Samanes
- Exercise Physiology Group, School of Physiotherapy, School of Health Sciences, Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223, Madrid, Spain.
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain
| | - Archit Navandar
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | - Per Aagaard
- Research Unit for Muscle Physiology and Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Víctor Moreno-Pérez
- Center for Translational Research in Physiotherapy, Department of Pathology and Surgery, Universidad Miguel Hernández, Elche, San Juan, Spain
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Anthropometric and physical performance characteristics in African women football players: A prospective, cross-sectional pilot study. CENTRAL EUROPEAN JOURNAL OF SPORT SCIENCES AND MEDICINE 2022. [DOI: 10.18276/cej.2022.4-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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The Intra- and Inter-Rater Reliability of a Hip Rotation Range-of-Motion Measurement Using a Smartphone Application in Academy Football (Soccer) Players. Sports (Basel) 2021; 9:sports9110148. [PMID: 34822348 PMCID: PMC8623895 DOI: 10.3390/sports9110148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/14/2021] [Accepted: 10/22/2021] [Indexed: 11/23/2022] Open
Abstract
The clinical assessment of hip rotation range-of-motion (ROM) is important for managing hip and groin injuries in footballers. Previously published reliability studies on hip ROM have employed protocols that are difficult to replicate under everyday clinical conditions. This single trial, intra- and inter-rater reliability study included 41 male academy football (soccer) players, aged 14–15 years, from one European football academy. Passive hip internal rotation (IR) and external rotation (ER) ROM were measured in supine with hip and knee flexed to 90°. The ROM was determined using a smartphone application, with the smartphone attached to the lower leg. The tests were performed on two separate occasions, one week apart, by two different physiotherapists and on both sides (left and right hips). Reliability was evaluated using Intra-Class Correlation Coefficients (ICCs) and Minimal Detectable Change (MDC). Hip IR and ER ROM displayed moderate to good intra-rater agreement (ICCs 0.54–0.75), with MDCs ranging from 10.9° to 16.4°. Inter-rater reliability displayed poor to moderate reliability (ICCs 0.33–0.75), with MDCs ranging from 11.7° to 16.5°. A hip rotation ROM test using a smartphone application and a protocol closely reflecting everyday clinical conditions displayed moderate to good intra-rater reliability and poor to moderate inter-rater reliability. Due to the high MDCs, the practical applicability of this test procedure is limited and further refinement is necessary.
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Dijkstra HP, Ardern CL, Serner A, Mosler AB, Weir A, Roberts NW, Mc Auliffe S, Oke JL, Khan KM, Clarke M, Glyn-Jones S. Primary cam morphology; bump, burden or bog-standard? A concept analysis. Br J Sports Med 2021; 55:1212-1221. [PMID: 34281962 PMCID: PMC8551977 DOI: 10.1136/bjsports-2020-103308] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cam morphology, a distinct bony morphology of the hip, is prevalent in many athletes, and a risk factor for hip-related pain and osteoarthritis. Secondary cam morphology, due to existing or previous hip disease (eg, Legg-Calve-Perthes disease), is well-described. Cam morphology not clearly associated with a disease is a challenging concept for clinicians, scientists and patients. We propose this morphology, which likely develops during skeletal maturation as a physiological response to load, should be referred to as primary cam morphology. The aim of this study was to introduce and clarify the concept of primary cam morphology. DESIGN We conducted a concept analysis of primary cam morphology using articles that reported risk factors associated with primary cam morphology; we excluded articles on secondary cam morphology. The concept analysis method is a rigorous eight-step process designed to clarify complex 'concepts'; the end product is a precise definition that supports the theoretical basis of the chosen concept. RESULTS We propose five defining attributes of primary cam morphology-tissue type, size, site, shape and ownership-in a new conceptual and operational definition. Primary cam morphology is a cartilage or bony prominence (bump) of varying size at the femoral head-neck junction, which changes the shape of the femoral head from spherical to aspherical. It often occurs in asymptomatic male athletes in both hips. The cartilage or bone alpha angle (calculated from radiographs, CT or MRI) is the most common method to measure cam morphology. We found inconsistent reporting of primary cam morphology taxonomy, terminology, and how the morphology is operationalised. CONCLUSION We introduce and clarify primary cam morphology, and propose a new conceptual and operational definition. Several elements of the concept of primary cam morphology remain unclear and contested. Experts need to agree on the new taxonomy, terminology and definition that better reflect the primary cam morphology landscape-a bog-standard bump in most athletic hips, and a possible hip disease burden in a selected few.
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Affiliation(s)
- H Paul Dijkstra
- Department for Continuing Education, University of Oxford, Oxford, UK .,Department of Medical Education, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Clare L Ardern
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia.,Musculoskeletal and Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden
| | - Andreas Serner
- Research & Scientific Support, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Andrea Britt Mosler
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia
| | - Adam Weir
- Aspetar Sports Groin Pain Centre, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Nia Wyn Roberts
- Bodleain Health Care Libraries, University of Oxford Bodleian Libraries, Oxford, UK
| | - Sean Mc Auliffe
- Department of Physical Therapy & Rehabilitation Science, Qatar University, Doha, Qatar
| | - Jason L Oke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Karim M Khan
- Family Practice & Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mike Clarke
- Northern Ireland Methodology Hub, Queen's University Belfast, Belfast, UK
| | - Siôn Glyn-Jones
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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14
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Chaari F, Rebai H, Boyas S, Rahmani A, Fendri T, Harrabi MA, Sahli S. Postural balance impairment in Tunisian second division soccer players with groin pain: A case-control study. Phys Ther Sport 2021; 51:85-91. [PMID: 34303123 DOI: 10.1016/j.ptsp.2021.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare postural balance outcomes between soccer players with and without groin pain (GP). DESIGN Case-control study. SETTING Laboratory. PARTICIPANTS Fifty-four soccer players, 27 with GP (GP group: GPG) and 27 healthy ones (control group: CG). MAIN OUTCOME MEASURES Static and dynamic postural balance were assessed with a force platform and Y-balance test (Y-BT), respectively. Hip abduction, internal rotation (IR), external rotation (ER) and total rotation (TR) of both limbs were evaluated. RESULTS The GPG exhibited significant higher centre of pressure values in the bipedal posture only on the foam surface in eyes opened and closed compared to controls. Besides, they had lower anterior, posteromedial and posterolateral reach distances and composite Y-BT score on the injured limb (IL) compared to non-injured limb (NIL) and dominant-limb (DL) of the CG. Moreover, they showed lower abduction, IR, ER, and TR on the IL compared to NIL and DL. CONCLUSIONS Dynamic unipedal postural balance disorder could be one of the limiting factors of performance in soccer players with non-time loss GP. Hence, postural balance data in these players could enable sport coaches and physical therapists to better understand the mechanisms contributing for performance decrease.
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Affiliation(s)
- Fatma Chaari
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Haithem Rebai
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Sébastien Boyas
- Le Mans University, MIP, EA, 4334, Laboratory "Movement, Interactions, Performance", Faculty of Sciences and Technologies, Department of Sport Sciences, Le Mans, France.
| | - Abderrahmane Rahmani
- Le Mans University, MIP, EA, 4334, Laboratory "Movement, Interactions, Performance", Faculty of Sciences and Technologies, Department of Sport Sciences, Le Mans, France.
| | - Thouraya Fendri
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Mohammed A Harrabi
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
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15
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Candela V, De Carli A, Longo UG, Sturm S, Bruni G, Salvatore G, Denaro V. Hip and Groin Pain in Soccer Players. JOINTS 2021; 7:182-187. [PMID: 34235383 PMCID: PMC8253608 DOI: 10.1055/s-0041-1730978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 04/18/2021] [Indexed: 10/29/2022]
Abstract
Purpose The aim of this article is to illustrate the recent framework necessary to standardize studies on groin pain and review the existing literature on groin pain in football. Methods The common pathological processes underlying groin pain such as muscle, tendon or ligament strain, bone injury or fracture, sport hernia, bursitis, osteitis pubis, and hip-related diseases have been reviewed and current management options have been considered. Results Groin pain is considered a pain in pubic or lower abdominal or adductors region which can be monolateral or bilateral. It is common in high-intensity team sports and can negatively affect an athlete's professional carrier, causing serious disruption in the performance. Despite a high prevalence of groin pain in athletes, diagnosis and management of the underlying pathological processes remain a challenge for surgeons, radiologists, and physiotherapists alike. Conclusion A multidisciplinary approach is essential for patients with groin pain allowing prompt diagnosis and initiation of treatment thus facilitating more rapid return to play and preventing potential long-term sequelae of chronic groin pathology.
