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Cotellessa F, Puce L, Formica M, May MC, Trompetto C, Perrone M, Bertulessi A, Anfossi V, Modenesi R, Marinelli L, Bragazzi NL, Mori L. Effectiveness of a Preventative Program for Groin Pain Syndrome in Elite Youth Soccer Players: A Prospective, Randomized, Controlled, Single-Blind Study. Healthcare (Basel) 2023; 11:2367. [PMID: 37685401 PMCID: PMC10486402 DOI: 10.3390/healthcare11172367] [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: 06/30/2023] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 09/10/2023] Open
Abstract
Groin pain syndrome (GPS) is a prevalent issue in soccer. This study assessed the effectiveness of a new preventive protocol on GPS for youth soccer players. The protocol included targeted stretching and strengthening exercises for the adductor and core muscles from preseason to midseason. A questionnaire and two pain provocation tests were used for the evaluation. Mild GPS required positive results in at least two evaluations, while severe GPS was associated with pain incompatible with engagement in any activity confirmed by diagnostic ultrasound. Forty-two elite male athletes (aged 16.9 ± 0.7 years) participated in the study, with half of them assigned to the usual training (control group) and the remaining athletes undergoing the preventive protocol (treatment group) for 24 weeks. GPS rates were 14.3% (three diagnoses: two mild, one severe) in the treatment group and 28.6% (six diagnoses: three mild, three severe) in the control group. Toward the end of the season, three players, one from the treatment group and two from the control group had to stop playing due to severe GPS problems. In addition, one player in the control group stopped midseason. Even though the reduction in the risk of developing GPS was not significant (relative risk of 0.50 ([95%CI 0.14 to 1.74], p = 0.2759), the halved incidence of severe GPS and the increased muscle strength related to the treatment (p = 0.0277) are encouraging data for future studies.
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Affiliation(s)
- Filippo Cotellessa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
| | - Luca Puce
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
| | - Matteo Formica
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
- Orthopedic Clinic, Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Maria Cesarina May
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Carlo Trompetto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Marco Perrone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
| | - Andrea Bertulessi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Vittorio Anfossi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Roberto Modenesi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada;
| | - Laura Mori
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
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Chaari F, Boyas S, Sahli S, Fendri T, Harrabi MA, Rebai H, Rahmani A. Postural balance asymmetry and subsequent noncontact lower extremity musculoskeletal injuries among Tunisian soccer players with groin pain: A prospective case control study. Gait Posture 2022; 98:134-140. [PMID: 36115130 DOI: 10.1016/j.gaitpost.2022.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/08/2022] [Accepted: 09/07/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Recent studies reported postural balance disorders in patients and soccer players with groin pain (GP) compared to controls. Since postural balance asymmetry identified after an initial injury contributes for subsequent injuries, identification of this asymmetry in soccer players with GP may highlight the risk of sustaining subsequent noncontact lower extremity musculoskeletal injuries in these players. Therefore, the aims of this study were to (i) examine static and dynamic unipedal postural balance asymmetry in soccer players with GP compared to healthy ones, and (ii) quantify the risk of subsequent noncontact lower extremity injuries in these players. RESEARCH QUESTION Do soccer players with GP exhibit higher static and dynamic unipedal postural balance asymmetry, and higher risk of sustaining subsequent injuries compared to controls? METHODS In this prospective case control study, 27 soccer players with non-time loss GP (GP group: GPG), and 27 healthy ones (control group: CG) were enrolled. Static and dynamic unipedal postural balance asymmetry were evaluated with a force platform using symmetry index (SI), and Y-balance test (Y-BT), respectively. Additionally, subsequent noncontact lower extremity musculoskeletal injuries were tracked for 10 months. RESULTS The GPG revealed higher (p < 0.01) SI in eyes closed condition, higher (p < 0.001) side-to-side asymmetry in anterior, posteromedial and posterolateral reach distances and in composite Y-BT score compared to CG. They showed lower (p < 0.001) composite score for injured limb and higher (p < 0.001) side-to-side asymmetry in posteromedial reach distance compared to the cut-off values of 89.6 % and 4 cm, respectively. Moreover, GPG exhibited higher odds (OR= 7.48; 95 % CI = 2.15, 26.00; p < 0.01) of sustaining subsequent injuries compared to CG. SIGNIFICANCE The Y-BT should be instituted into existing pre-participation physical examinations to screen for soccer players with non-time loss GP at an elevated risk of sustaining subsequent injuries. This could help coaches and clinicians make valid return to play decisions.
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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.
| | - Sébastien Boyas
- Le Mans University, Movement - Interactions, Performance, MIP, EA 4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France.
| | - Sonia Sahli
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - 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.
| | - Haithem Rebai
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Abderrahmane Rahmani
- Le Mans University, Movement - Interactions, Performance, MIP, EA 4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France.
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Koscso JM, McElheny K, Carr JB, Hippensteel KJ. Lower Extremity Muscle Injuries in the Overhead Athlete. Curr Rev Musculoskelet Med 2022; 15:500-512. [PMID: 35913667 PMCID: PMC9789236 DOI: 10.1007/s12178-022-09786-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/09/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Lower extremity (LE) injuries are a common source of disability and time-loss for overhead athletes, and muscles have been found to be the predominant soft tissue structure affected. The current review highlights the orthopaedic literature examining lower extremity muscle injuries in overhead athletes in regard to epidemiology, diagnosis, and conventional and emerging treatment measures. RECENT FINDINGS The hamstring muscles have been found to be the most commonly injured lower extremity muscle group in professional baseball, followed by the adductors, quadriceps, iliopsoas, and gastrocnemius-soleus complex. Strains and contusions comprise over 90% of these muscle injuries. Various advanced imaging grading systems have been developed to help characterize the nature of a muscle injury, although a clear and consistent prognostic utility of these systems is still unclear. The vast majority of lower extremity muscle injuries in overhead athletes are managed nonoperatively, and there is promising data on the use of emerging treatments such as platelet-rich plasma and blood flow restriction therapy. Lower extremity muscle injuries-often referred to as strains-are a relatively common issue in high-demand overhead athletes and can be a significant source of time-loss. Within baseball, position players are affected far more often than pitchers, and sprinting and fielding are the most common activities leading to strains. Magnetic resonance imaging (MRI) is considered the gold standard imaging modality to evaluate these muscle injuries and will allow for a detailed assessment of tissue damage. Nonetheless, return-to-play is often dictated by a given athlete's progression through a nonoperative rehabilitation protocol, with surgical intervention reserved for less common, select injury patterns.
