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Walker EM, Hunt NL, Holcomb AE, Fitzpatrick CK, Brown TN. Effect of age on ankle biomechanics and tibial compression during stair descent. Gait Posture 2024; 112:140-146. [PMID: 38781789 PMCID: PMC11193625 DOI: 10.1016/j.gaitpost.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/30/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Stress fracture is a concern among older adults, as age-related decrements in ankle neuromuscular function may impair their ability to attenuate tibial compressive forces experienced during daily locomotor tasks, such as stair descent. Yet, it is unknown if older adults exhibit greater tibial compression than their younger counterparts when descending stairs. RESEARCH QUESTION Do older adults exhibit differences in ankle biomechanics that alter their tibial compression during stair descent compared to young adults, and is there a relation between tibial compression and specific changes in ankle biomechanics? METHODS Thirteen young (18-25 years) and 13 older (> 65 years) adults had ankle joint biomechanics and tibial compression quantified during a stair descent. Discrete ankle biomechanics (peak joint angle and moment, and joint stiffness) and tibial compression (maximum and impulse) measures were submitted to an independent t-test, while ankle joint angle and moment, and tibial compression waveforms were submitted to an independent statistical parametric mapping t-test to determine group differences. Pearson correlation coefficients (r) determined the relation between discrete ankle biomechanics and tibial compression measures for all participants, and each group. RESULTS Older adults exhibited smaller maximum tibial compression (p = 0.004) from decreases in peak ankle joint angle and moment between 17 % and 34 % (p = 0.035), and 20-31 % of stance (p < 0.001) than young adults. Ankle biomechanics exhibited a negligible to weak correlation with tibial compression for all participants, with peak ankle joint moment and maximum tibial compression (r = -0.48 ± 0.32) relation the strongest. Older adults typically exhibited a stronger relation between ankle biomechanics and tibial compression (e.g., r = -0.48 ± 0.47 vs r = -0.27 ± 0.52 between peak ankle joint moment and maximum tibial compression). SIGNIFICANCE Older adults altered ankle biomechanics and decreased maximum tibial compression to safely execute the stair descent. Yet, specific alterations in ankle biomechanics could not be identified as a predictor of changes in tibial compression.
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Affiliation(s)
- Elijah M Walker
- Dept. of Kinesiology, Boise State University, Boise, ID, USA
| | - Nicholas L Hunt
- Dept. of Kinesiology, Boise State University, Boise, ID, USA
| | - Amy E Holcomb
- Dept. of Mechanical and Biomedical Engineering, Boise State University, Boise, ID, USA
| | - Clare K Fitzpatrick
- Dept. of Mechanical and Biomedical Engineering, Boise State University, Boise, ID, USA
| | - Tyler N Brown
- Dept. of Kinesiology, Boise State University, Boise, ID, USA.
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Rossi C, Roklicer R, Drid P, Milovancev A, Trivic T, Scardina A, Carraro A, Bianco A. Left Ventricular Hypertrophy in Male and Female Judo Athletes. Int J Sports Med 2024; 45:377-381. [PMID: 38401535 PMCID: PMC11065483 DOI: 10.1055/a-2252-1239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/13/2023] [Indexed: 02/26/2024]
Abstract
Changes in cardiac geometry develop after intense and prolonged training. Left ventricular enlargement, increased relative wall thickness, and growing mass of the left ventricle occur after strenuous exercise. Combat sports such as judo can lead to left ventricular hypertrophy. Previous studies have found that there are differences in left ventricular chamber size and thickness between the sexes, with female athletes having smaller wall diameters and less hypertrophy than male athletes. The research aims to examine heart muscle adaptations and remodeling of cardiac geometry among elite judo athletes and to evaluate differences between males and females. A cross-sectional study included a group of 19 (males n=10, females n=9) professional judokas between 20 and 30 years. Demographic and anthropometric data were collected. Cardiac geometry was determined by two-dimensional transthoracic echocardiography. In terms of left ventricular mass and the left ventricular mass index significant differences were found between male and female judokas (233.44±68.75 g vs. 164.11±16.59 g, p=0.009), (105.16±24.89 vs. 84.66±15.06, p=0.044), respectively. A greater enlargement of the heart muscle is observed in male athletes compared to the female group. Left ventricle enlargement is likely to occur among elite-level judokas.
