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Becker S, Simon S, Dindorf C, Dully J, Bartaguiz E, Schmitz L, Kothe N, Fröhlich M, Ludwig O. Fatigue as a key factor for testing knee stability with single leg drop landing for injury prevention and return to play tests. Front Sports Act Living 2023; 5:1243732. [PMID: 38022784 PMCID: PMC10657893 DOI: 10.3389/fspor.2023.1243732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Fatigue can decrease knee stability and increase the injury risk. However, fatigue is rarely being applied throughout movement analysis. The aim of this study was to investigate if the knee stability throughout SLDLs differ between cyclic and acyclic sports, before and after fatigue in general, and between the dominant and non-dominant leg of soccer players. Methods A total of 43 active male (n = 34) and female (n = 9) athletes (age: 26.5 ± 7.2) participated in this study with a pre-post-design. Subjects performed a single leg drop landing (SLDL) from a plyobox. For each leg, the two-dimensional frontal plane projection angle (FPPA) was analyzed. After pretesting the shuttle run test was performed until exhaustion, before repeating the measurements. Results ANOVA with repeated measures was applied and identified no significance difference for the FPPA between cyclic and acyclic sports (F = 0.98, p = 0.33), a significant difference before and after fatigue (F = 12.49, p = 0.002) and no significant difference between the dominant and non dominant leg of soccer players (F = 4.35, p = 0.26). Discussion Fatigue seems to be able to have a significant influence on knee stability in the frontal axis. Therefore, fatigue should be included in motion analysis for injury prevention and return to play tests because during this physical state most injuries happen.
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Affiliation(s)
- S. Becker
- Department of Sport Science, RPTU Kaiserslautern-Landau, Kaiserslautern, Germany
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2
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Gurau TV, Gurau G, Voinescu DC, Anghel L, Onose G, Iordan DA, Munteanu C, Onu I, Musat CL. Epidemiology of Injuries in Men's Professional and Amateur Football (Part I). J Clin Med 2023; 12:5569. [PMID: 37685638 PMCID: PMC10488230 DOI: 10.3390/jcm12175569] [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: 08/01/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Background (1): Football is the most popular sport among men, associated with a certain risk of injury, which leads to short- and long-term health consequences. While the injury profile of professional footballers is known, little is known about the injury profile of amateur footballers; amateur football is a major and diverse area, the development of which should be a priority for football associations around the world and UEFA. The aim of this study was to perform a systematic review of epidemiological literature data on injuries in professional and amateur football players belonging to certain leagues. Methods (2): A systematic review according to the PRISMA guidelines was performed until June 2023 in the databases PubMed, Web of Science, Google Academic, Google Scholar, and Diva portal. Forty-six studies reporting injury incidence in professional and amateur men's football were selected and analyzed. Two reviewers independently extracted data and assessed study quality using an adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): The overall incidence of injuries in professional male football players was 7.75 ± 2.28, 95% confidence interval, injuries/1000 h of exposure and that of amateur football players was 7.98 ± 2.95, 95% confidence interval, injuries/1000 h of exposure. The incidence of match injuries (30.64 ± 10.28, 95% confidence interval, injuries/1000 exposure hours) was 7.71 times higher than the training injury incidence rate (3.97 ± 1.35, 95% confidence interval, injuries/1000 h) in professional football players and 5.45 times higher in amateurs (17.56 ± 6.15 vs. 3.22 ± 1.4, 95% confidence interval, injuries/1000 h). Aggregate lower extremity injuries had the highest prevalence in both categories of footballers, being 83.32 ± 4.85% in professional footballers and 80.4 ± 7.04% in amateur footballers: thigh, ankle, and knee injuries predominated. Conclusions (4): Professional and amateur football players are at substantial risk of injury, especially during matches that require the highest level of performance. Injury rates have implications for players, coaches, and sports medicine practitioners. Therefore, information on football injuries can help develop personalized injury risk mitigation strategies that could make football safer for both categories of football players. The current findings have implications for the management, monitoring, and design of training, competition, injury prevention, especially severe injury, and education programs for amateur football players.
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Affiliation(s)
- Tudor Vladimir Gurau
- Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Lucretia Anghel
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Gelu Onose
- Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Ar-Seni”, 041915 Bucharest, Romania;
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Daniel Andrei Iordan
- Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
- Center of Physical Therapy and Rehabilitation, ‘Dunărea de Jos’ University of Galati, 800008 Galati, Romania
| | - Constantin Munteanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Ilie Onu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
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Kremen TJ, Wu SY, Upfill-Brown A, Bugarin A, Huang J, Jones KJ, Shi BY. Impact of the COVID-19 Pandemic Hiatus From Sports Activities on Injuries Observed Among Division I NCAA Athletes. Orthop J Sports Med 2023; 11:23259671231169188. [PMID: 37250744 PMCID: PMC10209719 DOI: 10.1177/23259671231169188] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/24/2023] [Indexed: 05/31/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic significantly disrupted athletic activities, including those in the Pacific 12 (Pac-12) Conference of the National Collegiate Athletic Association. It is currently unknown how the disruption in training and competition impacted athletes' risk of injury upon resumption of activities. Purpose To describe and compare the rate, timing, mechanism, and severity of injuries among collegiate athletes across multiple sports in the Pac-12 Conference before and after the COVID-19 pandemic-associated hiatus of intercollegiate athletic activities. Study Design Descriptive epidemiology study. Methods Descriptive and injury data among intercollegiate athletes from both the season before the hiatus and the season after the hiatus were acquired from the Pac-12 Health Analytics Program database. Injury elements (timing of injury onset, injury severity, mechanism, recurrence, outcome, need for procedural intervention, and event segment during which the injury took place) were compared by time using the chi-square test and a multivariate logistic regression model. Subgroup analyses were performed on knee and shoulder injuries among athletes participating in sports with traditionally high rates of knee and shoulder injuries. Results A total of 12,319 sports-related injuries across 23 sports were identified, with 7869 pre-hiatus injuries and 4450 post-hiatus injuries. There was no difference in the overall incidence of injury between the pre-hiatus and post-hiatus seasons. However, the proportion of noncontact injuries was higher in the post-hiatus season for football, baseball, and softball players, and the proportion of nonacute injuries in the post-hiatus season was higher among football, basketball, and rowing athletes. Finally, the overall proportion of injuries sustained by football players in the final 25% of competition or practice was higher in the post-hiatus season. Conclusion Athletes competing in the post-hiatus season were observed to have higher rates of noncontact injuries and injuries sustained in the final 25% of competition. This study demonstrates that the COVID-19 pandemic has had varied effects on athletes from different sports, suggesting that many factors must be considered when designing return-to-sports programs for athletes after an extended absence from organized training.
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Affiliation(s)
- Thomas J. Kremen
- Department of Orthopaedic Surgery,
David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Shannon Y. Wu
- David Geffen School of Medicine at
UCLA, Los Angeles, California, USA
| | - Alexander Upfill-Brown
- Department of Orthopaedic Surgery,
David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Amador Bugarin
- David Geffen School of Medicine at
UCLA, Los Angeles, California, USA
| | - Julian Huang
- University of California at Los
Angeles, Los Angeles, California, USA
| | - Kristofer J. Jones
- Department of Orthopaedic Surgery,
David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Brendan Y. Shi
- Department of Orthopaedic Surgery,
David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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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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5
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Rhon DI, Teyhen DS, Kiesel K, Shaffer SW, Goffar SL, Greenlee TA, Plisky PJ. Recovery, Rehabilitation, and Return to Full Duty in a Military Population After a Recent Injury: Differences Between Lower-Extremity and Spine Injuries. Arthrosc Sports Med Rehabil 2022; 4:e17-e27. [PMID: 35141533 PMCID: PMC8811499 DOI: 10.1016/j.asmr.2021.09.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/25/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose To compare readiness to return to duty in soldiers following recent lower-extremity versus spine injury. The secondary purposes were to provide normative data for the Selective Functional Movement Assessment Top Tier movements (SFMA-TTM) and assess the association between SFMA-TTM scores and future injury occurrence, comparing injuries of the lower extremity and thoracic/lumbar spine. Methods SFMA was rated by trained assessors on 480 U.S. Army soldiers within 2 weeks of being cleared to return to duty after recent lower-extremity or lumbar/thoracic injury. Participants were followed for 1 year to determine incidence of subsequent time-loss injury. Results Only 74.4% of soldiers felt 100% mission capable when returning to full duty (73.6% lower-extremity; 76.5% spine). After 1 year, 37.9% had sustained a time-loss injury, and pain with movement at baseline was associated with higher odds for having an injury (odd ratio 1.53 95% confidence interval 1.04-2.24; P = .032). Almost all (99.8%) had at least 1 dysfunctional pattern, and 44.1% had pain with at least 1 movement (40.3% with previous lower-extremity injury; 54.6% with previous spine injury) after being cleared to return to duty. Conclusions One in four patients did not feel 100% mission capable upon being cleared for full duty. Pain with movement was also associated with future injury. Regardless of recent injury type, 99.8% of soldiers returned to full unrestricted duty with at least 1dysfunctional movement pattern and 44.1% had pain with at least 1 of the SFMA-TTM movements. Level of Evidence Level III, retrospective comparative cohort study.
