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Zemková E, Amiri B, Horníková H, Zapletalová L. Potential neurophysiological and biomechanical risk factors for sport-related back problems: A scoping review. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:123-138. [PMID: 38708324 PMCID: PMC11067771 DOI: 10.1016/j.smhs.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/17/2023] [Accepted: 12/25/2023] [Indexed: 05/07/2024] Open
Abstract
This scoping review aims (1) to map the literature dealing with neurophysiological and biomechanical aspects of back problems in athletes in order to identify valid risk-factors for their prevention, plus (2) to identify gaps in the existing research and propose suggestions for future studies. A literature search conducted with Scopus, Web of Science, MEDLINE and Cochrane Library was completed by Elsevier, SpringerLink and Google Scholar. The main neurophysiological risk factors identified leading to back problems in athletes are neuromuscular imbalance, increased muscle fatigability, muscle dysfunction and impaired motor control, whilst biomechanical risk factors include maladaptive spinal, spinopelvic and lower limb kinematics, side-to-side imbalances in axial strength and hip rotation range of motion, spinal overloading and deficits in movement pattern. However, most studies focused on back pain in the lumbar region, whereas less attention has been paid to thoracic and cervical spine problems. The range of sports where this topic has been studied is relatively small. There is a lack of research in sports in which the core muscles are highly involved in specific movements such as lifting weights or trunk rotations. A limited number of studies include female athletes and master athletes of both genders. In addition to chronic back pain patients, it is equally important to conduct research on healthy athletes with a predisposition to spine problems. Investigators should focus their empirical work on identifying modifiable risk factors, predict which athletes are at risk for back problems, and develop personalized sport-specific assessment tools and targeted prevention strategies for them. This review was registered using the Open Science Framework Registries (https://osf.io/ha5n7).
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Affiliation(s)
- Erika Zemková
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia
- Faculty of Health Sciences, University of Ss. Cyril and Methodius in Trnava, Slovakia
| | - Banafsheh Amiri
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia
| | - Henrieta Horníková
- Department of Track and Field and Sport Conditioning, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia
| | - Ludmila Zapletalová
- Faculty of Health Sciences, University of Ss. Cyril and Methodius in Trnava, Slovakia
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Saw A, Eales B, Jones N, Obst A, Smith M, Kountouris A, Saw R. Lumbar Bone Stress Injuries and Nonunited Defects in Elite Australian Cricket Players. Clin J Sport Med 2024; 34:44-51. [PMID: 36853903 DOI: 10.1097/jsm.0000000000001132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/24/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVE To describe the presentation and management of lumbar bone stress injuries (LBSI), recurrent LBSI, and lumbar nonunited defects in elite Australian male and female cricket players. DESIGN Retrospective case series. SETTING Professional domestic and international cricket teams over 13 seasons. PARTICIPANTS Elite Australian cricket players. INDEPENDENT VARIABLES Symptomatic LBSI requiring time off cricket and lumbar nonunited defects, both confirmed by imaging. MAIN OUTCOME MEASURES Incidence, presentation, history, healing, and management. RESULTS 211 LBSI were identified at an average incidence of 5.4 per 100 players per season. LBSI were most common in male pace bowlers younger than 20 years of age (58.1 per 100 players per season), however, were also observed in older players, females, and non-pace bowlers. Recurrent LBSI accounted for 33% (27%-40%) of all LBSI. Median days to return to match availability was 182 (128-251) days for all LBSI, with a shorter time frame observed for new and less severe injuries, and male spin bowlers. Healing was demonstrated in 87% (81%-91%) of all LBSI cases. 29 nonunited defects were identified and predisposed subsequent pain, LBSI, and spondylolisthesis. CONCLUSIONS LBSI are experienced by approximately 5.4 in every 100 elite Australian cricket players per season, with a high time cost of approximately 4 to 8 months. Nonunited defects also have a high time cost with associated subsequent lumbar spine issues. The findings of this study reinforce the importance of early detection and conservative management of LBSI, particularly for younger male pace bowlers and players with recurrent LBSI, which may be supported by MRI.
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Affiliation(s)
- Anna Saw
- Cricket Australia, VIC, Australia
| | | | | | - Alan Obst
- South Australian Cricket Association, SA, Australia
| | | | | | - Richard Saw
- WA Cricket, WA, Australia
- Australian Institute of Sport, ACT, Australia
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3
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Farhart P, Beakley D, Diwan A, Duffield R, Rodriguez EP, Chamoli U, Watsford M. Intrinsic variables associated with low back pain and lumbar spine injury in fast bowlers in cricket: a systematic review. BMC Sports Sci Med Rehabil 2023; 15:114. [PMID: 37730648 PMCID: PMC10512628 DOI: 10.1186/s13102-023-00732-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Lumbar spine injuries in fast bowlers account for the greatest missed playing time in cricket. A range of extrinsic and intrinsic variables are hypothesised to be associated with low back pain and lumbar spine injury in fast bowlers, and an improved understanding of intrinsic variables is necessary as these may alter load tolerance and injury risk associated with fast bowling. This review critically evaluated studies reporting intrinsic variables associated with low back pain and lumbar spine injury in fast bowlers and identified areas for future investigation. METHODS OVID Medline, EMBASE, SPORTDiscus, CINAHL, Web of Science and SCOPUS databases were last searched on 3 June 2022 to identify studies investigating intrinsic variables associated with low back pain and lumbar spine injury in cricket fast bowlers. Terms relevant to cricket fast bowling, and intrinsic variables associated with lumbar spine injury and low back pain in fast bowlers were searched. 1,503 abstracts were screened, and 118 full-text articles were appraised to determine whether they met inclusion criteria. Two authors independently screened search results and assessed risk of bias using a modified version of the Quality in Prognostic Studies tool. RESULTS Twenty-five studies met the inclusion criteria. Overall, no included studies demonstrated a low risk of bias, two studies were identified as moderate risk, and twenty-three studies were identified as high risk. Conflicting results were reported amongst studies investigating associations of fast bowling kinematics and kinetics, trunk and lumbar anatomical features, anthropometric traits, age, and neuromuscular characteristics with low back pain and lumbar spine injury. CONCLUSION Inconsistencies in results may be related to differences in study design, injury definitions, participant characteristics, measurement parameters, and statistical analyses. Low back pain and lumbar spine injury occurrence in fast bowlers remain high, and this may be due to an absence of low bias studies that have informed recommendations for their prevention. Future research should employ clearly defined injury outcomes, analyse continuous datasets, utilise models that better represent lumbar kinematics and kinetics during fast bowling, and better quantify previous injury, lumbar anatomical features and lumbar maturation. TRIAL REGISTRATION Open Science Framework https://doi.org/10.17605/OSF.IO/ERKZ2 .
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Affiliation(s)
- Patrick Farhart
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia.
- Spine Labs, Discipline of Surgery, St. George and Sutherland Campus of the Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, NSW, 2217, Australia.
- Cricket New South Wales, 161 Silverwater Road, Sydney Olympic Park, Sydney, NSW, 2127, Australia.