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Affiliation(s)
| | - Kathryn McElheny
- Hospital for Special Surgery, 535 E 70th St, New York, NY 10021 USA
| | - James B. Carr
- Hospital for Special Surgery, 535 E 70th St, New York, NY 10021 USA
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Intra-day and inter-day reliabilities of the 0° and 45° adductor squeeze tests using hand-held dynamometry. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00957-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
We analyzed the Smart Groin Trainer device's validity and reliability to measure the isometric hip adduction strength during the adductor squeeze strength test. Fifteen professional soccer players (25.33±4.06 years) and fifteen university students (21.60±1.76 years) participated in this study. All participants performed the squeeze strength test using two portable dynamometers: Smart Groin Trainer and Globus Ergometer. Three maximal isometric hip adduction contractions lasting 5s, interspersed by 3min rest intervals, were performed. Reliability was analyzed with intraclass correlation coefficients, standard error of measurements, and minimal detectable change. The absolute percent error and inter-device accuracy were also analyzed. Correlation analysis assessed the inter-device concurrent validity. The results found no significant differences (p>0.05) between devices in the squeeze strength test values in soccer players and university students. Inter-device comparisons revealed excellent levels of reliability and accuracy in soccer players. Concurrent validity measures revealed strong inter-device relationships in soccer players (r=0.89) and very strong relationships in university students (r=0.99). Intra-device analysis using the Smart Groin Trainer showed excellent relative and absolute reliability in tested soccer players. Our data demonstrated excellent levels of agreement between both dynamometers during the squeeze strength test, suggesting the Smart Groin Trainer as a valid, reliable, and accurate device to measure isometric hip adduction strength.
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Lavoie-Gagne O, Mehta N, Patel S, Cohn MR, Forlenza E, Nwachukwu BU, Forsythe B. Adductor Muscle Injuries in UEFA Soccer Athletes: A Matched-Cohort Analysis of Injury Rate, Return to Play, and Player Performance From 2000 to 2015. Orthop J Sports Med 2022; 9:23259671211023098. [PMID: 35146028 PMCID: PMC8822003 DOI: 10.1177/23259671211023098] [Citation(s) in RCA: 1] [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: 02/12/2021] [Accepted: 02/24/2021] [Indexed: 11/15/2022] Open
Abstract
Background: The effects of adductor muscle injury on performance in soccer athletes are unknown. Purpose: To (1) determine the rate and time to return to play (RTP) after adductor muscle injury, (2) investigate the rate of reinjury after RTP, and (3) investigate any long-term effects of injury on elite soccer player performance. Study Design: Cohort study; Level of evidence, 3. Methods: Using publicly available records, athletes sustaining adductor muscle injury were identified across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2000 and 2015. Injured athletes were matched to controls by demographic characteristics and performance metrics from 1 season before the index timepoint. Investigations included the rate of RTP, reinjuries, player characteristics associated with RTP within 2 seasons, player availability, field time, and performance metrics during the 4 seasons after injury. Results: A total of 671 players with adductor muscle injury were included. Based on time to RTP, 86% of injuries were mild to moderate (4-28 days missed), and 4% required surgical intervention. Players with adductor muscle injury were absent for a median of 22 days (range, 1-700 days) and 4 games (range, 1-76 games). A total of 521 (78%) players returned at the same level, with no demographic or clinical characteristics associated with RTP on the multivariable regression. Of those returning to play, 143 (21%) experienced adductor reinjury. After RTP, defenders demonstrated decreased field time compared with controls (P < .05). As compared with controls, defenders and midfielders scored more points and goals per game during the season of the injury (P < .01), while attackers recorded more goals and assists per game the season after injury (P < .05). Conclusion: Only 3 in 4 players (78%) returned to participate in an official match, and the reinjury rate was high (21%). After RTP, defenders demonstrated decreased field time versus controls. On the other hand, defenders and midfielders recorded more points and goals per game, while attackers recorded more goals and assists per game versus controls. Although the multivariable analysis results did not identify player characteristics associated with RTP, there was a position-dependent association on player performance after RTP.
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Affiliation(s)
| | - Nabil Mehta
- Midwest Orthopaedics at Rush, Rush University, Chicago, Illinois, USA
| | - Sumit Patel
- Midwest Orthopaedics at Rush, Rush University, Chicago, Illinois, USA
| | - Matthew R Cohn
- Midwest Orthopaedics at Rush, Rush University, Chicago, Illinois, USA
| | - Enrico Forlenza
- Midwest Orthopaedics at Rush, Rush University, Chicago, Illinois, USA
| | - Benedict U Nwachukwu
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Brian Forsythe
- Midwest Orthopaedics at Rush, Rush University, Chicago, Illinois, USA
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Dallaudiere B, Sylvain B, Poussange N, Reboul G, Silvestre A, Meyer P, Hocquelet A, Pesquer L. Ultrasound feature variants of the adductor longus tendon in asymptomatic sportive subjects: Management implications. Eur J Radiol 2021; 144:109928. [PMID: 34562742 DOI: 10.1016/j.ejrad.2021.109928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/28/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The potential contribution of ultrasound (US) to diagnose adductor longus (AL) tendinopathy in athletic pubalgia requires clarification. We investigate US findings from AL tendons of asymptomatic participants to identify the range and prevalence of common US features not associated with groin pain. METHODS We consecutively enrolled 45 volunteers physically active participants with no history of groin pain. US features of bilateral AL tendons were investigated and recorded by two experienced musculoskeletal radiologists (MSKR) in accordance with a defined ultrasound protocol. Two other MSKRs retrospectively and independently analyzed all US images. RESULTS Ninety AL tendons from 45 participants (4/45 women) were imaged (average age: 35 years ±14.6; dominant side: 37/45 (82.2%) right, 8/45 (17.8%) left). Abnormalities on US were found in all 45 (100%) AL tendons, including: abnormal echogenicity (98.9%/100% respectively according to reader), loss of fibrillar structure (92.2%/97.8%), irregularities of the superficial paratendon (23.3%/30%), calcifications (22.2%/25.5%), and cortical erosion (52%/55.5%), with excellent inter-observer assessment. No AL tears or hyperemia at color Doppler were detectable. CONCLUSIONS AL tendon abnormalities were identified via US in 100% of our asymptomatic athletes. The significance of these US findings should be interpreted cautiously with respect to clinical presentation. On the other hand, there is a need for supplemental investigation into the clinical relevance of US AL tendon tears not present in the present asymptomatic athlete population.
