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Chen KK, Osadebey EN, Shupe PG, Gregory BP. Hip Sideline Emergencies and Hip Injuries in Elite Athletes. Curr Rev Musculoskelet Med 2024:10.1007/s12178-024-09914-x. [PMID: 39017861 DOI: 10.1007/s12178-024-09914-x] [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: 07/02/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE OF REVIEW Hip injuries in elite athletes are an increasingly recognized problem and range from chronic overuse injuries, such as adductor strains and labral tears, to acute traumatic injuries such as hip dislocations. In this article, we review common hip pathology experienced by elite athletes and sideline management of emergent hip injuries. RECENT FINDINGS Elite athletes are subject to unique physical and mental stresses and therefore must be evaluated and treated in a unique manner. Hip and groin injuries account for approximately 6% of sport injuries overall and 3-15% of all injuries in professional sports. Hip sideline emergencies were rare but can include hip dislocations, subluxations, and avulsion fractures. Hip and groin injuries represent an important subset of injuries which can greatly impact an athlete's ability to perform. Understanding the physiology and types of hip/groin injuries, which athletes are prone to injuries, the impact on recovery time, recurrence risk, and the potential need for surgery aid sports medicine physicians in decision-making.
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Affiliation(s)
- Kevin K Chen
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Emmanuel N Osadebey
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Paul G Shupe
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bonnie P Gregory
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
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Suits WH, O’Neil MM, Fogarty KJ. Acute Effects of Ice Hockey on Hip Range of Motion, Strength, and Pelvic Tilt in Competitive Male Players. Sports Health 2024; 16:616-621. [PMID: 37565469 PMCID: PMC11195869 DOI: 10.1177/19417381231190649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Ice hockey players are at high risk for hip and groin injury. Several risk factors have been identified or proposed, including lower hip rotation range of motion (ROM), lower hip adductor strength, lower ratio of hip adductor to abductor strength, and lower pelvic tilt angle. It is not known how these risk factors change acutely with ice hockey participation. HYPOTHESIS Acute exposure to ice hockey will result in a reduction in ROM, strength, and pelvic tilt angle in competitive male players. STUDY DESIGN Controlled cohort study. LEVEL OF EVIDENCE Level 3. METHODS Risk factors for hip and groin injury, including isometric hip adductor strength at 0° of flexion, the ratio of hip adductor to abductor strength, total hip rotation passive ROM in supine, and the resting pelvic tilt angle, were assessed immediately before, immediately after, and 24 hours after an ice hockey exposure in 42 competitive male ice hockey players. Rating of perceived exertion (RPE) was collected to identify the intensity of the exposure. RESULTS There was a significant decrease in total hip rotation ROM (-7.32°, P < 0.01 (-3.91, -10.70)) and hip adductor strength (-4.41 kg, P < 0.01 (-2.81, -6.00) immediately after the exposure, and a significant decrease in total hip rotation ROM (-18.54°, P < 0.01 (-14.35, -22.73)), hip adductor strength (-6.56 kg, P < 0.01 (-4.58, -8.61)), and the ratio of hip adductor to abductor strength (-0.12, P < 0.01 (-0.21, -0.45)) 24 hours after. There was no significant change in pelvic tilt found in this study immediately after or 24 hours after. There was a moderate relationship between changes in hip adductor strength and changes in the ratio of hip adductor to abductor strength (r = 0.433, P < 0.01). RPE was not significantly correlated to any of the changes observed. CONCLUSION Risk factors for hip and groin injury in ice hockey players are modifiable after a single ice hockey exposure. CLINICAL RELEVANCE The identified fluctuation of injury risk factors for hip and groin injury in ice hockey players has implications for injury risk profiling, rehabilitation, and return-to-competition decision-making.
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Affiliation(s)
- William H. Suits
- Department of Physical Therapy, University of Michigan-Flint, Flint, Michigan
- College of Health and Human Services, Western Michigan University, Kalamazoo, Michigan
| | - Margaret M. O’Neil
- Department of Physical Therapy, University of Michigan-Flint, Flint, Michigan
| | - Kieran J. Fogarty
- College of Health and Human Services, Western Michigan University, Kalamazoo, Michigan
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Magistrali M, Stefanini L, Abate M, Biancalana G, Stegagno A, Cugia P, Candoli P, Anania G, Lucchese PL, Gaddi D, Volpi P, Mariani F, Boldrini L, Filippi N, Cerrone A, Sirtori C, Battaglino P, Bravin G, Del Fabro E, Berti M, Vecchini E, Minetto MA. Epidemiology of Non-Contact Muscle Injuries in the Italian Male Elite Under-19 Football (Soccer) Championship. SPORTS MEDICINE - OPEN 2024; 10:75. [PMID: 38902551 PMCID: PMC11190129 DOI: 10.1186/s40798-024-00738-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/28/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND While extensive research exists on muscle injuries among adult football players, a notable gap persists in studies concerning younger footballers. The aim of the current study is to provide epidemiological data on the characteristics of time-loss muscle injuries in young football players participating in the Italian Under-19 male elite Championship ("Primavera 1"). RESULTS Conducted as a multicentre, prospective, observational cohort study, this research gathered injury data from the 2022-23 season across 14 of the 18 Clubs in the first Italian Under-19 championship. The cohort comprised 391 players with a mean age (± standard deviation) of 18.0 ± 0.4 years. A total of 479 injuries were reported, resulting in 14,231 days of activity lost. Of these, muscle injuries were 209 (44%), accounting for 4,519 (32%) days lost. Overall muscle injuries incidence was 1.82/1000 hours, with a mean injury burden of 39.4 days lost/1000 hours. Almost all muscle injuries (206 out of 209: 98.5%) occurred in hamstrings, quadriceps, adductors, calf and iliopsoas. Hamstrings injuries were the most burdensome (18.8 days lost/1000 hours) accounting for nearly half of all days lost due to muscle injuries. Incidence and burden of adductors injuries (0.25 injuries and 4.1 days lost/1000 hours, respectively) were found to be comparable to calf injuries (0.24 injuries and 4.7 days lost/1000 hours, respectively). Iliopsoas injuries accounted for a noteworthy portion of the total, with an injury incidence of 0.16/1000 hours and a burden of 3.3 days lost/1000 hours. Injuries with myo-tendinous or myo-aponeurotic involvement demonstrated delayed return-to-football compared to those without such involvement (35.6 vs. 18.5 days, p < 0.0001). CONCLUSIONS The study highlighted a peculiar distribution of non-contact muscle injuries among elite young football players. While hamstring injuries were confirmed as the most burdensome, incidence and burden of adductors and calf injuries were found to be similar. A significant incidence and burden of iliopsoas injuries were observed. These findings suggest potential implementations for targeted injury prevention strategies in the Italian male elite Under-19 football Championship.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Diego Gaddi
- FC Internazionale Milano SpA, Milano, Italy
- Department of Orthopedics and Traumatology, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
| | - Piero Volpi
- Istituto Clinico Humanitas IRCCS Rozzano, Milano, Italy
- FC Internazionale Milano SpA, Milano, Italy
| | | | | | | | | | | | | | - Guido Bravin
- SOC Ortopedia e Traumatologia ASUFC, Udine, Italy
- Udinese Calcio, Udine, Italy
| | | | - Mattia Berti
- Department of Knee Surgery, Policlinico Abano Terme, Abano Terme, Italy
- Hellas Verona Calcio, Verona, Italy
| | - Eugenio Vecchini
- Hellas Verona Calcio, Verona, Italy
- Clinica Ortopedica, University of Verona, Verona, Italy
| | - Marco A Minetto
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Torino, Italy
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McClean ZJ, Pasanen K, Lun V, Charest J, Herzog W, Werthner P, Black A, Vleuten RV, Lacoste E, Jordan MJ. A Biopsychosocial Model for Understanding Training Load, Fatigue, and Musculoskeletal Sport Injury in University Athletes: A Scoping Review. J Strength Cond Res 2024; 38:1177-1188. [PMID: 38781473 DOI: 10.1519/jsc.0000000000004789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
ABSTRACT McClean, ZJ, Pasanen, K, Lun, V, Charest, J, Herzog, W, Werthner, P, Black, A, Vleuten, RV, Lacoste, E, and Jordan, MJ. A biopsychosocial model for understanding training load, fatigue, and musculoskeletal sport injury in university athletes: A scoping review. J Strength Cond Res 38(6): 1177-1188, 2024-The impact of musculoskeletal (MSK) injury on athlete health and performance has been studied extensively in youth sport and elite sport. Current research examining the relationship between training load, injury, and fatigue in university athletes is sparse. Furthermore, a range of contextual factors that influence the training load-fatigue-injury relationship exist, necessitating an integrative biopsychosocial model to address primary and secondary injury prevention research. The objectives of this review were (a) to review the scientific literature examining the relationship between training load, fatigue, and MSK injury in university athletes and (b) to use this review in conjunction with a transdisciplinary research team to identify biopsychosocial factors that influence MSK injury and develop an updated, holistic biopsychosocial model to inform injury prevention research and practice in university sport. Ten articles were identified for inclusion in this review. Key findings were an absence of injury surveillance methodology and contextual factors that can influence the training load-fatigue-MSK injury relationship. We highlight the inclusion of academic load, social load, and mental health load as key variables contributing to a multifactorial, gendered environmental, scientific inquiry on sport injury and reinjury in university sport. An integrative biopsychosocial model for MSK injury in university sport is presented that can be used to study the biological, psychological, and social factors that modulate injury and reinjury risk in university athletes. Finally, we provide an example of how causal inference can be used to maximize the utility of longitudinally collected observational data that is characteristic of sport performance research in university sport.
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Affiliation(s)
- Zachary J McClean
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Kati Pasanen
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Victor Lun
- Sport Medicine Center, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Charest
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- École de Psychologie, Université Laval, Québec, Quebec, Canada; and
- Center for Sleep & Human Performance, Calgary, Alberta, Canada
| | - Walter Herzog
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Penny Werthner
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Amanda Black
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Reid Vander Vleuten
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Elise Lacoste
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Matthew J Jordan
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Sport Medicine Center, University of Calgary, Calgary, Alberta, Canada
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Hardaker NJ, Hume PA, Sims ST. Differences in Injury Profiles Between Female and Male Athletes Across the Participant Classification Framework: A Systematic Review and Meta-Analysis. Sports Med 2024; 54:1595-1665. [PMID: 38536647 DOI: 10.1007/s40279-024-02010-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Female sex is a significant determinant of anterior cruciate ligament (ACL) injury. It is not understood if sex is a key determinant of other sports-related injuries. OBJECTIVE The aim of this systematic review was to identify where differences in injury profiles are most apparent between the sexes in all sports across the six-tiered participant classification framework. METHODS This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the 'implementing PRISMA in Exercise, Rehabilitation, Sport medicine and SporTs science'(PERSiST) guidance. The databases PubMed, CINAHL, Web of Science, SPORTDiscus, Medline, Scopus, Cochrane Library and EBSCO were searched from database inception to 24 April 2023. Longitudinal, prospective and retrospective cohort studies and cross-sectional and descriptive epidemiology studies that used standard injury data collection were included. Studies were excluded if injuries were not medically diagnosed and if injuries were not reported and/or analysed by sex. Two reviewers independently extracted data and assessed study quality using the Downs and Black checklist. RESULTS Overall, 180 studies were included (8 tier-5, 40 tier-4, 98 tier-3, 30 tier-2, 5 tier-1 studies; one study included data in two tiers). Of those, 174 studies were of moderate quality and six studies were of limited quality. In sex-comparable sports, there was moderate evidence that female athletes had greater risk of knee injury (relative risk (RR) 2.7; 95% CI 1.4-5.5), foot/ankle injuries (RR 1.25; 95% CI 1.17-1.34), bone stress injury (RR 3.4; 95% CI 2.1-5.4) and concussion (RR 8.46; 95% CI 1.04-68.77) than male athletes. Male athletes were at increased risk of hip/groin injuries (RR 2.26; 95% CI 1.31-3.88) and hamstring injuries (RR 2.4; 95% CI 1.8-3.2) compared with females, particularly in dynamic sports. Male athletes were 1.8 (1.37-2.7) to 2.8 (2.45-3.24) times more likely to sustain acute fractures than female athletes, with the highest risk in competition. DISCUSSION Most studies in all cohorts were of moderate quality (mean/range of scores tier-5: 17 ± 2.2 [14-20], tier-4: 16.9 ± 1.9 [11-21], tier-3: 16.9 ± 1.5 [11-20], tier-2: 16.3 ± 2.2 [11-20], tier-1 studies: 15.6 ± 1.3 [14-17] out of 28 on the Downs and Black checklist), with only six studies of limited quality. Female athletes' propensity for bone stress injuries highlights opportunities to reinforce development of optimal bone health during adolescence and to outline the effects of energy availability. Earlier strength development and exposure to neuromuscular training programmes and modification of skill development in female athletes may be effective strategies for reducing lower limb injury risk. Key components of neuromuscular training programmes could be beneficial for reducing hip/groin and hamstring injury risk in male athletes. There may be a need for sex-specific prevention and return-to-sport protocols for sports-related concussion in female athletes. CONCLUSIONS Female sex was a key determinant of sports-related injuries beyond ACL injury including foot/ankle injury, bone stress injury and sports-related concussion. Male sex was a key determinant of hip/groin, hamstring injury and upper limb injury. TRIAL REGISTRY PROSPERO registration number: CRD42017058806 (last updated on 7th June 2023).