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6
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Eberbach H, Fürst-Meroth D, Kloos F, Leible M, Bohsung V, Bode L, Wenning M, Hagen S, Bode G. Long-standing pubic-related groin pain in professional academy soccer players: a prospective cohort study on possible risk factors, rehabilitation and return to play. BMC Musculoskelet Disord 2021; 22:958. [PMID: 34789227 PMCID: PMC8600924 DOI: 10.1186/s12891-021-04837-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/01/2021] [Indexed: 11/29/2022] Open
Abstract
Background Despite being a common overuse entity in youth soccer, scientific data on risk factors, rehabilitation and return to play for long-standing pubic-related groin pain is still rare. The current prospective cohort study aims to evaluate potential risk-factors, propose a criteria-based conservative rehabilitation protocol and assess return-to-play outcomes among professional youth soccer players suffering from long-standing pubic-related groin pain. Methods Male soccer players with long-standing (> 6 weeks) pubic-related groin pain from a professional soccer club’s youth academy were analyzed for possible risk factors such as age, team (U12 - U23), younger/older age group within the team, position and preinjury Functional movement score. All injured players received a conservative, standardized, supervised, criteria-based, 6-level rehabilitation program. Outcome measures included time to return to play, recurrent groin pain in the follow-up period and clinical results at final follow-up two years after their return to play. Results A total of 14 out of 189 players developed long-standing pubic-related groin pain in the 2017/2018 season (incidence 7.4%). The average age of the players at the time of the injury was 16.1 ± 1.9 years. Risk factor analysis revealed a significant influence of the age group within the team (p = .007). Only players in the younger age group were affected by long-standing pubic-related groin pain, mainly in the first part of the season. Injured players successfully returned to play after an average period of 135.3 ± 83.9 days. Only one player experienced a recurrence of nonspecific symptoms (7.1%) within the follow-up period. The outcome at the 24-month follow-up was excellent for all 14 players. Conclusions Long-standing pubic-related groin pain is an overuse entity with a markedly high prevalence in youth soccer players, resulting in a relevant loss of time in training and match play. In particular, the youngest players in each team are at an elevated risk. Applying a criteria-based rehabilitation protocol resulted in an excellent return-to-play rate, with a very low probability of recurrence. Trial registration The trial was retrospectively registered under DRKS00016510 in the German Clinical Trials Register on 19.04.2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04837-x.
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Affiliation(s)
- Helge Eberbach
- Department of Orthopedic and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - David Fürst-Meroth
- Department of Orthopedic and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Ferdinand Kloos
- Department of Orthopedic and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Magnus Leible
- Freiburg Youth Academy, Sports-Club Freiburg e.V., Schwarzwaldstr. 193, 79117, Freiburg, Germany
| | - Valentin Bohsung
- Freiburg Youth Academy, Sports-Club Freiburg e.V., Schwarzwaldstr. 193, 79117, Freiburg, Germany
| | - Lisa Bode
- Department of Orthopedic and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Markus Wenning
- Department of Orthopedic and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Schmal Hagen
- Department of Orthopedic and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.,Department of Orthopedic Surgery, University Hospital Odense, Sdr. Boulevard 29, 5000, Odense C, Denmark
| | - Gerrit Bode
- Sporthopaedicum Straubing, Bahnhofplatz 27, 94315, Straubing, Germany
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7
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Candela V, De Carli A, Longo UG, Sturm S, Bruni G, Salvatore G, Denaro V. Hip and Groin Pain in Soccer Players. JOINTS 2021; 7:182-187. [PMID: 34235383 PMCID: PMC8253608 DOI: 10.1055/s-0041-1730978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 04/18/2021] [Indexed: 10/29/2022]
Abstract
Purpose The aim of this article is to illustrate the recent framework necessary to standardize studies on groin pain and review the existing literature on groin pain in football. Methods The common pathological processes underlying groin pain such as muscle, tendon or ligament strain, bone injury or fracture, sport hernia, bursitis, osteitis pubis, and hip-related diseases have been reviewed and current management options have been considered. Results Groin pain is considered a pain in pubic or lower abdominal or adductors region which can be monolateral or bilateral. It is common in high-intensity team sports and can negatively affect an athlete's professional carrier, causing serious disruption in the performance. Despite a high prevalence of groin pain in athletes, diagnosis and management of the underlying pathological processes remain a challenge for surgeons, radiologists, and physiotherapists alike. Conclusion A multidisciplinary approach is essential for patients with groin pain allowing prompt diagnosis and initiation of treatment thus facilitating more rapid return to play and preventing potential long-term sequelae of chronic groin pathology.
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Affiliation(s)
- Vincenzo Candela
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Angelo De Carli
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza," Italy
| | - Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Sofia Sturm
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Giorgio Bruni
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza," Italy
| | - Giuseppe Salvatore
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
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8
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Rhon DI, Molloy JM, Monnier A, Hando BR, Newman PM. Much work remains to reach consensus on musculoskeletal injury risk in military service members: A systematic review with meta-analysis. Eur J Sport Sci 2021; 22:16-34. [PMID: 33993835 DOI: 10.1080/17461391.2021.1931464] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Musculoskeletal injuries are the most common reason military service members cannot perform their military duties. Not only are they costly and associated with long-term disability, often long after completion of military service, but injuries also adversely affect the military readiness of a nation. This can be seen as a threat to national security and part of the impetus behind many efforts to better understand, predict, and mitigate injury risk in the military. A systematic review of the literature published between 1995 and October 31, 2020 was conducted to identify significant risk factors of musculoskeletal injury in military populations across the world. 74 out of 170 eligible studies addressed comprehensive injuries, providing 994 unique risk factors. 46 of these studies provided data that could be included in a meta-analysis, which was possible for 15 predictor variables. Seven predictors were significant in meta-analysis: female sex(RR=1.46;95CI 1.30,1.64), high body mass index(RR=1.36;95CI 1.21,1.53), functional movement screen pain (RR=1.70;95CI 1.55,1.87) or scores ≤ 14(RR=1.42 95CI 1.29,1.56), prior injury(RR=1.54;95CI 1.32,1.80), slower running performance(RR=1.33;95CI 1.18,1.51), and poorer push-up performance(RR=1.15;95CI 1.04,1.27). Low BMI, height, weight, smoking, physical activity scores, and sit-up and jump performance were not significant risk factors in the meta-analysis. Most studies had a high risk of bias. Lack of raw data and large heterogeneity in definitions of predictors and injury outcomes limited comparison across many studies.Highlights Female sex, high body mass index, pain with functional movement screen or a score of ≤ 14, prior injury, slower running performance and poorer push-up performance were all significant predictors of musculoskeletal injury.Low body mass index, height, weight, smoking, physical activity scores, and sit-up and jump performance were not significant predictors of musculoskeletal injury.Many other predictors were present only in single studies, but large heterogeneity in definitions of both outcomes and predictors limited comparison across studies.Overall, studies assessing risk factors to predict musculoskeletal injuries in the military were at high risk for bias, especially in regards to statistical approaches.