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Affiliation(s)
- Benjamin Dallaudiere
- Centre d'imagerie ostéo-articulaire, clinique du sport de Bordeaux, 2, rue Georges-Negrevergne, 33700 Mérignac, France; Département d'imagerie musculo-squelettique, centre hospitalier universitaire Pellegrin, place Amélie-Léon-Rabat, 33000 Bordeaux, France.
| | - Bise Sylvain
- Centre d'imagerie ostéo-articulaire, clinique du sport de Bordeaux, 2, rue Georges-Negrevergne, 33700 Mérignac, France
| | - Nicolas Poussange
- Centre d'imagerie ostéo-articulaire, clinique du sport de Bordeaux, 2, rue Georges-Negrevergne, 33700 Mérignac, France
| | - Gilles Reboul
- Centre de chirurgie orthopédique et sportive, clinique du sport de Bordeaux, 2, rue Georges-Negrevergne, 33700 Mérignac, France
| | - Alain Silvestre
- Centre d'imagerie ostéo-articulaire, clinique du sport de Bordeaux, 2, rue Georges-Negrevergne, 33700 Mérignac, France
| | - Philippe Meyer
- Centre d'imagerie ostéo-articulaire, clinique du sport de Bordeaux, 2, rue Georges-Negrevergne, 33700 Mérignac, France
| | - Arnaud Hocquelet
- Service de radiologie et d'imagerie diagnostique et interventionnelle, CHU Vaudois, 1011 Lausanne, Suisse
| | - Lionel Pesquer
- Centre d'imagerie ostéo-articulaire, clinique du sport de Bordeaux, 2, rue Georges-Negrevergne, 33700 Mérignac, France
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Saleh A Al Attar W, Faude O, Husain MA, Soomro N, Sanders RH. Combining the Copenhagen Adduction Exercise and Nordic Hamstring Exercise Improves Dynamic Balance Among Male Athletes: A Randomized Controlled Trial. Sports Health 2021; 13:580-587. [PMID: 33588644 DOI: 10.1177/1941738121993479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Copenhagen adduction exercise (CAE) and Nordic hamstring exercise (NHE) reduce the incidence of groin and hamstring injuries. Efficient dynamic balance can improve motor performance and reduce the risk of injuries in athletes. However, the effects of these exercises on dynamic balance have not been investigated. HYPOTHESIS CAE and NHE, as well as a combination of both exercises, would improve dynamic balance among amateur male athletes. STUDY DESIGN Randomized controlled trial. LEVEL OF EVIDENCE Level 1. METHODS A total of 200 male athletes aged 21.9 ± 2.4 years were included in the study and randomly assigned to 4 groups: CAE group (n = 50), NHE group (n = 50), CAE and NHE group (n = 50), and a control group (n = 50). A total of 177 male athletes completed the study. The primary outcome measure was the limit of stability (LoS), which was measured using the Biodex Stability System to assess the performance of the dynamic balance. The LoS of the athletes' performance was measured pre- and postintervention after 6 weeks. RESULTS The LoS significantly improved in all treatment groups, including CAE (44.5% ± 5.3%), NHE (43.2% ± 5.3%), and CAE + NHE (48.4% ± 5.1%) groups when compared with the control group (28.3% ± 4.8%) after 6 weeks (all Ps < 0.01). The improvement of LoS was significantly greater in the CAE + NHE group compared with other groups (CAE, NHE, and control groups). CONCLUSION There was a significant increase in dynamic balance performance postintervention among male athletes. CAE and NHE may improve injury prevention programs. CLINICAL RELEVANCE The results of this study provide evidence for athlete trainers and coaches to consider including the CAE and NHE as components of injury prevention programs to improve balance capacity and performance in athletes. Such improvements in balance may prevent injury risk and decrease absenteeism and injury-related financial burdens.