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Affiliation(s)
- Natalie J Hardaker
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand.
- Accident Compensation Corporation, Wellington, New Zealand.
| | - Patria A Hume
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Tech & Policy Lab, Law School, The University of Western Australia, Perth, Australia
| | - Stacy T Sims
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
- Stanford Lifestyle Medicine, Stanford University, Palo Alto, CA, USA
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Ooi MWX, Marzetti M, Rowbotham E, Bertham D, Robinson P. MRI findings in athletic groin pain: correlation of imaging with history and examination in symptomatic and asymptomatic athletes. Skeletal Radiol 2024:10.1007/s00256-024-04603-9. [PMID: 38302788 DOI: 10.1007/s00256-024-04603-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE To determine differences in prevalence and diagnostic accuracy of MRI findings between asymptomatic athletes and athletes with longstanding groin pain. MATERIALS AND METHODS One hundred twenty-three adult male athletes were approached with 85 consecutive athletes recruited. Group 1 (symptomatic, n = 34) athletes referred for longstanding groin pain (insidious onset, > 3 weeks duration). Group 2 (control, n = 51) athletes referred for injuries remote from the pelvis and no groin pain in the last 12 weeks. All referrers completed a clinical examination proforma documenting absence or presence of pelvis and hip abnormality. All patients completed the Copenhagen Hip and Groin Outcome Score (HAGOS) questionnaire and underwent a 3T MRI groin and hip protocol. MRIs were scored independently by two musculoskeletal radiologists blinded to clinical details. Statistical analysis was performed to evaluate associations between MRI findings, inter-reader reliability, clinical examination and HAGOS scores. RESULTS Pubic body subchondral bone oedema, capsule/aponeurosis junction tear and soft tissue oedema were more prevalent in the symptomatic group (p = 0.0003, 0.0273 and 0.0005, respectively) and in athletes with clinical abnormality at symphysis pubis, adductor insertion, rectus abdominis, psoas and inguinal canal (p = 0.0002, 0.0459 and 0.00002, respectively). Pubic body and subchondral oedema and capsule/aponeurosis tear and oedema significantly correlated with lower (worse) HAGOS scores (p = 0.004, 0.00009, 0.0004 and 0.002, respectively). Inter-reader reliability was excellent, 0.87 (range 0.58-1). Symphyseal bone spurring, disc protrusion and labral tears were highly prevalent in both groups. CONCLUSION Clinical assessment and MRI findings of pubic subchondral bone oedema and capsule/aponeurosis abnormality appear to be the strongest correlators with longstanding groin pain.
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Affiliation(s)
- Michelle Wei Xin Ooi
- Musculoskeletal Centre X-Ray Department, Leeds Teaching Hospitals Trust, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK
| | - Matthew Marzetti
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Emma Rowbotham
- Musculoskeletal Centre X-Ray Department, Leeds Teaching Hospitals Trust, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Dominic Bertham
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Philip Robinson
- Musculoskeletal Centre X-Ray Department, Leeds Teaching Hospitals Trust, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
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Wörner T, Kauppinen S, Eek F. Injury patterns in Swedish elite female and male ice hockey - A cross-sectional comparison of past-season's injuries. Phys Ther Sport 2024; 65:83-89. [PMID: 38091928 DOI: 10.1016/j.ptsp.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVES To describe and compare seasonal prevalence, anatomical location, severity, and onset of injuries between female and male elite ice hockey players. DESIGN Cross-sectional survey study. SETTING Elite ice hockey. PARTICIPANTS Swedish elite ice hockey players (170 females & 190 males). MAIN OUTCOME MEASURES Past season injuries reported on a modified version of the Oslo Sports Trauma Research Center overuse injury questionnaire. Proportions of players who experienced any and substantial problems, as well as respective injury severity scores were presented and compared between sexes. RESULTS Highest seasonal prevalence was reported for hip/groin [31.1% (n = 112)], lower back [24.2% (n = 87)], and shoulder injuries [23.6% (n = 85)]. Prevalence of injuries was approximately similar between sexes. Substantial injuries were most prevalent in the hip/groin (13.3% [n = 48]) and knee (18.6% [n = 67]) region. Females reported a higher proportion of substantial hip/groin injuries. Most reported injuries were acute except for hip/groin and lower back injuries (74.4% and 81.8% due to overuse). CONCLUSION Seasonal prevalence of injuries in elite ice hockey players were comparable between sexes. Acute injuries were most common but hip/groin as well as lower back injuries were predominantly due to overuse. The highest reported prevalence was found for hip and groin-, lower back-, and shoulder injuries.
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Affiliation(s)
- Tobias Wörner
- Department of Health Sciences, Lund University, Lund, Sweden; Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
| | - Stefan Kauppinen
- Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
| | - Frida Eek
- Department of Health Sciences, Lund University, Lund, Sweden.
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Malam Moussa Ahmet H, Bika Lele EC, Guessogo WR, Bian WM, Guyot J, Ahmadou, Assomo-Ndemba PB, Ayina CN, Kojom Foko LP, Dupré C, Barth N, Bongue B, Ba A, Samb A, Mandengue SH, Mekoulou Ndongo J. Musculoskeletal pains among amateur and professional athletes of five disciplines in Senegal: a preliminary study. BMC Musculoskelet Disord 2023; 24:210. [PMID: 36949497 PMCID: PMC10031927 DOI: 10.1186/s12891-023-06275-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 02/27/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Musculoskeletal pains (MSPs) in sport are cause of poor performances and loss of competition in athletes. The present study aimed at determining the prevalence of MSPs with regard to sport disciplines and athletic status. METHODS A cross-sectional study was conducted among 320 Senegalese professional and amateur athletes practicing football, basketball, rugby, tennis, athletics, and wrestling. Rates of MSPs in the past year (MSPs-12) and week (MSPs-7d) were assessed using standard questionnaires. RESULTS Overall proportions of MSPs-12 and MSPs-7d were 70 and 74.2%, respectively. MSPs-12 were more frequently reported on shoulders (40.6%), neck (37.1%) and hips/thigh (34.4%), while MSPs-7d were predominant on hips/thigh (29.5%), shoulders (25.7%), and upper back (17.2%). Proportions of MSPs-12 and MSPs-7d varied significantly by sport disciplines, with highest values among basketball players. Again, highest MSPs-12 proportions on shoulders (29.7%, P = 0.02), wrists/hands (34.6%, P = 0.001), (40.2%, P = 0.0002), and knees (38.8%, P = 0.002) were seen among basketball players. High proportions of MSPs-7d were seen on shoulders (29.6%, P = 0.04) for tennis players, wrists/hands (29.4%, P = 0.03) for basketball and football players, and hips/thigh (38.8%, P < 0.00001) for basketball players. Football players had reduced risk of MSPs-12 by 75% on lower back (OR = 0.25; 95% CI. 0.10-0.63; P = 0.003) and by 72% on knees (OR = 0.28; 95% CI. 0.08-0. 95; P = 0.04). In contrast, tennis players were more at risk of MSPs-12 on shoulders (OR = 3.14; 95% CI. 1.14-8.68; P = 0.02), wrists/hands (OR = 5.18; 95% CI.1.40-11.13; P = 0.01), and hips/thigh (OR = 2.90; 95% CI. 1.1-8.38; P = 0.04). Professionals were protected from MSPs-12 on neck pain with a significant reduction of risk by 61% (OR = 0.39, 95% CI. 0.21-0.75, P = 0.03). CONCLUSION MSPs are a reality among athletes and their risk is modulated by sport disciplines, athletic status and gender.
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Affiliation(s)
| | - Elysée Claude Bika Lele
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | | | - Wiliam Mbang Bian
- National Institute for Youth and Sports Yaounde, University of Yaounde I, Yaounde, Cameroon
| | - Jessica Guyot
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, University Jean Monnet, Saint-Etienne, 42023, France
| | - Ahmadou
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Peguy Brice Assomo-Ndemba
- Department of Physiology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Clarisse Noel Ayina
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Loick Pradel Kojom Foko
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Caroline Dupré
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, University Jean Monnet, Saint-Etienne, 42023, France
| | - Nathalie Barth
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, University Jean Monnet, Saint-Etienne, 42023, France
| | - Bienvenu Bongue
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, University Jean Monnet, Saint-Etienne, 42023, France
| | - Abdoulaye Ba
- Laboratory of Physiology and Functional Explorations, Faculty of Medicine, Pharmacy and Dentistry, University of Cheikh Anta Diop Dakar, Dakar, Senegal
| | - Abdoulaye Samb
- Laboratory of Physiology and Functional Explorations, Faculty of Medicine, Pharmacy and Dentistry, University of Cheikh Anta Diop Dakar, Dakar, Senegal
| | - Samuel Honoré Mandengue
- Laboratory of Physiology and Functional Explorations, Faculty of Medicine, Pharmacy and Dentistry, University of Cheikh Anta Diop Dakar, Dakar, Senegal
| | - Jerson Mekoulou Ndongo
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon.
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Chan JJ, Xiao RC, Hasija R, Huang HH, Kim JM. Epidemiology of Hand and Wrist Injuries in Collegiate-Level Athletes in the United States. J Hand Surg Am 2023; 48:307.e1-307.e7. [PMID: 34895779 DOI: 10.1016/j.jhsa.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/26/2021] [Accepted: 10/27/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE Hand and wrist injuries are common among competitive athletes and can have a substantial impact on playing time and future participation. The purpose of this study was to provide epidemiological data from the National Collegiate Athletic Association Injury Surveillance Program to correlate injury diagnosis with the need for surgery and time loss. METHODS Using the National Collegiate Athletic Association Injury Surveillance Program, this retrospective study extracted data of hand and wrist injuries for all 25 National Collegiate Athletic Association sports from the academic years 2004-2005 to 2013-2014. The "severe" category was defined as injuries resulting in the following: (1) surgery, (2) season-ending status, or (3) more than 30 days of playing time loss. The epidemiologic data included injury rate per 100,000 athlete exposures (defined as 1 athlete participating in 1 practice or competition) based on diagnoses and demographic information such as sports and sex. We used a Poisson regression model to estimate the incidence rate and 95% confidence interval. RESULTS Overall, 4,851 hand injuries were identified, with an injury rate of 41.2 per 100,000 athlete exposures. The most common diagnoses were metacarpal or phalangeal fractures (19.9%), lacerations or contusions (15.4%), and wrist sprains (14.7%). The surgical rate was 9.6%, and the season-ending rate was 5.8%. Severe injuries occurred in 17.5% of the hand and wrist injuries; within this subset, the most common diagnoses included metacarpal or phalangeal fractures (43.8%), scaphoid fractures (12.8%), and thumb ulnar collateral ligament tears (8.7%). Scaphoid fractures and metacarpal or phalangeal fractures had the highest surgical rate and season-ending rate among all the injuries. CONCLUSIONS The injury rate of hand and wrist injuries is comparable with those of other common sports injuries. Approximately one fifth of the injuries were considered severe, which led to a high surgical rate, and these had a considerable impact on the athletes' ability to finish the season. TYPE OF STUDY/LEVEL OF EVIDENCE Outcome research level II.