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Affiliation(s)
- Vincenzo Candela
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Angelo De Carli
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza," Italy
| | - Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Sofia Sturm
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Giorgio Bruni
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza," Italy
| | - Giuseppe Salvatore
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
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16
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Migliorini F, Liu Y, Catalano G, Trivellas A, Eschweiler J, Tingart M, Maffulli N. Medium-term results of arthroscopic treatment for femoroacetabular impingement. Br Med Bull 2021; 138:68-84. [PMID: 33454746 DOI: 10.1093/bmb/ldaa038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 05/16/2020] [Accepted: 10/24/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Femoroacetabular impingement (FAI) is a dynamic pathomechanical process of the femoral head-neck junction. Arthroscopic surgery for FAI has increased exponentially in the last decade, and this trend is expected to increase. SOURCE OF DATA Recent published literatures. AREAS OF AGREEMENT FAI promotes quick rehabilitation and low complication rates in the short-term follow-up. AREAS OF CONTROVERSY Despite the growing interest on arthroscopic surgery for FAI, current evidence regarding the medium- and long-term role of arthroscopy are unsatisfactory. GROWING POINTS Systematically summarize current evidences, analyse the quantitative available data and investigate the medium- and long-term outcomes of arthroscopic surgery for FAI. AREAS TIMELY FOR DEVELOPING RESEARCH Arthroscopic surgery achieves very satisfactory outcomes for patients with FAI at a mean follow-up of 4 years.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Yu Liu
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Giovanni Catalano
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Andromahi Trivellas
- Department of Orthopaedics, David Geffen School of Medicine at UCLA, 90095 Los Angeles, CA, USA
| | - Jörg Eschweiler
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Markus Tingart
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, Baronissi, SA 84081, Italy.,School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, ST5 5BG Stoke on Trent, UK.,Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, E1 4DG London, UK
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17
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van den Noort D, Oltmans E, Aoki H, Kerkhoffs GMMJ, Gouttebarge V. Clinical Hip Osteoarthritis in Current and Former Professional Footballers and Its Effect on Hip Function and Quality of Life. JOURNAL OF SPORTS SCIENCE AND MEDICINE 2021; 20:284-290. [PMID: 34211321 DOI: 10.52082/jssm.2021.284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/28/2021] [Indexed: 12/20/2022]
Abstract
The objective of the study was to establish the prevalence of clinical hip osteoarthritis in current and former professional footballers and to explore its consequences on hip function and health-related quality of life (HRQoL). A cross-sectional study by means of questionnaire was conducted among current and former professional footballers fulfilling the following inclusion criteria: (1) male (2) active or retired professional footballer (3) member of FIFPRO (Football Players Worldwide) (4) between 18 and 50 years old (5) could read and understand texts in French, Spanish, or English. Controls (matched for: gender, age, body weight and height) were also recruited. The main outcome measures were clinical hip osteoarthritis, hip function and HRQoL. Questionnaires were sent to 2,500 members of which 1,401 participated (1,000 current and 401 former professional footballers). Fifty-two controls were recruited. Prevalence of hip osteoarthritis was 2% among current and 8% among former professional footballers. Hip function was significantly (p ≤ 0.001) lower in both types of footballers with hip osteoarthritis than in footballers without hip osteoarthritis and controls. Current and former professional footballers with hip osteoarthritis reported significantly lower physical health scores (p = 0.032, p = 0.002) than those without. Hip osteoarthritis led to a significantly lower score in the physical (p = 0.004) and mental (p = 0.014) component of HRQoL in former footballers compared to the controls, while in current footballers only the physical component was significantly (p = 0.012) lower compared to the controls. Hip osteoarthritis has a higher prevalence in former than in current professional footballers and impacts hip function and HRQoL negatively.
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Affiliation(s)
- Dennie van den Noort
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Emmeline Oltmans
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Haruhito Aoki
- St. Marianna University School of Medicine, Kawasaki, Japan.,Yokohama City Sports Medical Center, Yokohama, Japan
| | - Gino M M J Kerkhoffs
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands.,Academic Center for Evidence based Sports medicine (ACES), Amsterdam, the Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, the Netherlands
| | - Vincent Gouttebarge
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands.,Academic Center for Evidence based Sports medicine (ACES), Amsterdam, the Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, the Netherlands.,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.,FIFPRO (Football Players Worldwide), Hoofddorp, the Netherlands
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18
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Dooley K, Drew MK, Snodgrass SJ, Schultz A, McGann T, Blyton S, Pizzari T, Rio E, Donnan L, Edwards S. Male basketball players who report hip and groin pain perceive its negative impact both on- and off-court: A cross-sectional study. J Sci Med Sport 2021; 24:660-664. [PMID: 33707154 DOI: 10.1016/j.jsams.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/25/2021] [Accepted: 02/07/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To identify if basketball players aged <20 years (U20) self-report hip and/or groin pain and if they perceive this as a problem. To determine potential differences in self-reported playing (training and match play) loads and Copenhagen Hip and Groin Outcome Score (HAGOS) between those with and without hip/groin pain. DESIGN Cross-sectional. METHODS Fifty-one pre-elite (state/national representative level) male U20 basketball players (Australian n=38; Italian n=13) self-reported current/historical hip/groin 'discomfort/pain' and 'problems', and playing loads. A two-factor regression model was fitted including main effects for hip/groin pain and Cohort and their interaction, with outcome variables playing loads and HAGOS subscale scores and dependent variable hip/groin pain. RESULTS Twenty-one players (41%) self-reported hip/groin 'discomfort/pain', of which nine perceived no 'problems'. Two of these nine players reported training/playing time loss due to pain. Those self-reporting hip/groin discomfort/pain scored lower than those without in HAGOS subscales Symptoms (mean difference in score 8.94; 95%CI -25.24, -5.97), Pain (5.00; -16.42, -2.81), Function in daily living (0.00; -26.72 to -5.59), Function in sport and recreation (6.25; -21.24, -5.33), and hip and/or groin Quality of Life (5.00; -28.63, -8.10), indicating worse hip/groin problems. Participation subscale scores were different only for Italian players (36.25; -51.25, -20.00), with players self-reporting hip/groin discomfort/pain scoring lower. CONCLUSION Most players who perceive both hip/groin 'discomfort/pain' and 'problems' also report training/playing time loss, suggesting players' perceptions of problematic symptoms and time-loss are associated. Adolescent basketball players perceive hip/groin pain to negatively impact their daily lives and sporting function.
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Affiliation(s)
- Katherine Dooley
- School of Health Sciences, The University of Newcastle, Australia.
| | - Michael K Drew
- Department of Physical Therapies, Australian Institute of Sport, Australia
| | | | - Adrian Schultz
- School of Environmental & Life Sciences, The University of Newcastle, Australia
| | - Tye McGann
- School of Health Sciences, The University of Newcastle, Australia
| | - Sarah Blyton
- School of Environmental & Life Sciences, The University of Newcastle, Australia
| | - Tania Pizzari
- Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - Ebonie Rio
- Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - Luke Donnan
- School of Community Health, Charles Sturt University, Australia
| | - Suzi Edwards
- School of Environmental & Life Sciences, The University of Newcastle, Australia
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19
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Bento AO, Falótico G, Enseki K, Cunha RA, Ejnisman B, Arliani G, Cohen M. Morphological Changes of the Hip Commonly Associated With Femoroacetabular Impingement Are Not Correlated With Rotational Range of Hip Motion in Elite Soccer Athletes. Sports Health 2021; 13:341-346. [PMID: 33535888 DOI: 10.1177/1941738120973662] [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: 11/16/2022] Open
Abstract
BACKGROUND Morphological changes characteristic of femoroacetabular impingement (FAI) are common in soccer players. However, the clinical relevance of such anatomical variations is still not well-defined. HYPOTHESIS We hypothesized that high alpha angle values and/or acetabular retroversion index (ARI) are correlated with rotational range of motion (ROM) of the hip and that there are clinical-radiological diferences between the dominant lower limb (DLL) and nondominant lower limb (NDLL) in professional soccer players. STUDY DESIGN Cross-sectional. LEVEL OF EVIDENCE Level 3. METHODS A total of 59 male professional soccer players (average age 25.5 years, range 18-38 years) were evaluated in the preseason. As main outcome measures, we evaluated the alpha angle and the ARI and hip IR and ER ROM with radiographic analysis. RESULTS The measurements taken on DLL and NDLL were compared and a significant difference was found between the sides in the ER (P = 0.027), where the DLL measures were 1.54° (95% CI, 0.18-2.89) greater than the NDLL. There were no significant differences between the sides in the measures of IR (P > 0.99), total ROM (P = 0.07), alpha angle (P = 0.250), and ARI (P = 0.079). The correlations between the rotation measurements and the alpha angle in each limb were evaluated and the coefficient values showed no correlation; so also between the ARI and rotation measures. CONCLUSION Morphological changes of the femur or acetabulum are not correlated with hip IR and ER ROM in male professional soccer players. ER on the dominant side was greater than on the nondominant side. There was no significant difference in the other measurements between sides. CLINICAL RELEVANCE In clinical practice, it is common to attribute loss of hip rotational movement to the presence of FAI. This study shows that anatomical FAI may not have a very strong influence on available hip rotational movement in professional soccer athletes.