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Affiliation(s)
- Wesam Saleh A Al Attar
- Department of Physical Therapy, Faculty of Applied Medical Science, Umm Al Qura University, Makkah, Saudi Arabia.,Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland.,Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Oliver Faude
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Mohamed A Husain
- Department of Physiotherapy, College of Health and Sport Sciences, University of Bahrain, Manama, Bahrain
| | - Najeebullah Soomro
- The Broken Hill University Department of Rural Health, Faculty of Medicine and Health, The University of Sydney, Broken Hill, Australia.,Bunbury Regional Hospital WACHS-SW, Bunbury, Western Australia, Australia
| | - Ross H Sanders
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
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Brunner R, Bizzini M, Niedermann K, Maffiuletti NA. Epidemiology of Traumatic and Overuse Injuries in Swiss Professional Male Ice Hockey Players. Orthop J Sports Med 2020; 8:2325967120964720. [PMID: 33178879 PMCID: PMC7592329 DOI: 10.1177/2325967120964720] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/21/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Ice hockey injury patterns in Europe were last evaluated in the 1990s. Purpose: The aim of this study was to assess the frequency, type, location, and incidence of traumatic injuries, as well as the prevalence and relative effect of overuse injuries in professional male ice hockey players. Study Design: Descriptive epidemiology study. Methods: Traumatic injuries were assessed using a standardized injury report form over a 1-year period (including the preparatory phase and season). The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire was used to determine overall and substantial overuse injuries and their relative effect on ice hockey players. Results: Five Swiss National League teams participated in the study. From a total of 321 recorded injuries, 179 led to time loss from sport. The game-related time-loss injury incidence during the season was 88.6/1000 player-game hours.Time-loss injuries affected mainly the hip/groin/thigh region (23%), followed by the head (17%). Most time-loss injuries were classified as muscle strains (24%), followed by concussions (18%). The most common injury mechanism involved collision with an opponent’s body (31%), and right forward players (23%) were most likely to report a game-related injury. Most injuries (27%) occurred within the defending zone along the boards. The average prevalence rates of all overuse and substantial overuse injuries were 49% and 13%, respectively. The hip/groin displayed the highest average prevalence for all overuse problems (16%), translating to the highest relative effect. Conclusion: Muscle strains and concussions were the most frequent time-loss injuries in Swiss professional ice hockey players. The hip/groin was the most affected region for both traumatic and overuse injuries.
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Affiliation(s)
- Romana Brunner
- Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
| | - Mario Bizzini
- Investigation performed at the Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
| | - Karin Niedermann
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Winterthur, Switzerland
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Abstract
A case report is presented that gives new insight into a very rare cause of athletic pubalgia. Up till now, no case has been published in literature about the relevance of an arcuate pubic ligament (APL) injury in athletic pubalgia. The APL or inferior pubic ligament is a thick triangular arch of ligamentous fibers connecting the 2 pubic bones below. The main function of the APL is to stabilize the symphysis pubis. The rupture of this ligament can lead to groin pain due to lack of stabilization of the symphysis pubis. Despite the importance of the anatomical and clinical function of the APL, very limited research is available about injuries of this ligament. This report describes a case of a traumatic left APL rupture, confirmed by magnetic resonance imaging, causing longstanding left groin pain in an amateur athlete.
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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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Otten R, Stam S, Langhout R, Weir A, Tak I. The effect of compression shorts on pain and performance in male football players with groin pain - A double blinded randomized controlled trial. Phys Ther Sport 2019; 38:87-95. [PMID: 31071660 DOI: 10.1016/j.ptsp.2019.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/21/2019] [Accepted: 04/21/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate the effects of compression shorts on pain and performance in football players with groin pain. STUDY DESIGN Double blinded randomized controlled trial. SETTING Soccer pitch. PARTICIPANTS Thirty-four male football players with groin pain. MAIN OUTCOME MEASURES The effect of wearing zoned high compression shorts (ZHC-shorts), non-zoned low compression shorts (NZLC-shorts), and normal sports clothes on pain measured with the Numeric Pain Rating Scale (NPRS) and performance during the Copenhagen 5-s squeeze test (CS), the Illinois Agility test (IAT), and maximum shooting (ST). The effects of wearing ZHC versus NZLC shorts on symptoms were measured using the Hip and groin outcome score (HAGOS) during actual football activities. RESULTS Wearing ZHC-shorts reduced pain during the IAT (1.4, ES = 0.58, p= <0.01) and ST (1.2, ES = 0.47, p= <0.01) compared to wearing normal sports clothes, but did not negatively affect performance. Compared to the baseline HAGOS scores a clinically significant improvement in the symptoms (9.7, ES = 0.63, p= <0.01) and sport/recreation (13.2, ES = 0.68, p = 0.01) subscales was found when wearing the ZHC-short during football activities. CONCLUSION Wearing zoned high compression shorts could be useful in reducing groin pain in football players during their football activities.
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Affiliation(s)
- Roald Otten
- Roald Otten Sportsrehab (Part of J&C Sportsrehab), Amstelveen, the Netherlands.
| | | | - Rob Langhout
- Dutch Institute for Allied Health Care (NPi), Master of Physical Therapy in Sports, Amersfoort, the Netherlands; Amsterdam Collaboration on Health and Safety in Sports, International Olympic Committee Research Center for Prevention of Injury and Protection of Athlete Health, Amsterdam, the Netherlands; Physiotherapy Dukenburg, Nijmegen, the Netherlands; Master Musculoskeletal Therapy (SOMT), Amersfoort, the Netherlands
| | - Adam Weir
- Erasmus MC Center for Groin Injuries, Department of Orthopaedics, Erasmus MC University Medical Centre, Rotterdam, the Netherlands; Aspetar Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Hospital, Doha, Qatar; Sport Medicine and Exercise Clinic Haarlem (SBK), Haarlem, the Netherlands
| | - Igor Tak
- Dutch Institute for Allied Health Care (NPi), Master of Physical Therapy in Sports, Amersfoort, the Netherlands; Amsterdam Collaboration on Health and Safety in Sports, International Olympic Committee Research Center for Prevention of Injury and Protection of Athlete Health, Amsterdam, the Netherlands; Physiotherapy Utrecht Oost, Utrecht, the Netherlands; Amsterdam University Medical Centre, Department of Orthopaedics and Sports Traumatology, Amsterdam, the Netherlands; Academic Centre for Evidence Based Sports Medicine (ACES), Amsterdam, the Netherlands
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A Pilot RCT Investigating the Effects of Targeted Compression on Athletes With Pelvic/Groin Pain. J Sport Rehabil 2018; 28:133-143. [PMID: 29091519 DOI: 10.1123/jsr.2017-0097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
CONTEXT Athletic pelvic/groin pain is a common yet often challenging problem to both diagnose and manage. A new tool has been developed based on the clinical effects of applied force on the pelvis. Early findings indicate that this customized compression orthosis may have a positive effect on pelvic/groin pain and performance measures. OBJECTIVES To inform the design and test the practicality of procedures for a future definitively powered randomized controlled trial and to provide an estimate of the effect size of this orthosis on selected clinical and performance measures. DESIGN Pilot randomized controlled trial with participants randomly allocated to an intervention or waiting-list control group. SETTING The training location of each athlete. PARTICIPANTS 24 athletes with subacute and chronic pelvic conditions were proposed to be recruited. INTERVENTION A customized compression orthosis, delivering targeted compression to the pelvic girdle. OUTCOME MEASURES Measures were the active straight leg raise (ASLR) test, squeeze test, broad jump, and the multiple single-leg hop-stabilization test. RESULTS A total of 16 athletes completed the study. The invention group demonstrated moderate to large estimated effect sizes on the squeeze test and active straight leg raise tests (d = 0.6-1.1) while wearing the orthosis. Small effect sizes (d = 0.2) were seen on jump distance and the dominant leg balance score. Compared with the control group, the intervention group also showed moderate to large estimated effect sizes on the active straight leg raise measures (d = 0.5-0.9) when wearing sports shorts. CONCLUSIONS The protocol was feasible. Effect sizes and recruitment/attrition rates suggest that the intervention holds promise and that a future definitively powered randomized controlled trial appears feasible and is indicated.