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Affiliation(s)
- Jimmy J Chan
- Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ryan C Xiao
- Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Rohit Hasija
- Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hsin-Hui Huang
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jaehon M Kim
- Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
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10
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Zilles G, Grim C, Wegener F, Engelhardt M, Hotfiel T, Hoppe MW. [Groin pain in sports games: a systematic review]. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2023; 37:18-36. [PMID: 36878218 DOI: 10.1055/a-1912-4642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
BACKGROUND In sports games, epidemiological data show that groin pain is relatively common and can lead to repeated loss of time. Consequently, it is essential to be aware of the evidence-based prevention strategies. The aim of this systematic review was to examine risk factors and prevention strategies for groin pain and to rank them based on their evidence in sports games. METHODS The review was conducted according to the PRISMA guidelines, using a PICO-scheme in the PubMed, Web of Science and SPOLIT databases. We included all available intervention and observational studies on the influence of risk factors and prevention strategies on groin pain in sports games. The methodological quality and level of evidence was assessed using the PEDro-Scale and OCEBM model, respectively. Finally, the quantity, quality and level of evidence was used to rank each risk factor for its grade. RESULTS Moderate evidence was found for four risk factors that significantly influence the risk of groin pain: male sex, previous groin pain, hip adductor strength and not participating in the FIFA 11+ Kids. Moreover, moderate evidence was found for the following non-significant risk factors: older age, body height and weight, higher BMI, body fat percentage, playing position, leg dominance, training exposure, reduced hip abduction, adduction, extension, flexion, and internal rotation-ROM, hip flexor strength, hip abductor, adductor, flexor and core strengthening with balance exercises, clinical hip mobility tests and physical capacities. CONCLUSION The identified risk factors can be considered when developing prevention strategies to reduce the risk of groin pain in sports games. Thereby, not only the significant, but also the non-significant risk factors should be considered for prioritisation.
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Affiliation(s)
- Gabriel Zilles
- Bewegungs- und Trainingswissenschaft, Sportwissenschaftliche Fakultät, Universität Leipzig, Leipzig, GERMANY
| | - Casper Grim
- Osnabrücker Zentrum für Muskuloskelettale Chirurgie, Klinikum Osnabrück, Osnabrück, GERMANY
| | - Florian Wegener
- Bewegungs- und Trainingswissenschaft, Sportwissenschaftliche Fakultät, Universität Leipzig, Leipzig, GERMANY
| | - Martin Engelhardt
- Osnabrücker Zentrum für Muskuloskelettale Chirurgie, Klinikum Osnabrück, Osnabrück, GERMANY
| | - Thilo Hotfiel
- Osnabrücker Zentrum für Muskuloskelettale Chirurgie, Klinikum Osnabrück, Osnabrück, GERMANY
| | - Matthias Wilhelm Hoppe
- Bewegungs- und Trainingswissenschaft, Sportwissenschaftliche Fakultät, Universität Leipzig, Leipzig, GERMANY
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11
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Tramer JS, Jildeh TR, Castle JP, Buckley P, Nowak C, Okoroha KR. The impact of nonoperative hip and core injuries on National Football League athlete performance. PHYSICIAN SPORTSMED 2023; 51:27-32. [PMID: 34488522 DOI: 10.1080/00913847.2021.1976603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Hip and core injuries are common in National Football League (NFL) athletes; however, the impact following injury remains unclear. The goal of this manuscript was to determine the impact of nonoperative hip and core injuries on return to play and performance. METHODS NFL athletes who sustained a hip or core injury treated nonoperatively between 2010 and 2016 were identified. Offensive and defensive power ratings were calculated for each player's injury season and two seasons before and after to assess longitudinal impact. A matched control group without an identified hip and/or core injury was assembled for comparison. RESULTS A total of 41 offensive and 71 defensive players with nonoperative hip or core injury were analyzed. All athletes returned to play; offensive and defensive players missed 4.0 ± 5.2 and 3.1 ± 2.6 games after injury, respectively. Offensive players played fewer cumulative career games returning from core injury versus hip (23.5 ± 20.6 vs 41.0 ± 26.4). Defensive players played fewer games (58.1 ± 41.1 versus 37.4 ± 27.1, p < 0.05) with lower defensive power rating (133.9 ± 128.5 versus 219.8 ± 212.2, p < 0.05) cumulatively after hip or core injury. Additionally, 2 years following injury, defensive players played fewer games compared to controls (9.5 ± 7.0 versus 10.9 ± 6.8, p < 0.05). Following hip injury specifically, NFL defenders played fewer games (39.8 ± 27.9 vs 61.9 ± 38.8; p < 0.05) and had a lower defensive power rating (145.9 ± 131.7 vs 239.0 ± 205.9; p < 0.05) compared to before injury. CONCLUSION Overall, NFL players return to play following nonoperative hip and core injuries. Defensive players played in fewer games following hip or core injury compared to controls; offensive players were unaffected. Hip injuries have a greater impact on performance compared to core injuries in defensive athletes; offensive players played fewer games upon return from core injury.
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Affiliation(s)
- Joseph S Tramer
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, United States
| | - Toufic R Jildeh
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, United States
| | - Joshua P Castle
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, United States
| | - Patrick Buckley
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, United States
| | - Caden Nowak
- Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Kelechi R Okoroha
- Department of Orthopedic Surgery, Division of Sports Medicine, Mayo Clinic, Minneapolis, Minnesota, United States
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12
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Town CM, Gyemi DL, Ellis Z, Kahelin C, Laing AC, Andrews DM. Predicting soft tissue thicknesses overlying the iliac crests and greater trochanters of younger and older adults. PLoS One 2023; 18:e0283012. [PMID: 36917601 PMCID: PMC10013917 DOI: 10.1371/journal.pone.0283012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023] Open
Abstract
Soft tissues overlying the hip play a critical role in protecting against fractures during fall-related hip impacts. Consequently, the development of an efficient and cost-effective method for estimating hip soft tissue thicknesses in living people may prove to be valuable for assessing an individual's injury risk and need to adopt preventative measures. The present study used multiple linear stepwise regression to generate prediction equations from participant characteristics (i.e., height, sex) and anthropometric measurements of the pelvis, trunk, and thigh to estimate soft tissue thickness at the iliac crests (IC) and greater trochanters (GT) in younger (16-35 years of age: 37 males, 37 females) and older (36-65 years of age: 38 males, 38 females) adults. Equations were validated against soft tissue thicknesses measured from full body Dual-energy X-ray Absorptiometry scans of independent samples (younger: 13 males, 13 females; older: 13 males, 12 females). Younger adult prediction equations exhibited adjusted R2 values ranging from 0.704 to 0.791, with more explained variance for soft tissue thicknesses at the GT than the IC; corresponding values for the older adult equations were higher overall and ranged from 0.819 to 0.852. Predicted and actual soft tissue thicknesses were significantly correlated for both the younger (R2 = 0.466 to 0.738) and older (R2 = 0.842 to 0.848) adults, averaging ≤ 0.75cm of error. This research demonstrates that soft tissue thicknesses overlying the GT and IC can be accurately predicted from equations using anthropometric measurements. These equations can be used by clinicians to identify individuals at higher risk of hip fractures who may benefit from the use of preventative measures.
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Affiliation(s)
- Claudia M. Town
- Department of Kinesiology, University of Windsor, Windsor, Ontario, Canada
- * E-mail:
| | - Danielle L. Gyemi
- Department of Kinesiology, University of Windsor, Windsor, Ontario, Canada
| | - Zoe Ellis
- Department of Kinesiology, University of Windsor, Windsor, Ontario, Canada
| | - Charles Kahelin
- Department of Kinesiology, University of Windsor, Windsor, Ontario, Canada
| | - Andrew C. Laing
- Department of Kinesiology, University of Windsor, Windsor, Ontario, Canada
| | - David M. Andrews
- Department of Kinesiology, University of Windsor, Windsor, Ontario, Canada
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13
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Return to Play in Long-Standing Adductor-Related Groin Pain: A Delphi Study Among Experts. SPORTS MEDICINE - OPEN 2022; 8:11. [PMID: 35043267 PMCID: PMC8766680 DOI: 10.1186/s40798-021-00400-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 12/21/2021] [Indexed: 11/10/2022]
Abstract
Background Groin pain is a very common injury in multidirectional sports such as soccer, ice hockey, rugby and Australian football. Long-standing adductor-related groin pain is a persistent clinical condition and a frequent complaint in athletes involved in sports that require multiplanar movement patterns (change of direction, high-speed sprinting and kicking). To date, the lack of rehabilitation guidelines and return-to-play criteria makes this clinical entity difficult to manage. The aim of the present Delphi was to suggest, based on opinion and practical experience of a panel of experts, potential criteria that could be taken into consideration by clinicians in the RTP decision-making process in athletes suffering from long-standing adductor-related groin pain. Methods Thirty two out of 40 experts participated to a 3-Round Delphi questionnaire. In round 1, open-ended and closed questions about 9 different sections (palpation, flexibility, strength, patient-reported outcome measures, imaging, intersegmental control, performance tests, sport-specific skills, training load) were proposed to investigate return to play evaluation criteria used by each expert. Responses were analysed and coded to produce round 2 questionnaire that investigated only the sections and the items that reached the cut-off value (≥ 70%). Round 3 questionnaire was based on sections and items that reached cut-off value in previous rounds and experts rated their agreement for return to play criteria with a 5-point Likert Scale. Descriptive statistics enabled interpretation of consensus. Results High participation rate (80%) and response rate across the 3 rounds (100%) were recorded. 6 sections reached positive consensus in round 1, 1 section reached negative consensus. In round 2 positive consensus was confirmed only for 3 sections and negative consensus for 1 section. In round 3, positive agreement was established for strength (3 items), performance tests (3 items) and sport-specific skills (2 items) sections. Negative consensus was confirmed for imaging section. Conclusion Experts agreed that strength, performance tests and sport-specific skills can be used to support RTP decision, while imaging cannot be used. These findings could be useful in assisting clinicians in the RTP decision making. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-021-00400-z.
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14
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Fasulo SM, Dávila Castrodad IM, Kraeutler MJ, Doerr N, Talishinskiy T, Scillia AJ. Robotic Abdominal Wall Repair with Endoscopic Adductor Lengthening: A Minimally Invasive Approach for Core Muscle Injuries. Arthrosc Tech 2022; 11:e2233-e2241. [PMID: 36632407 PMCID: PMC9827066 DOI: 10.1016/j.eats.2022.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022] Open
Abstract
Groin pain is a common complaint in sports medicine practices but can be a challenge to accurately diagnose given the expanse of differentials. In the athlete, groin pain may be caused by a core muscle injury, also known as sports hernia or athletic pubalgia. These injuries most frequently occur in young males who participate in explosive and rotationally demanding activities such as soccer, football, and ice hockey, which generate large forces across the trunk and hip joint. These injuries are becoming more frequently diagnosed, in part, due to the utilization of diagnostic modalities, such as dynamic ultrasound and magnetic resonance imaging (MRI) and sensitive physical examination tests, such as the cross-body sit-up and squeeze test. When conservative management fails, surgical intervention is a good option for the athletes who desire to return to play. Surgical options include both open and laparoscopic techniques to repair abdominopelvic defects with or without attention to adductor pathology. The purpose of this article is to present a technique for minimally invasive robotic abdominal wall repair with endoscopic adductor lengthening for core muscle injuries.