- Delhi Capitals, JSW GMR Cricket Private Limited, Bahadurshah Zafar Marg, New Delhi, 110002, India.
| | - David Beakley
- Deakin University, Burwood Highway, Burwood, VIC, 3125, Australia
| | - Ashish Diwan
- Spine Labs, Discipline of Surgery, St. George and Sutherland Campus of the Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, NSW, 2217, Australia
- Spine Service, Department of Orthopaedic Surgery, St. George Hospital Campus, Kogarah, NSW, 2217, Australia
| | - Rob Duffield
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia
| | - Elizabeth Pickering Rodriguez
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia
| | - Uphar Chamoli
- Spine Labs, Discipline of Surgery, St. George and Sutherland Campus of the Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, NSW, 2217, Australia
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Broadway, NSW, 2007, Australia
| | - Mark Watsford
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia
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Bell AJ, Nunnerley JL, Shackel DF, Coates MH, Campbell RG, Frampton CM, Schouten R. Is MRI screening for bone marrow oedema useful in predicting lumbar bone stress injuries in adult male professional cricketers? A New Zealand pilot study. J Sci Med Sport 2023; 26:410-414. [PMID: 37541867 DOI: 10.1016/j.jsams.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 04/29/2023] [Accepted: 06/28/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES The aims were to (1) prospectively observe the incidence of bone marrow oedema in asymptomatic adult male domestic professional cricketers during a season and evaluate its relationship to the development of lumbar bone stress injury and (2) further understand the practicalities of implementing a Magnetic Resonance Imaging-based screening program to prevent lumbar bone stress injury in New Zealand cricket. DESIGN Prospective observational cohort. METHODS Adult male pace bowlers received 6-weekly pre-planned Magnetic Resonance Imaging scans over a single season to determine the presence and intensity of bone marrow oedema in the posterior vertebral arches of the lumbar spine. The participants bowling volume and back pain levels were monitored prospectively. RESULTS 22 participants (mean age 25.3 years (range 20-32 years)) completed all 4 scans. Ten participants had a prior history of lumbar bone stress injury. Ten participants (45 %, 95 % confidence interval 24-68 %) had bone marrow oedema evident on at least one scan, with 9 (41 %) participants recording a bone marrow oedema intensity ≥ 2 and 5 (23 %) participants demonstrated an intensity ≥ 3. During the study one participant was diagnosed with a lumbar bone stress reaction. No participants developed a lumbar bone stress fracture. CONCLUSIONS Due to the lower incidence of lumbar bone stress injuries in adult bowlers coupled with uncertainty over appropriate threshold values for bone marrow oedema intensity, implementation of a resource intense screening program aimed at identifying adult domestic cricketers at risk of developing a lumbar bone stress injury is not currently supported.
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Affiliation(s)
| | - Joanne L Nunnerley
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Burwood Academy, New Zealand
| | | | | | | | - Chris M Frampton
- Department of Public Health and General Practice, University of Otago, New Zealand
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Chepurin D, Chamoli U, Diwan AD. Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: A Systematic Review of Clinical and Basic Science Studies. Global Spine J 2022; 12:964-979. [PMID: 34018442 PMCID: PMC9344512 DOI: 10.1177/21925682211008837] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
STUDY DESIGN Translational review encompassing basic science and clinical evidence. OBJECTIVES Multiple components of the lumbar spine interact during its normal and pathological function. Bony stress in the lumbar spine is recognized as a factor in the development of pars interarticularis defect and stress fractures, but its relationship with intervertebral disc (IVD) degeneration is not well understood. Therefore, we conducted a systematic review to examine the relationship between bony stress and IVD degeneration. METHODS Online databases Scopus, PubMed and MEDLINE via OVID were searched for relevant studies published between January 1980-February 2020, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Two authors independently analyzed the data, noting characteristics and biases in various studies. RESULTS Thirty-two articles were included in the review: 8 clinical studies, 9 finite element modeling studies, 3 in-vivo biomechanical testing studies, and 12 in-vitro biomechanical testing studies. Of the 32 articles, 19 supported, 4 rejected and 9 made no conclusion on the hypothesis that there is a positive associative relationship between IVD degeneration and bony stress. However, sufficient evidence was not available to confirm or reject a causal relationship. CONCLUSIONS Most studies suggest that the prevalence of IVD degeneration increases in the presence of bony stress; whether a causal relationship exists is unclear. The literature recommends early diagnosis and clinical suspicion of IVD degeneration and bony stress. Longitudinal studies are required to explore causal relationships between IVD degeneration and bony stress.
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Affiliation(s)
- Daniel Chepurin
- Department of Orthopaedic Surgery,
Spine Service, St. George & Sutherland Clinical School, University of New South
Wales Australia, Kogarah, Sydney, New South Wales, Australia,Department of Medicine, Faculty of Medicine Nursing & Health
Sciences, Monash University, Clayton, Melbourne, Victoria, Australia
| | - Uphar Chamoli
- Department of Orthopaedic Surgery,
Spine Service, St. George & Sutherland Clinical School, University of New South
Wales Australia, Kogarah, Sydney, New South Wales, Australia,School of Biomedical Engineering,
Faculty of Engineering & Information Technology, University of Technology
Sydney, Ultimo, Sydney, New South Wales, Australia,Uphar Chamoli, Spine Service, L5, Suite 16,
St. George Private Hospital, Kogarah, NSW 2217, Australia.
| | - Ashish D. Diwan
- Department of Orthopaedic Surgery,
Spine Service, St. George & Sutherland Clinical School, University of New South
Wales Australia, Kogarah, Sydney, New South Wales, Australia
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Varley I, Ward M, Thorpe C, Beardsley N, Greeves J, Sale C, Saward C. Modelling Changes in Bone and Body Composition Over a Season in Elite Male Footballers. Int J Sports Med 2022; 43:729-739. [PMID: 35523202 DOI: 10.1055/a-1810-6774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study investigated the change in bone and body composition characteristics of elite football players and recreationally active control participants across the course of a season. Fortysix participants (20 footballers and 26 recreationally active controls) were assessed by dual-energy x-ray absorptiometry and peripheral Quantitative Computed Tomography for a range of bone and body composition characteristics at four points over the course of a competitive season. Multilevel modelling was used to examine changes. Footballers had higher characteristics than controls for 24 out of 29 dual-energy x-ray absorptiometry and peripheral Quantitative Computed Tomography variables (all p<0.05). However, there was also significant random inter-individual variation in baseline values for all variables, for both footballers and controls (p < 0.05). Wholebody bone mineral density, leg and whole-body bone mineral content, tibial bone mass and area (38%) increased across the season in footballers (p < 0.05), and there was significant random inter-individual variation in the rate of increase of leg and whole-body bone mineral content (p<0.05). Whole-body bone mineral density, leg and whole-body bone mineral content, tibial bone mass and area (38%) increased over the course of the season in elite football players. The modelling information on expected changes in bone characteristics provides practitioners with a method of identifying those with abnormal bone response to football training and match-play.
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Affiliation(s)
- Ian Varley
- Department of Sport Science, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Marcus Ward
- Department of Sport Science, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Chris Thorpe
- Al Duhail Sports Club, Al Duhail Sports Club, Doha, Qatar
| | - Nathan Beardsley
- England Rugby, England Rugby, London, United Kingdom of Great Britain and Northern Ireland
| | - Julie Greeves
- Army Health and Performance Research, Army Headquarters, Andover, United Kingdom of Great Britain and Northern Ireland
| | - Craig Sale
- Department of Sport Science, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Chris Saward
- Department of Sport Science, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
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Bullock GS, Perera N, Murray A, Orchard J, Arden NA, Filbay SR. The relationship between cricket participation, health and wellbeing: A scoping review. Int J Sports Med 2021; 43:401-410. [PMID: 34734400 DOI: 10.1055/a-1686-6632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Summarising and synthesising the evidence on cricket health and wellbeing can help inform cricket stakeholders and navigate future research directions. The purpose of this study was to investigate the relationship between cricket participation, health and wellbeing at all ages and playing standards, and identify research gaps in the existing literature. A scoping review was performed from inception to March, 2020. Studies were included if they assessed a construct related to health and/or wellbeing in cricketers, available in English. 219 articles were eligible. Injury incidence per 1,000 player exposures ranged from 1.8-5.7 injuries. 48% of former cricketers experienced persistent joint pain. However, former cricketers reported greater physical activity levels and mental-components of quality of life compared to the general population. Heat injury/illness and skin cancer are concerns and require further research. Cricket participation is associated with an inherent injury risk, which may have negative implications for musculoskeletal health in later life. However, cricket participation is associated with high quality of life which can persist after retirement. Gaps in the literature include prospective studies on health and wellbeing of cricketers, female cricketers, injury prevention strategies, and the impact of cricket participation on metabolic health and lifetime physical activity.