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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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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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Light N, Smith N, Delahunt E, Thorborg K. Hip and groin injury management in English youth football: a survey of 64 professional academies. SCI MED FOOTBALL 2018. [DOI: 10.1080/24733938.2018.1441536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Neil Light
- Department of Sport and Exercise Sciences, University of Chichester, Chichester, UK
| | - Neal Smith
- Department of Sport and Exercise Sciences, University of Chichester, Chichester, UK
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Kristian Thorborg
- Department of Orthopedic Surgery, Sports Orthopedic Research Center - Copenhagen (SORC-C), Copenhagen University Hospital, Amager-Hvidovre, Copenhagen, Denmark
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Hammer AM, Hammer RL, Lomond KV, O'Connor P. Acute changes of hip joint range of motion using selected clinical stretching procedures: A randomized crossover study. Musculoskelet Sci Pract 2017; 32:70-77. [PMID: 28888207 DOI: 10.1016/j.msksp.2017.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 08/15/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Hip adductor flexibility and strength is an important component of athletic performance and many activities of daily living. Little research has been done on the acute effects of a single session of stretching on hip abduction range of motion (ROM). OBJECTIVES The aim of this study was to compare 3 clinical stretching procedures against passive static stretching and control on ROM and peak isometric maximal voluntary contraction (MVC). DESIGN Using a randomized crossover study design, a total of 40 participants (20 male and 20 female) who had reduced hip adductor muscle length attended a familiarization session and 5 testing sessions on non-consecutive days. METHOD Following the warm-up and pre-intervention measures of ROM and MVC, participants were randomly assigned 1 of 3 clinical stretching procedures (modified lunge, multidirectional, and joint mobilization) or a static stretch or control condition. Post-intervention measures of ROM and MVC were taken immediately following completion of the assigned condition. RESULTS An ANOVA using a repeated measure design with the change score was conducted. All interventions resulted in small but statistically significant (p < 0.05) increases (1.0°-1.7°) in ROM with no inter-condition differences except one. Multidirectional stretching was greater than control (p = 0.031). CONCLUSIONS These data suggest that a single session of stretching has only a minimal effect on acute changes of hip abduction ROM. Although hip abduction is a frontal plane motion, to effectively increase the extensibility of the structures that limit abduction, integrating multi-planar stretches may be indicated.
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Affiliation(s)
- Adam M Hammer
- Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, School of Rehabilitation and Medical Sciences, Doctoral Program in Physical Therapy, 1220 Health Professions Building, Mount Pleasant, MI 48859, USA.
| | - Roger L Hammer
- Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, School of Health Sciences, Division of Exercise Science, 2219 Health Professions Building, Mount Pleasant, MI 48859, USA.
| | - Karen V Lomond
- Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, School of Health Sciences, Division of Exercise Science, 2219 Health Professions Building, Mount Pleasant, MI 48859, USA.
| | - Paul O'Connor
- Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, School of Health Sciences, Division of Exercise Science, 2219 Health Professions Building, Mount Pleasant, MI 48859, USA.
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Zupon AB, Kerr ZY, Dalton SL, Dompier TP, Gardner EC. The epidemiology of back/neck/spine injuries in National Collegiate Athletic Association men's and women's ice hockey, 2009/2010 to 2014/2015. Res Sports Med 2017; 26:13-26. [PMID: 28869402 DOI: 10.1080/15438627.2017.1365295] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study describes the epidemiology of back/neck/spine injuries in National Collegiate Athletic Association (NCAA) men's and women's ice hockey. Data from 66 NCAA men's and 29 women's ice hockey programmes (total of 147 and 67 team-seasons, respectively) were analysed from the NCAA Injury Surveillance Program during the 2009/2010-2014/2015 academic years. In the study period, 226 and 97 back/neck/spine injuries were reported in men and women, respectively, for injury rates of 0.56 and 0.65/1000 athlete exposures. Injury rates were higher in competitions than practices in men (injury rate ratio [IRR] = 4.22; 95% confidence interval [CI]: 3.24-5.49) and women (IRR = 2.49; 95% CI: 1.67-3.70). Most injuries occurred in the lower back/lumbar spine (men: 52.2%; women: 48.5%). There were notably low rates of fractures and severe spinal injuries for both sexes. This study enhances our understanding of the incidence, mechanisms and factors influencing these injuries and can ultimately lead to more effective injury prevention.