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Affiliation(s)
- Daniel I Rhon
- Military Performance Division, United States Army Research Institute of Environmental Medicine (USARIEM), Natick, MA, USA.,Department of Rehab Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, USA
| | - Joseph M Molloy
- Physical Performance Service Line, G 3/5/7, U.S. Army Office of the Surgeon General, Falls Church, VA, USA
| | - Andreas Monnier
- Military Academy Karlberg, Swedish Armed Forces, Solna, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Ben R Hando
- Human Performance Support Group, U.S. Air Force Special Warfare Training Wing, Joint Base San Antonio-Lackland, San Antonio, TX, USA
| | - Phillip M Newman
- University of Canberra, Research Institute for Sport and Exercise, Canberra, Australia
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9
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Dupré T, Tryba J, Potthast W. Muscle activity of cutting manoeuvres and soccer inside passing suggests an increased groin injury risk during these movements. Sci Rep 2021; 11:7223. [PMID: 33790373 PMCID: PMC8012386 DOI: 10.1038/s41598-021-86666-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
Cutting manoeuvres and inside passing are thought to increase the risk of sustaining groin injuries. But both movements have received little research attention in this regard. The purpose of this study was to investigate the muscle activity of adductor longus and gracilis as well as hip and knee joint kinematics during \documentclass[12pt]{minimal}
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\begin{document}$$90^{\circ }$$\end{document}90∘-cutting and inside passing. Thirteen male soccer players were investigated with 3D-motion capturing and surface electromyography of adductor longus and gracilis while performing the two movements. Hip and knee joint kinematics were calculated with AnyBody Modelling System. Muscle activity of both muscles was significantly higher during the cutting manoeuvre compared to inside passing. Kinematics showed that the highest activity occurred during phases of fast muscle lengthening and eccentric contraction of the adductors which is known to increase the groin injury risk. Of both movements, cutting showed the higher activity and is therefore more likely to cause groin injuries. However, passing might also increase the risk for groin injuries as it is one of the most performed actions in soccer, and therefore most likely causes groin injuries through overuse. Practitioners need to be aware of these risks and should prepare players accordingly through strength and flexibility training.
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Affiliation(s)
- Thomas Dupré
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, 50933, Cologne, Germany.
| | - Julian Tryba
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, 50933, Cologne, Germany
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, 50933, Cologne, Germany
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10
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Harmath DM, Lejkowski PM. Pubic and adductor related groin pain in an athlete: A case report linking pathology to conservative care. J Bodyw Mov Ther 2021; 27:344-351. [PMID: 34391256 DOI: 10.1016/j.jbmt.2021.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/06/2020] [Accepted: 03/13/2021] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN Case Report. BACKGROUND Groin pain in athletes is considered a common condition among males participating in sports that require sprinting, twisting, pivoting and kicking activities. While the condition is considered self-limiting, it often keeps athletes away from sport for a prolonged period of time. Much controversy exists regarding the pathogenesis of groin pain. This conflict translates to disagreement regarding diagnostic criteria, reporting and management strategies. CASE PRESENTATION a 28-year old recreational soccer player presented with a five-month history of groin pain that was resistant to passive care. With reference to the current conservative management literature, the athlete was progressed through an individualized multimodal program of care. OUTCOMES Following 10-weeks of care, the athlete was able to return to sport participation pain-free. CONCLUSION It is suggested that groin pain in athletes is likely multifactorial and therefore the management should reflect its multifactorial nature. Conservative therapy can evidently reduce the time to return to play however the benefits of incorporating plyometrics into the rehabilitation program should be investigated.
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Affiliation(s)
- Dominique M Harmath
- Graduate Studies, Sports Sciences, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada.
| | - Peter M Lejkowski
- Graduate Studies, Sports Sciences, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada.
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11
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Christopher R, Brandt C, Benjamin-Damon N. Systematic review of screening tools for common soccer injuries and their risk factors. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1496. [PMID: 33824917 PMCID: PMC8010269 DOI: 10.4102/sajp.v77i1.1496] [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] [Received: 05/01/2020] [Accepted: 10/28/2020] [Indexed: 11/22/2022] Open
Abstract
Background Several screening tools are available for use in a clinical setting to predict injury. However, there is a lack of evidence regarding the accuracy of these tools to predict soccer-specific injuries. Objectives The purpose of this systematic literature review was to determine the psychometric properties or accuracy of screening tools for common soccer injuries. Methods A systematic review of diagnostic test accuracy was undertaken based on the Joanna Briggs Institute (JBI) procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed and grey literature were searched in order to access suitable studies. Results A total of 10 studies were included for the analysis – three were analysed quantitatively whilst the remaining seven were analysed qualitatively. The screening tools were of high reliability, sensitivity and specificity (calculated as intraclass correlation coefficient [ICC] (0.68 95% confidence interval [CI]: 0.52–0.84 and 0.64 95% CI: 0.61–0.66, respectively). Conclusion The screening tools assessed for the prediction of common soccer injuries that emerged from this systematic review include the Functional Movement Screening (FMS™), the Landing Error Scoring System (LESS), the Tuck Jump Assessment, the Soccer Injury Movement Screening (SIMS) and the conventional hamstrings to quadriceps ratio; all with good evidence of predicting common soccer injuries. These tools were of high sensitivity and specificity thus reliable for soccer screening. Clinical implications The validity of these tools is acceptable and therefore the authors recommend that these tools be included in an injury prevention programme for soccer players.
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Affiliation(s)
- Raphael Christopher
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Corlia Brandt
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Natalie Benjamin-Damon
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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12
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Markovic G, Šarabon N, Pausic J, Hadžić V. Adductor Muscles Strength and Strength Asymmetry as Risk Factors for Groin Injuries among Professional Soccer Players: A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144946. [PMID: 32659937 PMCID: PMC7400295 DOI: 10.3390/ijerph17144946] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/01/2020] [Accepted: 07/03/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to prospectively examine the association between isometric hip adductor strength and between-limb strength asymmetry to groin injuries in male professional soccer players. Isometric hip adductor strength and between-limb strength asymmetry of 45 professional outfield soccer players from three First Division teams were tested during the 2017/2018 preseason. Players were then monitored throughout the 2017/2018 season for groin injuries. Ten groin injuries were recorded. When compared with uninjured players, players who sustained groin injury had significantly lower strength of respective muscle groups and significantly higher between-limb strength asymmetries (all p < 0.05; ES = 1.16 and 0.88; mean % difference = 26% and 51%). Isometric hip adductor strength had a significant inverse relationship with the incidence of occurring groin injuries (p = 0.016). No significant relationship between hip adductor strength asymmetry and the incidence of future groin injury was observed (p = 0.09). Finally, players' age and previous groin injury were not significantly associated with the incidence of future groin injuries (all p > 0.05). These results generally suggest that isometric adductor strength is a significant predictor of future groin injuries in men's professional football; however, due to the relatively low sample size, further studies are required.
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Affiliation(s)
- Goran Markovic
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia
- Motus Melior Ltd., Hektorovićeva 2, 10000 Zagreb, Croatia
- Correspondence:
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia;
- S2P, Science to Practice, Ltd., Laboratory for Motor Control and Motor Behavior, Tehnološki Park 19, 1000 Ljubljana, Slovenia
| | - Jelena Pausic
- Faculty of Kinesiology, University of Split, Ul. Nikole Tesle 6, 21000 Split, Croatia;
| | - Vedran Hadžić
- Faculty of Sport, University of Ljubljana, Gortanova ul. 22, 1000 Ljubljana, Slovenia;
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13
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De Bleecker C, Vermeulen S, De Blaiser C, Willems T, De Ridder R, Roosen P. Relationship Between Jump-Landing Kinematics and Lower Extremity Overuse Injuries in Physically Active Populations: A Systematic Review and Meta-Analysis. Sports Med 2020; 50:1515-1532. [DOI: 10.1007/s40279-020-01296-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Does athletic groin pain affect the muscular co-contraction during a change of direction. Gait Posture 2019; 73:173-179. [PMID: 31344606 DOI: 10.1016/j.gaitpost.2019.07.249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/04/2019] [Accepted: 07/17/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Groin pain is one of the common problems in multidirectional sports. It seems that abnormal muscular activity and improper movement strategy led to prolongation and high rate of this injury. Therefore, the aim of this study was to Comparing the Average amplitude of Electromyography (AEMG), co-contraction ratio (CCR) of selected thigh and thoracic muscle during turning in individuals with chronic groin pain and healthy individuals. METHODS Surface electromyography was collected from the internal oblique/transversus abdominis (IO/TrA), multifidus (MF), adductor Longus (AL) and gluteus Medius (GM) for AEMG and CCR analyzed in 16-males with LSGP and 16-controls in four motion phases during 11 cycles of gait coupled with turning. RESULTS Results revealed that in the AEMG apart from the third phase in the muscle of the IO/ Tr. A muscle and in the second phase in the MF muscle in the trunk and in the third phase in the muscle of the AL and the fourth phase in the GM foot Left There was a significant difference in other phases. There was a significant difference in the CCR, except in the second phase of the trunk and the fourth phase of the left foot in the rest of the phases. CONCLUSIONS It seems that in athletes with LSGP, have selective muscular activation and CCR have during turning, that may be resulting in compensatory strategies and movement control defects, which may be a useful tool to predict LSGP occurrence in players with a history of groin pain.