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Affiliation(s)
- Sydney M. Fasulo
- Department of Orthopaedic Surgery, St. Joseph’s University Medical Center, Paterson, New Jersey, U.S.A
| | - Iciar M. Dávila Castrodad
- Department of Orthopaedic Surgery, St. Joseph’s University Medical Center, Paterson, New Jersey, U.S.A
| | - Matthew J. Kraeutler
- Department of Orthopaedic Surgery, St. Joseph’s University Medical Center, Paterson, New Jersey, U.S.A
| | - Nikki Doerr
- Rowan University School of Osteopathic Medicine, Stratford, New Jersey, U.S.A
| | - Toghrul Talishinskiy
- Department of Orthopaedic Surgery, St. Joseph’s University Medical Center, Paterson, New Jersey, U.S.A.,Rowan University School of Osteopathic Medicine, Stratford, New Jersey, U.S.A
| | - Anthony J. Scillia
- Department of Orthopaedic Surgery, St. Joseph’s University Medical Center, Paterson, New Jersey, U.S.A.,Seton Hall University, South Orange, New Jersey, U.S.A.,Hackensack Meridian School of Medicine, Nutley, New Jersey, U.S.A.,Address correspondence to Anthony J. Scillia, M.D., St. Joseph’s University Medical Center, Department of Orthopaedic Surgery, 703 Main St., Paterson, NJ 07503, U.S.A.
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15
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Marušič J, Šarabon N. Hip adduction and abduction strength in youth male soccer and basketball players with and without groin pain in the past year. PLoS One 2022; 17:e0275650. [PMID: 36197941 PMCID: PMC9534424 DOI: 10.1371/journal.pone.0275650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
The objectives of this study were to 1) assess the differences between youth soccer and basketball players with and without past year groin pain (GP) in hip adduction and abduction strength and several training characteristics (age at the start of regular training, weekly training frequency, warm-up and training duration, use of stretching and/or stabilisation exercises during warm-up, use of resistance training); 2) present strength reference values for youth soccer and basketball players. 227 players participated (age 16.9 ± 1.4 years; height 184.2 ± 8.5 cm; mass 75.5 ± 11.9 kg). Hip adduction and abduction strength was measured in supine position (hip, knee and ankle in neutral position) using a MuscleBoard dynamometer. Interlimb asymmetries and hip adduction:abduction ratios were calculated. Past year GP and training characteristics were assessed with a retrospective questionnaire. 11.9% of players reported past year GP (16.9% in soccer and 6.4% in basketball). The only significant difference between the past year GP and the control groups was found in the age of the players at the start of regular training (7.2 ± 1.8 years for the GP group vs. 8.5 ± 2.6 years for the control group). Additionally, soccer players without past year GP have significantly higher hip adduction strength (1.1 ± 0.2 Nm/kg vs. 1.0 ± 0.2 Nm/kg) and adduction:abduction strength ratio (1.10 ± 0.18 vs. 1.03 ± 0.16) compared to basketball players. Our results show that hip adduction and abduction strength, interlimb asymmetry and hip adduction:abduction ratio do not differentiate between players with and without past year GP (p = 0.29-0.90), which means that their adduction or abduction strength can be analysed regardless of the GP presence in the past year. Additionally, players with past year GP started regularly training at significantly lower age, which could indicate the problematic nature of early/premature sports specialisation.
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Affiliation(s)
- Jan Marušič
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Science to Practice, Ltd., Laboratory for Motor Control and Motor Behavior, Ljubljana, Slovenia
- * E-mail:
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16
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Groin Pain in Athletes. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00364-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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17
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Ross KA, Fried JW, Bloom DA, Gonzalez-Lomas G. The effect of specialization and level of competition on injury in elite male ice hockey players. PHYSICIAN SPORTSMED 2022; 50:295-300. [PMID: 33840376 DOI: 10.1080/00913847.2021.1916786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Young players experience pressure to focus on ice hockey at the exclusion of other sports in order to improve chances of success. Early specialization in other sports has been associated with increased injury without the benefit of improved success. The objective of the current study was to investigate whether earlier specialization results in increased injury without higher rates of career success. This study also aimed to compare rates of injury in athletes at various levels of competition. METHODS An original survey was issued to men's ice hockey players at the juniorA, collegiate, and professional levels. The survey consisted of 34 questions on various demographic, specialization, and injury variables. All participants were >18 years of age. RESULTS The survey was completed by 101 athletes. The mean age at specialization was 13 (±4) overall and 14 (±3), 13 (±4), and 11(±4) for professional, collegiate, and junior players, respectively. There was no difference in age at specialization between each group and professional players did not specialize earlier than the remainder of the cohort as a whole (p > 0.05). There was no significant correlation between age at specialization and total injuries (p > 0.05). There was no difference in concussions causing missed play time between groups (p > 0.05) but professional players had more overall concussions and underwent more surgeries due to hockey-related injuries (p = 0.01). CONCLUSIONS Specializing exclusively in ice hockey earlier in life was not associated with playing professionally. Both collegiate and professional players do not tend to specialize prior to age 12. Age at specialization was not associated with overall number of injuries. Professional players with longer careers appear to sustain more concussions and undergo more surgery.
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Affiliation(s)
- Keir A Ross
- Department of Orthopedic Surgery, New York University School of Medicine, New York, NY 10003, USA
| | - Jordan W Fried
- Department of Orthopedic Surgery, New York University School of Medicine, New York, NY 10003, USA
| | - David A Bloom
- Department of Orthopedic Surgery, New York University School of Medicine, New York, NY 10003, USA
| | - Guillem Gonzalez-Lomas
- Department of Orthopedic Surgery, New York University School of Medicine, New York, NY 10003, USA
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18
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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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19
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Risk Factors for Groin Pain in Male High School Soccer Players Undergoing an Injury Prevention Program: A Cluster Randomized Controlled Trial. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Little is known about the risk factors for developing groin pain in high school soccer players. Therefore, the purpose of the study is to investigate the risk factors for developing inguinal pain in high school soccer players who are undergoing an injury prevention program. A cluster randomized controlled trial was conducted on 202 high school soccer players. Players were allocated to either group A (3 schools, 66 players) receiving the Copenhagen adduction exercise (CAE) alone, or group B (2 schools, 73 players) receiving the CAE and Nordic hamstrings exercise, or group C, the control group without any intervention (2 schools, 63 players). Hip range of motion (ROM) and strength measures were assessed prior to a groin injury prevention program and used in univariate and multivariate analysis to predict development of groin pain. Logistic regression analysis identified that hip abduction ROM and eccentric adductor strength of the dominant leg were factors in the development of groin pain. Increased abduction ROM and decreased eccentric adductor muscle strength of the dominant leg were risk factors for the development of groin pain.
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Szukics PF, Otlans PT, Arevalo A, Meade M, DeLuca P, Salvo JP. A Scoping Review of Injuries in Amateur and Professional Men’s Ice Hockey. Orthop J Sports Med 2022; 10:23259671221085968. [PMID: 35464903 PMCID: PMC9019336 DOI: 10.1177/23259671221085968] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/31/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Orthopaedic injuries are common in ice hockey at all levels and can result in physical and psychological adverse effects on these athletes. Purpose: Primarily, to summarize published data on orthopaedic hockey injuries at the junior through professional level. Secondarily, to characterize the literature based on anatomic site injured, return-to-play rates, cause/mechanism of injury, time lost, and treatments used. Study Design: Scoping review; Level of evidence, 4. Methods: PubMed, EMBASE, Cochrane library, and SCOPUS were searched using the terms “hockey” and “injuries” using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and 4163 studies involving orthopaedic injuries were identified. Our inclusion criteria consisted of accessible full-text articles that evaluated orthopaedic injuries in men’s ice hockey athletes of all levels. We excluded case reports and articles evaluating women’s ice hockey injuries, as well as those evaluating nonorthopaedic injuries, such as concussions; traumatic brain injuries; and facial, dental, and vascular injuries, among others. Studies were divided based on level of play and anatomic site of injury. Level of evidence, year published, country of corresponding author, method of data collection, incidence of injury per athlete-exposure, and time lost were extracted from each article. Results: A total of 92 articles met the inclusion criteria and were performed between 1975 and 2020, with the majority published between 2015 and 2020. These were divided into 8 anatomic sites: nonanatomic-specific (37%), intra-articular hip (20.7%), shoulder (9.8%), knee (8.7%), trunk/pelvis (7.6%), spine (7.6%), foot/ankle (6.5%), and hand/wrist (2.2%). Of these studies, 71% were level 4 evidence. Data were obtained mostly via surveillance programs and searches of publicly available information (eg, injury reports, player profiles, and press releases). Conclusion: This scoping review provides men’s hockey players and physicians taking care of elite ice hockey athletes of all levels with a single source of the most current literature regarding orthopaedic injuries. Most research focused on nonanatomic-specific injuries, intra-articular hip injuries, knee injuries, and shoulder injuries, with the majority having level 4 evidence.
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Affiliation(s)
- Patrick F. Szukics
- Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Peters T. Otlans
- Proliance Southwest Seattle Orthopedics, Seattle, Washington, USA
| | - Alfonso Arevalo
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
| | - Matthew Meade
- Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Peter DeLuca
- Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - John P. Salvo
- Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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21
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Safran MR, Foard SJ, Robell K, Pullen WM. Incidence of Symptomatic Femoroacetabular Impingement: A 4-Year Study at a National Collegiate Athletic Association Division I Institution. Orthop J Sports Med 2022; 10:23259671221084979. [PMID: 35434170 PMCID: PMC9008859 DOI: 10.1177/23259671221084979] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Femoroacetabular impingement (FAI) is an increasingly recognized
cause of hip pain in young athletes. Although there are multiple
studies that describe the radiographic prevalence of FAI in
athletes, its true incidence within this population is
unknown. Purpose: To report on the overall and sport-specific incidence of
symptomatic FAI in National Collegiate Athletic Association
(NCAA) Division I athletes. Return-to-sport times were reported
for patients treated operatively. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted to identify all reported hip
injuries within a large, multisport NCAA Division I institution.
Hip injuries were stratified into FAI, general pain/dysfunction,
musculotendinous, ligament, bursitis, bone stress, contusion,
and other. FAI was diagnosed based on history, physical
examinations, imaging, and symptomatic relief after a diagnostic
injection. Descriptive statistics were used to calculate the
overall and sport-specific incidence, and chi-square analysis
was performed to identify contingency data. Results: In a 3-year period, a total of 5319 musculoskeletal injuries
occurred in 1072 athletes. There were 491 (9.2%) hip injuries
that occurred in 288 athletes, of which 40 injuries were FAI.
The overall incidence of symptomatic FAI was 3.0% of the total
population, 3.7% of all injured athletes, and 13.9% of athletic
hip injuries. There were no statistically significant
differences in FAI rates among male and female athletes overall
or among male and female athletes within similar sports. Of the
19 athletes who were treated nonoperatively, 2 failed to return
to play: 1 secondary to multiple musculoskeletal injuries and 1
related to cardiac issues. There were 21 hips in 20 patients
that were treated operatively, with 1 athlete failing to return
to sport. Return to play occurred at a mean of 202 days (range,
81-360 days) after hip arthroscopic surgery. Conclusion: In this large, multisport NCAA Division I cohort, the overall
incidence of symptomatic FAI was 3.0% and represented 13.9% of
hip injuries. The successful management of FAI with return to
play was achieved by both nonoperative and operative treatment
methods. The relatively low incidence of symptomatic FAI,
despite reports of a high prevalence of FAI morphology in
athletes, serves to emphasize the importance of clinical
evaluations in treating patients with FAI.