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Affiliation(s)
- Alyssa B Zupon
- a Yale School of Medicine , Yale University , New Haven , CT , USA
| | - Zachary Y Kerr
- b Department of Exercise and Sport Science , University of North Carolina , Chapel Hill , NC , USA
| | - Sara L Dalton
- c Datalys Center for Sports Injury Research and Prevention, Inc. , Indianapolis , IN , USA
| | - Thomas P Dompier
- d Department of Athletic Training , Lebanon Valley College , Annville , PA , USA
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Moreno-Pérez V, Lopez-Valenciano A, Barbado D, Moreside J, Elvira JLL, Vera-Garcia FJ. Comparisons of hip strength and countermovement jump height in elite tennis players with and without acute history of groin injuries. Musculoskelet Sci Pract 2017; 29:144-149. [PMID: 28433808 DOI: 10.1016/j.msksp.2017.04.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/01/2017] [Accepted: 04/07/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Despite the high groin-injury (GI) prevalence in tennis, no studies have assessed the extent to which intrinsic groin injury risk factors, such as hip muscle strength, have recovered in elite tennis players with a history of previous GI. OBJECTIVE To investigate whether elite tennis players with a history of GI show differences in hip strength and jump height between injured and uninjured limbs and compared with dominant limb in tennis players without history of acute groin-injuries (NGI). DESIGN Cohort study. PARTICIPANTS Sixty-one tennis players completed this study: 17 in the GI group and 44 in the NGI. Isometric adductor and abductor hip strength were assessed with a handheld dynamometer, and unilateral counter-movement jump tests were performed on a contact mat connected to an Ergo tester. Paired t-tests were conducted to identify differences between injured and non-injured limbs in the GI group, and independent measures t-tests were conducted to compare between GI and NGI groups. RESULTS Isometric adductor strength and adductor/abductor strength ratios were lower in the injured limb (16.4% and 20.1%, respectively) compared with uninjured side within the GI group, and lower than the dominant side in the NGI group. No significant differences were found for unilateral jump heights between sides in the GI, nor isometric abductor strength, when comparing GI to NGI groups. CONCLUSIONS Isometric adductor weakness and adductor/abductor strength ratio deficits suggest that adductor muscle strength is not fully recovered in these athletes, potentially increasing their risk of a repeat groin injury.
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Affiliation(s)
- V Moreno-Pérez
- Sports Research Centre, Miguel Hernandez University of Elche, Avda. de la Universidad s/n., C.P. 03202, Elche, Alicante, Spain
| | - A Lopez-Valenciano
- Sports Research Centre, Miguel Hernandez University of Elche, Avda. de la Universidad s/n., C.P. 03202, Elche, Alicante, Spain
| | - D Barbado
- Sports Research Centre, Miguel Hernandez University of Elche, Avda. de la Universidad s/n., C.P. 03202, Elche, Alicante, Spain
| | - J Moreside
- School of Health and Human Performance, Dalhousie University, Halifax, Canada
| | - J L L Elvira
- Sports Research Centre, Miguel Hernandez University of Elche, Avda. de la Universidad s/n., C.P. 03202, Elche, Alicante, Spain
| | - F J Vera-Garcia
- Sports Research Centre, Miguel Hernandez University of Elche, Avda. de la Universidad s/n., C.P. 03202, Elche, Alicante, Spain.
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Popkin CA, Schulz BM, Park CN, Bottiglieri TS, Lynch TS. Evaluation, management and prevention of lower extremity youth ice hockey injuries. Open Access J Sports Med 2016; 7:167-176. [PMID: 27920584 PMCID: PMC5123732 DOI: 10.2147/oajsm.s118595] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ice hockey is a fast-paced sport played by increasing numbers of children and adolescents in North America and around the world. Requiring a unique blend of skill, finesse, power and teamwork, ice hockey can become a lifelong recreational activity. Despite the rising popularity of the sport, there is ongoing concern about the high frequency of musculoskeletal injury associated with participation in ice hockey. Injury rates in ice hockey are among the highest in all competitive sports. Numerous research studies have been implemented to better understand the risks of injury. As a result, rule changes were adopted by the USA Hockey and Hockey Canada to raise the minimum age at which body checking is permitted to 13–14 years (Bantam level) from 11–12 years (Pee Wee). Continuing the education of coaches, parents and players on rules of safe play, and emphasizing the standards for proper equipment use are other strategies being implemented to make the game safer to play. The objective of this article was to review the evaluation, management and prevention of common lower extremity youth hockey injuries.
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Affiliation(s)
- Charles A Popkin
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
| | | | - Caroline N Park
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
| | - Thomas S Bottiglieri
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
| | - T Sean Lynch
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
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Röling MA, Mathijssen NM, Bloem RM. Incidence of symptomatic femoroacetabular impingement in the general population: a prospective registration study. J Hip Preserv Surg 2016; 3:203-7. [PMID: 27583159 PMCID: PMC5005059 DOI: 10.1093/jhps/hnw009] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/19/2016] [Accepted: 02/05/2016] [Indexed: 01/21/2023] Open
Abstract
Groin pain is a frequent cause of discomfort in patients and highly prevalent in active patients. One of the diagnoses causing groin pain is femoroacetabular impingement (FAI). However, the incidence of FAI in the general population is unknown. This study aimed to identify the incidence of groin pain suggestive of FAI in a cohort of 31 451 patients in the Netherlands during 1 year. A cooperation of 16 general practitioners (GPs) participated in this prospective registry. All GPs were educated in the clinical manifestation of FAI and the physical examination for FAI. Patients of all ages were registered when presenting with 'groin pain'. Between July 2013 and July 2014, 84 patients aged between 15 and 60 years of age presented with groin pain, reflecting an incidence of 0.44%. Of these patients, 17% (14 patients) were radiologically diagnosed with FAI. Another 30% of these patients had a high clinical suspicion for FAI. This is the first report on the incidence of groin pain suggestive of FAI in a general population diagnosed by GPs. Of all 84 patients presenting with groin pain, 17% were diagnosed with FAI. Creating awareness of FAI in GPs helps identifying patients that might benefit from FAI treatment.