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Affiliation(s)
- Garrett Scott Bullock
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, United States.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Nirmala Perera
- Sport Medicine, Australian Institute of Sport, Belconnen, Australia
| | - Andrew Murray
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - John Orchard
- Medicine, University of Sydney, Sydney, Australia
| | - Nigel A Arden
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Stephanie R Filbay
- Physiotherapy, The University of Melbourne Department of Physiotherapy, Melbourne, Australia
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Risk Factors, Diagnosis and Management of Bone Stress Injuries in Adolescent Athletes: A Narrative Review. Sports (Basel) 2021; 9:sports9040052. [PMID: 33923520 PMCID: PMC8073721 DOI: 10.3390/sports9040052] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/03/2021] [Accepted: 04/13/2021] [Indexed: 12/14/2022] Open
Abstract
Physical activity is known to be beneficial for bone; however, some athletes who train intensely are at risk of bone stress injury (BSI). Incidence in adolescent athlete populations is between 3.9 and 19% with recurrence rates as high as 21%. Participation in physical training can be highly skeletally demanding, particularly during periods of rapid growth in adolescence, and when competition and training demands are heaviest. Sports involving running and jumping are associated with a higher incidence of BSI and some athletes appear to be more susceptible than others. Maintaining a very lean physique in aesthetic sports (gymnastics, figure skating and ballet) or a prolonged negative energy balance in extreme endurance events (long distance running and triathlon) may compound the risk of BSI with repetitive mechanical loading of bone, due to the additional negative effects of hormonal disturbances. The following review presents a summary of the epidemiology of BSI in the adolescent athlete, risk factors for BSI (physical and behavioural characteristics, energy balance and hormone disruption, growth velocity, sport-specific risk, training load, etc.), prevention and management strategies.
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Taylor J, Saw AE, Saw R, Sims K, Kountouris A. Presence of bone marrow oedema in asymptomatic elite fast bowlers: Implications for management. Bone 2021; 143:115626. [PMID: 32891868 DOI: 10.1016/j.bone.2020.115626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/18/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES 1) Quantify the intensity of bone marrow oedema (BMO) present in the lumbar vertebrae of asymptomatic elite adult fast bowlers; 2) relate the intensity of BMO to bowling workload and lumbar bone stress injury (LBSI), and; 3) evaluate the utility of MRI screening to reduce the risk of LBSI. METHODS Thirty-eight elite Australian fast bowlers (21.6 ± 3.7 years) completed 48 screening MRI over 3 years. BMO intensity was quantified on MRI retrospectively. Standard practices for bowling workload monitoring and injury diagnosis were followed. RESULTS Clinically significant BMO (signal intensity ratio ≥ 2.0) was observed in 22 (46%, 95% CI 31-61) screening MRI. These bowlers had a total of 77 (IQR 45-115) days off between seasons, compared to 66 (IQR 41-94) days off for bowlers with a BMO intensity less than 2.0 (p = 0.510). Fifteen bowlers received follow up MRI as part of individualised management based on their screening MRI, of which less than five went on to develop LBSI in the subsequent season. There was no difference in days or balls bowled in the 12 months following screening MRI between those who sustained LBSI and those who did not. CONCLUSIONS BMO is common in asymptomatic bowlers. Identification of high-risk bowlers using screening MRI informs individualised management and may prevent progression to LBSI.
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Affiliation(s)
- Jane Taylor
- Cricket Australia, 60 Jolimont St, Jolimont, Victoria 3002, Australia.
| | - Anna E Saw
- Cricket Australia, 60 Jolimont St, Jolimont, Victoria 3002, Australia.
| | - Richard Saw
- Cricket Australia, 60 Jolimont St, Jolimont, Victoria 3002, Australia
| | - Kevin Sims
- Cricket Australia, 60 Jolimont St, Jolimont, Victoria 3002, Australia
| | - Alex Kountouris
- Cricket Australia, 60 Jolimont St, Jolimont, Victoria 3002, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne 3086, Australia
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Connolly M, Rotstein AH, Roebert J, Grabinski R, Malara F, O'Shea T, Wood T, Omizzolo M, Kovalchik S, Reid M. Lumbar spine abnormalities and facet joint angles in asymptomatic elite junior tennis players. SPORTS MEDICINE-OPEN 2020; 6:57. [PMID: 33237502 PMCID: PMC7688834 DOI: 10.1186/s40798-020-00285-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Lumbar spine abnormalities, in particular stress fractures to the pars interarticularis, are common in elite junior tennis players, though the difference in prevalence between males and females remains unclear. Further, facet joint orientation appears to be a possible option for recognizing which players might go on to present with a pars stress fracture. Given the link between pars stress fractures and low back pain in tennis players, it appears logical to explore the link between facet joint angle and pars abnormalities. Thus, the purpose of this study was to describe the prevalence of lumbar spine abnormalities and explore the relationship between facet joint orientation and pars abnormalities in elite adolescent tennis players. METHODOLOGY Lumbar spine MRI images of 25 elite junior tennis players were obtained and distributed between five radiologists for analysis. Descriptive comparisons and confidence intervals were used to describe the prevalence of the abnormalities. A generalized linear regression model was conducted to investigate the relationship between lumbar pars abnormalities and lumbar facet joint angles. RESULTS Sixteen (64%) of 25 players were found to have at least one lumbar spine abnormality. Pars abnormalities affected 36% of players while bone marrow edema was found in 24% of players. Disc herniation, disc degeneration, and facet joint degeneration were diagnosed in 20%, 44%, and 24% of players respectively. Lastly, one player (4%) was diagnosed with spondylolisthesis. Females had significantly larger facet joint angles across L3/4 L5/S1 compared to males (p < 0.01). Further, those who had pars abnormalities had larger facet joint angles compared to those who did not (p < 0.001). CONCLUSION Disc degeneration, pars abnormalities, including bone marrow edema, and facet joint degeneration were common findings among elite adolescent tennis players. Additionally, this study is the first to discover that pars abnormalities are linked to facet joint angle in elite adolescent tennis players. This finding might assist in identifying tennis players at a greater risk of developing lumbar spine pars abnormalities in the future.
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Affiliation(s)
- Molly Connolly
- Institute for Health and Sport, Victoria University, Melbourne, Australia. .,Performance, Tennis Australia, Melbourne, Australia.