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Affiliation(s)
- André Orlandi Bento
- Department of Orthopedics and Traumatology, Center of Sports Traumatology (CETE), Federal University of São Paulo, São Paulo, Brazil
| | - Guilherme Falótico
- Department of Orthopedics and Traumatology, Center of Sports Traumatology (CETE), Federal University of São Paulo, São Paulo, Brazil
| | - Keelan Enseki
- University of Pittsburgh Medical Center, Center for Sports Medicine, Pittsburgh, Pennsylvania
| | - Ronaldo Alves Cunha
- Department of Orthopedics and Traumatology, Center of Sports Traumatology (CETE), Federal University of São Paulo, São Paulo, Brazil
| | - Benno Ejnisman
- Department of Orthopedics and Traumatology, Center of Sports Traumatology (CETE), Federal University of São Paulo, São Paulo, Brazil
| | - Gustavo Arliani
- Department of Orthopedics and Traumatology, Center of Sports Traumatology (CETE), Federal University of São Paulo, São Paulo, Brazil
| | - Moisés Cohen
- Department of Orthopedics and Traumatology, Center of Sports Traumatology (CETE), Federal University of São Paulo, São Paulo, Brazil
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20
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Estberger A, Pålsson A, Kostogiannis I, Ageberg E. Less hip range of motion is associated with a greater alpha angle in people with longstanding hip and groin pain. Knee Surg Sports Traumatol Arthrosc 2021; 29:4091-4099. [PMID: 34510222 PMCID: PMC8595235 DOI: 10.1007/s00167-021-06733-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 08/30/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE A higher alpha angle has been proposed to correlate with lower hip range of motion, but the association in people with longstanding hip and groin pain is currently unclear. The aims were to: (1) assess the association between range of motion and alpha angle in patients with longstanding hip and groin pain; (2) examine if a cut-off value in range of motion variables could identify patients with an alpha angle above or below 60°. METHODS Seventy-two participants were consecutively recruited from an orthopaedic department after referral for hip- and groin-related pain. Passive hip range of motion was measured in flexion, internal rotation with 90° hip flexion, internal rotation in neutral hip position, external rotation with 90° hip flexion, and abduction. The alpha angle was calculated from a frog-leg lateral radiograph. Linear regression examined the association between range of motion and alpha angle, and an ROC-curve analysis was performed to identify the sensitivity and specificity of range of motion cut-offs. RESULTS Lower range of motion in internal rotation in flexion, external rotation, and abduction were associated with higher alpha angle. Internal rotation of 27° or less displayed good sensitivity (81%) and specificity (85%) to detect an alpha angle above 60°, while a cut-off of 41° in external rotation and 27° in abduction showed a sensitivity of 72% and specificity of 50% and 60%, respectively. CONCLUSION Less internal rotation in flexion, external rotation, and abduction are associated with a greater alpha angle in a cohort of people with longstanding hip and groin pain. A cut-off of 27° in internal rotation has good sensitivity and specificity to identify people with an alpha angle above or below 60° and have the potential to be used in the clinical setting to identify patients that require further imaging, or that are unlikely to have cam morphology. LEVEL OF EVIDENCE II.
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Affiliation(s)
| | - Anders Pålsson
- grid.4514.40000 0001 0930 2361Department of Health Sciences, Lund University, Lund, Sweden
| | - Ioannis Kostogiannis
- grid.4514.40000 0001 0930 2361Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden
| | - Eva Ageberg
- grid.4514.40000 0001 0930 2361Department of Health Sciences, Lund University, Lund, Sweden
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21
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Marom N, Dooley MS, Burger JA, Chang B, Coleman SH, Ranawat AS, Kelly BT, Nawabi DH. Characteristics of Soccer Players Undergoing Primary Hip Arthroscopy for Femoroacetabular Impingement: A Sex- and Competitive Level-Specific Analysis. Am J Sports Med 2020; 48:3255-3264. [PMID: 32966110 DOI: 10.1177/0363546520958697] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Radiographic features of femoroacetabular impingement (FAI) are prevalent in kicking athletes, especially soccer players. However, there remains a paucity of data on the characteristics of symptomatic soccer players with an established diagnosis of FAI. PURPOSE To report on patient demographics, injury, and clinical and radiographic characteristics in a large cohort of soccer players who underwent primary hip arthroscopy for FAI and to perform a sex- and competition level-specific analysis of these data. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS An institutional hip preservation registry containing 3318 consecutive primary hip arthroscopies for FAI performed between March 2010 and January 2016 was retrospectively reviewed for patients identified as soccer players. Patient demographics, injury characteristics, and clinical and radiographic findings were recorded, and sex- and competition level-specific differences were analyzed. RESULTS A total of 421 hips (336 soccer players) were identified, including 257 (61.0%) men and 164 (39.0%) women. Of these, 105 (24.9%) were reported as highly competitive, 194 (46.1%) as competitive, 75 (17.8%) as recreational, and 47 (11.2%) did not report a level. The majority of the 336 soccer players (231 hips; 55%) reported chronic hip pain lasting >6 months with no acute injury at the initial visit. Alpha angle, coronal center-edge angle, and femoral version on computed tomography scan measured 64.5°± 12°, 32.3°± 9°, and 13.7°± 10° (mean ± SD), respectively. There were 230 (55%) hips with a type 2 anterior inferior iliac spine (AIIS), 78 (18.5%) with a type 1 AIIS, and 19 (4.5%) with a type 3 AIIS. When compared with male athletes, female athletes had more hip internal rotation on physical examination (14.9° vs 8°; P < .001), lower alpha angles (57.5° vs 68.5°; P < .001), and lower-grade AIIS morphology (P = .003). Acute injury as the reason for hip symptoms was most likely in the highly competitive group (P < .001). CONCLUSION Female soccer players were more likely to have less severe clinical and radiographic findings than were male soccer players. Acute injury as the cause of hip symptoms was more common in highly competitive players. CLINICAL RELEVANCE Focusing on soccer players with an established FAI diagnosis, the findings of this study suggest that there are sex- and competition level-based differences in the presentation, physical examination, and imaging characteristics among the players. These findings can better guide clinicians in the diagnostic evaluation of symptomatic soccer players with FAI and in tailoring treatment recommendations to specific cohorts.
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Affiliation(s)
- Niv Marom
- Sports Medicine Institute and Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA
| | - Matthew S Dooley
- Sports Medicine Institute and Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA
| | - Joost A Burger
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Brenda Chang
- Biostatistics Core, Hospital for Special Surgery, New York, New York, USA
| | - Struan H Coleman
- Sports Medicine Institute and Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA
| | - Anil S Ranawat
- Sports Medicine Institute and Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA
| | - Bryan T Kelly
- Sports Medicine Institute and Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA
| | - Danyal H Nawabi
- Sports Medicine Institute and Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA
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DeLang MD, Garrison JC, Hannon JP, McGovern RP, Christoforetti J, Thorborg K. Short and long lever adductor squeeze strength values in 100 elite youth soccer players: Does age and previous groin pain matter? Phys Ther Sport 2020; 46:243-248. [PMID: 33049480 DOI: 10.1016/j.ptsp.2020.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/28/2020] [Accepted: 10/02/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine adductor squeeze strength in elite youth soccer players by investigating the relationship of age and previous one-year groin pain on adductor squeeze force outputs, and to provide reference values for youth players. DESIGN Cross-sectional study. PARTICIPANTS Elite youth soccer players (n = 100; age 14.5 ± 1.9 years; height 168.0 ± 10.7 cm; mass 60.7 ± 13.0 kg) participated. MAIN OUTCOME MEASURES Adductor squeeze tests were captured in short and long lever positions, and groin pain assessed via subjective retrospective questionnaire. Multiple linear regressions were computed to compare the effects of age and previous one-year groin pain on adductor squeeze strength. RESULTS Raw adductor squeeze force values (N) had a moderate positive relationship with age (short r = 0.517, p < 0.001; long r = 0.457, p < 0.001), but not when force is normalized to body mass (N/kg; short r = 0.014, p = 0.444; long r = -0.173, p = 0.043). Previous groin pain did not have an effect on short or long lever squeeze strength. Reference values for long lever adductor squeeze strength (3.59 ± 0.77 Nm/kg) are provided. CONCLUSION Age and previous groin pain do not have an effect on adductor squeeze strength values in elite youth soccer players, so comparing values to the present adolescent cohort can be quickly interpreted without adjustment for age or previous injury.
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Affiliation(s)
| | | | | | | | | | - Kristian Thorborg
- Sports Orthopedic Research Center Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre Hospital, Copenhagen University, Denmark
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Tak IJR, Weerink M, Barendrecht M. Judokas with low back pain have lower flexibility of the hip-spine complex: A case-control study. Phys Ther Sport 2020; 45:30-37. [PMID: 32619846 DOI: 10.1016/j.ptsp.2020.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Study whether male adult judokas with and without low back pain (LBP) have different hip-spine flexibility. DESIGN Cross-sectional. SETTING Judo training centres. PARTICIPANTS Judokas with (n = 29) and without (n = 33) LBP. MAIN OUTCOME MEASURES Range of motion (ROM) (passive and active rotations) of hips, lumbar spine (flexion-extension) and fingertip-to-floor distance (FTFD). RESULTS The non-dominant hips of judokas with LBP had 6.8 ± 1.2° (ES:1.45, p < 0.001) lower passive and 8.0 ± 1.3° (ES:1.55, p < 0.001) lower active internal rotation. Dominant hips of judokas with LBP had 5.1 ± 1.6° (ES: 0.81, p = 0.002) lower active internal rotation and 8.8 ± 2.9° (ES:0.79, p = 0.003) lower active total rotation. The LBP group showed 8.0 ± 2.8° (ES: 0.73, p = 0.006) lower flexion and 6.0 ± 2.2° (ES: 0.69, p = 0.009) lower extension of the lumbar spine. The FTFD in the LBP group was 7.3 ± 2.6 cm (ES: 0.72, p = 0.007) lower. The multi-level regression analyses showed passive (OR 1.54, 95%CI 1.18-2.00, p = 0.001) and active (OR 1.47, 95%CI 1.16-1.87, p = 0.001) hip internal rotation of the non-dominant leg and lumbar spinal flexion (OR 1.11, 95%CI 1.03-1.20, p = 0.006) and extension (OR 1.16, 95%CI 1.01-1.33, p = 0.035) were related to LBP. CONCLUSION Lower hip internal rotation of the non-dominant leg (passive and active) and lower lumbar flexibility are significantly related to LBP in male adult judokas.