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Affiliation(s)
- Marc R. Safran
- Department of Orthopaedic Surgery, Stanford University, Redwood City, California, USA
| | | | | | - W. Michael Pullen
- Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
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22
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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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23
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Ultrasound Shear Modulus and Thickness of Lateral Abdominal Muscles in Different Contractile States in Relation to Self‐ Reported Hip/Groin Problems in Youth Soccer Players. J Hum Kinet 2022; 81:97-108. [PMID: 35291629 PMCID: PMC8884866 DOI: 10.2478/hukin-2022-0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To date, no studies have assessed lateral abdominal muscles’ (LAM) elasticity and thickness in relation to hip and groin symptoms in any population. The objectives were to a) assess the relationship between LAM ultrasound measurements (elasticity and thickness) and self-reported subscales of the Copenhagen Hip and Groin Outcome Score (HAGOS) and b) compare LAM elasticity and thickness between asymptomatic and symptomatic sides. Shear modulus and thickness of the oblique external (OE), internal (OI) and transversus abdominis (TrA) muscles in 25 young soccer players were assessed at rest and during isometric contraction using ultrasound shear wave elastography. HAGOS subscales were used to assess self-reported hip/groin problems. There was a significant (p < 0.05) moderate correlation between allometric-scaled OI resting thickness (mean of right and left) and the Activities of Daily Living (r = 0.40), Sport (r = 0.57) and Quality of Life (QOL) (r = 0.41) HAGOS subscales. Also, a moderate significant correlation was found between allometric-scaled TrA resting thickness and the QOL subscale (r = 0.47). Moderate correlations were found between resting OI shear modulus and the QOL (r = 0.44), between right TrA shear modulus during contraction and Symptoms (r = 0.57), and between the left TrA shear modulus during contraction and Physical Activity (r = 0.41) subscales. No differences were found between the symptomatic and asymptomatic side in thickness and elasticity measurements among soccer players with unilateral symptoms (p > 0.05). The relationships found between LAM and hip/groin problems in youth male soccer players indicate that muscles are thinner and more elastic (less stiff) in more symptomatic athletes.
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24
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Rice RP, Roach K, Kirk-Sanchez N, Waltz B, Ellenbecker TS, Jayanthi N, Raya M. Age and Gender Differences in Injuries and Risk Factors in Elite Junior and Professional Tennis Players. Sports Health 2022; 14:466-477. [PMID: 35037501 PMCID: PMC9214903 DOI: 10.1177/19417381211062834] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Elite tennis athletes experience injuries throughout the entire body. Impairments in trunk stability, lower limb flexibility, and hip range of motion (ROM) are modifiable risk factors that can impact injuries and performance. Information on nonmodifiable risk factors such as age and gender is limited. The purpose of this investigation was to provide information on risk factors to direct clinical decision-making and injury prevention and rehab programming in this population. HYPOTHESIS Prevalence and location of injuries will differ by age group and gender. Trunk stability, lower limb flexibility, and hip ROM will differ by age group and gender. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS A de-identified database (n = 237; females = 126) from the United States Tennis Association High Performance Profile (HPP) 2014-2015 was used for the analysis. Subjects were elite junior and professional tennis players (mean age 14.6 [range, 9-27] years). The HPP is a tennis-specific assessment and questionnaire that includes retrospective information on injury history. Subjects were categorized by injury, gender, and age. Injury locations were classified by region. Trunk stability measures included drop vertical jump (DVJ), single-leg squat, and prone and side planks. Lower limb measures included hamstring, quadriceps and hip flexor flexibility, and hip rotation ROM. RESULTS A total of 46% of athletes reported an injury. Significant differences were found for injury prevalence and location by age group. Adolescent athletes (age 13-17 years) had more trunk injuries, while adult athletes (age ≥18 years) had more lower limb injuries. Adolescent athletes performed worse on DVJ, dominant side plank, and hamstring flexibility compared with young (age ≤12 years) and adult athletes. Significant gender differences in hip ROM included internal rotation on both the dominant and nondominant sides. CONCLUSION Impairments in trunk stability, lower limb flexibility, and hip rotation ROM may affect both health and performance outcomes in this population. Elite tennis athletes may benefit from additional off court programming to address trunk and lower limb impairments. CLINICAL RELEVANCE Adolescent elite tennis athletes may be at higher risk of trunk injuries. Age, gender, injury history, and impairments should be considered with all assessments and programming.
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Affiliation(s)
- Robyn Porter Rice
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida,Robyn Porter Rice, PT, PhD, Department of Physical Therapy, Miller School of Medicine, University of Miami, 5915 Ponce de Leon Boulevard, Coral Gables FL 33146 () (Twitter: @RiceRobynp)
| | - Kathryn Roach
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida
| | - Neva Kirk-Sanchez
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida
| | - Bret Waltz
- DocWaltz LLC, Scottsdale, Arizona,USTA Player Development, Orlando, Florida
| | - Todd S. Ellenbecker
- Vice President Medical Services, ATP Tour, Ponte Vedra Beach, Florida,Rehab Plus Sports Therapy Scottsdale, Scottsdale, Arizona
| | - Neeru Jayanthi
- Emory Sports Medicine Center, Department of Orthopedic Surgery and Family Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Michele Raya
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida
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25
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Wörner T, Thorborg K, Clarsen B, Eek F. Incidence, Prevalence, and Severity of and Risk Factors for Hip and Groin Problems in Swedish Male Ice Hockey Players: A 1-Season Prospective Cohort Study. J Athl Train 2022; 57:72-78. [PMID: 34038950 PMCID: PMC8775280 DOI: 10.4085/1062-6050-0522.20] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT The epidemiologic focus on time loss may underestimate the true magnitude of hip and groin problems in male ice hockey players. OBJECTIVE To describe the prevalence, incidence, and severity of hip and groin problems (time loss and non-time loss) in Swedish ice hockey players over the course of a season and explore potential preseason risk factors for these conditions. DESIGN Prospective 1-season cohort study. SETTING Professional and semiprofessional Swedish ice hockey players. PATIENTS OR OTHER PARTICIPANTS A total of 12 professional and semiprofessional male ice hockey teams were invited to participate. Of those, 9 teams agreed, and 163 players were included in the analyses. MAIN OUTCOME MEASURE(S) Hip and groin problems in the previous season (time loss, non-time loss), isometric adduction and abduction strength, and 5-second squeeze test results were recorded before the season and served as independent variables in the risk factor analysis. Main outcome measures were cumulative incidence of hip and groin problems, average prevalence, and odds ratios (ORs) for groin problems in season. RESULTS Cumulative incidence was 45.4% (95% CI = 37.6%, 53.4%) for all problems and 19% (95% CI = 13.3%, 25.9%) for substantial problems. Average prevalence was 14.1% (95% CI = 10.8%, 17.5%) for all and 5.7% (95% CI = 4.3%, 7.2%) for substantial problems. Among reported problems, 69.2% had a gradual onset, and only 17% led to time loss. Players with non-time-loss problems in the previous season had higher odds for new problems (all: OR = 3.3 [95% CI = 1.7, 6.3]; substantial: OR = 3.6 [95% CI = 1.8, 8.4]). Preseason strength was not significantly associated with the odds for subsequent problems. CONCLUSION Hip and groin problems are common in ice hockey players and may lead to substantial impairments in performance. Only 1 in 5 problems led to time loss, and 7 in 10 had a gradual onset. Non-time-loss problems in the previous season were a significant risk factor for new problems, whereas decreased preseason hip-adduction and -abduction strength was not.
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Affiliation(s)
- Tobias Wörner
- Department of Health Sciences, Lund University, Sweden
| | - Kristian Thorborg
- Sports Orthopedic Research Center–Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Benjamin Clarsen
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Norway
| | - Frida Eek
- Department of Health Sciences, Lund University, Sweden
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26
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Bisciotti GN, Auci A, Bona S, Bisciotti A, Bisciotti A, Cassaghi G, DI Marzo F, DI Pietto F, Eirale C, Panascì M, Parra F, Zini R. Long-standing groin pain syndrome in athletic women: a multidisciplinary assessment in keeping with the italian consensus agreement. J Sports Med Phys Fitness 2021; 62:1199-1210. [PMID: 34931789 DOI: 10.23736/s0022-4707.21.13322-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Long-standing groin pain syndrome (LSGPS) is a form of groin pain syndrome in which the cohort of symptoms reported by patients is experienced for a long period, typically for over 12 weeks, and is recalcitrant to any conservative therapy. The aim of this prospective epidemiological study was to describe the clinical causes of LSGPS in 37 female athletic subjects in Italy through the Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athletes classification and guidelines. METHODS Thirty-seven female athletes affected by LSGPS were evaluated following the guidelines issued by the Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment of groin pain in athletes. RESULTS In the considered population, each patient presented only one pathological cause for LSGPS. The most frequent aetiologies were inguinal pathologies (54.05% of the cases), acetabular labrum tear (18.92%) and pelvic floor disorders (8.11%). Adductor tendinopathy represented only 2.70% of cases. CONCLUSIONS Female athletic patients affected by LSGPS show a similar incidence of inguinal and hip pathologies as in male populations. However, these clinical situations do not seem to be associated in women unlike in the male population. This difference is probably due to particular anatomical differences related to gender. For this reason, women affected by LSGPS represent an important subset of patients. Moreover, adductor tendinopathy is probably overrated as an etiopathogenetic source of LSGPS in women.
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Affiliation(s)
- Gian Nicola Bisciotti
- Paris Saint Germain FC, Paris, France - .,Kinemove Rehabilitations Center, Pontremoli, Massa Carrara, Italy -
| | - Alessio Auci
- Azienda USL Toscana Nord-Ovest, Massa Carrara, Italy
| | - Stefano Bona
- Humanitas Resarch Institute, Rozzano, Milan, Italy
| | | | - Andrea Bisciotti
- Kinemove Rehabilitations Center, Pontremoli, Massa Carrara, Italy
| | | | | | | | | | | | - Federica Parra
- Kinemove Rehabilitations Center, Pontremoli, Massa Carrara, Italy
| | - Raul Zini
- Università degli Studi di Ferrara, Ferrara, Italy.,Maria Cecilia Hospital, Cotignola, Ravenna, Italy
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27
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Collings TJ, Diamond LE, Barrett RS, Timmins RG, Hickey JT, du Moulin WS, Gonçalves BAM, Cooper C, Bourne MN. Impact of prior anterior cruciate ligament, hamstring or groin injury on lower limb strength and jump kinetics in elite female footballers. Phys Ther Sport 2021; 52:297-304. [PMID: 34742028 DOI: 10.1016/j.ptsp.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To compare lower limb strength and countermovement jump (CMJ) kinetics between elite female footballers with and without a history of anterior cruciate ligament reconstruction (ACLR), hamstring strain, or hip/groin injury. DESIGN Cross-sectional. SETTING Field-based. PARTICIPANTS 369 elite female Australian football, soccer and rugby league players aged 15-35. MAIN OUTCOME MEASURES Isometric hip adductor and abductor strength, eccentric knee flexor strength, and CMJ vertical ground reaction forces, including between-leg asymmetry. Players reported their lifetime history of ACLR, and whether they had sustained a hamstring strain, or hip/groin injury in the previous 12-months. RESULTS Players with a unilateral history of ACLR (n = 24) had significant between-leg asymmetry in eccentric knee flexor strength (mean = -6.3%, 95%CI = -8.7 to -3.9%, P < .001), isometric hip abductor strength (mean = -2.5%, 95%CI = -4.3 to -0.7%, P = .008), and CMJ peak landing force (mean = -5.5%, 95%CI = -10.9 to -0.1%, P = .046). Together, between-leg asymmetry in eccentric knee flexor strength, isometric hip abductor strength, and CMJ peak landing force distinguished between players with and without prior ACLR with 93% accuracy. CONCLUSION Elite female footballers with a history of ACLR, but not hamstring or hip/groin injury, exhibit persistent between-leg asymmetries in lower limb strength and jump kinetics following a return to sport.
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Affiliation(s)
- Tyler J Collings
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Laura E Diamond
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia; Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Rod S Barrett
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia; Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, Victoria, Australia.
| | - Jack T Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia.
| | - William S du Moulin
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Basílio A M Gonçalves
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Christopher Cooper
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Matthew N Bourne
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia.