| | - Andrew H Rotstein
- Victoria House Medical Imaging, 435 Malvern Rd, South Yarra, Melbourne, Australia
| | - Justin Roebert
- Victoria House Medical Imaging, 435 Malvern Rd, South Yarra, Melbourne, Australia
| | - Rafal Grabinski
- Victoria House Medical Imaging, 435 Malvern Rd, South Yarra, Melbourne, Australia
| | - Frank Malara
- Victoria House Medical Imaging, 435 Malvern Rd, South Yarra, Melbourne, Australia
| | - Tomas O'Shea
- Victoria House Medical Imaging, 435 Malvern Rd, South Yarra, Melbourne, Australia
| | - Tim Wood
- Glenferrie Private Hospital, Melbourne, Australia
| | | | - Stephanie Kovalchik
- Institute for Health and Sport, Victoria University, Melbourne, Australia.,Game Insight Group, Tennis Australia, Melbourne, Australia
| | - Machar Reid
- Game Insight Group, Tennis Australia, Melbourne, Australia
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Wilson F, Ardern CL, Hartvigsen J, Dane K, Trompeter K, Trease L, Vinther A, Gissane C, McDonnell SJ, Caneiro JP, Newlands C, Wilkie K, Mockler D, Thornton JS. Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis. Br J Sports Med 2020; 55:bjsports-2020-102537. [PMID: 33077481 DOI: 10.1136/bjsports-2020-102537] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We aimed to determine the prevalence of low back pain (LBP) in sport, and what risk factors were associated with LBP in athletes. DESIGN Systematic review with meta-analysis. DATA SOURCES Literature searches from database inception to June 2019 in Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus, supplemented by grey literature searching. ELIGIBILITY CRITERIA Studies evaluating prevalence of LBP in adult athletes across all sports. RESULTS Eighty-six studies were included (30 732, range 20-5958, participants), of which 45 were of 'high' quality. Definitions of LBP varied widely, and in 17 studies, no definition was provided. High-quality studies were pooled and the mean point prevalence across six studies was 42%; range 18%-80% (95% CI 27% to 58%, I2=97%). Lifetime prevalence across 13 studies was 63%; range 36%-88% (95% CI 51% to 74%, I2=99%). Twelve-month LBP prevalence from 22 studies was 51%; range 12%-94% (95% CI 41% to 61%, I2=98%). Comparison across sports was limited by participant numbers, study quality and methodologies, and varying LBP definitions. Risk factors for LBP included history of a previous episode with a pooled OR of 3.5; range 1.6-4.0 (95% CI 1.9 to 6.4). Statistically significant associations were reported for high training volume, periods of load increase and years of exposure to the sport. CONCLUSION LBP in sport is common but estimates vary. Current evidence is insufficient to identify which sports are at highest risk. A previous episode of LBP, high training volume, periods of load increase and years of exposure are common risk factors.
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Affiliation(s)
- Fiona Wilson
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | - Clare L Ardern
- Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden
- Sport & Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Kathryn Dane
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | - Katharina Trompeter
- Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Bochum, Germany
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Larissa Trease
- Healthcare in Remote and Extreme Environments program, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy and QD-Research Unit, Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
| | - Conor Gissane
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | | | - J P Caneiro
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
| | | | - Kellie Wilkie
- Bodysystem Physiotherapy, Hobart, Tasmania, Australia
| | - David Mockler
- John Stearne Library, Trinity College Dublin, Dublin, Ireland
| | - Jane S Thornton
- Fowler Kennedy Sports Medicine Clinic, Western University, London, Ontario, Canada
- Western Centre for Public Health and Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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12
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Senington B, Lee RY, Williams JM. Biomechanical risk factors of lower back pain in cricket fast bowlers using inertial measurement units: a prospective and retrospective investigation. BMJ Open Sport Exerc Med 2020; 6:e000818. [PMID: 32843992 PMCID: PMC7430332 DOI: 10.1136/bmjsem-2020-000818] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2020] [Indexed: 12/23/2022] Open
Abstract
Objectives To investigate spinal kinematics, tibial and sacral impacts during fast bowling, among bowlers with a history of low back pain (LBP) (retrospective) and bowlers who developed LBP in the follow-up season (prospective). Methods 35 elite male fast bowlers; senior (n=14; age=24.1±4.3 years; height=1.89±0.05 m; weight=89.2±4.6 kg) and junior (n=21; age=16.9±0.7; height=1.81±0.05; weight=73.0±9.2 kg) were recruited from professional county cricket clubs. LBP history was gathered by questionnaire and development of LBP was monitored for the follow-up season. Spinal kinematics, tibial and sacral impacts were captured using inertial measurement units placed over S1, L1, T1 and anteromedial tibia. Bonferroni corrected pairwise comparisons and effect sizes were calculated to investigate differences in retrospective and prospective LBP groups. Results Approximately 38% of juniors (n=8) and 57% of seniors (n=8) reported a history of LBP. No differences were evident in spinal kinematics or impacts between those with LBP history and those without for seniors and juniors. Large effect sizes suggest greater rotation during wind-up (d=1.3) and faster time-to-peak tibial impacts (d=1.5) in those with no history of LBP. One junior (5%) and four (29%) seniors developed LBP. No differences were evident in spinal kinematics or impacts between those who developed LBP and those who did not for seniors. In seniors, those who developed LBP had lower tibial impacts (d=1.3) and greater lumbar extension (d=1.9) during delivery. Conclusion Retrospective analysis displayed non-significant differences in kinematics and impacts. It is unclear if these are adaptive or impairments. Prospective analysis demonstrated large effect sizes for lumbar extension during bowling suggesting a target for future coaching interventions.
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Affiliation(s)
- Billy Senington
- School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Raymond Y Lee
- Faculty of Technology, University of Portsmouth, Portsmouth, UK
| | - Jonathan M Williams
- Department of Rehabilitation and Sport Sciences, Bournemouth University, Bournemouth, UK
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13
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Radiological healing of lumbar spine stress fractures in elite cricket fast bowlers. J Sci Med Sport 2020; 24:112-115. [PMID: 32680702 DOI: 10.1016/j.jsams.2020.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/20/2020] [Accepted: 06/27/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Review magnetic resonance imaging (MRI) of elite adult fast bowlers with a history of lumbar spine stress fracture for evidence of bone healing. The findings will determine whether bone healing can occur in this population, and whether MRI may be used as a tool to assess bone healing and inform clinical decision making. DESIGN Retrospective cohort. METHODS Participants were elite Australian fast bowlers who sustained a lumbar spine stress fracture confirmed on MRI and had at least one subsequent MRI. Two radiologists independently reviewed all images. RESULTS Thirty-one fractures from 20 male fast bowlers were reviewed. Median maximum fracture size was 6mm (range 2-25mm). Twenty-five fractures achieved bone healing, with a median 203 (IQR 141-301) days between the initial MRI (to confirm diagnosis) and the MRI when bone healing was observed. Fracture size and signal intensity of bone marrow oedema were positively associated with the number of days to the MRI when bone healing was observed (r2=0.245, p<0.001 and r2=0.292, p<0.001 respectively). Fractures which occurred at the same site as a previously united fracture took longer to heal than the first fracture (median 276 days to the MRI when bone healing was observed compared to 114 days for first fracture; p=0.036). CONCLUSIONS Lumbar spine stress fractures in elite adult fast bowlers are capable of achieving complete bone healing, as demonstrated in the majority of bowlers in this study. Larger fractures, greater bone marrow oedema, and history of previous injury at the same site may require longer healing time which may be monitored with MRI.
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14
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Abstract
Athletes should pay more attention to their bone health, whether this relates to their longer-term bone health (e.g. risk of osteopenia and osteoporosis) or their shorter-term risk of bony injuries. Perhaps the easiest way to do this would be to modify their training loads, although this advice rarely seems popular with coaches and athletes for obvious reasons. As such, other possibilities to support the athletes’ bone health need to be explored. Given that bone is a nutritionally modified tissue and diet has a significant influence on bone health across the lifespan, diet and nutritional composition seem like obvious candidates for manipulation. The nutritional requirements to support the skeleton during growth and development and during ageing are unlikely to be notably different between athletes and the general population, although there are some considerations of specific relevance, including energy availability, low carbohydrate availability, protein intake, vitamin D intake and dermal calcium and sodium losses. Energy availability is important for optimising bone health in the athlete, although normative energy balance targets are highly unrealistic for many athletes. The level of energy availability beyond which there is no negative effect for the bone needs to be established. On the balance of the available evidence it would seem unlikely that higher animal protein intakes, in the amounts recommended to athletes, are harmful to bone health, particularly with adequate calcium intake. Dermal calcium losses might be an important consideration for endurance athletes, particularly during long training sessions or events. In these situations, some consideration should be given to pre-exercise calcium feeding. The avoidance of vitamin D deficiency and insufficiency is important for the athlete to protect their bone health. There remains a lack of information relating to the longer-term effects of different dietary and nutritional practices on bone health in athletes, something that needs to be addressed before specific guidance can be provided.