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Affiliation(s)
- I J R Tak
- Fysiotherapie Utrecht Oost, Bloemstraat 65d, 3581 WD, Utrecht, the Netherlands; Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - M Weerink
- Paramedisch Centrum Albergen, Albergen, Hoofdstraat 51, 7665 AN, the Netherlands; Avans+ Improving Professionals, Heerbaan 14/40, 4817 NL, Breda, the Netherlands
| | - M Barendrecht
- Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; Avans+ Improving Professionals, Heerbaan 14/40, 4817 NL, Breda, the Netherlands; Mijn Fysio en Adviespunt, Rhijnvis Feithlaan 12, 2533 GE, Den Haag, the Netherlands
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De-la-Cruz-Torres B, Abuín-Porras V, Blanco-Morales M, de-la-Cueva-Reguera M, Calvo-Lobo C, López-López D, Romero-Morales C. Acute Effects of a Single Football Training or Match on Passive Hip Rotation Range of Motion in Semi-Professional Football Players: A Pilot Study. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E228. [PMID: 32397596 PMCID: PMC7279367 DOI: 10.3390/medicina56050228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 04/26/2020] [Accepted: 05/07/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES The repetitive loading forces generated during football activities may induce alterations in the hip rotation range of motion (ROM) in players. The objective of this study was to evaluate the acute effects of a training and a match on bilateral passive hip rotation ROM in both lower limbs in soccer. MATERIAL AND METHODS Twenty-eight male players were divided into two groups: 14 players (28 limbs) with normal bilateral hip rotation ROM (NH group) and 14 players (28 limbs) with restricted bilateral hip ROM (RH group). Passive bilateral hip rotation ROM was measured, by goniometer, before and after training or a match. Internal-rotation ROM (ROMIR), external-rotation ROM (ROMER), total ROM (ROMTOT) and relative internal rotation (ROMREL) were calculated. RESULTS The NH group did not show substantial changes in hip ROM after a training nor a match. After a training session, only the RH group exhibited a substantial increase in ROMIR, ROMER and ROMTOT. After a match, only the RH group exhibited a substantial increase in ROMER and ROMTOT and exhibited a substantial decrease in ROMREL. Comparing both groups, there were significant differences within ROM changes for ROMER and ROMTOT after training and for ROMER and ROMREL after a match. CONCLUSIONS Despite the small sample size of the present study, the findings indicate that a single football activity leads to significant changes in hip rotation ROM in players with restricted bilateral hip external-rotation ROM. However, these changes did not reach reference cut-off scores.
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Affiliation(s)
| | - Vanesa Abuín-Porras
- Faculty of Sport Sciences, Universidad Europea, Villaviciosa de Odón, 28670 Madrid, Spain; (V.A.-P.); (M.B.-M.); (M.d.-l.-C.-R.); (C.R.-M.)
| | - Maria Blanco-Morales
- Faculty of Sport Sciences, Universidad Europea, Villaviciosa de Odón, 28670 Madrid, Spain; (V.A.-P.); (M.B.-M.); (M.d.-l.-C.-R.); (C.R.-M.)
| | - Mónica de-la-Cueva-Reguera
- Faculty of Sport Sciences, Universidad Europea, Villaviciosa de Odón, 28670 Madrid, Spain; (V.A.-P.); (M.B.-M.); (M.d.-l.-C.-R.); (C.R.-M.)
| | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 15403 Ferrol, Spain;
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea, Villaviciosa de Odón, 28670 Madrid, Spain; (V.A.-P.); (M.B.-M.); (M.d.-l.-C.-R.); (C.R.-M.)
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Stevenson K, Bleakley C, Tak I, Langhout R, Saligari R, Glasgow P. Active posterior pelvic tilt range of motion is decreased in soccer players with chronic groin pain: A case‐control study. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- K. Stevenson
- Faculty of Life and Health Sciences Ulster University Newtownabbey Northern Ireland
| | - C. Bleakley
- Faculty of Life and Health Sciences Ulster University Newtownabbey Northern Ireland
- Department of Physical Therapy Congdon School of Health Science High Point University High Point NC USA
| | - I.J.R. Tak
- Physiotherapy Utrecht Oost Utrecht The Netherlands
- Academic Center for Evidence‐Based Sports Medicine (ACES) Amsterdam The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS) Amsterdam The Netherlands
| | - R.F.H. Langhout
- Academic Center for Evidence‐Based Sports Medicine (ACES) Amsterdam The Netherlands
- Physiotherapy Dukenburg Nijmegen The Netherlands
- Department of Orthopaedics and Sports Traumatology Amsterdam University Medical Centre Amsterdam The Netherlands
- Masters Program in Manual Therapy SOMT Amersfoort The Netherlands
| | - R. Saligari
- Active Health Solutions County Down Holywood Northern Ireland
| | - P. Glasgow
- Faculty of Life and Health Sciences Ulster University Newtownabbey Northern Ireland
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van Klij P, Ginai AZ, Heijboer MP, Verhaar JAN, Waarsing JH, Agricola R. The relationship between cam morphology and hip and groin symptoms and signs in young male football players. Scand J Med Sci Sports 2020; 30:1221-1231. [PMID: 32201993 PMCID: PMC7317829 DOI: 10.1111/sms.13660] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 12/11/2022]
Abstract
Background Conflicting and limited high‐quality prospective data are available on the associations between cam morphology and hip and groin symptoms and range of motion (ROM). Objectives This cross‐sectional cohort study investigated associations between cam morphology presence, size and duration and symptoms and ROM. Methods Academy male football players (n = 49, 17‐24 years) were included. Standardized antero‐posterior pelvic and frog‐leg lateral radiographs were obtained at baseline, 2.5‐ and 5‐year follow‐up. The femoral head‐neck junction was quantified by:
Visual score. Cam morphology (flattening or prominence), large cam (prominence). Alpha angle. Cam morphology (≥60°), large cam (≥78°).
Cam morphology duration was defined as long (first present at baseline) or short (only from 2.5‐ to 5‐year follow‐up). Current symptoms at 5‐year follow‐up were assessed using a hip and groin pain question and by the “Hip and Groin Outcome Score” (HAGOS). HAGOS scores were categorized into: most symptoms (≥2 domains in lowest interquartile range [IQR]), least symptoms (≥2 domains in highest IQR). Hip ROM was measured by goniometry at 5‐year follow‐up. Results Large cam morphology based on visual score was associated with hip and groin pain (23.8% vs. 7.1%, OR: 3.17, CI: [1.15‐8.70], P = .026), but not with HAGOS scores. Cam morphology presence, size, and duration were associated with limited flexion of around 6° and/or 3° to 6° for internal rotation. Conclusion Cam morphology presence, size, and duration were associated with limited hip flexion and/or internal rotation, but differences might not exceed the minimal clinical important difference. Whether cam morphology results in symptoms is uncertain.
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Affiliation(s)
- Pim van Klij
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Abida Z Ginai
- Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marinus P Heijboer
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jan A N Verhaar
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jan H Waarsing
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rintje Agricola
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Philippi MT, Kahn TL, Adeyemi TF, Maak TG, Aoki SK. Leg dominance as a risk factor for femoroacetabular impingement syndrome. J Hip Preserv Surg 2020; 7:22-26. [PMID: 32382425 PMCID: PMC7195927 DOI: 10.1093/jhps/hnaa007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/05/2022] Open
Abstract
One etiological factor of femoroacetabular impingement syndrome (FAIS) is high impact athletics involving deep hip flexion, axial loading and jumping during skeletal development. Previous work has established that there is physiologic asymmetry of the lower limbs regarding function, with the dominant limb being primarily responsible for propulsion and kicking while the non-dominant limb is responsible for stability and planting. The authors hypothesize that the dominant limb will be more likely to undergo hip arthroscopy for symptomatic FAIS. Four hundred and sixty-nine patients at a single surgical center who underwent primary or revision hip arthroscopy for cam-type FAIS were identified. Patients were asked to identify their dominant lower extremity, defined as the lower extremity preferred for kicking. Sixty patients who indicated bilateral leg dominance were excluded. It was assumed that with no association between limb dominance and the need for surgery, the dominant side would have surgery 50% of the time. Enrichment for surgery in the dominant limb was tested for using a one-sample test of proportions, determining whether the rate differed from 50%. The enrichment for surgery on the dominant side was 57% (95% confidence interval 52–62%) which was significantly different from the rate expected by chance (50%), P = 0.003. No other significant differences were noted between groups. Limb dominance appears to be an etiological factor in the development of cam-type FAIS. Patients are more likely to undergo arthroscopic treatment of FAIS on their dominant lower extremity, although the non-dominant lower extremity frequently develops FAIS as well.