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Affiliation(s)
- Carlo Rossi
- Department of Psychology, Educational Science and Human Movement,
University of Palermo, Palermo, Italy
- Research and Innovation, Centro Medico di Fisioterapia “Villa Sarina”,
91011 Alcamo, Trapani, Italy
| | - Roberto Roklicer
- Faculty of Sport and Physical Education, University of Novi Sad, Novi
Sad, Serbia
- Faculty of Education, Free University of Bozen–Bolzano, 39042
Brixen–Bressanone, Italy, Free University of Bozen-Bolzano, Bolzano,
Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi
Sad, Serbia
| | - Aleksandra Milovancev
- Internal medicine, cardiology, University of Novi Sad Medical Faculty,
Novi Sad, Serbia
- Cardiology, Institute of Cardiovascular Diseases of Vojvodina, Sremska
Kamenica, Serbia
| | - Tatjana Trivic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi
Sad, Serbia
| | - Antonino Scardina
- Department of Psychology, Educational Science and Human Movement,
University of Palermo, Palermo, Italy
| | - Attilio Carraro
- Faculty of Education, Free University of Bozen–Bolzano, 39042
Brixen–Bressanone, Italy, Free University of Bozen-Bolzano, Bolzano,
Italy
| | - Antonino Bianco
- Department of Psychology, Educational Science and Human Movement,
University of Palermo, Palermo, Italy
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Raiser SN, Schroeder AN, Lawley RJ, Tenforde AS. Bone health and the masters runner. PM R 2024; 16:363-373. [PMID: 38532664 DOI: 10.1002/pmrj.13175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 02/13/2024] [Accepted: 02/25/2024] [Indexed: 03/28/2024]
Abstract
Masters runners are often defined as those ages 35 years and older who train and compete in running events. These runners represent a growing population of the overall running community and experience running-related injuries including bone stress injuries (BSIs). Similar to younger runners, health considerations in masters runners include the goal to optimize bone health with focus on mitigating age-associated loss of bone strength and preventing BSIs through a combination of ensuring appropriate physical activity, optimizing nutrition, and correcting faulty biomechanics. Importantly, BSIs in masters runners may include characteristics of both overuse injury from insufficient recovery and failure of bone weakened by age-related loss of bone (insufficiency fractures). This narrative review covers the limited available research on strategies to optimize bone health in masters runners. Applying knowledge on masters athletes and extrapolating from other populations, we propose strategies on treatment and prevention of BSIs. Finally, the review highlights gaps in knowledge that require further age-specific discoveries to advance treatment and prevention.
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Affiliation(s)
- Sara N Raiser
- Department of Physical Medicine & Rehabilitation, University of Virginia, Charlottesville, Virginia, USA
| | - Allison N Schroeder
- Department of Orthopedics, University Hospitals and Case Western Reserve University, Cleveland, Ohio, USA
| | - Richard J Lawley
- Department of Physical Medicine & Rehabilitation, Loyola University Medical Center, Maywood, Illinois, USA
| | - Adam S Tenforde
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
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Paavana T, Rammohan R, Hariharan K. Stress fractures of the foot - current evidence on management. J Clin Orthop Trauma 2024; 50:102381. [PMID: 38435398 PMCID: PMC10904895 DOI: 10.1016/j.jcot.2024.102381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/06/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Stress fractures are a consequence of repeated submaximal loads with inadequate time for recovery and biologic repair or remodelling. The foot and ankle complex (FAC) represents a common site for development of stress fractures. Whilst the overall incidence of stress fractures is low, they are prevalent in athletes and military personnel causing significant time away from sports or work. Within these populations, certain stress fractures directly correlate to specific activities. Factors that commonly influence these fractures include an acute increase in new repetitive physical activity combined with muscle fatigue, training errors or improper athletic techniques, which challenge the regenerative and remodelling capacity of bone. Depending on the site that is subject to repetitive loading, various biomechanical factors can result in abnormal concentration of forces to specific areas of the FAC resulting in stress fracture. Decreased bone marrow density (BMD) is a major biologic cause for developing stress fractures. The female athlete triad comprising eating disorder, amenorrhea and osteoporosis in competitive athletes also predisposes to stress fractures. Vitamin D deficiency is also postulated to be the cause of these fractures and may contribute to poor healing. Clinical presentation is usually with vague pain of insidious onset which worsens with activity and improves with rest. Diffuse tenderness over the affected bone is common with only a minority having any visible swelling. Plain radiographs are the first line of investigation but rarely reveal an obvious fracture. MRI scans aid in diagnosis and CT scans help in treatment and characterisation of the fracture and monitor healing. Management relates to the site of injury, which stratifies them into high or low-risk. Stress fractures of the calcaneus, cuboid and cuneiforms are classed as low-risk fractures as they usually heal with simple activity modification or short duration of non-weight bearing. Stress fractures of the navicular, talus and hallucal sesamoids are classed as high-risk fractures due to higher rates of non-union and prolonged recovery time. Metatarsal fractures can be considered high or low-risk depending on location. These warrant aggressive management, often requiring surgical intervention. Adjuncts such as vitamin D supplements, external shockwave therapy, low-intensity pulsed ultrasound therapy have been used with varying success but there remains little supportive evidence of superiority in the available literature.