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Dalton SL, Zupon AB, Gardner EC, Djoko A, Dompier TP, Kerr ZY. The Epidemiology of Hip/Groin Injuries in National Collegiate Athletic Association Men's and Women's Ice Hockey: 2009-2010 Through 2014-2015 Academic Years. Orthop J Sports Med 2016; 4:2325967116632692. [PMID: 26998502 PMCID: PMC4780099 DOI: 10.1177/2325967116632692] [Citation(s) in RCA: 24] [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: 11/16/2022] Open
Abstract
Background: There is limited research regarding the epidemiology of hip/groin injuries in ice hockey, the majority of which is restricted to time-loss injuries only. Purpose: To describe the epidemiology of hip/groin injuries in collegiate men’s and women’s ice hockey from 2009-2010 through 2014-2015. Study Design: Descriptive epidemiology study. Methods: Hip/groin injury data from the National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) during the 2009-2010 through 2014-2015 seasons were analyzed. Injury rates, rate ratios (RRs), and injury proportion ratios (IPRs) were reported with 95% confidence intervals (CIs). Results: During the 2009-2010 through 2014-2015 seasons, 421 and 114 hip/groin injuries were reported in men’s and women’s ice hockey, respectively, leading to injury rates of 1.03 and 0.78 per 1000 athlete-exposures (AEs), respectively. The hip/groin injury rate was greater in men than in women (RR, 1.32; 95% CI, 1.08-1.63). In addition, 55.6% and 71.1% of hip/groin injuries in men’s and women’s ice hockey, respectively, were non–time loss (NTL) injuries (ie, resulted in participation restriction time <24 hours); 7.6% and 0.9%, respectively, were severe (ie, resulted in participation restriction time >3 weeks). The proportion of hip/groin injuries that were NTL injuries was greater in women than in men (IPR, 1.28; 95% CI, 1.11-1.48). Conversely, the proportion of hip/groin injuries that were severe was greater in men than in women (IPR, 8.67; 95% CI, 1.20-62.73). The most common hip/groin injury diagnosis was strain (men, 67.2%; women, 76.3%). Also, 12 (2.9%) and 3 (2.6%) cases of hip impingement were noted in men’s and women’s ice hockey, respectively. Conclusion: Hip/groin injury rates were greater in men’s than in women’s ice hockey. Time loss varied between sexes, with men sustaining more injuries with time loss over 3 weeks. Despite increasing concerns of femoroacetabular impingement in ice hockey players, few cases of hip impingement were reported in this dataset.
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Affiliation(s)
- Sara L Dalton
- Datalys Center for Sports Injury Research and Prevention Inc, Indianapolis, Indiana, USA
| | - Alyssa B Zupon
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | | | - Aristarque Djoko
- Datalys Center for Sports Injury Research and Prevention Inc, Indianapolis, Indiana, USA
| | - Thomas P Dompier
- Datalys Center for Sports Injury Research and Prevention Inc, Indianapolis, Indiana, USA
| | - Zachary Y Kerr
- Datalys Center for Sports Injury Research and Prevention Inc, Indianapolis, Indiana, USA
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St-Onge E, MacIntyre IG, Galea AM. Multidisciplinary approach to non-surgical management of inguinal disruption in a professional hockey player treated with platelet-rich plasma, manual therapy and exercise: a case report. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2015; 59:390-397. [PMID: 26816415 PMCID: PMC4711326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To present the clinical management of inguinal disruption in a professional hockey player and highlight the importance of a multidisciplinary approach to diagnosis and management. CLINICAL FEATURES A professional hockey player with recurrent groin pain presented to the clinic after an acute exacerbation of pain while playing hockey. INTERVENTION The patient received a clinical diagnosis of inguinal disruption. Imaging revealed a tear in the rectus abdominis. Management included two platelet-rich plasma (PRP) injections to the injured tissue, and subsequent manual therapy and exercise. The patient returned to his prior level of performance in 3.5 weeks. DISCUSSION This case demonstrated the importance of a multidisciplinary team and the need for advanced imaging in athletes with groin pain. SUMMARY Research quality concerning the non-surgical management of inguinal disruption remains low. This case adds evidence that PRP, with the addition of manual therapy and exercise may serve as a relatively quick and effective non-surgical management strategy.
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Affiliation(s)
- Eric St-Onge
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1
- Sports Sciences Resident, Division of Graduate Studies
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Abstract
STUDY DESIGN Resident's case problem. BACKGROUND Groin pain represents a diagnostic challenge and requires a diagnostic process that rules out life-threatening illness or disease processes. Osteomyelitis is a potential fatal disease process that requires accurate diagnosis and medical management. Osteomyelitis presents a problem for the outpatient physical therapist, as the described physical findings for the diagnosis of osteomyelitis are nonspecific. DIAGNOSIS A 67-year-old man with groin and bilateral medial thigh pain was referred for physical therapy care to address right adductor weakness and generalized deconditioning. He had undergone extensive treatment for bladder cancer, with a recent radical cystoprostatectomy and cutaneous urinary diversion with an Indiana pouch. Postsurgical magnetic resonance imaging indicated normal findings, and the patient was currently being managed by an orthopaedic surgeon, who diagnosed the patient as having obturator nerve palsy. The physical therapist's examination produced findings inconsistent with this diagnosis. Subsequently, nuclear medicine studies revealed pubic symphysitis/osteomyelitis with secondary myositis, predominantly affecting the right adductor muscles. DISCUSSION Osteomyelitis represents a difficult problem for the outpatient physical therapist. Careful consideration of red-flag symptoms and inconclusive physical testing indicate the need for further medical work-up. In this case, appropriate medical management led to improvement in patient function, highlighting the need for early diagnosis. LEVEL OF EVIDENCE Differential diagnosis, level 4.