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28
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Schaber M, Guiser Z, Brauer L, Jackson R, Banyasz J, Miletti R, Hassen-Miller A. The Neuromuscular Effects of the Copenhagen Adductor Exercise: A Systematic Review. Int J Sports Phys Ther 2021; 16:1210-1221. [PMID: 34631242 PMCID: PMC8486394 DOI: 10.26603/001c.27975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Groin strains are one of the most common time-loss injuries in athletes. The Copenhagen Adductor Exercise (CAE) eccentrically strengthens the adductors and may function to prevent adductor strains, similar to the eccentric mechanism in which the Nordic Hamstrings exercise acts to prevent hamstring strains. OBJECTIVE The purpose of this study was to systematically review the literature on the CAE and its effects on adductor muscle strength and muscle activity in athletes. STUDY DESIGN Systematic Review. METHODS A systematic search of the literature was performed in the following databases: Pubmed; Medline (EBSCO); Sportdiscus; Scopus; Web of Science; CINAHL; Proquest; Cochrane Library; Physiotherapy Evidence Database (PEDro). Inclusion criteria consisted of 1) implements CAE, 2) includes athletes of any age participating in at least one sport, 3) study type is a cohort study or randomized control trial. Studies were excluded if they were not written in English or did not measure strength as an outcome. Data were extracted on eccentric hip adductor strength (EHAD), eccentric hip abductor strength (EHAB), EHAD:EHAB ratio, and electromyography (EMG) activity of the adductor muscles. Quality assessment was performed on all included studies using Quality Assessment Tool for Quantitative Studies. RESULTS Five articles were identified for inclusion, four of which received a strong rating, and one a moderate rating on the Quality Assessment Tool for Quantitative Studies. The CAE significantly increased EHAD in four of the four studies that examined it; significantly increased EHAB and EHAD:EHAB in three of the three studies that examined them, and increased the EMG activity of the adductors in the dominant leg 108%. CONCLUSION Overall, the CAE increases EHAD, EHAB, EHAD:EHAB, and EMG activity in the hip adductors in male soccer players. The increase in strength may reduce adductor muscle injuries, although more research needs to be done in this area to identify a clear relationship between the CAE and groin injury prevention. LEVEL OF EVIDENCE 1b.
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29
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Parisien RL, Pontillo M, Farooqi AS, Trofa DP, Sennett BJ. Implementation of an Injury Prevention Program in NCAA Division I Athletics Reduces Injury-Related Health Care Costs. Orthop J Sports Med 2021; 9:23259671211029898. [PMID: 34552992 PMCID: PMC8450687 DOI: 10.1177/23259671211029898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The estimated cost per year of injuries in collegiate athletics has been
reported to be billions of dollars in the United States. Injury prevention
programs are often assessed only by their ability to reduce injuries, and
there is little evidence of any potential reduction in associated health
care costs. Purpose: To investigate changes in injury-related health care costs at a National
Collegiate Athletic Association (NCAA) Division I university after the
implementation of an injury prevention program. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 12 sports teams that used the injury prevention program (user
group) and 16 teams that did not implement the program (nonuser group). The
injury surveillance and prevention system (Sparta Science) utilized a
commercially available force-plate system to assess kinematic variables,
flag high-risk athletes, and guide individual conditioning programs. Data
were obtained from 3 academic years before (2012-2014) and 2 academic years
after (2015-2016) implementation of the Sparta Science system. The number of
injuries and associated health care costs (surgery, clinic visits, imaging,
and physical therapy) were compared between users and nonusers. Results: Total average annual injuries did not change significantly between users and
nonusers after implementation of the program; however, users demonstrated a
23% reduction in clinic visits as compared with a 14% increase for nonusers
(P = .049). Users demonstrated a 13% reduction in
associated health care encounters, compared with a 13% increase for nonusers
(P = .032). Overall health care costs changed
significantly for both groups, with an observed 19% decrease ($2,456,154 to
$1,978,799) for users and an 8% increase ($1,177,542 to $1,270,846) for
nonusers (P < .01 for both). Costs related to associated
health care encounters also decreased by 20% for users as compared with a
39% increase for nonusers (P = .027). Conclusion: This study demonstrated the ability to significantly reduce injury-related
health care costs in NCAA Division I athletes via a comprehensive injury
surveillance and prevention program utilizing force-plate technology. Given
the substantial and appropriate focus on value of care delivery across the
US health care system, we recommend the continued study of sports injury
surveillance and prevention programs for reducing injury-related health care
costs.
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Affiliation(s)
- Robert L Parisien
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Marisa Pontillo
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ali S Farooqi
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David P Trofa
- Department of Orthopaedic Surgery, Columbia University Medical Center, New York, New York, USA
| | - Brian J Sennett
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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30
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Bojicic KM, Meyer NB, Yablon CM, Brigido MK, Gaetke-Udager K. Hip Pain: Imaging of Intra-articular and Extra-articular Causes. Clin Sports Med 2021; 40:713-729. [PMID: 34509207 DOI: 10.1016/j.csm.2021.05.008] [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: 11/28/2022]
Abstract
Hip pain is a common and complex clinical entity. The causes of hip injuries in athletes are many and diverse, requiring efficient, accurate diagnosis for proper management. Imaging is an important step in the clinical evaluation of hip pain, and familiarity with multiple imaging modalities as well as characteristic imaging findings is a helpful tool for sports medicine clinicians. This article discusses imaging recommendations and gives imaging examples of common causes of intra-articular and extra-articular hip pain including femoroacetabular impingement, labral tears, cartilage defects, ligamentum teres injuries, snapping hip syndrome, femoral stress injuries, thigh splints, athletic pubalgia, avulsion injuries, and hip dislocation.
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Affiliation(s)
- Katherine M Bojicic
- Diagnostic Radiology Resident, University of Michigan Medical Center, 1500 E Medical Center Drive, B1 D502, Ann Arbor, MI 48103, USA
| | - Nathaniel B Meyer
- University of Michigan Medical Center, 1500 E Medical Center Drive, TC 2910, Ann Arbor, MI 48103, USA
| | - Corrie M Yablon
- University of Michigan Medical Center, 1500 E Medical Center Drive, TC 2910, Ann Arbor, MI 48103, USA
| | - Monica Kalume Brigido
- University of Michigan Medical Center, 1500 E Medical Center Drive, TC 2910, Ann Arbor, MI 48103, USA
| | - Kara Gaetke-Udager
- University of Michigan Medical Center, 1500 E Medical Center Drive, TC 2910, Ann Arbor, MI 48103, USA.
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31
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Afonso J, Claudino JG, Fonseca H, Moreira-Gonçalves D, Ferreira V, Almeida JM, Clemente FM, Ramirez-Campillo R. Stretching for Recovery from Groin Pain or Injury in Athletes: A Critical and Systematic Review. J Funct Morphol Kinesiol 2021; 6:jfmk6030073. [PMID: 34564192 PMCID: PMC8482255 DOI: 10.3390/jfmk6030073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 01/01/2023] Open
Abstract
Stretching is usually used as part of rehabilitation protocols for groin pain or injury, but its specific contribution to and within multimodal recovery protocols is unclear. Our goal was to systematically review the effects of stretching for the recovery from groin pain or injury. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, with eligibility criteria defined according to PICOS: (Participants) athletes with groin pain or injuries; (Interventions) interventions with stretching as the differentiating factor; (Comparators) comparators not applying stretching; (Outcomes) symptom remission or improvement and/or time to return to sport and/or return to play; (Study design) randomized controlled trials. Searches were performed on 26 March 2021, in CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus, and Web of Science, with no limitations regarding language or date, and no filters. Of 117 retrieved results, 65 were duplicates and 49 were excluded at the screening stage. The three articles eligible for full-text analysis failed to comply with one or more inclusion criteria (participants, intervention and/or comparators). We then went beyond the protocol and searched for non-randomized trials and case series, but no intervention was found where stretching was the differentiating factor. We found no trials specifically assessing the effects of stretching on recovery or improvement of groin pain or injury in athletes. Currently, the efficacy of these interventions is unknown, and more research is warranted.
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Affiliation(s)
- José Afonso
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), 4200-450 Porto, Portugal; (J.A.); (V.F.); (J.M.A.)
| | - João Gustavo Claudino
- Laboratory of Biomechanics, School of Physical Education and Sport, Universidade de São Paulo, São Paulo 05403-010, Brazil;
- Research and Development Department, LOAD CONTROL, Contagem 32280-440, Brazil
| | - Hélder Fonseca
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport of the University of Porto (FADEUP), 4200-450 Porto, Portugal; (H.F.); (D.M.-G.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-091 Porto, Portugal
| | - Daniel Moreira-Gonçalves
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport of the University of Porto (FADEUP), 4200-450 Porto, Portugal; (H.F.); (D.M.-G.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-091 Porto, Portugal
| | - Victor Ferreira
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), 4200-450 Porto, Portugal; (J.A.); (V.F.); (J.M.A.)
| | - José Marques Almeida
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), 4200-450 Porto, Portugal; (J.A.); (V.F.); (J.M.A.)
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, 1049-001 Lisboa, Portugal
- Correspondence:
| | - Rodrigo Ramirez-Campillo
- Department of Physical Activity Sciences, Universidad de Los Lagos, Santiago 8320000, Chile;
- Centro de Investigación en Fisiología del Ejercicio, Facultad de Ciencias, Universidad Mayor, Santiago 7500000, Chile
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Lohrer H. [Avulsion injuries of the adductors and iliopsoas]. Unfallchirurg 2021; 124:550-559. [PMID: 34106283 DOI: 10.1007/s00113-021-01019-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Abstract
Avulsion injuries of the tendon-bone junction of the adductor longus are rare. Avulsions of the iliopsoas tendon insertion on the lesser trochanter are even rarer. Avulsion injuries of the adductor insertion occur predominantly in active athletes. Iliopsoas tendon avulsions are described mainly in nonathletes, in old age and frequently with no triggering event. In these cases possible underlying pathologies (e.g. tumor or metastases in the lesser trochanter) must be ruled out. In the literature no generally accepted recommendations for treatment of these injuries can be found because only a few retrospective anecdotal case reports and case studies have been published. For this reason, it is mostly unclear if and when a conservative or operative approach is indicated.A PubMed/Medline literature search resulted in 86 articles for iliopsoas avulsions and 155 hits for adductor tendon avulsions. Accordingly, both injuries can basically be treated conservatively. A surgical treatment is recommended only occasionally when conservative treatment fails and when the adductor insertion or the apophysis of the lesser trochanter is dislocated more than 2 cm after avulsion. Reinsertion for adductor longus tendon avulsion injuries is usually performed by open repair using various anchor systems, while extensive avulsion injuries or non-unions of the apophysis of the lesser trochanter are treated by refixation by cannulated screw systems or resection and anchor refixation of the tendon. The postoperative outcome in most cases is described as good or very good (excellent). No major complications were reported in both groups.
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Affiliation(s)
- Heinz Lohrer
- Zentrum für Sportorthopädie, ESN - European Sportscare Network, Borsigstr. 2, 65205, Wiesbaden-Nordenstadt, Deutschland. .,Institut für Sport und Sportwissenschaft, Albert-Ludwigs-Universität, Freiburg, Deutschland.
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Horga LM, Henckel J, Fotiadou A, Di Laura A, Hirschmann A, Hart A. 3.0 T MRI findings of 104 hips of asymptomatic adults: from non-runners to ultra-distance runners. BMJ Open Sport Exerc Med 2021; 7:e000997. [PMID: 34104474 PMCID: PMC8144041 DOI: 10.1136/bmjsem-2020-000997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives To determine and compare the health status of hip joints of individuals undertaking various lengths of long-distance running and of those who are not running. Methods Fifty-two asymptomatic volunteers underwent bilateral hip 3.0 Tesla MRI: (1) 8 inactive non-runners; (2) 28 moderately active runners (average half a marathon (21 km)/week) and (3) 16 highly active runners (≥ marathon (42 km)/week). Two musculoskeletal radiologists reported the hip MRI findings using validated scoring systems. Study participants completed a Hip disability and Osteoarthritis Outcome Score (HOOS) questionnaire to indicate their perceived hip function. Results The MRI findings show that there were no significant differences among inactive non-runners, moderately active runners and highly active runners in the amount of labral abnormalities (p=0.327), articular cartilage lesions (p=0.270), tendon abnormalities (p=0.141), ligament abnormalities (p=0.519). Bone marrow oedema was significantly more common in moderately active runners than in non-runners and highly active runners (p=0.025), while small subchondral cysts were more common in runners than in non-runners (p=0.017), but these were minor/of small size, asymptomatic and did not indicate specific exercise-related strain. Articular cartilage lesions and bone marrow oedema were not found in highly active runners. HOOS scores indicate no hip symptoms or functional problems among the three groups. Conclusion The imaging findings were not significantly different among inactive non-runners, moderately active runners and highly active runners, in most hip structures, suggesting that long-distance running may not add further damage to the hip joints.