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15
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Daun F, Kibele A. Different strength declines in leg primary movers versus stabilizers across age-Implications for the risk of falls in older adults? PLoS One 2019; 14:e0213361. [PMID: 30845168 PMCID: PMC6405087 DOI: 10.1371/journal.pone.0213361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/20/2019] [Indexed: 11/19/2022] Open
Abstract
This study investigated differences in the declines of isometric strength in hip abductors and adductors versus knee extensors across four different age groups (n = 31: 11.2 ± 1.0 y, n = 30: 23.1 ± 2.7 y, n = 27: 48.9 ± 4.4 y, and n = 33: 70.1 ± 4.2 y) with a total of 121 female subjects. As a starting point, we assumed that, during their daily activities, elderly people would use their leg stabilizers less frequently than their leg primary movers as compared to younger people. Given that muscle strength decreases in the course of the aging process, we hypothesized that larger strength declines in hip abductors and hip adductors as compared to knee extensors would be detected across age. Maximal isometric force for these muscle groups was assessed with a digital hand-held dynamometer. Measurements were taken at 75% of the thigh or shank length and expressed relative to body weight and lever arm length. Intratester reliability of the normalized maximal torques was estimated by using Cronbach’s alpha and calculated to be larger than 0.95. The obtained results indicate a clearly more pronounced strength decline in hip abductors and hip adductors across age than in the knee extensors. Therefore, a particular need for strength training of the lower extremity stabilizer muscles during the aging process is implied.
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Affiliation(s)
- Franziska Daun
- Institute for Sports and Sport Science, University of Kassel, Germany
| | - Armin Kibele
- Institute for Sports and Sport Science, University of Kassel, Germany
- * E-mail:
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16
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Balloch AS, Meghji M, Newton RU, Hart NH, Weber JA, Ahmad I, Habibi D. Assessment of a Novel Algorithm to Determine Change-of-Direction Angles While Running Using Inertial Sensors. J Strength Cond Res 2019; 34:134-144. [PMID: 30707134 DOI: 10.1519/jsc.0000000000003064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Balloch, AS, Meghji, M, Newton, RU, Hart, NH, Weber, JA, Ahmad, I, and Habibi, D. Assessment of a novel algorithm to determine change-of-direction angles while running using inertial sensors. J Strength Cond Res 34(1): 134-144, 2020-The ability to detect and quantify change-of-direction (COD) movement may offer a unique approach to load-monitoring practice. Validity and reliability of a novel algorithm to calculate COD angles for predetermined COD movements ranging from 45 to 180° in left and right directions was assessed. Five recreationally active men (age: 29.0 ± 0.5 years; height: 181.0 ± 5.6 cm; and body mass: 79.4 ± 5.3 kg) ran 5 consecutive predetermined COD trials each, at 4 different angles (45, 90, 135, and 180°), in each direction. Participants were fitted with a commercially available microtechnology unit where inertial sensor data were extracted and processed using a novel algorithm designed to calculate precise COD angles for direct comparison with a high-speed video (remotely piloted, position-locked aircraft) criterion measure. Validity was assessed using Bland-Altman 95% limits of agreement and mean bias. Reliability was assessed using typical error (expressed as a coefficient of variation [CV]). Concurrent validity was present for most angles. Left: (45° = 43.8 ± 2.0°; 90° = 88.1 ± 2.0°; 135° = 136.3 ± 2.1°; and 180° = 181.8 ± 2.5°) and Right: (45° = 46.3 ± 1.6°; 90° = 91.9 ± 2.2°; 135° = 133.4 ± 2.0°; 180° = 179.2 ± 5.9°). All angles displayed excellent reliability (CV < 5%) while greater mean bias (3.6 ± 5.1°, p < 0.001), weaker limits of agreement, and reduced precision were evident for 180° trials when compared with all other angles. High-level accuracy and reliability when detecting COD angles further advocates the use of inertial sensors to quantify sports-specific movement patterns.
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Affiliation(s)
- Aaron S Balloch
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.,Fremantle Dockers Football Club, Perth, Western Australia, Australia
| | - Mahir Meghji
- School of Engineering, Edith Cowan University, Perth, Western Australia, Australia
| | - Robert U Newton
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.,Center for Exercise and Sports Science Research, Edith Cowan University, Perth, Western Australia, Australia
| | - Nicolas H Hart
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.,Center for Exercise and Sports Science Research, Edith Cowan University, Perth, Western Australia, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia; and.,Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Jason A Weber
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.,Fremantle Dockers Football Club, Perth, Western Australia, Australia
| | - Iftekhar Ahmad
- School of Engineering, Edith Cowan University, Perth, Western Australia, Australia
| | - Daryoush Habibi
- School of Engineering, Edith Cowan University, Perth, Western Australia, Australia
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17
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Esmaeili A, Hopkins WG, Stewart AM, Elias GP, Lazarus BH, Aughey RJ. The Individual and Combined Effects of Multiple Factors on the Risk of Soft Tissue Non-contact Injuries in Elite Team Sport Athletes. Front Physiol 2018; 9:1280. [PMID: 30333756 PMCID: PMC6176657 DOI: 10.3389/fphys.2018.01280] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 08/24/2018] [Indexed: 11/26/2022] Open
Abstract
Aim: Relationships between athlete monitoring-derived variables and injury risk have been investigated predominantly in isolation. The aim of this study was to evaluate the individual and combined effects of multiple factors on the risk of soft-tissue non-contact injuries in elite team sport athletes. Methods: Fifty-five elite Australian footballers were prospectively monitored over two consecutive seasons. Internal and external training load was quantified using the session rating of perceived exertion and GPS/accelerometry, respectively. Cumulative load and acute-to-chronic workload ratios were derived using rolling averages and exponentially weighted moving averages. History of injuries in the current and previous seasons was recorded along with professional experience, weekly musculoskeletal screening, and subjective wellness scores for individual athletes. Individual and combined effects of these variables on injury risk were evaluated with generalized linear mixed models. Results: High cumulative loads and acute-to-chronic workload ratios were associated with increased risk of injuries. The effects for measures derived using exponentially weighted moving averages were greater than those for rolling averages. History of a recent injury, long-term experience at professional level, and substantial reductions in a selection of musculoskeletal screening and subjective wellness scores were associated with increased risk. The effects of high cumulative loads were underestimated by ~20% before adjusting for previous injuries, whereas the effects of high acute-to-chronic workload ratios were overestimated by 10-15%. Injury-prone players, identified via player identity in the mixed model, were at > 5 times higher risk of injuries compared to robust players (hazard ratio 5.4, 90% confidence limits 3.6-12) despite adjusting for training load and previous injuries. Combinations of multiple risk factors were associated with extremely large increases in risk; for example, a hazard ratio of 22 (9.7-52) was observed for the combination of high acute load, recent history of a leg injury, and a substantial reduction in the adductor squeeze test score. Conclusion: On the basis of our findings with an elite team of Australian footballers, the information from athlete monitoring practices in team sports should be interpreted collectively and used as a part of the injury prevention decision-making process along with consideration of individual differences in risk.