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Esteve E, Rathleff MS, Bagur-Calafat C, Urrútia G, Thorborg K. Prevention of groin injuries in sports: a systematic review with meta-analysis of randomised controlled trials. Br J Sports Med 2015; 49:785-91. [DOI: 10.1136/bjsports-2014-094162] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2015] [Indexed: 11/04/2022]
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Ellsworth AA, Zoland MP, Tyler TF. Athletic pubalgia and associated rehabilitation. Int J Sports Phys Ther 2014; 9:774-784. [PMID: 25383246 PMCID: PMC4223287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Evaluation and treatment of groin pain in athletes is challenging. The anatomy is complex, and multiple pathologies often coexist. Different pathologies may cause similar symptoms, and many systems can refer pain to the groin. Many athletes with groin pain have tried prolonged rest and various treatment regimens, and received differing opinions as to the cause of their pain. The rehabilitation specialist is often given a non-specific referral of "groin pain" or "sports hernia." The cause of pain could be as simple as the effects of an adductor strain, or as complex as athletic pubalgia or inguinal disruption. The term "sports hernia" is starting to be replaced with more specific terms that better describe the injury. Inguinal disruption is used to describe the syndromes related to the injury of the inguinal canal soft tissue environs ultimately causing the pain syndrome. The term athletic pubalgia is used to describe the disruption and/or separation of the more medial common aponeurosis from the pubis, usually with some degree of adductor tendon pathology. TREATMENT Both non-operative and post-operative treatment options share the goal of returning the athlete back to pain free activity. There is little research available to reference for rehabilitation guidelines and creation of a plan of care. Although each surgeon has their own specific set of post-operative guidelines, some common concepts are consistent among most surgeons. Effective rehabilitation of the high level athlete to pain free return to play requires addressing the differences in the biomechanics of the dysfunction when comparing athletic pubalgia and inguinal disruption. CONCLUSION Proper evaluation and diagnostic skills for identifying and specifying the difference between athletic pubalgia and inguinal disruption allows for an excellent and efficient rehabilitative plan of care. Progression through the rehabilitative stages whether non-operative or post-operative allows for a focused rehabilitative program. As more information is obtained through MRI imaging and the diagnosis and treatment of inguinal disruption and athletic pubalgia becomes increasingly frequent, more research is warranted in this field to better improve the evidence based practice and rehabilitation of patients. LEVELS OF EVIDENCE 5.
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Affiliation(s)
| | - Mark P. Zoland
- General and Laparoscopic Surgeons of NY, New York, NY, USA
| | - Timothy F. Tyler
- Nicholas Institute for Sports Medicine and Athletic Trauma (NISMAT) Lenox Hill Hospital, New York, NY, USA
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Cheatham SW, Hanney WJ, Kolber MJ, Salamh PA. Adductor-related groin pain in the athlete. PHYSICAL THERAPY REVIEWS 2014. [DOI: 10.1179/1743288x14y.0000000147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Coughlan GF, Delahunt E, Caulfield BM, Forde C, Green BS. Normative adductor squeeze test values in elite junior rugby union players. Clin J Sport Med 2014; 24:315-9. [PMID: 24561635 DOI: 10.1097/jsm.0000000000000046] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To establish normative adductor squeeze test (AST) values in elite junior rugby union players and investigate if differences existed between field position units and categorizations. DESIGN Cross-sectional study. SETTING National underage screening camp. PARTICIPANTS One hundred four healthy players attending an under-19 and under-18 national musculoskeletal and fitness screening camp. Players had no history of surgery, no self-reported history of groin or pelvic pain in either limb and no other lower limb injury in the past 3 months, and no pain reported during the testing procedure. MAIN OUTCOME MEASURES The AST in 3 positions of hip flexion (0, 45, and 90 degrees), position unit, and categorizations. RESULTS The highest AST values were observed at 45 degrees of hip flexion in all field position categories. No differences were observed between position units and categorizations. CONCLUSIONS Normative AST values in an elite junior rugby union population were established in this investigation. Clinically, the sports medicine professional may use these results in making decisions on the management of both symptomatic and asymptomatic players.
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Affiliation(s)
- Garrett F Coughlan
- *Medical Department, Irish Rugby Football Union, Dublin, Ireland; †School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland; ‡Institute for Sport and Health, University College Dublin, Dublin, Ireland; §School of Public Health, Physiotherapy and Population Science, Health Sciences Centre, University College Dublin, Dublin, Ireland; and ¶USA Rugby, Denver, Colorado
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Sedaghati P, Alizadeh MH, Shirzad E, Ardjmand A. Review of sport-induced groin injuries. Trauma Mon 2013; 18:107-12. [PMID: 24350166 PMCID: PMC3864393 DOI: 10.5812/traumamon.12666] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 07/22/2013] [Accepted: 09/16/2013] [Indexed: 11/16/2022] Open
Abstract
CONTEXT Groin injuries are among the most common injuries co-existing with sports. The aim of this review was to outline the epidemiology and identify risk factors, as well as examine preventative and interventional measures for reducing the occurrence of this form of injury among athletes. EVIDENCE ACQUISITION An electronic, systematic search for relevant keywords, either separately or in combination was sought in the academic scientific databases. RESULTS Groin injuries, acute or chronic, consist of a high percentage of injuries that manifest with pain. Despite the specific tendency for injury among some sports, such injuries make up 2-5% of sport-induced injuries. There are few available reports on lower limb injuries, especially groin injuries, in Iran. Numerous factors predispose to groin injuries. A lengthy list of preventive/ treatment measures, from preliminary to sophisticated, have been proposed. CONCLUSIONS Although using a programmed strategy designed to decrease the risk of groin injuries by taking a strategic approach to exercise may alleviate complications, in some cases the chronic nature of the injury may threaten the professional life of the athlete. More research is required to plan suitable programs for reducing the risk of this type of injury in athletes.
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Affiliation(s)
- Parisa Sedaghati
- Department of Physical Training and Sport Sciences, Kish International Campus, University of Tehran, Tehran, IR Iran
| | | | - Elham Shirzad
- Department of Corrective Exercises and Sports Injuries, University of Tehran, Tehran, IR Iran
| | - Abolfazl Ardjmand
- Physiology Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding author: Abolfazl Ardjmand, Physiology Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel.:+98-3615550021, Fax: +98-3615621157, E-mail:
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