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15
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Goggins L, Peirce N, Ranson C, McCaig S, Newman D, Langley B, Griffin S, Young M, McKay C, Stokes K, Williams S. Injuries in England and Wales elite men's domestic cricket: A nine season review from 2010 to 2018. J Sci Med Sport 2020; 23:836-840. [PMID: 32303476 DOI: 10.1016/j.jsams.2020.03.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/06/2020] [Accepted: 03/16/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study primarily aimed to explore injury incidence rates in the three main domestic competition formats in England and Wales (First-Class, One-Day and Twenty20 [T20]). For the first time, the study also describes the epidemiology of elite men's domestic cricket injuries across nine seasons (2010-2018 inclusive). DESIGN Prospective cohort analysis. METHODS Injury incidence and prevalence from all injuries calculated according to the updated international consensus statement on injury surveillance in cricket, with statistical process control charts (SPC) used to detect trends in the data. RESULTS The average match injury incidence was 102 injuries/1000 days of play, with highest incidence in One-Day (254 injuries/1000 days of play), followed by T20 (136 injuries/1000 days of play) and First-Class Cricket (68 injuries/1000 days of play). Most match injuries were sustained during bowling (41.6 injuries/1000 days of play), followed by fielding (26.8 injuries/1000 days of play) and batting (22.3 injuries/1000 days of play). The thigh was the body area most commonly injured (7.4 injuries/100 players per season), with lumbar spine injuries the most prevalent (1.3% of players unavailable on any given day during the season). On average, 7.5% of players were unavailable on any given day during the domestic season when all injuries were considered (match and training). The SPC charts showed relatively consistent match injury incidence for all competitions, reproduced across all nine seasons. CONCLUSION These findings provide a robust empirical base for the extent of the injury problem in domestic cricket played in England and Wales, with similar injury profiles across the three formats.
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Affiliation(s)
- Luke Goggins
- Sport Injury Prevention at Bath, Department for Health, University of Bath, United Kingdom.
| | - Nicholas Peirce
- England and Wales Cricket Board, National Cricket Performance Centre, Loughborough University, United Kingdom
| | - Craig Ranson
- English Institute of Sport, The Manchester Institute of Health and Performance, United Kingdom
| | - Steve McCaig
- English Institute of Sport, The Manchester Institute of Health and Performance, United Kingdom
| | - David Newman
- England and Wales Cricket Board, National Cricket Performance Centre, Loughborough University, United Kingdom
| | - Ben Langley
- England and Wales Cricket Board, National Cricket Performance Centre, Loughborough University, United Kingdom
| | - Steve Griffin
- England and Wales Cricket Board, National Cricket Performance Centre, Loughborough University, United Kingdom
| | - Mark Young
- Geelong Cats Football Club, GMHBA Stadium, Australia
| | - Carly McKay
- Sport Injury Prevention at Bath, Department for Health, University of Bath, United Kingdom
| | - Keith Stokes
- Sport Injury Prevention at Bath, Department for Health, University of Bath, United Kingdom
| | - Sean Williams
- Sport Injury Prevention at Bath, Department for Health, University of Bath, United Kingdom
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16
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Abstract
STUDY DESIGN Literature review. OBJECTIVE To conduct a literature review of studies reporting the incidence of pars interarticularis defects in athletes of specific sports, in order to allow more targeted prevention and treatment strategies to be implemented for the groups at highest risk. METHODS Electronic searches were performed using PubMed, Ovid Medline, EMBASE, Google Scholar, Cochrane Database of Systematic Reviews, and Cochrane Database of Controlled Trials from their dates of inception to September 2017, with the following keywords: "spondylolysis," "sports," "low back pain," and "pars defects." RESULTS A total of 509 total articles were retrieved, of which 114 were used in the final review. The incidence of pars interarticularis defects was found to be highest in diving (35.38%), cricket (31.97%), baseball/softball (26.91%), rugby (22.22%), weightlifting (19.49%), sailing (17.18%), table tennis (15.63%), and wrestling (14.74%). Only 5 studies reported the management instituted for their participants, and these were all case reports. Of 74 players with spondylolysis in these studies, 70 (94.59%) underwent conservative treatment and 4 (5.41%) underwent surgical treatment. 61 (82.43%) returned to their previous level of play, 6 (8.11%) retired, and the disposition of the final 7 was not reported. CONCLUSION The current medical literature provides good evidence that the incidence of pars interarticularis defects is higher in the athletic population, with the highest incidence in diving. There remains no gold standard protocol for the management of pars interarticularis defects. Further research is required to compare conservative therapy to surgical therapy and to compare the various surgical techniques to each other.
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Affiliation(s)
- Samuel Tawfik
- University of New South Wales, Sydney, New South Wales, Australia,St George Hospital, Sydney, New South Wales, Australia,Samuel Tawfik, St George Hospital, Sydney, New South Wales, Australia 2217.
| | - Kevin Phan
- University of New South Wales, Sydney, New South Wales, Australia,Neurospine Surgery Research Group, Sydney, New South Wales, Australia
| | - Ralph J. Mobbs
- Neurospine Surgery Research Group, Sydney, New South Wales, Australia,Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Prashanth J. Rao
- Neurospine Surgery Research Group, Sydney, New South Wales, Australia,University of Sydney, Sydney, New South Wales, Australia,Westmead Hospital, Sydney, New South Wales, Australia
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17
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Is there an association between external workload and lower-back injuries in cricket fast bowlers? A systematic review. Phys Ther Sport 2020; 41:71-79. [DOI: 10.1016/j.ptsp.2019.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/31/2019] [Accepted: 11/14/2019] [Indexed: 12/18/2022]
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18
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Bony stress in the lumbar spine is associated with intervertebral disc degeneration and low back pain: a retrospective case-control MRI study of patients under 25 years of age. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:2470-2477. [PMID: 31529214 DOI: 10.1007/s00586-019-06148-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/04/2019] [Accepted: 09/10/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE Abnormal stress in the lumbar vertebra, also known as bony stress, can be a precursor to degenerative changes which may manifest as low back pain (LBP). However, the prevalence of bony stress in the lumbar spine and its relationship with degenerative changes and LBP is unclear. The purpose of this study was to evaluate the prevalence of bony stress in the lumbar spine and its relationship with intervertebral disc (IVD) degeneration, facet osteoarthritis and LBP in patients under 25 years of age. METHODS A retrospective case-control study of 130 patients under 25 years of age was conducted from a population of 493 patients who had lumbar MRI across three imaging centres over three years. A cohort of 55 consecutive patients with bony stress was identified. A control group of consecutive patients (n = 75) without bony stress was also selected from the population. RESULTS Bony stress was prevalent in 11% (95% CI [8.4-14.5%]) of patients and was not diagnosed in 36% (95% CI [22-55%]) of these cases. Patients with bony stress had over twofold (OR 2.3, 95% CI [1.1-4.8]) and fivefold (OR 5.3, 95% CI [2.11-13.3]) higher likelihood of having IVD degeneration and LBP, respectively, when compared with the control group. Bony stress was not found to be associated with facet osteoarthritis. CONCLUSION Bony stress in the lumbar spine was prevalent in 11% of patients under 25 years of age. It was commonly undiagnosed in radiology reports (not reported in 36% of the cases). Being significantly associated and with an increased likelihood of IVD degeneration and LBP, we posit that bony stress is likely a symptomatic and clinically meaningful diagnostic entity in the assessment of LBP. These slides can be retrieved under Electronic Supplementary Material.