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Affiliation(s)
| | | | | | | | | | - Robert J. Aughey
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia
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18
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Lauersen JB, Andersen TE, Andersen LB. Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis. Br J Sports Med 2018; 52:1557-1563. [DOI: 10.1136/bjsports-2018-099078] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2018] [Indexed: 12/24/2022]
Abstract
ObjectiveThis review aims to analyse strength training-based sports injury prevention randomised controlled trials (RCT) and present best evidence recommendations for athletes and future research. A priori PROSPERO registration; CRD42015006970.DesignSystematic review, qualitative analysis and meta-analysis. Sorting of studies and quality assessments were performed by two independent authors. Qualitative analyses, relative risk (RR) estimate with robustness and strength of evidence tests, formal tests of publication bias and post-hoc meta-regression were performed.Data sourcesPubMed, Embase, Web of Science and SPORTDiscus were searched to July 2017.Eligibility criteria for selecting studiesRCTs on strength training exercises as primary prevention of sports injuries.ResultsSix studies analysed five different interventions with four distinct outcomes. 7738 participants aged 12–40 years were included and sustained 177 acute or overuse injuries. Studies were published in 2003–2016, five from Europe and one from Africa. Cluster-adjusted intention-to-treat analysis established RR 0.338 (0.238–0.480). The result was consistent across robustness tests and strength of evidence was high. A 10% increase in strength training volume reduced the risk of injury by more than four percentage points. Formal tests found no publication bias.ConclusionThe included studies were generally well designed and executed, had high compliance rates, were safe, and attained consistently favourable results across four different acute and overuse injury outcomes despite considerable differences in populations and interventions. Increasing strength training volume and intensity were associated with sports injury risk reduction. Three characteristically different approaches to prevention mechanisms were identified and incorporated into contemporary strength training recommendations.
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19
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Kerbel YE, Smith CM, Prodromo JP, Nzeogu MI, Mulcahey MK. Epidemiology of Hip and Groin Injuries in Collegiate Athletes in the United States. Orthop J Sports Med 2018; 6:2325967118771676. [PMID: 29780846 PMCID: PMC5952296 DOI: 10.1177/2325967118771676] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Hip and groin pain is a common complaint among athletes. Few studies have examined the epidemiology of hip and groin injuries in collegiate athletes across multiple sports. Purpose: To describe the rates, mechanisms, sex-based differences, and severity of hip/groin injuries across 25 collegiate sports. Study Design: Descriptive epidemiology study. Methods: Data from the 2009-2010 through 2013-2014 academic years were obtained from the National Collegiate Athletic Association Injury Surveillance Program (NCAA ISP). The rate of hip/groin injuries, mechanism of injury, time lost from competition, and need for surgery were calculated. Differences between sex-comparable sports were quantified using rate ratios (RRs) and injury proportion ratios (IPRs). Results: In total, 1984 hip/groin injuries were reported, giving an overall injury rate of 53.06 per 100,000 athlete-exposures (AEs). An adductor/groin tear was the most common injury, comprising 24.5% of all injuries. The sports with the highest rates of injuries per 100,000 AEs were men’s soccer (110.84), men’s ice hockey (104.90), and women’s ice hockey (76.88). In sex-comparable sports, men had a higher rate of injuries per 100,000 AEs compared with women (59.53 vs 42.27, respectively; RR, 1.41 [95% CI, 1.28-1.55]). The most common injury mechanisms were noncontact (48.4% of all injuries) and overuse/gradual (20.4%). In sex-comparable sports, men had a greater proportion of injuries due to player contact than women (17.0% vs 3.6%, respectively; IPR, 4.80 [95% CI, 3.10-7.42]), while women had a greater proportion of injuries due to overuse/gradual than men (29.1% vs 16.7%, respectively; IPR, 1.74 [95% CI, 1.46-2.06]). Overall, 39.3% of hip/groin injuries resulted in time lost from competition. Only 1.3% of injuries required surgery. Conclusion: Hip/groin injuries are most common in sports that involve kicking or skating and sudden changes in direction and speed. Most hip/groin injuries in collegiate athletes are noncontact and do not result in time lost from competition, and few require surgery. This information can help guide treatment and prevention measures to limit such injuries in male and female collegiate athletes.
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Affiliation(s)
- Yehuda E Kerbel
- Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Christopher M Smith
- Department of Emergency Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - John P Prodromo
- Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Michael I Nzeogu
- Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Mary K Mulcahey
- Department of Orthopaedics, Tulane University School of Medicine, New Orleans, Louisiana, USA
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20
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Mosler AB, Weir A, Serner A, Agricola R, Eirale C, Farooq A, Bakken A, Thorborg K, Whiteley RJ, Hölmich P, Bahr R, Crossley KM. Musculoskeletal Screening Tests and Bony Hip Morphology Cannot Identify Male Professional Soccer Players at Risk of Groin Injuries: A 2-Year Prospective Cohort Study. Am J Sports Med 2018; 46:1294-1305. [PMID: 29585730 DOI: 10.1177/0363546518763373] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Musculoskeletal hip/groin screening tests are commonly performed to detect at-risk individuals. Bony hip morphology is considered a potential intrinsic risk factor but has not been examined prospectively. PURPOSE To evaluate the association between intrinsic risk factors identified from musculoskeletal and radiographic screening tests and hip/groin injuries leading to time loss from training and/or match play in professional male soccer players. STUDY DESIGN Prospective cohort study; Level of evidence, 2. METHODS Male professional soccer players, aged ≥18 years, underwent screening specific for hip/groin pain during 2 consecutive seasons of the Qatar Stars League. The screening battery included pain provocation, range of motion, and strength tests as well as a hip radiographic examination. The radiographic examination included an anteroposterior pelvic view and 45° Dunn view, with bony hip morphology determined using quantitative methods. Time-loss (≥1 day) hip/groin injuries and individual player exposure (training and match play) were recorded prospectively, and injuries were categorized as adductor-related, inguinal-related, iliopsoas-related, pubic-related, or hip-related groin pain, or "other," as recommended in the Doha agreement. We calculated hazard ratios (HRs) from univariate and multivariate Cox regression models to assess the relationship between potential risk factors and hip/groin injuries. RESULTS There were 438 players, completing 609 player seasons, and 113 hip/groin injuries that met the criteria for inclusion, with 85 injuries categorized as adductor-related. The proportion of players with bony morphological variants was the following: cam, 71%; pincer, 5%; and acetabular dysplasia, 13%. Previous hip/groin injuries (HR, 1.8; 95% CI, 1.2-2.7) and eccentric adduction strength were associated with the risk of hip/groin injuries. Higher (>1 SD above the mean) than normal eccentric adduction strength was associated with an increased risk for all hip/groin injuries (HR, 1.6; 95% CI, 1.0-2.5). Lower (<1 SD below the mean) than normal eccentric adduction strength was associated with an increased risk for adductor-related injuries (HR, 1.7; 95% CI, 1.0-3.0). No other musculoskeletal screening test or bony hip morphology variables were associated with the injury risk. CONCLUSION Previous groin injuries and eccentric adduction strength were associated with the risk of groin injuries. However, these associations were not strong enough to identify an "at-risk" individual, and therefore, musculoskeletal screening tests were not useful to dictate individualized prevention strategies. Bony hip morphology was not associated with the risk of groin injuries.
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Affiliation(s)
- Andrea B Mosler
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Adam Weir
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Center for Groin Injuries, Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Andreas Serner
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Rintje Agricola
- Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | - Arnhild Bakken
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kristian Thorborg
- Sports Orthopedic Research Center-Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Rod J Whiteley
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Per Hölmich
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Sports Orthopedic Research Center-Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Roald Bahr
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
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21
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Werner J, Hägglund M, Ekstrand J, Waldén M. Hip and groin time-loss injuries decreased slightly but injury burden remained constant in men's professional football: the 15-year prospective UEFA Elite Club Injury Study. Br J Sports Med 2018; 53:539-546. [PMID: 29691289 DOI: 10.1136/bjsports-2017-097796] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Hip and groin injuries are common in men's professional football, but the time-trend of these injuries is not known. AIM To investigate hip and groin injury rates, especially time-trends, in men's professional football over 15 consecutive seasons. STUDY DESIGN Prospective cohort study. SETTING Men's professional football. METHODS 47 European teams were followed prospectively for a varying number of seasons between 2001/2002 and 2015/2016, totalling 268 team seasons. Time-loss injuries and individual player exposure during training and matches were recorded. Injury rate was defined as the number of injuries/1000 hours and injury burden as the number of lay-off days/1000 hours. Time-trends for total hip and groin injuries and adductor-related injury rates were analysed using Poisson regression, and injury burden was analysed using a negative binomial regression model. RESULTS Hip and groin injuries contributed 1812 out of 12 736 injuries (14%), with adductor-related injury as the most common of hip and groin injuries (n=1139, 63%). The rates of hip and groin injury and adductor-related injury were 1.0/1000 hours and 0.6/1000 hours, and these rates decreased significantly with on average 2% (Exp(b)=0.98, 95% CI 0.97 to 0.99, P=0.003) and 3% (Exp(b)=0.97, 95% CI 0.95 to 0.99, P<0.001) per season (year on year), respectively. The seasonal trend of hip and groin injury burden did not improve (Exp(b)=0.99, 95% CI 0.97 to 1.01, P=0.40). CONCLUSIONS Hip and groin injuries constitute a considerable part of all time-loss injuries in men's professional football. Although there was a promising slight decreasing trend in the rates of hip and groin injury (as a category) and adductor-related injury (as a specific diagnosis), the injury burden remained at a consistent level over the study period.