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Affiliation(s)
- Matthew T Philippi
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Timothy L Kahn
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Temitope F Adeyemi
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Travis G Maak
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Stephen K Aoki
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
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Ralston B, Arthur J, Makovicka JL, Hassebrock J, Tummala S, Deckey DG, Patel K, Chhabra A, Hartigan D. Hip and Groin Injuries in National Collegiate Athletic Association Women's Soccer Players. Orthop J Sports Med 2020; 8:2325967119892320. [PMID: 32030343 PMCID: PMC6977238 DOI: 10.1177/2325967119892320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 09/03/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Hip and groin injuries are common in competitive soccer players and have been shown to be significant sources of time loss. There are few studies describing the epidemiology of hip and groin injuries in female National Collegiate Athletic Association (NCAA) soccer players. Purpose: To describe the epidemiology of hip and groin injuries in women’s collegiate soccer players. Study Design: Descriptive epidemiology study. Methods: The NCAA Injury Surveillance System/Program (ISS/ISP) was analyzed from 2004 through 2014 for data related to hip and groin injuries in female collegiate soccer players. Injuries and athlete-exposures (AEs) were reported by athletic trainers. Data were stratified by time of season, event type, injury type, treatment outcome, time loss, and player field position. Results: Between 2004 and 2014, there were 439 recorded hip or groin injuries in female soccer players and an overall rate of injury of 0.57 per 1000 AEs. Injuries were 12.0 times more likely to occur during the preseason (4.41/1000 AEs) as opposed to during the regular season (0.37/1000 AEs) (injury rate ratio [IRR], 12.01; 95% confidence interval [CI], 9.92-14.55) or postseason (0.38/1000 AEs) (IRR, 11.55; 95% CI, 7.06-18.91). Rates of injury were similar during the regular season and postseason (IRR, 0.96; 95% CI, 0.59-1.58). Rates of injury were higher during competition (0.69/1000 AEs) than during practice (0.52/1000 AEs) (IRR, 1.33; 95% CI, 1.08-1.63). Most injuries were new (87.5%; n = 384) and unlikely to recur (12.5%; n = 55). Conclusion: Hip and groin injuries in female NCAA soccer players are uncommon, and fortunately, most players return to play quickly without recurrence. Future prospective studies should evaluate the effectiveness of strength and conditioning programs in preventing these injuries.
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Affiliation(s)
- Bridget Ralston
- University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Jaymeson Arthur
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | | | - Jeff Hassebrock
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Sailesh Tummala
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | - David G Deckey
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Karan Patel
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Anikar Chhabra
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - David Hartigan
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
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The Efficacy of Lower-Limb Screening Tests in Predicting PlayerLoad Within a Professional Soccer Academy. J Sport Rehabil 2019; 28:860-865. [PMID: 30300046 DOI: 10.1123/jsr.2018-0175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/18/2018] [Accepted: 08/27/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Training exposure has been associated with injury epidemiology in elite youth soccer, where lower-limb musculoskeletal screening is commonly used to highlight injury risk. However, there has been little consideration of the relationship between lower-limb screening and the loading response to soccer activities. OBJECTIVE To quantify the efficacy of using screening tests to predict the loading elicited in soccer-specific activities and to develop a hierarchical ordering of musculoskeletal screening tests to identify test redundancy and inform practice. DESIGN Correlational. SETTING Professional soccer club academy. PARTICIPANTS A total of 21 elite male soccer players aged 15.7 (0.9) years. INTERVENTION Players completed a battery of 5 screening tests (knee to wall, hip internal rotation, adductor squeeze, single-leg hop, and anterior reach) and a 25-minute standardized soccer session with a Global Positioning System unit placed at C7 to collect multiplanar PlayerLoad data. MAIN OUTCOME MEASURES Baseline data on each screening test, along with uniaxial PlayerLoad in the mediolateral, anteroposterior, and vertical planes. RESULTS Stepwise hierarchical modeling of the screening tests revealed that dominant leg knee-to-wall distance was the most prevalent and powerful predictor of multiplanar PlayerLoad, accounting for up to 42% of variation in uniaxial loading. The adductor squeeze test was the least powerful predictor of PlayerLoad. Of note, one player who incurred a knee injury within 3 weeks of testing had shown a 20% reduction in knee-to-wall distance compared with peers, and elicited 23% greater PlayerLoad, supporting the hierarchical model. CONCLUSIONS There was some evidence of redundancy in the screening battery, with implications for clinical choice. Hierarchical ordering and a concurrent case study highlight dominant leg knee-to-wall distance as the primary predictor of multiaxial loading in soccer. This has implications for the design and interpretation of screening data in elite youth soccer.
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Langhout RR, Tak IJ. Including performance level lowers prevalence of non-timeloss groin injury. A cross-sectional study in 383 female amateur football players. Phys Ther Sport 2019; 40:225-230. [DOI: 10.1016/j.ptsp.2019.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 09/28/2019] [Accepted: 09/29/2019] [Indexed: 12/25/2022]
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Kim YO, Jo YJ, Kim SH, Park KN. Shoulder Pain and Rotational Range of Motion of the Trunk, Shoulder, and Hip in Baseball Players. J Athl Train 2019; 54:1149-1155. [PMID: 31483149 DOI: 10.4085/1062-6050-203-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Deficient glenohumeral rotational range of motion (ROM) is a risk factor for shoulder pain. Adapted ROM of the trunk and hip in response to loss of glenohumeral ROM has been suggested, as the nature of baseball leads to ROM adaptations. OBJECTIVE To compare the bilateral rotational ROM values of the trunk and glenohumeral and hip joints in adolescent baseball players with or without shoulder pain and to measure the correlation between shoulder-pain intensity and bilateral rotational ROM values for each body area. DESIGN Cross-sectional study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Ninety-five adolescent baseball players (60 with shoulder pain, 35 without shoulder pain). MAIN OUTCOME MEASURE(S) Bilateral trunk rotation and internal rotation, external rotation, and total rotation of the dominant and nondominant glenohumeral and hip joints. RESULTS Glenohumeral and hip ROM did not differ between groups, and pain intensity and rotational ROM were not related in either joint. Trunk rotational ROM was greater in the pain group than in the control group (dominant side = 48.8° ± 14.2° versus 41.8° ± 11.9°, respectively; nondominant side = 45.1° ± 14.2° versus 38.9° ± 7.7°, respectively; P values < .05), although the difference was clinically small (mean differences = 7.0° ± 2.7° [95% confidence interval = 1.7, 12.4] on the dominant side, P = .01, and 6.1° ± 2.7° [95% confidence interval = 0.8, 11.5] on the nondominant side, P = .03). Positive but low correlations in all players (ρ = 0.27, P = .01) and in those with shoulder pain (ρ = 0.36, P = .001) were present between shoulder-pain intensity and trunk rotational ROM toward the dominant side. CONCLUSIONS We found no clinical relationship between shoulder pain and rotational ROM and no clinical differences in rotational ROM values between players with and those without shoulder pain.
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Affiliation(s)
- Yeol-Oh Kim
- Department of Physical Therapy, College of Medical Sciences, Jeonju University, South Korea
| | - Yoon-Ju Jo
- Department of Physical Therapy, College of Medical Sciences, Jeonju University, South Korea
| | - Si-Hyun Kim
- Department of Physical Therapy, Sangji University, Wonju, South Korea
| | - Kyue-Nam Park
- Department of Physical Therapy, College of Medical Sciences, Jeonju University, South Korea
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Knapik DM, Gaudiani MA, Camilleri BE, Nho SJ, Voos JE, Salata MJ. Reported Prevalence of Radiographic Cam Deformity Based on Sport: A Systematic Review of the Current Literature. Orthop J Sports Med 2019; 7:2325967119830873. [PMID: 30915376 PMCID: PMC6429661 DOI: 10.1177/2325967119830873] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Repetitive loading and shear stress across the proximal femur account for the high prevalence of cam deformity in athletes. Purpose To systematically review the literature to identify the reported number, age, mean alpha angle measurements, and differences between male and female athletes with radiographic cam deformity based on sport. Study Design Systematic review; Level of evidence, 4. Methods A systematic review was conducted of studies in the literature between January 1990 and March 2018 that reported on athletes with radiographic cam deformity based on sport. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed, and PubMed, Biosis Previews, SPORTDiscus, PEDro, and EMBASE databases were used. Inclusion criteria included studies documenting radiographic cam deformity based on alpha angle measurements categorized according to the athlete's primary sport and according to sex. Exclusion criteria were (1) studies not documenting primary sport, (2) studies not reporting total number of athletes with radiographic cam deformity, and (3) studies not separating cam deformity based on sex or using alpha angle measurements. Statistical analysis was used to compare mean reported age and alpha angle measurements between males and females. Results A total of 28 studies consisting of 1160 male and 53 female athletes with radiographic cam deformity were identified. Cam lesions were most commonly reported in soccer athletes among both males and females, followed by hockey and American football. Male athletes had significantly higher mean alpha angle measurements (59.9° ± 5.5°) compared with female athletes (48.3° ± 6.9°) (P = .001). No significant difference in age was appreciated between males (21.1 ± 4.0 years) and females (21.7 ± 3.0 years) (P = .62). Conclusion Radiographic cam deformity is most commonly reported in athletes participating in soccer and hockey. Males possessed significantly greater mean alpha angle measurements compared with females, whereas no significant difference in mean age at the time of diagnosis was appreciated between sexes.