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Affiliation(s)
- Thumri Paavana
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
| | - R. Rammohan
- The Grange University Hospital, Cwmbran, United Kingdom
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Fukuda Y, Kato K, Otoshi K, Hakozaki M, Kaneuchi Y, Matsumoto Y. Rib stress fracture in a female athlete caused by bouncing the barbell in bench press exercise: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241232863. [PMID: 38362226 PMCID: PMC10868490 DOI: 10.1177/2050313x241232863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
Rib stress fractures can occur in sports involving repetitive trunk muscle contractions. Few documented cases show rib fractures from repetitive upper-limb training. This report presents a case of a rib stress fracture from micro blunt trauma during bench press exercises. The patient was a 24-year-old elite female sprinter with a history of left navicular stress fracture and secondary amenorrhea treatment a year prior. She modified her bench press technique to involve bouncing the barbell on her rib cage. Within weeks, she experienced anterior chest pain, exacerbated by sneezing. Computed tomography revealed a fifth rib fracture with callus formation. After refraining from bench presses for 4 weeks, her chest pain subsided, allowing her to resume upper-limb training. When athletes performing bench press exercises experience chest pain, rib fractures should be considered, even without acute trauma. Additionally, research on the safety of the bouncing bench pressing technique is required.
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Affiliation(s)
- Yuya Fukuda
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Japan
- Department of Orthopaedic Surgery, Shirakawa Kosei General Hospital, Shirakawa City, Japan
| | - Kinshi Kato
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Japan
- Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan
| | - Kenichi Otoshi
- Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan
| | - Michiyuki Hakozaki
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Japan
| | - Yoichi Kaneuchi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Japan
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Japan
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Matsumoto Y, Ogihara N, Kosuge S, Hanawa H, Kokubun T, Kanemura N. Sex differences in the kinematics and kinetics of the foot and plantar aponeurosis during drop-jump. Sci Rep 2023; 13:12957. [PMID: 37563188 PMCID: PMC10415335 DOI: 10.1038/s41598-023-39682-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 07/28/2023] [Indexed: 08/12/2023] Open
Abstract
Plantar fasciitis is one of the most common musculoskeletal injuries in runners and jumpers, with a higher incidence in females. However, mechanisms underlying sex-associated differences in its incidence remain unclear. This study investigated the possible differences in landing and jumping kinematics and kinetics of the foot between sexes during drop-jump activities. Twenty-six participants, including 13 males and 13 females, performed drop-jumps from a platform onto force plates. Nineteen trials including ten males and nine females were selected for inverse dynamics analysis. The patterns of stretch and tensile force generated by the plantar aponeurosis (PA) were estimated using a multi-segment foot model incorporating the PA. Our results demonstrated that dorsiflexion, angular velocity, and normalized plantarflexion moment of the midtarsal joint right after the heel landed on the floor were significantly larger in females than in males. Consequently, the PA strain rate and tensile stress tended to be larger in females than in males. Such differences in the kinematics and kinetics of the foot and the PA between sexes could potentially lead to a higher prevalence of foot injuries such as plantar fasciitis in females.
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Affiliation(s)
- Yuka Matsumoto
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
- Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
| | - Sachiko Kosuge
- Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
- Maeda Seikeigeka, Saitama, Japan
| | - Hiroki Hanawa
- Department of Health Science, University of Human Arts and Sciences, Saitama, Japan
| | - Takanori Kokubun
- Department of Health and Social Services, Saitama Prefectural University, 820 Sannomiya, Koshigaya, Saitama, 343-8540, Japan
| | - Naohiko Kanemura
- Department of Health and Social Services, Saitama Prefectural University, 820 Sannomiya, Koshigaya, Saitama, 343-8540, Japan.
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Vitamin D Supplementation and Its Impact on Different Types of Bone Fractures. Nutrients 2022; 15:nu15010103. [PMID: 36615761 PMCID: PMC9824692 DOI: 10.3390/nu15010103] [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: 11/20/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Vitamin D helps to balance the levels of calcium and phosphorus to maintain proper bone structure. It is also involved in essential biological roles and displays a wide spectrum of potential benefits in the human body. Since there are many types of fractures that occur at specific ages and due to different circumstances, the influence of vitamin D on the frequency of a particular fracture may differ. Thus, the authors investigated the possible preventive effect of vitamin D on the risks of vertebral fractures, hip fractures, stress fractures and pediatric fractures. Additional aspects of vitamin D, especially on recuperation after injures and its impact on the severity of particular fractures, were also discussed. It was suggested that vitamin D supplementation may contribute to a reduction in hip fracture risk due to reduced bone turnover, decreased frequency of falls and improved muscle function. Furthermore, vitamin D appears to lower the risk of stress fractures in athletes and military recruits. Due to a nonunified protocol design, presented investigations show inconsistencies between vitamin D supplementation and a decreased risk of vertebral fractures. However, a vitamin D preventive effect on pediatric fractures seems to be implausible.
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Stone GL. 50 Years of Title IX. Sports Health 2022; 14:793-794. [PMID: 36317472 PMCID: PMC9631042 DOI: 10.1177/19417381221129265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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