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Affiliation(s)
- Laura Maria Horga
- Department of Orthopaedics and Musculoskeletal Science, University College London, Stanmore, London, UK
| | - Johann Henckel
- Royal National Orthopaedic Hospital, Stanmore, London, UK
| | | | - Anna Di Laura
- Royal National Orthopaedic Hospital, Stanmore, London, UK
| | - Anna Hirschmann
- Department of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Alister Hart
- Department of Orthopaedics and Musculoskeletal Science, University College London, Stanmore, London, UK.,Royal National Orthopaedic Hospital, Stanmore, London, UK
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Carter CW, Campbell A, Whitney D, Feder O, Kingery M, Baron S, Youm T, Gonzalez-Lomas G. Characterizing cam-type hip impingement in professional women's ice hockey players. PHYSICIAN SPORTSMED 2021; 49:203-206. [PMID: 32799611 DOI: 10.1080/00913847.2020.1808434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE There is a high prevalence of femoroacetabular impingement (FAI) amongst elite men's ice hockey players, yet little is known about the hips of players in the National Women's Hockey League (NWHL). The primary purpose of this study was to determine the prevalence of radiographic cam-type FAI in women's professional ice hockey players. The secondary purpose was to analyze the relationship between the cam deformity and both menarchal age and hip range-of-motion (ROM). METHODS Data were collected for NWHL players during pre-participation physicals. Alpha angles were measured on 45° Dunn radiographs, with alpha angles >55° defined as cam-positive. Pearson correlation coefficients (ρ) were performed to analyze the relationship between alpha angle and both ROM measurements and menarchal age, with statistical significance set at p < 0.05. RESULTS Twenty-six athletes were included. Twenty-four (92%) had alpha angles >55°; 20 players (77%) had bilateral cam deformity. Average menarchal age was 13.8 ± 1.7 years. There was a significant association between age of menarche and alpha angle (ρ = 0.36, p < 0.02). There was no significant association between alpha angle and hip ROM (p > 0.05). CONCLUSION Elite women's ice hockey players have a higher prevalence of cam-type morphology than the general population. The positive association between alpha angle and menarchal age lends additional support to the etiological hypothesis of the cam lesion resulting from activity-related stress at the proximal femoral physis during skeletal development. Professional women's ice hockey players have a high risk of developing cam-type morphology, although each player's menarchal age may mediate her individual risk for cam development.
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Affiliation(s)
- Cordelia W Carter
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | - Abigail Campbell
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | - Darryl Whitney
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | - Oren Feder
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | - Matthew Kingery
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | - Samuel Baron
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | - Thomas Youm
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
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Abstract
Hip pain is a common complaint in athletes and can result in a significant amount of time lost from sport. Diagnosis of the source of hip pain can be a clinical challenge because of the deep location of the hip and the extensive surrounding soft tissue envelope. Establishing whether the source of hip pain is intra-articular or extra-articular is the first step in the process. A thorough history and a consistent and comprehensive physical examination are the foundation for the proper management of athletes with hip pain.
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Affiliation(s)
- Jacob G Calcei
- Department of Orthopaedic Surgery, University Hospitals of Cleveland, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA. https://twitter.com/drcalcei
| | - Marc R Safran
- Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, CA, USA.
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36
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Chan JJ, Geller JS, Chen KK, Huang HH, Huntley SR, Vulcano E, Aiyer A. Epidemiology of Severe Foot Injuries in US Collegiate Athletes. Orthop J Sports Med 2021; 9:23259671211001131. [PMID: 33997068 PMCID: PMC8076772 DOI: 10.1177/23259671211001131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/10/2021] [Indexed: 11/16/2022] Open
Abstract
Background The effects of foot injuries on collegiate athletes in the United States are of interest because of the short 5-year eligibility period in the National Collegiate Athletic Association (NCAA). Purpose To discuss the epidemiology of severe NCAA foot injuries sustained over 10 years in 25 sports. Study Design Descriptive epidemiology study. Methods We utilized the NCAA Injury Surveillance System, which prospectively collects deidentified injury data for collegiate athletes. Severe injuries were classified as season- or career-ending injuries, injuries with >30-day time loss, or injuries requiring operative treatment. Injury rates (IRs) were analyzed per 100,000 athlete-exposures. Results Of 3607 total foot injuries, 18.71% (n = 675) were classified as severe, with an IR of 5.73 per 100,000 athletic-exposures. For all severe injuries, the operative rate was 24.3%, the season-ending rate 37.0%, and the career-ending rate 4.4%. The proportion of recurrent injuries was 13.9%. Men's sports with the highest severe foot IRs were basketball (IR = 10.71), indoor track (IR = 7.16), and football (IR = 7.08). Women's sports with the highest severe foot IRs were cross-country (IR = 17.15), gymnastics (IR = 14.76), and outdoor track (IR = 14.65). Among all severe foot injuries, the most common was a fifth metatarsal fracture. The highest contact/noncontact injury ratios were phalangeal fracture, turf toe, and Lisfranc injury. The severe injuries with the highest operative rates were Lisfranc injuries, fifth metatarsal fractures, and midfoot fractures. The severe injuries associated with the highest season-ending IRs were Lisfranc injury, midfoot fracture, and general metatarsal fractures. Severe flexor/extensor injuries had the highest career-ending IRs, followed by turf toe. Severe injuries with the highest median time loss were sesamoidal fractures, calcaneal fractures, and plantar fascial injuries. Conclusion Of all collegiate foot injuries sustained over a 10-year period, 18.7% were characterized as severe, and 24.3% of severe injuries required surgery. Basketball was the men's sport with the highest severe IR, and cross-country was the women's sport with the highest severe IR. Overall, female athletes experienced slightly higher severe foot IRs as compared with male athletes.
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Affiliation(s)
- Jimmy J Chan
- Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joseph S Geller
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Kevin K Chen
- Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hsin-Hui Huang
- Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Samuel R Huntley
- Department of Orthopedic Surgery, University of Miami, Miami, Florida, USA
| | - Ettore Vulcano
- Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amiethab Aiyer
- Department of Orthopedic Surgery, University of Miami, Miami, Florida, USA
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37
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Hammond KE, Kneer L, Cicinelli P. Rehabilitation of Soft Tissue Injuries of the Hip and Pelvis. Clin Sports Med 2021; 40:409-428. [PMID: 33673896 DOI: 10.1016/j.csm.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The athlete's hip is complex when it comes to the surrounding musculature-approximately 21 different muscles can cross the hip and pelvis region, all synchronously working to maintain pelvic stability and functional hip activities. Commonly injured muscle groups for high-level athletes include flexors, adductors, abductors, and/or proximal hamstring musculotendinous complex. These muscle groups work in harmony; however, each has an independent function and propensity for injury. Rehabilitation phases for each injury group can be broken down into 3 phases: acute management, strengthening, and return-to-sport or return-to-competition phase. Specific rehabilitation principles and modalities are described for each injury group.
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Affiliation(s)
- Kyle E Hammond
- Emory University Sports Medicine Center, 1968 Hawks Lane, Atlanta, GA 30329, USA.
| | - Lee Kneer
- Emory University Sports Medicine Center, 1968 Hawks Lane, Atlanta, GA 30329, USA. https://twitter.com/kneermd
| | - Pete Cicinelli
- Atlanta Braves, Truist Park, 755 Battery Avenue, Southeast, Atlanta, GA 30339, USA
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Abstract
This article provides concise and up-to-date information on the most common hip pathologies that affect adolescent athletes. We cover the evaluation and treatment of avulsion injuries, stress fractures, slipped capital femoral epiphysis (SCFE), femoroacetabular impingement, developmental dysplasia of the hip, Legg-Calve-Perthes disease, and coxa saltans focusing on minimizing advanced imaging and using conservative therapy when applicable. Although this is not an all-encompassing list of disorders, it is key to understand these hip pathologies because these injuries occur commonly and can also have detrimental complications if not diagnosed and addressed early, especially SCFE and femoral neck stress fractures.
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Affiliation(s)
- Paul B Schroeder
- Department of Orthopaedics, San Antonio Military Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA
| | - Marc A Nicholes
- School of Osteopathic Medicine, University of the Incarnate Word, 7615 Kennedy Hill, Building 1, San Antonio, TX 78234, USA
| | - Matthew R Schmitz
- Department of Orthopaedics, San Antonio Military Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA.
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Gianakos AL, Yurek JW, Mulcahey MK. Sex-Related Differences in Hip Injury Rates and Strength and Conditioning. Clin Sports Med 2021; 40:399-408. [PMID: 33673895 DOI: 10.1016/j.csm.2020.12.004] [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: 11/28/2022]
Abstract
Hip injuries are common in the athletic population, typically occurring in sports as a result of contact or overuse. Previous literature describes differences in injury rates between male and female athletes, clinical presentation, treatment, and outcomes. In addition, anatomic differences in acetabular and femoral version, hip alpha angles, lateral center-edge angles, pelvic tilt, and knee biomechanics have been demonstrated. These differences may alter injury patterns between male and female athletes and contribute to differences in hip pathology. Therefore, individualized treatment and rehabilitation strategies should be taken into consideration in order to expedite an athlete's return to play.
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Affiliation(s)
- Arianna L Gianakos
- Department of Orthopaedic Surgery, Robert Wood Johnson Barnabas Health - Jersey City Medical Center (Colony Plaza) Suite 14 Grand Street, Jersey City, NJ 07302, USA
| | - John W Yurek
- Department of Orthopaedic Surgery, Robert Wood Johnson Barnabas Health - Jersey City Medical Center (Colony Plaza) Suite 14 Grand Street, Jersey City, NJ 07302, USA
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, 1430 Tulane Avenue #8632, New Orleans, LA 70112, USA.
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40
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Guerrero-Tapia H, Martín-Baeza R, Cuesta-Barriuso R. Effectiveness of Abdominal and Gluteus Medius Training in Lumbo-Pelvic Stability and Adductor Strength in Female Soccer Players. A Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1528. [PMID: 33562743 PMCID: PMC7914958 DOI: 10.3390/ijerph18041528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/27/2021] [Accepted: 02/03/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Abdominal and lumbo-pelvic stability alterations may be the origin of lower limb injuries, such as adductor pathology in soccer players. Imbalance can be caused by both intrinsic and extrinsic factors. METHODS In this randomized controlled trial over 8 weeks, 25 female footballers were randomly allocated to an experimental group (isometric abdominal training and gluteus medius-specific training) or a control group (isometric abdominal training). Evaluations were performed at baseline, at the end of the intervention and after a 4-week follow-up period. The exercise protocol in common for both groups included three exercises: Plank, Lateral plank and Bird dog. Specific exercises for the gluteus medius were: Pelvic drop and Stabilization of the gluteus medius in knee valgus. Outcome measures were lumbar-pelvic stability and adductor strength. RESULTS After the intervention, there was an increase in lumbo-pelvic stability in both groups, being greater in the control group than in the experimental group (mean differences [MD]: 4.84 vs. MD: 9.58; p < 0.01) with differences in the analysis of repeated measures (p < 0.001), but not in group interaction (p = 0.26). Changes were found in adductor strength in the experimental group (MD: -2.48; p < 0.001 in the left adductor; MD: -1.48; p < 0.01 in right adductor) and control group (MD: -1.68; p < 0.001 in the left adductor; MD: -2.05; p < 0.001 in the right adductor) after the intervention, with differences in the analysis of repeated measures in left (p < 0.001) and right (p < 0.001) adductor strength. CONCLUSIONS An abdominal and gluteal training protocol shows no advantage over a protocol of abdominal training alone for lumbo-pelvic stability and adductor strength, while improvements in both variables are maintained at four weeks follow-up.