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19
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Alway P, Brooke-Wavell K, Langley B, King M, Peirce N. Incidence and prevalence of lumbar stress fracture in English County Cricket fast bowlers, association with bowling workload and seasonal variation. BMJ Open Sport Exerc Med 2019; 5:e000529. [PMID: 31205746 PMCID: PMC6540320 DOI: 10.1136/bmjsem-2019-000529] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Since much of the previous epidemiological research into lumbar stress fracture was conducted, there has been a marked increase in the amount of cricket being played. The aims were to determine the incidence and prevalence of lumbar stress fracture in English County Cricket fast bowlers between 2010 and 2016, determine the association with match bowling workload and observe seasonal variation in workload and injury. METHODS Lumbar stress fracture incidence and prevalence rates were calculated using new international methods for epidemiology in 368 professional English fast bowlers from 2010 to 2016. Workload variables were compared between lumbar stress fracture case and non-injured control groups, before entry in a logistic regression. RESULTS Fifty-seven lumbar stress fractures (mean age 22.81) were reported. Injury was most common in July and September. Match incidence was 0.16 lumbar stress fractures per 10 000 deliveries, annual incidence was 2.46 lumbar stress fractures per 100 fast bowlers and annual prevalence of lumbar stress fractures was 1.67% of squad days. Significant workload variables were observed between cases and controls. A peak 7-day workload of greater than 234 deliveries significantly increased the odds of sustaining a lumbar stress fracture 11-fold compared with bowling fewer than 197 deliveries. CONCLUSION Lumbar stress fractures are common in young fast bowlers possibly due to immaturity of the lumbar spine. The condensed early and late-season schedule may be causing periods of overuse, resulting in an increase in incidence of lumbar stress fracture. Reduction of workload in young fast bowlers is needed to reduce incidence.
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Affiliation(s)
- Peter Alway
- SSEHS, Loughborough University, Loughborough, UK
| | | | - Ben Langley
- Science and Medicine, England and Wales Cricket Board, Loughborough, UK
| | - Mark King
- SSEHS, Loughborough University, Loughborough, UK
| | - Nicholas Peirce
- Science and Medicine, England and Wales Cricket Board, Loughborough, UK
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20
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Nutrition for the Prevention and Treatment of Injuries in Track and Field Athletes. Int J Sport Nutr Exerc Metab 2019; 29:189-197. [PMID: 30676133 DOI: 10.1123/ijsnem.2018-0290] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Injuries are an inevitable consequence of athletic performance with most athletes sustaining one or more during their athletic careers. As many as one in 12 athletes incur an injury during international competitions, many of which result in time lost from training and competition. Injuries to skeletal muscle account for over 40% of all injuries, with the lower leg being the predominant site of injury. Other common injuries include fractures, especially stress fractures in athletes with low energy availability, and injuries to tendons and ligaments, especially those involved in high-impact sports, such as jumping. Given the high prevalence of injury, it is not surprising that there has been a great deal of interest in factors that may reduce the risk of injury, or decrease the recovery time if an injury should occur: One of the main variables explored is nutrition. This review investigates the evidence around various nutrition strategies, including macro- and micronutrients, as well as total energy intake, to reduce the risk of injury and improve recovery time, focusing upon injuries to skeletal muscle, bone, tendons, and ligaments.
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21
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Herbert AJ, Williams AG, Hennis PJ, Erskine RM, Sale C, Day SH, Stebbings GK. The interactions of physical activity, exercise and genetics and their associations with bone mineral density: implications for injury risk in elite athletes. Eur J Appl Physiol 2019; 119:29-47. [PMID: 30377780 PMCID: PMC6342881 DOI: 10.1007/s00421-018-4007-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 10/04/2018] [Indexed: 01/30/2023]
Abstract
Low bone mineral density (BMD) is established as a primary predictor of osteoporotic risk and can also have substantial implications for athlete health and injury risk in the elite sporting environment. BMD is a highly multi-factorial phenotype influenced by diet, hormonal characteristics and physical activity. The interrelationships between such factors, and a strong genetic component, suggested to be around 50-85% at various anatomical sites, determine skeletal health throughout life. Genome-wide association studies and case-control designs have revealed many loci associated with variation in BMD. However, a number of the candidate genes identified at these loci have no known associated biological function or have yet to be replicated in subsequent investigations. Furthermore, few investigations have considered gene-environment interactions-in particular, whether specific genes may be sensitive to mechanical loading from physical activity and the outcome of such an interaction for BMD and potential injury risk. Therefore, this review considers the importance of physical activity on BMD, genetic associations with BMD and how subsequent investigation requires consideration of the interaction between these determinants. Future research using well-defined independent cohorts such as elite athletes, who experience much greater mechanical stress than most, to study such phenotypes, can provide a greater understanding of these factors as well as the biological underpinnings of such a physiologically "extreme" population. Subsequently, modification of training, exercise or rehabilitation programmes based on genetic characteristics could have substantial implications in both the sporting and public health domains once the fundamental research has been conducted successfully.
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Affiliation(s)
- Adam J. Herbert
- Department of Sport and Exercise, School of Health Sciences, Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - Alun G. Williams
- Sports Genomics Laboratory, Manchester Metropolitan University, Cheshire Campus, Crewe Green Road, Crewe, CW1 5DU UK
- Institute of Sport, Exercise and Health, University College London, Tottenham Court Road, London, W17 7HA UK
| | - Philip J. Hennis
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Clifton Lane, Clifton, Nottingham, NG11 8NS UK
| | - Robert M. Erskine
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF UK
- Institute of Sport, Exercise and Health, University College London, Tottenham Court Road, London, W17 7HA UK
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Clifton Lane, Clifton, Nottingham, NG11 8NS UK
| | - Stephen H. Day
- Department of Biomedical Science & Physiology, School of Sciences, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, UK
| | - Georgina K. Stebbings
- Sports Genomics Laboratory, Manchester Metropolitan University, Cheshire Campus, Crewe Green Road, Crewe, CW1 5DU UK
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22
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Kountouris A, Sims K, Beakley D, Saw AE, Orchard J, Rotstein A, Cook JL. MRI bone marrow oedema precedes lumbar bone stress injury diagnosis in junior elite cricket fast bowlers. Br J Sports Med 2018; 53:1236-1239. [PMID: 30425044 DOI: 10.1136/bjsports-2017-097930] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Lumbar bone stress injury ('bone stress injury') is common in junior fast bowlers. The repetitive loading of cricket fast bowling may cause bone marrow oedema (BMO), detectable on MRI, before the bowler suffers from symptomatic bone stress injury. We investigated the temporal relationship between BMO, bone stress injury, along with bowling workload correlates, in elite junior fast bowlers throughout a cricket season. METHODS 65 junior fast bowlers were prospectively monitored for one 8-month cricket season. For research purposes, participants had up to six MRI scans at set times in the season; findings were withheld from them and their clinicians. Standard practices for bowling workload monitoring and injury diagnosis were followed. RESULTS 15 (23%) participants developed bone stress injury during the study. All 15 of these participants had BMO detected on at least one of the preceding MRI scans, including the scan immediately prior to diagnosis. The risk of BMO progressing to bone stress injury during the season was greatest for participants with BMO present 2 weeks prior to the national championship tournament (period of high load) (RR=18.9, OR=44.8). Both bone stress injury and BMO were associated with bowling a higher percentage of days in training and having a shorter bowling break during the season. The number of balls bowled and acute-to-chronic workload were not associated with imaging abnormalities or injury. CONCLUSION The presence of BMO on MRI in asymptomatic junior cricket fast bowlers confers a very high risk for bone stress injury. The risk may be managed by MRI screening and monitoring bowling frequency.