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Affiliation(s)
- Derrick M Knapik
- University Hospitals Sports Medicine Institute, Cleveland, Ohio, USA.,Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA
| | - Michael A Gaudiani
- Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA
| | | | - Shane J Nho
- Midwest Orthopaedics at Rush University, Chicago, Illinois, USA
| | - James E Voos
- University Hospitals Sports Medicine Institute, Cleveland, Ohio, USA.,Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA
| | - Michael J Salata
- University Hospitals Sports Medicine Institute, Cleveland, Ohio, USA.,Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA
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Moreno-Pérez V, Travassos B, Calado A, Gonzalo-Skok O, Del Coso J, Mendez-Villanueva A. Adductor squeeze test and groin injuries in elite football players: A prospective study. Phys Ther Sport 2019; 37:54-59. [PMID: 30856592 DOI: 10.1016/j.ptsp.2019.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 02/28/2019] [Accepted: 03/01/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To examining the relationship between hip adductor strength and groin injury incidence during the competitive season of professional football teams. DESIGN Prospective Cohort study. SETTING Controlled laboratory environment. PARTICIPANTS Seventy-one players volunteered to participate. MAIN OUTCOME MEASURES In the pre-season, maximal hip adductor strength was measured by means of the isometric adductor squeeze test. Hip adductor strength, normalized by body mass, was compared between players who suffered a groin injury (n = 18) vs uninjured players (n = 53). Risk ratios (RR) were used to evaluate the likelihood of players to suffer this type of injury. RESULTS Most of the reported groin injuries occurred during competitive matches (5.5 per 1000 match hours). Maximal isometric hip adductor strength was lower in the groin-injured group compared with their uninjured counterparts (429.8 ± 100 vs 564 ± 58.7 N, d = -1.58 and 5.40 ± 1.27 vs 7.71 ± 0.89 N/kg, d = -1.88, respectively). Results revealed that values of maximal isometric adductor strength lower than 465.33 N increased the probability to suffer a groin injury by 72%. Furthermore, values of force relative to body mass lower than 6.971 N/kg increased the probability to suffer a groin injury by 83%. CONCLUSION The assessment of Hip adductor strength, in addition to other measurements, might help practitioners to determine the probability of suffering an overuse groin injuries in elite football players.
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Affiliation(s)
- V Moreno-Pérez
- Sports Research Centre, Miguel Hernandez University of Elche, Avda. de La Universidad s/n, 03202, Elche, Alicante, Spain.
| | - B Travassos
- Departamento de Ciências do Desporto, Universidade da Beira Interior, Convento de Sto. António. 6201-001, Covilhã, Portugal.
| | - A Calado
- Rio Ave Rendimento, Rio Ave FC, Rua Sancho I, Estadio do Rio Ave, 4489-876, Vila do Conde, Portugal.
| | - O Gonzalo-Skok
- Faculty of Health Sciences, University of San Jorge of Zaragoza, Villanueva de Gállego, 50830, Zaragoza, Spain.
| | - J Del Coso
- Exercise Physiology Laboratory, Camilo José Cela University, Sport Sciences Institute Castillo de Alarcón, 49, Villafranca del Castillo, None, 28692, Spain.
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Walker D. Hip range of motion increases after a 12-week rest period in elite Australian Rules Football players. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03802-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Active pelvic tilt is reduced in athletes with groin injury; a case-controlled study. Phys Ther Sport 2019; 36:14-21. [DOI: 10.1016/j.ptsp.2018.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/20/2018] [Accepted: 12/22/2018] [Indexed: 11/19/2022]
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Langhout R, Weir A, Litjes W, Gozeling M, Stubbe JH, Kerkhoffs G, Tak I. Hip and groin injury is the most common non-time-loss injury in female amateur football. Knee Surg Sports Traumatol Arthrosc 2019; 27:3133-3141. [PMID: 29860603 PMCID: PMC6754353 DOI: 10.1007/s00167-018-4996-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/30/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Hip and groin injuries in football are problematic due to their high incidence and risk of chronicity and recurrence. The use of only time-loss injury definitions may underestimate the burden of hip and groin injuries. Little is known about hip and groin injury epidemiology in female football. The first aim of this study was to examine the within-season (2014-2015) prevalence of total injury with and without time-loss in female amateur football players. The second aim was to study the within-season and preseason (2015-2016) prevalence of hip/groin injuries with and without time-loss. The third aim was to study the association between the duration of hip and groin injury in the 2014-2015 season and the severity of hip/groin problems during the 2015-2016 preseason. METHODS During the preseason, 434 Dutch female amateur football players completed an online questionnaire based on the previous season and current preseason. The hip and groin outcome score (HAGOS) was used to assess the severity of hip and groin injuries. RESULTS The hip/groin (17%), knee (14%), and ankle (12%) were the most frequent non-time-loss injury locations. The ankle (22%), knee (18%), hamstring (11%), thigh (10%), and hip/groin (9%) were the most common time-loss injury locations. The previous season prevalence of total injury was 93%, of which non-time-loss injury was 63% and time-loss injury was 37%. The prevalence of hip/groin injury was 40%, non-time-loss hip/groin injury was 36% and time-loss hip/groin injury was 11%. The preseason prevalence of hip/groin injury was 27%, non-time-loss hip/groin injury was 25%, and time-loss hip/groin injury was 4%. Players with longstanding hip/groin injury (> 28 days) in the previous season had lower HAGOS scores at the next preseason than players with short-term (1-7 days) or no hip/groin injury (p < 0.001). From all players with hip/groin injury from the previous season, 52% also sustained hip/groin injury in the following preseason, of which 73% were recurrent and 27% were chronic hip/groin injuries. CONCLUSION Injury risk, and especially non-time-loss hip and groin injury risk, is high in female amateur football. Three-quarters of the players with longstanding hip and groin injuries in the previous season have residual problems at the start of the following season. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Rob Langhout
- Department for Manual Therapy and Sports Rehabilitation, Physiotherapy Dukenburg Nijmegen, Aldenhof 7003, 6537 DZ, Nijmegen, The Netherlands.
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC-VUmc IOC Research Center, Amsterdam, The Netherlands.
- Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands.
- Advanced Studies Manual Therapy, SOMT University, Amersfoort, The Netherlands.
- Dutch Center for Allied Health Care (NPi), Amersfoort, The Netherlands.
| | - Adam Weir
- Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Department of Orthopaedics, Erasmus MC Center for Groin Injuries, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Wendy Litjes
- Department of Sports Rehabilitation, Physiotherapy Wijchen, Wijchen, The Netherlands
| | - Maarten Gozeling
- Department of Physiotherapy, PSV Eindhoven, Eindhoven, The Netherlands
| | - Janine H Stubbe
- Codarts Rotterdam, University of the Arts, Rotterdam, The Netherlands
| | - Gino Kerkhoffs
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC-VUmc IOC Research Center, Amsterdam, The Netherlands
- Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Igor Tak
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC-VUmc IOC Research Center, Amsterdam, The Netherlands
- Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Dutch Center for Allied Health Care (NPi), Amersfoort, The Netherlands
- Department for Manual Therapy and Sports Rehabilitation, Physiotherapy Utrecht Oost, Utrecht, The Netherlands
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Abrahamson J, Aminoff AS, Todd C, Agnvall C, Thoreson O, Jónasson P, Karlsson J, Baranto A. Adolescent elite skiers with and without cam morphology did change their hip joint range of motion with 2 years follow-up. Knee Surg Sports Traumatol Arthrosc 2019; 27:3149-3157. [PMID: 29881884 PMCID: PMC6754347 DOI: 10.1007/s00167-018-5010-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 06/01/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate how range of motion of the hips and the lumbar spine are affected by continued elite, alpine skiing in young subjects, with and without a magnetic resonance imaging verified cam morphology, in a 2-year follow-up study. The hypothesis is that skiers with cam morphology will show a decrease in hip joint range of motion as compared with skiers without cam, after a 2-year follow-up. METHOD Thirty adolescent elite alpine skiers were examined at the baseline (mean age 17.3 ± 0.7 years) and after 2 years. All skiers were examined for the presence of cam morphology (α-angle > 55°) using magnetic resonance imaging at the baseline. Clinical examinations of range of motion in standing lumbar flexion and extension, supine hip flexion, internal rotation, FABER test and sitting internal rotation and external rotation were performed both at the baseline and after 2 years. RESULTS Skiers with and without cam morphology showed a significant decrease from baseline to follow-up in both hips for supine internal rotation (right: mean - 13.3° and - 10.9° [P < 0.001]; left: mean - 7.6° [P = 0.004] and - 7.9° [P = 0.02]), sitting internal rotation (right: mean - 9.6° and - 6.3° [P < 0.001]; left: mean - 7.6° [P = 0.02] and - 3.3° [P = 0.008]) and sitting external rotation (right: mean - 16.9° and - 11.4° and left: mean - 17.9° and - 14.5° [P < 0.001]) and were shown to have an increased left hip flexion (mean + 8.4° and + 4.6° [P = 0.004]). Skiers with cam were also shown to have an increased right hip flexion (mean + 6.4° [P = 0.037]). Differences were found between cam and no-cam skiers from baseline to follow-up in the sitting internal rotation in both hips (right: mean 3.25°, left: mean 4.27° [P < 0.001]), the right hip flexion (mean 6.02° [P = 0.045]) and lumbar flexion (mean - 1.21°, [P = 0.009]). CONCLUSION Young, elite alpine skiers with cam morphology decreased their internal rotation in sitting position as compared with skiers without the cam morphology after 2 years of continued elite skiing. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Josefin Abrahamson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Occupational Orthopedics and Research, Sahlgrenska University Hospital/Mölndals Hospital, R-house, Floor 7, 431 80, Mölndal, Sweden.