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Affiliation(s)
- Jonas Werner
- Department of Orthopaedics, Vrinnevisjukhuset, Norrköping, Sweden.,Football Research Group, Linköping, Sweden
| | - Martin Hägglund
- Football Research Group, Linköping, Sweden.,Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Jan Ekstrand
- Football Research Group, Linköping, Sweden.,Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Markus Waldén
- Football Research Group, Linköping, Sweden.,Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Orthopaedics, Hässleholm-Kristianstad-Ystad Hospitals, Hässleholm, Sweden
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22
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Tak I, Pope D, Engelaar L, Gouttebarge V, Barendrecht M, Van den Heuvel S, Kerkhoffs G, Langhout R, Stubbe J, Weir A. Infographic. Is lower hip range of motion a risk factor for groin pain in athletes? A systematic review with clinical applications. Br J Sports Med 2018; 52:1022-1023. [PMID: 29449206 DOI: 10.1136/bjsports-2017-098535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Igor Tak
- Manual Therapy and Sports Rehabilitation, Physiotherapy Utrecht Oost, Utrecht, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Academic Medical Center Amsterdam, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - David Pope
- Clinical Edge, Terrigal, New South Wales, Australia
| | | | - Vincent Gouttebarge
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Maarten Barendrecht
- Dutch Center for Allied Health Care, Amersfoort, The Netherlands.,Master Physical Therapy in Sports, Avans+ Improving Professionals, Breda, The Netherlands
| | | | - Gino Kerkhoffs
- Academic Center for Evidence Based Sports Medicine (ACES), Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Rob Langhout
- Manual Therapy and Sports Rehabilitation, Physiotherapy Dukenburg Nijmegen, Nijmegen, The Netherlands
| | - Janine Stubbe
- School of Sports & Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Adam Weir
- Department of Sports Medicine, Aspetar Hospital, Doha, Qatar
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23
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Dupré T, Funken J, Müller R, Mortensen KRL, Lysdal FG, Braun M, Krahl H, Potthast W. Does inside passing contribute to the high incidence of groin injuries in soccer? A biomechanical analysis. J Sports Sci 2018; 36:1827-1835. [PMID: 29333946 DOI: 10.1080/02640414.2017.1423193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Thomas Dupré
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | - Johannes Funken
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | - Ralf Müller
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | | | | | - Markus Braun
- Ballspielverein Borussia 09 e.V. Dortmund, Dortmund, Germany
| | - Hartmut Krahl
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
- ARCUS Clinics Pforzheim, Pforzheim, Germany
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24
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Hammer AM, Hammer RL, Lomond KV, O'Connor P. Acute changes of hip joint range of motion using selected clinical stretching procedures: A randomized crossover study. Musculoskelet Sci Pract 2017; 32:70-77. [PMID: 28888207 DOI: 10.1016/j.msksp.2017.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 08/15/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Hip adductor flexibility and strength is an important component of athletic performance and many activities of daily living. Little research has been done on the acute effects of a single session of stretching on hip abduction range of motion (ROM). OBJECTIVES The aim of this study was to compare 3 clinical stretching procedures against passive static stretching and control on ROM and peak isometric maximal voluntary contraction (MVC). DESIGN Using a randomized crossover study design, a total of 40 participants (20 male and 20 female) who had reduced hip adductor muscle length attended a familiarization session and 5 testing sessions on non-consecutive days. METHOD Following the warm-up and pre-intervention measures of ROM and MVC, participants were randomly assigned 1 of 3 clinical stretching procedures (modified lunge, multidirectional, and joint mobilization) or a static stretch or control condition. Post-intervention measures of ROM and MVC were taken immediately following completion of the assigned condition. RESULTS An ANOVA using a repeated measure design with the change score was conducted. All interventions resulted in small but statistically significant (p < 0.05) increases (1.0°-1.7°) in ROM with no inter-condition differences except one. Multidirectional stretching was greater than control (p = 0.031). CONCLUSIONS These data suggest that a single session of stretching has only a minimal effect on acute changes of hip abduction ROM. Although hip abduction is a frontal plane motion, to effectively increase the extensibility of the structures that limit abduction, integrating multi-planar stretches may be indicated.
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Affiliation(s)
- Adam M Hammer
- Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, School of Rehabilitation and Medical Sciences, Doctoral Program in Physical Therapy, 1220 Health Professions Building, Mount Pleasant, MI 48859, USA.
| | - Roger L Hammer
- Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, School of Health Sciences, Division of Exercise Science, 2219 Health Professions Building, Mount Pleasant, MI 48859, USA.
| | - Karen V Lomond
- Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, School of Health Sciences, Division of Exercise Science, 2219 Health Professions Building, Mount Pleasant, MI 48859, USA.
| | - Paul O'Connor
- Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, School of Health Sciences, Division of Exercise Science, 2219 Health Professions Building, Mount Pleasant, MI 48859, USA.
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25
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Hughes T, Sergeant JC, Parkes MJ, Callaghan MJ. Prognostic factors for specific lower extremity and spinal musculoskeletal injuries identified through medical screening and training load monitoring in professional football (soccer): a systematic review. BMJ Open Sport Exerc Med 2017; 3:e000263. [PMID: 29177074 PMCID: PMC5623323 DOI: 10.1136/bmjsem-2017-000263] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2017] [Indexed: 12/26/2022] Open
Abstract
Background Medical screening and load monitoring procedures are commonly used in professional football to assess factors perceived to be associated with injury. Objectives To identify prognostic factors (PFs) and models for lower extremity and spinal musculoskeletal injuries in professional/elite football players from medical screening and training load monitoring processes. Methods The MEDLINE, AMED, EMBASE, CINAHL Plus, SPORTDiscus and PubMed electronic bibliographic databases were searched (from inception to January 2017). Prospective and retrospective cohort studies of lower extremity and spinal musculoskeletal injury incidence in professional/elite football players aged between 16 and 40 years were included. The Quality in Prognostic Studies appraisal tool and the modified Grading of Recommendations Assessment, Development and Evaluation synthesis approach was used to assess the quality of the evidence. Results Fourteen studies were included. 16 specific lower extremity injury outcomes were identified. No spinal injury outcomes were identified. Meta-analysis was not possible due to heterogeneity and study quality. All evidence related to PFs and specific lower extremity injury outcomes was of very low to low quality. On the few occasions where multiple studies could be used to compare PFs and outcomes, only two factors demonstrated consensus. A history of previous hamstring injuries (HSI) and increasing age may be prognostic for future HSI in male players. Conclusions The assumed ability of medical screening tests to predict specific musculoskeletal injuries is not supported by the current evidence. Screening procedures should currently be considered as benchmarks of function or performance only. The prognostic value of load monitoring modalities is unknown.