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Affiliation(s)
- Alex Kountouris
- Cricket Australia, Brisbane, Queensland, Australia.,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Kevin Sims
- Cricket Australia, Brisbane, Queensland, Australia
| | | | - Anna E Saw
- Cricket Australia, Brisbane, Queensland, Australia
| | - John Orchard
- Cricket Australia, Brisbane, Queensland, Australia.,School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew Rotstein
- Victoria House Medical Imaging, Melbourne, Victoria, Australia
| | - Jill L Cook
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
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23
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Forrest MRL, Hebert JJ, Scott BR, Brini S, Dempsey AR. Risk Factors for Non-Contact Injury in Adolescent Cricket Pace Bowlers: A Systematic Review. Sports Med 2018; 47:2603-2619. [PMID: 28879571 DOI: 10.1007/s40279-017-0778-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Adolescent cricket pace bowlers are prone to injury. Recognising the risk factors for non-contact injury in this population will aid future injury prevention strategies. OBJECTIVE To identify the risk factors for non-contact injury in adolescent cricket pace bowlers. METHODS We systematically searched PubMed, Cochrane Library, PEDro, SPORTDiscus, Embase, and the South African Journal of Sports Medicine to identify all experimental and observational studies reporting risk factors for non-contact injuries in pace bowlers (aged 12-19 years). The search syntax included terms relevant to cricket bowling, injury, and known risk factors for injury. The Newcastle-Ottawa Quality Assessment Scale and a modified Newcastle-Ottawa Quality Assessment Scale were used to assess the risk of bias in the cohort and cross-sectional studies, respectively. RESULTS Sixteen studies (five cross-sectional studies, 11 cohort studies) comprising 687 participants (96% male, 75% playing cricket in Australia) met the selection criteria and were included for qualitative synthesis. Three cross-sectional studies were rated as high risk of bias and two as very high risk of bias. For the cohort studies, three were rated as low risk of bias, and eight as high risk of bias. Injury was associated with bowling biomechanics (excessive lateral trunk flexion and pelvis/hip kinematics), reduced trunk endurance, poor lumbo-pelvic-hip movement control, and early signs of lumbar bone stress. Conflicting results were found by studies examining the mixed technique, bowling workload and quadratus lumborum asymmetry. CONCLUSIONS The current systematic review identified a number bowling biomechanics and various neuromuscular deficiencies as risk factors for non-contact injury in adolescent pace bowlers. These factors may provide a useful target for future interventional research aiming to prevent injury in this population. Future studies should utilise prospective cohort designs, and ensure that participants are injury-free at baseline, confounding factors are well controlled and attrition rates are reported. REGISTRATION This systematic review was registered a priori (PROSPERO, CRD42016043956).
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Affiliation(s)
- Mitchell R L Forrest
- School of Psychology and Exercise Science, Murdoch University, 90 South St, Murdoch, Perth, WA, 6150, Australia.
| | - Jeffrey J Hebert
- School of Psychology and Exercise Science, Murdoch University, 90 South St, Murdoch, Perth, WA, 6150, Australia.,Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
| | - Brendan R Scott
- School of Psychology and Exercise Science, Murdoch University, 90 South St, Murdoch, Perth, WA, 6150, Australia
| | - Stefano Brini
- School of Psychology and Exercise Science, Murdoch University, 90 South St, Murdoch, Perth, WA, 6150, Australia.,Department of Psychology and Speech-Language Pathology, University of Turku, 20014, Turku, Finland
| | - Alasdair R Dempsey
- School of Psychology and Exercise Science, Murdoch University, 90 South St, Murdoch, Perth, WA, 6150, Australia
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24
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Cheung KK, Dhawan RT, Wilson LF, Peirce NS, Rajeswaran G. Pars interarticularis injury in elite athletes – The role of imaging in diagnosis and management. Eur J Radiol 2018; 108:28-42. [DOI: 10.1016/j.ejrad.2018.08.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 08/31/2018] [Indexed: 02/01/2023]
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25
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The association of novel polymorphisms with stress fracture injury in Elite Athletes: Further insights from the SFEA cohort. J Sci Med Sport 2017; 21:564-568. [PMID: 29129460 DOI: 10.1016/j.jsams.2017.10.038] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 09/24/2017] [Accepted: 10/31/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To determine, in conjunction with a wider investigation, whether 11 genetic variants in the vicinity of vitamin D, collagen and Wnt signalling pathways were associated with stress fracture injury in the Stress Fracture Elite Athlete (SFEA) cohort. DESIGN Genotype-phenotype association study. METHODS Self-reported stress fracture history and demographic data were recorded in 518 elite athletes, 449 male and 69 female (mean age 24.2±5.5 years) from the SFEA cohort. Elite athletes were assigned to two groups based on history of stress fracture injury. Data were analysed for the whole cohort and sub-stratified in to male only and multiple stress fracture cases. Genotype was determined using a proprietary fluorescence-based competitive allele-specific polymerase chain reaction assay. RESULTS SOST SNP rs1877632 and VDR SNPs rs10735810 and rs731236 were associated with stress fracture (p<0.05). In the whole cohort, rs1877632 heterozygotes and homozygotes of the rare allele combined made up 59% of stress fracture sufferers in comparison to 46% in the non-stress fracture group (p=0.05). In the multiple stress fracture cohort, homozygotes of the rare allele of rs10735810 and rs731236 showed an association with stress fracture when compared to those homozygotes for the common allele combined with heterozygotes (p=0.03; p=0.01). No significant associations were shown in the other SNPs analysed (p>0.05). CONCLUSIONS These data suggest an important role for SOST SNP rs1877632 and VDR SNPs rs10735810 and rs731236 in the pathophysiology of stress fracture. This might be due to the role of the SNPs in the regulation of bone remodelling and adaptation to mechanical loading, with potential implications for the prevention and treatment of stress fracture injuries.
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Abstract
Context: Cricket is a popular global sport that requires a combination of physical
fitness, skill, and strategy. Although a noncontact sport, overuse and
impact injuries are common since players engage in a wide range of physical
activities, including running, throwing, batting, bowling, catching, and
diving. Significant or match time-loss injuries are defined as those that
either prevent a player from being fully available for selection in a major
match, or during a major match, cause a player to be unable to bat, bowl, or
keep wicket when required by either the rules or the team’s captain. This
review describes the various region-wise injuries sustained in cricket along
with their epidemiology, biomechanics, treatment, and prevention. Evidence Acquisition: Data were collected from peer-reviewed articles (obtained via PubMed search)
published through November 2016 that involved the medical, biomechanical,
and epidemiological aspects of cricket injuries. Study Design: Clinical review. Level of Evidence: Level 4. Results: Cricket was one of the first sports to publish recommended methods for injury
surveillance in 2005 from England, South Africa, Australia, the West Indies,
and India. While the incidence of injuries is about the same, the prevalence
of injuries has increased due to game format changes, increasing number of
matches played, and decreased rest between matches. Bowling (41.3%),
fielding, and wicket keeping (28.6%) account for most injuries. Acute
injuries are most common (64%-76%), followed by acute-on-chronic (16%-22.8%)
and chronic ones (8%-22%). The most common modern-day cricket injury is
hamstring strain, and the most severe is lumbar stress fracture in young
fast bowlers. Conclusion: With improved understanding of the scientific and medical aspects of cricket,
along with advances in surgical and nonsurgical treatment techniques, the
time to return to play has shortened considerably. While the prevalence of
cricket injuries has increased, their severity has decreased over the past
decades.