| | - Anna Swärd Aminoff
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Todd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Olof Thoreson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Jón Karlsson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Adad Baranto
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational Orthopedics and Research, Sahlgrenska University Hospital/Mölndals Hospital, R-house, Floor 7, 431 80, Mölndal, Sweden
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Tummala SV, Chhabra A, Makovicka JL, Patel KA, Hartigan DE. Hip and Groin Injuries Among Collegiate Male Soccer Players: The 10-Year Epidemiology, Incidence, and Prevention. Orthopedics 2018; 41:e831-e836. [PMID: 30321437 DOI: 10.3928/01477447-20181010-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 05/14/2018] [Indexed: 02/03/2023]
Abstract
The physical and demanding style of play in soccer places these athletes at an elevated risk for hip and groin injuries. Several studies have examined hip and groin injuries in professional and youth soccer in European countries, but few have involved American counterparts. Hip injury data were analyzed retrospectively from the National Collegiate Athletic Association Injury Surveillance Program for the 2004 to 2014 academic years for collegiate men's soccer. This study found that hip and groin injuries among collegiate male soccer players were most often new injuries (87.8%; n=527) that were noncontact in nature (77.3%; n=464) and resulted in time loss of less than 7 days (67.5%; n=405). Hip injuries were significantly more likely during the pre-season (5.72 per 1000 athlete exposures) relative to in-season (injury proportion ratio, 1.64; 95% confidence interval, 1.39-1.94) and post-season (injury proportion ratio, 1.69; 95% confidence interval, 1.18-2.41). Further, they were more likely in competition relative to practice (injury proportion ratio, 2.33; 95% confidence interval, 1.98-2.74). The most common injuries were adductor strains (46.5%; n=279) followed by hip flexor strains (27.3%; n=164) and hip contusions (10.8%; n=65). Among these injuries, adductor (73.1%; n=204) and hip flexor (59.8%; n=98) strains were more commonly noncontact related and occurred in practice, whereas hip contusions were due to contact and during competition. The study of the complex and lingering nature of hip and groin injuries in soccer players is critical because these injuries not only are prevalent but also have multifactorial risks associated with coexisting pathologies that make them difficult to prevent and treat effectively. [Orthopedics. 2018; 41(6):e831-e836.].
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Tak I, Langhout R, Bertrand B, Barendrecht M, Stubbe J, Kerkhoffs G, Weir A. Manual therapy and early return to sport in football players with adductor-related groin pain: A prospective case series. Physiother Theory Pract 2018; 36:1009-1018. [DOI: 10.1080/09593985.2018.1531096] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Igor Tak
- Sports Rehabilitation and Manual Therapy, Physiotherapy Utrecht Oost, Utrecht, Netherlands
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Rob Langhout
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam University Medical Center, Amsterdam, Netherlands
- Sports Rehabilitation and Manual Therapy, Physiotherapy Dukenburg Nijmegen, Nijmegen, Netherlands
| | | | | | - Janine Stubbe
- University for the Arts, Codarts, Rotterdam, Netherlands
| | - Gino Kerkhoffs
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam University Medical Center, Amsterdam, Netherlands
- Orthopaedic Surgery and Sports Traumatology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Adam Weir
- Sports Rehabilitation and Manual Therapy, Physiotherapy Dukenburg Nijmegen, Nijmegen, Netherlands
- Aspetar Hospital, Doha, Qatar
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Wollin M, Thorborg K, Welvaert M, Pizzari T. In-season monitoring of hip and groin strength, health and function in elite youth soccer: Implementing an early detection and management strategy over two consecutive seasons. J Sci Med Sport 2018; 21:988-993. [DOI: 10.1016/j.jsams.2018.03.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/15/2018] [Accepted: 03/07/2018] [Indexed: 10/17/2022]
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Risk Factors for Groin Injury and Groin Symptoms in Elite-Level Soccer Players: A Cohort Study in the Dutch Professional Leagues. J Orthop Sports Phys Ther 2018; 48:704-712. [PMID: 29792105 DOI: 10.2519/jospt.2018.7990] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Groin injury and groin symptoms are common in soccer players. The relationship of groin injury and groin symptoms to reduced hip range of motion (ROM) and previous injury is unclear. Objectives To conduct a retrospective assessment of associations between previous injury and preseason hip ROM and preseason prevalence of severe groin symptoms, and to prospectively identify risk factors for within-season groin injury. Methods During the period of 2015 to 2016, 190 players from 9 Dutch professional soccer clubs participated in this cohort study with prospective and retrospective elements. Univariate and multivariate logistic regressions were used to predict preseason severe groin symptoms, identified using the Copenhagen Hip and Groin Outcome Score, from a history of previous groin injury, general injury (minimum of 1 week in duration) in the previous season, and hip ROM. Cox regression was used to predict within-season groin injury. Results Point prevalence of severe groin symptoms was 24% and within-season incidence of groin injury was 11%. Total, training, and match groin injury incidences were 0.5, 0.2, and 2.6 injuries per 1000 playing hours, respectively. A history of more than 1 previous groin injury was associated with current severe groin symptoms (odds ratio = 3.0; 95% confidence interval: 1.0, 8.3; P = .038). General injury sustained in the previous season (ankle, knee, thigh, shoulder; median, 9 weeks of time loss) was a risk factor for groin injury (hazard ratio = 5.1; 95% confidence interval: 1.8, 14.6; P = .003). Conclusion Severe injuries in the previous season to locations other than the groin increase the risk of groin injury the next season. A history of groin injury is associated with current severe groin symptoms. Preseason hip ROM does not identify players at risk for groin injury. Level of Evidence Prevention, level 2b. J Orthop Sports Phys Ther 2018;48(9):704-712. Epub 23 May 2018. doi:10.2519/jospt.2018.7990.
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Swärd Aminoff A, Agnvall C, Todd C, Jónasson P, Sansone M, Thoreson O, Swärd L, Karlsson J, Baranto A. The effect of pelvic tilt and cam on hip range of motion in young elite skiers and nonathletes. Open Access J Sports Med 2018; 9:147-156. [PMID: 30123011 PMCID: PMC6084081 DOI: 10.2147/oajsm.s162675] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Current knowledge of the effect of changes in posture and the way cam morphology of the hip joint may affect hip range of motion (ROM) is limited. Purpose To determine the effect of changes in pelvic tilt (PT) on hip ROM and with/without the presence of cam. Study design This was a cross-sectional study. Materials and methods The hip ROM of 87 subjects (n=61 young elite skiers, n=26 nonathletes) was examined using a goniometer, in three different seated postures (flexed, neutral, and extended). The hips of the subjects were further subgrouped into cam and no-cam morphology, based on the magnetic resonance imaging findings in the hips. Results There was a significant correlation between the hip ROM and the seated posture in both extended and flexed postures compared with the neutral posture. There was a significant decrease in internal hip rotation when the subjects sat with an extended posture with maximum anterior PT (p<0.0001). There was a significant increase in internal hip rotation when the subjects sat with a flexed posture with maximum posterior PT (p<0.001). External rotation was significantly decreased in an extended posture with maximum anterior PT (p<0.0001), but there was no difference in flexed posture with maximum posterior PT. The hips with cam morphology had reduced internal hip rotation in all three positions, but they responded to the changes in position in a similar manner to hips without cam morphology. Conclusion Dynamic changes in PT significantly influence hip ROM in young people, independent of cam or no-cam morphology.
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Affiliation(s)
- Anna Swärd Aminoff
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden,
| | - Cecilia Agnvall
- Sports Medicine Åre, Åre, Sweden.,Åre Ski Academy, Åre, Sweden
| | - Carl Todd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden,
| | | | - Mikael Sansone
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden,
| | - Olof Thoreson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden,
| | - Leif Swärd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden,
| | - Jon Karlsson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden,
| | - Adad Baranto
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden,
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Milani CJE, Moley PJ. Advanced Concepts in Hip Morphology, Associated Pathologies, and Specific Rehabilitation for Athletic Hip Injuries. Curr Sports Med Rep 2018; 17:199-207. [PMID: 29889149 DOI: 10.1249/jsr.0000000000000492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Hip and groin injuries comprise up to 17% of athletic injuries and can pose rehabilitation challenges for many athletes. Injuries involving abnormal femoral acetabular morphology, reduced range of motion, and decreased lumbopelvic strength and endurance also may increase the risk of injury to lower extremities and delay return to play if proper rehabilitation does not take place. The rehabilitation of athletic hip injuries requires a multifaceted interdisciplinary approach that manages the interplay of multiple factors to restore preinjury function and facilitate return to play. Emphasis should be placed on activity modification, preservation of the arcs of range of motion, functional strengthening of the lumbopelvic core, and optimization of proprioceptive and neuromechanical strategies. Communication between providers and the injured athlete also is crucial to ensure that proper therapeutic approaches are being applied.