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Affiliation(s)
- Tom Hughes
- Manchester United Football Club, Manchester, UK.,Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Jamie C Sergeant
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.,NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Matthew J Parkes
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Michael J Callaghan
- Manchester United Football Club, Manchester, UK.,Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.,Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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26
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Serner A, Weir A, Tol JL, Thorborg K, Roemer F, Guermazi A, Yamashiro E, Hölmich P. Characteristics of acute groin injuries in the hip flexor muscles - a detailed MRI study in athletes. Scand J Med Sci Sports 2017. [DOI: 10.1111/sms.12939] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. Serner
- Aspetar Orthopaedic and Sports Medicine Hospital; Doha Qatar
- Sports Orthopaedic Research Center (SORC-C); Department of Orthopaedic Surgery; Copenhagen University Hospital; Amager-Hvidovre Denmark
| | - A. Weir
- Aspetar Orthopaedic and Sports Medicine Hospital; Doha Qatar
| | - J. L. Tol
- Aspetar Orthopaedic and Sports Medicine Hospital; Doha Qatar
- The Sports Physician Group; Department of Sports Medicine; OLVG; Amsterdam The Netherlands
- Amsterdam Center of Evidence Based Sports Medicine; Academic Medical Center; Amsterdam The Netherlands
| | - K. Thorborg
- Sports Orthopaedic Research Center (SORC-C); Department of Orthopaedic Surgery; Copenhagen University Hospital; Amager-Hvidovre Denmark
| | - F. Roemer
- Quantitative Imaging Center (QIC); Department of Radiology; Boston University School of Medicine; Boston MA USA
- Department of Radiology; University of Erlangen-Nuremberg; Erlangen Germany
| | - A. Guermazi
- Quantitative Imaging Center (QIC); Department of Radiology; Boston University School of Medicine; Boston MA USA
| | - E. Yamashiro
- Aspetar Orthopaedic and Sports Medicine Hospital; Doha Qatar
| | - P. Hölmich
- Aspetar Orthopaedic and Sports Medicine Hospital; Doha Qatar
- Sports Orthopaedic Research Center (SORC-C); Department of Orthopaedic Surgery; Copenhagen University Hospital; Amager-Hvidovre Denmark
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27
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Malfliet A, Leysen L, Pas R, Kuppens K, Nijs J, Van Wilgen P, Huysmans E, Goudman L, Ickmans K. Modern pain neuroscience in clinical practice: applied to post-cancer, paediatric and sports-related pain. Braz J Phys Ther 2017; 21:225-232. [PMID: 28579013 PMCID: PMC5537480 DOI: 10.1016/j.bjpt.2017.05.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/10/2017] [Accepted: 01/25/2017] [Indexed: 12/18/2022] Open
Abstract
Generalized hypersensitivity in post-cancer, sports-related and pediatric pain. Rationale for pain education, stress management and cognition targeted exercises. Need to change from a biomedical or psychosocial to an integrated approach.
In the last decade, evidence regarding chronic pain has developed exponentially. Numerous studies show that many chronic pain populations show specific neuroplastic changes in the peripheral and central nervous system. These changes are reflected in clinical manifestations, like a generalized hypersensitivity of the somatosensory system. Besides a hypersensitivity of bottom-up nociceptive transmission, there is also evidence for top-down facilitation of pain due to malfunctioning of the endogenous descending nociceptive modulatory systems. These and other aspects of modern pain neuroscience are starting to be applied within daily clinical practice. However, currently the application of this knowledge is mostly limited to the general adult population with musculoskeletal problems, while evidence is getting stronger that also in other chronic pain populations these neuroplastic processes may contribute to the occurrence and persistence of the pain problem. Therefore, this masterclass article aims at giving an overview of the current modern pain neuroscience knowledge and its potential application in post-cancer, paediatric and sports-related pain problems.
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Affiliation(s)
- Anneleen Malfliet
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Pain in Motion International Research Group,(◊); Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium.
| | - Laurence Leysen
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Pain in Motion International Research Group,(◊)
| | - Roselien Pas
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Pain in Motion International Research Group,(◊); Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Kevin Kuppens
- Pain in Motion International Research Group,(◊); Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Jo Nijs
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Pain in Motion International Research Group,(◊); Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium
| | - Paul Van Wilgen
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Pain in Motion International Research Group,(◊); Transcare, Transdisciplinary Pain-management Centre,(◊◊) The Netherlands
| | - Eva Huysmans
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Pain in Motion International Research Group,(◊)
| | - Lisa Goudman
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Pain in Motion International Research Group,(◊); Department of Neurosurgery, University Hospital Brussels, Brussels, Belgium
| | - Kelly Ickmans
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Pain in Motion International Research Group,(◊); Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium
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28
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Tak I, Engelaar L, Gouttebarge V, Barendrecht M, Van den Heuvel S, Kerkhoffs G, Langhout R, Stubbe J, Weir A. Is lower hip range of motion a risk factor for groin pain in athletes? A systematic review with clinical applications. Br J Sports Med 2017; 51:1611-1621. [PMID: 28432076 PMCID: PMC5754850 DOI: 10.1136/bjsports-2016-096619] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Whether hip range of motion (ROM) is a risk factor for groin pain in athletes is not known. OBJECTIVES To systematically review the relationship between hip ROM and groin pain in athletes in cross-sectional/case-control and prospective studies. STUDY DESIGN Systematic review, prospectively registered (PROSPERO) according to PRISMA guidelines. METHODS Pubmed, Embase, CINAHL and SPORTDiscus were systematically searched up to December 2015. Two authors performed study selection, data extraction/analysis, quality assessment (Critical Appraisal Skills Programme) and strength of evidence synthesis. RESULTS We identified seven prospective and four case-control studies. The total quality score ranged from 29% to 92%. Heterogeneity in groin pain classification, injury definitions and physical assessment precluded data pooling. There was strong evidence that total rotation of both hips below 85° measured at the pre-season screening was a risk factor for groin pain development. Strong evidence suggested that internal rotation, abduction and extension were not associated with the risk or presence of groin pain. CONCLUSION Total hip ROM is the factor most consistently related to groin pain in athletes. Screening for hip ROM is unlikely to correctly identify an athlete at risk of developing groin pain because of the small ROM differences found and poor ROM measurement properties.
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Affiliation(s)
- Igor Tak
- Manual Therapy and Sports Rehabilitation, Physiotherapy Utrecht Oost, Utrecht, The Netherlands.,Academic Center for Evidence based Sports Medicine (ACES), AMC, Amsterdam, The Netherlands
| | | | - Vincent Gouttebarge
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Maarten Barendrecht
- Dutch Center for Allied Health Care, Amersfoort, The Netherlands.,Master Physical Therapy in Sports, Avans+ Improving Professionals, Breda, The Netherlands
| | | | - Gino Kerkhoffs
- Department of Orthopedic Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Rob Langhout
- Manual Therapy and Sports Rehabilitation, Physiotherapy Dukenburg Nijmegen, Nijmegen, The Netherlands
| | - Janine Stubbe
- School of Sports & Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Codarts University of the arts, Rotterdam, The Netherlands
| | - Adam Weir
- Department of Sports Medicine, Aspetar hospital, Doha, Qatar
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29
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Shrier I, Zhao M, Piché A, Slavchev P, Steele RJ. A higher sport-related reinjury risk does not mean inadequate rehabilitation: the methodological challenge of choosing the correct comparison group. Br J Sports Med 2017; 51:630-635. [PMID: 28219942 DOI: 10.1136/bjsports-2016-096922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2017] [Indexed: 11/04/2022]
Abstract
Previous injury is a well-established predictor of subsequent injury in sports medicine. Some have interpreted this to mean that either our current methods of rehabilitation are inadequate or there is some permanent damage to the tissue and 100% rehabilitation is not possible. In 2011, we illustrated that these analyses and interpretations failed to account for the fact that some athletes are more prone to get injured, either physiologically, or because of their role/type of play. We suggested that the appropriate analysis would simply require using statistical methods that measured how each individual athlete's risk changed from preinjury to postinjury.In this paper, we revisit our recommendation and illustrate that it too would be flawed if the risk of injury changed over time independent of an injury ever occurring. This might be expected if general fitness were to decline over the season, or if the style of play changed between early season games and postseason championship games. Acknowledging that risk may change regardless of whether an injury occurred or not leads to three different general definitions of 100% rehabilitation: (1) a return to the baseline state, (2) a return to the immediate preinjury state and (3) a return to the state that would have been present had the initial injury never occurred. We guide the reader on how to estimate the risks for each definition and the assumptions that must be acknowledged.