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Affiliation(s)
| | | | - Rubén Cuesta-Barriuso
- Department of Physiotherapy, Faculty of Sport Sciences, European University of Madrid, 28670 Madrid, Spain; (H.G.-T.); (R.M.-B.)
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Christopher ZK, Hassebrock JD, Anastasi MB, Economopoulos KJ. Hip Flexor Injuries in the Athlete. Clin Sports Med 2021; 40:301-310. [PMID: 33673888 DOI: 10.1016/j.csm.2020.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Athletic injuries to the hip flexors and iliopsoas have been described in populations across all levels of competitive sports. Overall estimates of hip flexor pathology have ranged from 5% to 28% of injuries among high-risk sport specific groups. Although most of these injuries are successfully treated with conservative management, and high rates of return to play are observed, significant rehabilitation time can be involved. As the understanding of hip pathology with imaging modalities such as MRI has advanced, greater importance has been placed on accurately diagnosing hip flexor injuries and initiating rehabilitation protocols early to minimize time loss from sport.
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Affiliation(s)
- Zachary K Christopher
- Mayo Clinic Arizona, Orthopedics, Sports Medicine Department, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.
| | - Jeffrey D Hassebrock
- Mayo Clinic Arizona, Orthopedics, Sports Medicine Department, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA
| | - Matthew B Anastasi
- Mayo Clinic Arizona, Orthopedics, Sports Medicine Department, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA
| | - Kostas J Economopoulos
- Mayo Clinic Arizona, Orthopedics, Sports Medicine Department, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA
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42
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HIP AND GROIN PROBLEMS IN THE PREVIOUS SEASON ARE ASSOCIATED WITH IMPAIRED FUNCTION IN THE BEGINNING OF THE NEW SEASON AMONG PROFESSIONAL FEMALE ICE HOCKEY PLAYERS - A CROSS SECTIONAL STUDY. Int J Sports Phys Ther 2020; 15:763-769. [PMID: 33110695 DOI: 10.26603/ijspt20200763] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Hip and groin problems are common in ice hockey but studies on professional female players are sparse. The available literature describes hip and groin problems by reporting incidence of time-loss injuries and may thereby underestimate the scope of these problems, which are often due to overuse and may not lead to absence from ice hockey participation. Purpose The purpose of this study was to describe the seasonal prevalence and severity of hip and groin problems in professional female ice hockey players. A further aim was to examine the relation between previous problems and self-reported function in the beginning of the new season. Study design Cross-sectional study. Methods Female ice hockey players from the highest league in Sweden [n=69 (19 goalkeepers, 18 defenders, 30 forwards)], responded to an online survey, retrospectively assessing the prevalence of hip and groin problems (time loss and non-time loss) and their duration during the previous season. Furthermore, players reported current self-reported function on the Copenhagen Hip and Groin Outcome Score (HAGOS). Results Two thirds of the players experienced hip and groin problems during the previous season [62.3% (N=43)]. A quarter of the players experienced a hip and groin problem leading to time loss [26.1% (N=18)]. The majority of problems were of short (1-2 weeks) or medium (3-5 weeks) duration [29% (N=20) of players, respectively], while longstanding problems ( ≥ 6 weeks) were rare [4,4% (N=3)]. Players that retrospectively reported hip and groin problems during the previous season reported statistically significant impairments on all HAGOS subscales in the beginning of the new season (p ≤ 0.011). Conclusion Hip and groin problems are prevalent in professional female ice hockey players, experienced by 62% during the previous season with resulting time-loss in 26.1%. Reported problems were rarely of longstanding nature, but players who reported problems in the previous season had significantly impaired hip and groin function in the beginning of the new season. Even though results of this study are based on retrospective player reports this may be a first step toward a greater understanding of the true burden of hip and groin players in professional female ice hockey players. Level of evidence 3b.
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43
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Ejnisman L, Ricioli Júnior W, Queiroz MC, Vicente JRN, Croci AT, Polesello GC. Femoroacetabular Impingement and Acetabular Labral Tears - Part 1: Pathophysiology and Biomechanics. Rev Bras Ortop 2020; 55:518-522. [PMID: 33093713 PMCID: PMC7575372 DOI: 10.1055/s-0040-1702964] [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] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 11/12/2019] [Indexed: 11/02/2022] Open
Abstract
Femoroacetabular impingement (FAI) is an important cause of hip pain, and the main etiology of hip osteoarthritis in the young population. Femoroacetabular impingement is characterized by subtle alterations in the anatomy of the acetabulum and proximal femur, which can lead to labrum tearing. The acetabular labrum is essential to the stability of the hip joint. Three types of FAI were described: cam (anespherical femoral head), pincer (acetabular overcoverage) and mixed (characteristics of both cam and pincer). The etiology of FAI is related to genetic and environmental characteristics. Knowledge of this condition is essential to adequately treat patients presenting with hip pain.
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Affiliation(s)
- Leandro Ejnisman
- Grupo de Quadril, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Walter Ricioli Júnior
- Grupo de Quadril, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Marcelo Cavalheiro Queiroz
- Grupo de Quadril, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Jose Ricardo Negreiros Vicente
- Grupo de Quadril, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Alberto Tesconi Croci
- Grupo de Quadril, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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44
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Abstract
A 20-year-old male collegiate soccer goalkeeper presented to an athletic trainer during the season complaining of right (dominant kicking leg) groin pain. The athletic trainer identified a mass and hematoma and suspected myositis ossificans. The patient was referred to the team physician, who ordered radiographs and magnetic resonance imaging to confirm the diagnosis and rule out other injuries. Imaging demonstrated an adductor longus muscle strain with myositis ossificans. J Orthop Sports Phys Ther 2020;50(10):586. doi:10.2519/jospt.2020.9573.
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45
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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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Sheppard M, Nicknair J, Goetschius J. Early Sport Specialization and Subjective Hip and Groin Dysfunction in Collegiate Ice Hockey Athletes. J Athl Train 2020; 55:232-237. [PMID: 32031885 DOI: 10.4085/1062-6050-0375-19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT Sport specialization is a popular trend among youth athletes that has been associated with an increased risk for developing lower extremity overuse injuries. Early ice hockey specialization may contribute to the high rates of noncontact and overuse hip and groin injuries in collegiate ice hockey athletes. OBJECTIVE To examine the effects of high, moderate, and low levels of sport specialization on subjective hip and groin dysfunction in collegiate ice hockey athletes. DESIGN Retrospective cohort study. SETTING Data were collected during the midseason of the 2018-2019 hockey season at a local ice hockey arena. PATIENTS OR OTHER PARTICIPANTS National Collegiate Athletic Association Division III and club ice hockey players from Midwestern college programs (n = 187; 81 women, 106 men). MAIN OUTCOME MEASURE(S) Participants were stratified into high-, moderate-, and low-specialization groups based on ice hockey participation before grade 9 of high school. The 6 subscales of the Hip and Groin Outcome Score questionnaire were used to assess current subjective hip and groin dysfunction. RESULTS The high-specialization group had lower scores than the low-specialization group on the Symptoms (P = .001), Pain (P = .003), Activities of Daily Living (P = .001), Sport and Recreation (P = .014), and Quality of Life (P = .002) subscales. The moderate-specialization group had lower scores than the low-specialization group on the Symptoms (P = .015) and Activities of Daily Living (P = .006) subscales. CONCLUSIONS Collegiate ice hockey athletes who were highly specialized before high school reported greater current hip and groin pain, symptoms, and dysfunction during activities of daily living and sport and recreation and lower current hip- and groin-related quality of life compared with low-specialization ice hockey athletes. Early ice hockey specialization may be detrimental to hip and groin function in collegiate ice hockey athletes.
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High prevalence of hip and groin problems in professional ice hockey players, regardless of playing position. Knee Surg Sports Traumatol Arthrosc 2020; 28:2302-2308. [PMID: 31734706 PMCID: PMC7347705 DOI: 10.1007/s00167-019-05787-7] [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: 06/05/2019] [Accepted: 11/04/2019] [Indexed: 12/02/2022]
Abstract
PURPOSE The prevalence of hip and groin problems in professional male ice hockey is unknown and suspected to differ between playing positions. The purpose of this study was to explore potential differences in the seasonal prevalence of hip and groin problems between playing positions in male elite ice hockey players and to explore the relationship between symptom duration and hip and groin function at the beginning of the new season. METHODS Male ice hockey players [n = 329 (92 goalkeepers, 93 defensemen, 144 forwards), Mean age (SD): 24 (5)] from the professional leagues in Sweden responded to an online survey. The survey assessed presence of hip and groin problems (time loss and non-time loss) and symptom duration (categorized into 0, 1-6, or > 6 weeks) in the previous season, and current self-reported hip and groin function (Copenhagen Hip and Groin Outcome Score). RESULTS During the previous season, 175 players (53.2%) had experienced hip and groin problems. Non time loss problems were experienced by 158 (48%) and time loss problems were experienced by 97 (29.5%) players. No significant differences between playing positions were found. Self-reported function differed significantly between players with different symptom duration and more disability was reported among players with longer symptom duration (p ≤ 0.002). CONCLUSION Regardless of playing position, hip and groin problems were prevalent in male ice hockey players. Players with hip and groin problems during the previous season had significantly worse hip and groin function in the beginning of the new season, and longer symptom duration was associated with more disability. LEVEL OF EVIDENCE III.
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Wörner T, Clarsen B, Thorborg K, Eek F. Elite Ice Hockey Goalkeepers Have a High Prevalence of Hip and Groin Problems Associated With Decreased Sporting Function: A Single-Season Prospective Cohort Study. Orthop J Sports Med 2019; 7:2325967119892586. [PMID: 31897413 PMCID: PMC6920599 DOI: 10.1177/2325967119892586] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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 The modern style of goalkeeping in ice hockey is thought to predispose athletes to hip and groin problems. However, little is known about the magnitude of these problems in elite goalkeepers. PURPOSE To describe the incidence, prevalence, and severity of hip and groin problems in elite ice hockey goalkeepers over the course of a single season. STUDY DESIGN Descriptive epidemiology study. METHODS We invited all elite Swedish ice hockey goalkeepers (n = 128) to participate in this prospective cohort study. Every second week, players reported hip and groin problems experienced within the past 14 days on the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O), classifying problems into "all" and "substantial" hip and groin problems. Three times during the season (pre-, mid-, and end-season), players reported hip and groin function on the Hip and Groin Outcome Score (HAGOS) as well as on the OSTRC-O. RESULTS A total of 101 goalkeepers participated in the study (83.3% male [seniors, 44.1%; juniors, 39.2%], 16.7% female). The cumulative incidences of all hip and groin problems and substantial hip and groin problems were 69% (95% CI, 59%-79%) and 36% (95% CI, 26%-46%), respectively. The average biweekly prevalence for all hip and groin problems and substantial hip and groin problems was 28.1% (95% CI, 25.0%-31.3%) and 10% (95% CI, 8.7%-11.4%), respectively. Among all the reported hip and groin problems, 16.9% (n = 70) were acute, 83.1% (n = 343) were because of overuse, and 15.5% (n = 64) led to time loss. HAGOS did not differ in the pre-, mid-, or end-season. Players reporting hip and groin problems on the OSTRC-O had significantly worse HAGOS scores than players without problems (P < .01). CONCLUSION Hip and groin problems are highly prevalent in elite ice hockey goalkeepers. During a competitive season, 69% of players experienced hip and groin problems and 36% of players suffered from substantial problems. The vast majority of problems were because of overuse, not leading to time loss but related to reduced self-reported hip and groin function.
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Affiliation(s)
- Tobias Wörner
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Benjamin Clarsen
- Oslo Sports Trauma Research Center, Norwegian School of Sport
Sciences, Oslo, Norway
| | - Kristian Thorborg
- Sports Orthopaedic Research Center–Copenhagen (SORC-C), Department
of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre,
Denmark
| | - Frida Eek
- Department of Health Sciences, Lund University, Lund, Sweden
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Nho DSJ. Introduction. OPER TECHN SPORT MED 2019. [DOI: 10.1053/j.otsm.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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