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Affiliation(s)
- Dinshaw N Pardiwala
- Centre for Sports Medicine, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India.,International Cricket Council (ICC) Medical Advisory Committee, Dubai, United Arab Emirates
| | - Nandan N Rao
- Centre for Sports Medicine, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - Ankit V Varshney
- Centre for Sports Medicine, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
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TOWNSEND REBECCA, ELLIOTT-SALE KIRSTYJ, CURRELL KEVIN, TANG JONATHAN, FRASER WILLIAMD, SALE CRAIG. The Effect of Postexercise Carbohydrate and Protein Ingestion on Bone Metabolism. Med Sci Sports Exerc 2017; 49:1209-1218. [DOI: 10.1249/mss.0000000000001211] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bayne H, Elliott B, Campbell A, Alderson J. Lumbar load in adolescent fast bowlers: A prospective injury study. J Sci Med Sport 2016; 19:117-22. [DOI: 10.1016/j.jsams.2015.02.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 11/10/2014] [Accepted: 02/27/2015] [Indexed: 11/30/2022]
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29
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Which Extrinsic and Intrinsic Factors are Associated with Non-Contact Injuries in Adult Cricket Fast Bowlers? Sports Med 2015; 46:79-101. [DOI: 10.1007/s40279-015-0383-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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King M, Worthington P, Ranson C. Does maximising ball speed in cricket fast bowling necessitate higher ground reaction forces? J Sports Sci 2015; 34:707-12. [DOI: 10.1080/02640414.2015.1069375] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Arora M, Paoloni JA, Kandwal P, Diwan AD. Are Fast-Bowlers Prone to Back Injuries? Prevalence of Lumbar Spine Injuries in Fast-Bowlers: Review of MRI-Based Studies. Asian J Sports Med 2015; 5:e24291. [PMID: 25741421 PMCID: PMC4335482 DOI: 10.5812/asjsm.24291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 08/19/2014] [Accepted: 07/29/2014] [Indexed: 12/01/2022] Open
Abstract
Background: Fast-bowlers in cricket subject their spines to repetitive stress. Objectives: The aim of this study was to review the prevalence of lumbar spine injuries among fast-bowlers. Materials and Methods: Medline and embase searches were performed. Further, the authors canvassed the reference list of available articles and used other search engines such as Google Scholar to identify a total of nine studies. Results: The prevalence of lumbar disc degeneration in fast-bowlers ranges from 21-65% with an incidence rate of 15% per year, and the prevalence of lumbar spine bony abnormalities ranges from 24-81%. Factors associated with lumbar spine injury in fast-bowlers are classified into un-modifiable (age) and modifiable (more intense bowling workload and mixed-bowling technique). Conclusions: Fast-bowlers have a high prevalence of lumbar spine injuries. Appropriate interventions, such as educational sessions, may be able to modify risk factors such as bowling workload and bowling technique and thus reduce injury prevalence.
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Affiliation(s)
- Manit Arora
- St George Clinical School, University of New South Wales, Sydney, Australia
- Department of Spine Service, St George Private Hospital, Sydney, Australia
- Orthopaedics Research Institute, St George Hospital, Sydney, Australia
- Corresponding author: Manit Arora, Department of St George Clinical School, University of New South Wales, Sydney, Australia. Tel: +61-8452846005, E-mail:
| | - Justin A Paoloni
- Orthopaedics Research Institute, St George Hospital, Sydney, Australia
| | - P. Kandwal
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | - A. D. Diwan
- St George Clinical School, University of New South Wales, Sydney, Australia
- Department of Spine Service, St George Private Hospital, Sydney, Australia
- Orthopaedics Research Institute, St George Hospital, Sydney, Australia
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Varley I, Hughes DC, Greeves JP, Stellingwerff T, Ranson C, Fraser WD, Sale C. RANK/RANKL/OPG pathway: genetic associations with stress fracture period prevalence in elite athletes. Bone 2015; 71:131-6. [PMID: 25464125 DOI: 10.1016/j.bone.2014.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 09/09/2014] [Accepted: 10/09/2014] [Indexed: 01/13/2023]
Abstract
CONTEXT The RANK/RANKL/OPG signalling pathway is important in the regulation of bone turnover, with single nucleotide polymorphisms (SNPs) in genes within this pathway associated with bone phenotypic adaptations. OBJECTIVE To determine whether four SNPs associated with genes in the RANK/RANKL/OPG signalling pathway were associated with stress fracture injury in elite athletes. DESIGN, PARTICIPANTS, AND METHODS Radiologically confirmed stress fracture history was reported in 518 elite athletes, forming the Stress Fracture Elite Athlete (SFEA) cohort. Data were analysed for the whole group and were sub-stratified into male and cases of multiple stress fracture groups. Genotypes were determined using proprietary fluorescence-based competitive allele-specific PCR assays. RESULTS SNPs rs3018362 (RANK) and rs1021188 (RANKL) were associated with stress fracture injury (P<0.05). 8.1% of the stress fracture group and 2.8% of the non-stress fracture group were homozygote for the rare allele of rs1021188. Allele frequency, heterozygotes and homozygotes for the rare allele of rs3018362 were associated with stress fracture period prevalence (P<0.05). Analysis of the male only group showed 8.2% of rs1021188 rare allele homozygotes had suffered a stress fracture whilst 2.5% of the non-stress fracture group were homozygous. In cases of multiple stress fractures, homozygotes for the rare allele of rs1021188 and individuals possessing at least one copy of the rare allele of rs4355801 (OPG) were shown to be associated with stress fracture injury (P<0.05). CONCLUSIONS The data support an association between SNPs in the RANK/RANKL/OPG signalling pathway and the development of stress fracture injury. The association of rs3018362 (RANK) and rs1021188 (RANKL) with stress fracture injury susceptibility supports their role in the maintenance of bone health and offers potential targets for therapeutic interventions.
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Affiliation(s)
- Ian Varley
- Biomedical Life and Health Sciences Research Centre, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK.
| | - David C Hughes
- Biomedical Life and Health Sciences Research Centre, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK.
| | - Julie P Greeves
- Department of Occupational Medicine, Headquarters Army Recruiting and Training Division, UK.
| | | | - Craig Ranson
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, Wales, UK.
| | | | - Craig Sale
- Biomedical Life and Health Sciences Research Centre, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK.
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Cricket fast bowlers without low back pain have larger quadratus lumborum asymmetry than injured bowlers. Clin J Sport Med 2013; 23:300-4. [PMID: 23377354 DOI: 10.1097/jsm.0b013e318280ac88] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of the study was to determine the magnitude and side of quadratus lumborum (QL) asymmetries in elite, adult, cricket fast bowlers and the relationship with lumbar spine injury. DESIGN Cohort study. SETTING Cricket fast bowers had magnetic resonance (MR) scans at the start of a cricket season and their injury characteristics over the next cricket season were compared with the amount of QL asymmetry. PARTICIPANTS Twenty-three elite, asymptomatic, adult, cricket fast bowlers. ASSESSMENT OF RISK FACTORS The cross-sectional area (CSA) of QL was measured using MR imaging. The association between side-to-side differences in CSA (asymmetry) was evaluated as a possible risk factor for development of lumbar spine injury. MAIN OUTCOME MEASURES The main outcome measurements were QL CSA and asymmetry in relation to lumbar spine injury in cricket fast bowlers. RESULTS There were a greater proportion of dominant- (bowling arm) side asymmetries (65%). Asymmetry magnitudes that favored the dominant side were not significantly larger than those on the nondominant side. Four participants who had bone oedema on MR imaging preseason went on to develop symptomatic lumbar stress fractures. Participants with no lumbar spine injury had significantly larger QL asymmetries than those who sustained lumbar spine injury. CONCLUSIONS Cricket fast bowlers demonstrated asymmetrical QL development, which may be related to the trunk positions adopted in the fast bowling technique. Uninjured bowlers had larger asymmetries than those who developed lumbar spine injury, which is contrary to some previous research.
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Morton S, Barton CJ, Rice S, Morrissey D. Risk factors and successful interventions for cricket-related low back pain: a systematic review. Br J Sports Med 2013; 48:685-91. [DOI: 10.1136/bjsports-2012-091782] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kountouris A, Portus M, Cook J. Quadratus lumborum asymmetry and lumbar spine injury in cricket fast bowlers. J Sci Med Sport 2012; 15:393-7. [DOI: 10.1016/j.jsams.2012.03.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 03/22/2012] [Accepted: 03/24/2012] [Indexed: 10/28/2022]
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Crewe H, Elliott B, Couanis G, Campbell A, Alderson J. The lumbar spine of the young cricket fast bowler: An MRI study. J Sci Med Sport 2012; 15:190-4. [DOI: 10.1016/j.jsams.2011.11.251] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 11/06/2011] [Accepted: 11/10/2011] [Indexed: 11/30/2022]
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