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Affiliation(s)
- Carlo J E Milani
- Department of Physiatry, Hospital for Special Surgery, Darien, CT
| | - Peter J Moley
- Department of Physiatry, Hospital for Special Surgery, New York, NY
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Mandema L, Tak I, Mooij B, Groeneweg R, Bakker E, van Veldhoven P. Assessment of cam morphology of the hip with ultra sound imaging by physical therapists is reliable and valid. Phys Ther Sport 2018; 32:167-172. [PMID: 29793125 DOI: 10.1016/j.ptsp.2018.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/21/2018] [Accepted: 04/10/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Femoroacetabular impingement syndrome is considered present when a combination of clinical symptoms, signs and morphological features of the hip co-exist. Imaging is increasingly popular in primary health care settings with physical therapists performing ultrasound (US). OBJECTIVE The aim of this study was to assess the diagnostic accuracy and inter-rater reliability of ultrasound in determining presence of cam morphology. DESIGN A concurrent validity and inter-rater reliability study. METHODS The presence of cam morphology of the hip was determined by α angle measures using Kinovea software. A cam was defined present when the α angle >60°. The index test was US and radiographs served as a gold standard. RESULTS Correlation between the radiographic α angle and ultrasound measures was r = 0.82 (p < 0.01). Inter-rater reliability was high with an ICC of 0.74 (95% CI 0.61-0.84). The predictive value for presence of cam morphology had a sensitivity of 79% and a specificity of 94%. The positive predictive value was 79% whereas the negative predictive value was 94%. Total accuracy was 90%. CONCLUSIONS Ultrasound conducted by trained physical therapists is a valid, reliable, specific and sensitive diagnostic tool to assess the presence of cam morphology.
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Kerbel YE, Smith CM, Prodromo JP, Nzeogu MI, Mulcahey MK. Epidemiology of Hip and Groin Injuries in Collegiate Athletes in the United States. Orthop J Sports Med 2018; 6:2325967118771676. [PMID: 29780846 PMCID: PMC5952296 DOI: 10.1177/2325967118771676] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Hip and groin pain is a common complaint among athletes. Few studies have examined the epidemiology of hip and groin injuries in collegiate athletes across multiple sports. Purpose: To describe the rates, mechanisms, sex-based differences, and severity of hip/groin injuries across 25 collegiate sports. Study Design: Descriptive epidemiology study. Methods: Data from the 2009-2010 through 2013-2014 academic years were obtained from the National Collegiate Athletic Association Injury Surveillance Program (NCAA ISP). The rate of hip/groin injuries, mechanism of injury, time lost from competition, and need for surgery were calculated. Differences between sex-comparable sports were quantified using rate ratios (RRs) and injury proportion ratios (IPRs). Results: In total, 1984 hip/groin injuries were reported, giving an overall injury rate of 53.06 per 100,000 athlete-exposures (AEs). An adductor/groin tear was the most common injury, comprising 24.5% of all injuries. The sports with the highest rates of injuries per 100,000 AEs were men’s soccer (110.84), men’s ice hockey (104.90), and women’s ice hockey (76.88). In sex-comparable sports, men had a higher rate of injuries per 100,000 AEs compared with women (59.53 vs 42.27, respectively; RR, 1.41 [95% CI, 1.28-1.55]). The most common injury mechanisms were noncontact (48.4% of all injuries) and overuse/gradual (20.4%). In sex-comparable sports, men had a greater proportion of injuries due to player contact than women (17.0% vs 3.6%, respectively; IPR, 4.80 [95% CI, 3.10-7.42]), while women had a greater proportion of injuries due to overuse/gradual than men (29.1% vs 16.7%, respectively; IPR, 1.74 [95% CI, 1.46-2.06]). Overall, 39.3% of hip/groin injuries resulted in time lost from competition. Only 1.3% of injuries required surgery. Conclusion: Hip/groin injuries are most common in sports that involve kicking or skating and sudden changes in direction and speed. Most hip/groin injuries in collegiate athletes are noncontact and do not result in time lost from competition, and few require surgery. This information can help guide treatment and prevention measures to limit such injuries in male and female collegiate athletes.
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Affiliation(s)
- Yehuda E Kerbel
- Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Christopher M Smith
- Department of Emergency Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - John P Prodromo
- Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Michael I Nzeogu
- Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Mary K Mulcahey
- Department of Orthopaedics, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Is Bony Hip Morphology Associated With Range of Motion and Strength in Asymptomatic Male Soccer Players? J Orthop Sports Phys Ther 2018; 48:250-259. [PMID: 29548272 DOI: 10.2519/jospt.2018.7848] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Cross-sectional cohort study. Objectives To investigate the relationship between musculoskeletal screening findings and bony hip morphology in asymptomatic male soccer players. Background Athletes with femoroacetabular impingement (FAI) syndrome have cam and/or pincer morphology, pain on orthopaedic testing, and often reduced hip range of motion (ROM) and strength. However, cam and pincer morphology is also common in asymptomatic hips. Therefore, it is currently unknown whether the ROM and strength deficits observed in athletes with FAI syndrome result from the variance in their bony hip morphology or from their hip condition. Methods Male professional soccer players in Qatar were screened specifically for hip/groin pain in 2 consecutive seasons. The screening battery included pain provocation, ROM and strength tests, and hip radiographs. Univariate and multivariate regression analyses, using generalized estimating equations, evaluated the relationship between musculoskeletal screening findings and each bony hip morphological variant (cam, large cam, pincer, and acetabular dysplasia). Results Asymptomatic hips with cam and large cam morphology were associated with lower internal rotation ROM and bent-knee fall-out, and with a higher likelihood of pain on provocation testing. Pincer morphology was associated with lower abduction ROM and higher abduction strength. Acetabular dysplasia was associated with higher abduction ROM. Each association was weak and demonstrated poor or failed discriminatory power. Conclusion Bony hip morphology is associated with hip joint ROM and abduction strength, but musculoskeletal screening tests have a poor ability to discriminate between the different morphologies. J Orthop Sports Phys Ther 2018;48(4):250-259. doi:10.2519/jospt.2018.7848.
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Locks R, Utsunomiya H, Briggs KK, McNamara S, Chahla J, Philippon MJ. Return to Play After Hip Arthroscopic Surgery for Femoroacetabular Impingement in Professional Soccer Players. Am J Sports Med 2018; 46:273-279. [PMID: 29135269 DOI: 10.1177/0363546517738741] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Arthroscopic hip surgery has been shown to be effective in returning professional athletes back to play at a high level of performance in different sports. Limited information exists regarding professional soccer players and their return to play. PURPOSE To determine the rate and time to return to sport for professional soccer players after hip arthroscopic surgery for the treatment of femoroacetabular impingement (FAI) and to identify possible risk factors associated with a delay in returning to play. STUDY DESIGN Case series; Level of evidence, 4. METHODS Professional soccer players who underwent hip arthroscopic surgery for FAI by a single surgeon between 2005 and 2015 were evaluated. Data retrieved from www.mlssoccer.com , www.fifa.com , www.transfermarkt.co.uk , and www.wikipedia.org included information on each player's professional career, participation on the national team, length of professional career before surgery, number of appearances (games) before surgery, time between surgery and first appearance in a professional game, and number of appearances after surgery. Other data were obtained from the patient's medical records. RESULTS Twenty-four professional soccer players (26 hips) were included. The mean age at surgery was 25.0 ± 4.0 years (range, 19-32 years). A total of 96% of patients were able to return to play at the professional level. The mean time between surgery and the first professional game played was 9.2 months (range, 1.9-24.0 months). On average, players played in 70 games after surgery (range, 0-224). National team players were able to return to play significantly earlier than the rest of the players (median, 5.7 months vs 11.6 months, respectively; P = .018). Severe chondral damage and microfracture did not interfere with return to play. CONCLUSION The arthroscopic management of FAI in symptomatic professional soccer players allowed 96% of them to return to play. Players with national team experience were able to return to play earlier than those without it. Severe chondral damage and microfracture did not interfere with return to play.
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Affiliation(s)
- Renato Locks
- Steadman Philippon Research Institute, Vail, Colorado, USA
| | | | - Karen K Briggs
- Steadman Philippon Research Institute, Vail, Colorado, USA
| | | | - Jorge Chahla
- Steadman Philippon Research Institute, Vail, Colorado, USA
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Dupré T, Funken J, Müller R, Mortensen KRL, Lysdal FG, Braun M, Krahl H, Potthast W. Does inside passing contribute to the high incidence of groin injuries in soccer? A biomechanical analysis. J Sports Sci 2018; 36:1827-1835. [PMID: 29333946 DOI: 10.1080/02640414.2017.1423193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Thomas Dupré
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | - Johannes Funken
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | - Ralf Müller
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | | | | | - Markus Braun
- Ballspielverein Borussia 09 e.V. Dortmund, Dortmund, Germany
| | - Hartmut Krahl
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
- ARCUS Clinics Pforzheim, Pforzheim, Germany
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Dischiavi S, Wright A, Hegedus E, Bleakley C. Biotensegrity and myofascial chains: A global approach to an integrated kinetic chain. Med Hypotheses 2018; 110:90-96. [DOI: 10.1016/j.mehy.2017.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 10/20/2017] [Accepted: 11/16/2017] [Indexed: 01/13/2023]
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