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Affiliation(s)
- Ian Shrier
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, Québec, Canada
| | - Meng Zhao
- Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada
| | - Alexandre Piché
- Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada
| | - Pavel Slavchev
- Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada
| | - Russell J Steele
- Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada
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30
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Bisciotti GN, Volpi P, Zini R, Auci A, Aprato A, Belli A, Bellistri G, Benelli P, Bona S, Bonaiuti D, Carimati G, Canata GL, Cassaghi G, Cerulli S, Delle Rose G, Di Benedetto P, Di Marzo F, Di Pietto F, Felicioni L, Ferrario L, Foglia A, Galli M, Gervasi E, Gia L, Giammattei C, Guglielmi A, Marioni A, Moretti B, Niccolai R, Orgiani N, Pantalone A, Parra F, Quaglia A, Respizzi F, Ricciotti L, Pereira Ruiz MT, Russo A, Sebastiani E, Tancredi G, Tosi F, Vuckovic Z. Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athlete. BMJ Open Sport Exerc Med 2016; 2:e000142. [PMID: 28890800 PMCID: PMC5566259 DOI: 10.1136/bmjsem-2016-000142] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/14/2022] Open
Abstract
The nomenclature and the lack of consensus of clinical evaluation and imaging assessment in groin pain generate significant confusion in this field. The Groin Pain Syndrome Italian Consensus Conference has been organised in order to prepare a consensus document regarding taxonomy, clinical evaluation and imaging assessment for groin pain. A 1-day Consensus Conference was organised on 5 February 2016, in Milan (Italy). 41 Italian experts with different backgrounds participated in the discussion. A consensus document previously drafted was discussed, eventually modified, and finally approved by all members of the Consensus Conference. Unanimous consensus was reached concerning: (1) taxonomy (2) clinical evaluation and (3) imaging assessment. The synthesis of these 3 points is included in this paper. The Groin Pain Syndrome Italian Consensus Conference reached a consensus on three main points concerning the groin pain syndrome assessment, in an attempt to clarify this challenging medical problem.
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Affiliation(s)
- G N Bisciotti
- Qatar Orthopedic and Sport Medicine Hospital, Doha, Qatar
| | - P Volpi
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy.,FC Internazionale, Milan, Italy
| | - R Zini
- Azienda Ospedaliera "Ospedale San Salvatore", Pesaro, Italy
| | - A Auci
- Kinemove Rehabilitation Center, Pontremoli, La Spezia, Italy
| | | | - A Belli
- FC Internazionale, Milan, Italy
| | | | | | - S Bona
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - D Bonaiuti
- Fisioclinic Centro Medico Polispecialistico, Pesaro, Italy
| | - G Carimati
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | | | - G Cassaghi
- Kinemove Rehabilitation Center, Pontremoli, La Spezia, Italy
| | - S Cerulli
- Institute of Sports Medicine of Turin, Italy
| | - G Delle Rose
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | | | - F Di Marzo
- Azienda Ospedaliera Universitaria di Udine, Italy
| | | | - L Felicioni
- Ospedale della Misericordia, Grosseto, Italy
| | | | - A Foglia
- Studio di fisioterapia Riabilita, Pesaro, Italy
| | - M Galli
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | | | - L Gia
- Azienda Ospedaliera Universitaria di Udine, Italy
| | | | - A Guglielmi
- Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - A Marioni
- Azienda Policlinico Università di Bari, Bari, Italy
| | | | | | - N Orgiani
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | | | - F Parra
- Kinemove Rehabilitation Center, Pontremoli, La Spezia, Italy
| | - A Quaglia
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - F Respizzi
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - L Ricciotti
- Kinemove Rehabilitation Center, Pontremoli, La Spezia, Italy
| | | | | | | | | | - F Tosi
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - Z Vuckovic
- Qatar Orthopedic and Sport Medicine Hospital, Doha, Qatar
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31
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Tak I, Glasgow P, Langhout R, Weir A, Kerkhoffs G, Agricola R. Hip Range of Motion Is Lower in Professional Soccer Players With Hip and Groin Symptoms or Previous Injuries, Independent of Cam Deformities. Am J Sports Med 2016; 44:682-8. [PMID: 26673034 DOI: 10.1177/0363546515617747] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Soccer (football) players often have hip and groin symptoms (HGS), and a previous groin injury is a risk factor for a relapse. Decreased hip range of motion (HROM) has been related to both hip and groin pain and the presence of a cam deformity. How these factors interact is unknown. PURPOSE The first aim was to study whether HGS are associated with HROM. The second aim was to study the association of the presence of a cam deformity with HROM. Additionally, the influence of a cam deformity on the relationship between HGS and HROM was examined. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS Seasonal screening data of 2 professional soccer clubs were used. Variables for HGS were current hip or groin pain, the Copenhagen Hip and Groin Outcome Score (HAGOS), and previous hip- and groin-related time-loss injuries (HGTIs). HROM was determined for hip internal rotation (IR), external rotation, and total rotation (TR) in the supine position and for the bent knee fall out (BKFO) test. A cam deformity was defined by an alpha angle >60° on standardized anteroposterior pelvic and frog-leg lateral radiographs. RESULTS Sixty players (mean [±SD] age, 23.1 ± 4.2 years) were included. All were noninjured at the time of screening. Current hip or groin pain was not associated with HROM. Hips of players in the lowest HAGOS interquartile range (thus most affected by complaints; n = 12) showed less IR (23.9° ± 8.7° vs 28.9° ± 7.8°, respectively; P = .036) and TR (58.2° ± 13.5° vs 65.6° ± 11.8°, respectively; P = .047) than those in the highest interquartile range (n = 29). No such differences were found for BKFO (P = .417). Hips of players with a previous HGTI showed less IR (21.1° ± 6.8° vs 28.3° ± 8.9°, respectively; P < .001) and TR (56.0° ± 8.2° vs 64.5° ± 13.6°, respectively; P < .001) than those without a previous HGTI. This was independent of the presence of a cam deformity. BKFO did not differ between groups (P = .983). Hips with a cam deformity showed less but nonsignificant IR (25.5° ± 10.3° vs 29.0° ± 7.1°, respectively; P = .066) and TR (P = .062) and higher but nonsignificant BKFO values (17.1 cm ± 3.4 cm vs 14.2 cm ± 4.6 cm, respectively; P = .078) than those without a cam deformity. CONCLUSION Decreased HROM in professional soccer players is associated with more hip- and groin-related symptoms and with previous injuries, independent of the presence of a cam deformity.
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Affiliation(s)
- Igor Tak
- Sports Rehabilitation and Manual Therapy Department, Physiotherapy Utrecht Oost, Utrecht, the Netherlands Department of Orthopaedics, Academic Medical Centre, Amsterdam, the Netherlands Academic Centre for Evidence based Sports Medicine (ACES), Amsterdam, the Netherlands Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam, the Netherlands
| | - Philip Glasgow
- Sports Institute of Northern Ireland, Belfast, Northern Ireland Sports Medicine Department, Ulster University, Belfast, Northern Ireland
| | - Rob Langhout
- Sports and Manual Therapy, Physiotherapy Dukenburg, Nijmegen, the Netherlands
| | - Adam Weir
- Sports Medicine Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Gino Kerkhoffs
- Department of Orthopaedics, Academic Medical Centre, Amsterdam, the Netherlands Academic Centre for Evidence based Sports Medicine (ACES), Amsterdam, the Netherlands Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam, the Netherlands
| | - Rintje Agricola
- Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, the Netherlands
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32
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Mosler AB, Agricola R, Weir A, Hölmich P, Crossley KM. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis. Br J Sports Med 2016; 49:810. [PMID: 26031646 PMCID: PMC4484362 DOI: 10.1136/bjsports-2015-094602] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Hip and groin injuries are common in many sports. Understanding the factors differentiating athletes with hip/groin pain from those without these injuries could facilitate management and prevention. Objective Conduct a systematic review and meta-analysis of the literature on factors differentiating athletes with and without hip/groin pain. Methods The review was registered as PROSPERO CRD42014007416 and a comprehensive, systematic search was conducted in June 2014. Inclusion criteria were: cross-sectional, cohort or case–control study designs of n>10 that examined outcome measures differentiating athletes with and without hip/groin pain. Two authors independently screened search results, assessed study quality, and performed data extraction. Methodological heterogeneity was determined and data pooled for meta-analysis when appropriate. A best evidence synthesis was performed on the remaining outcome measures. Results Of 2251 titles identified, 17 articles were included of which 10 were high quality. Sixty two different outcome measures were examined, 8 underwent meta-analysis. Pooled data showed strong evidence that athletes with hip/groin pain demonstrated: pain and lower strength on the adductor squeeze test, reduced range of motion in hip internal rotation and bent knee fall out; however, hip external rotation range was equivalent to controls. Strong evidence was found that lower patient-reported outcome (PRO) scores, altered trunk muscle function, and moderate evidence of bone oedema and secondary cleft sign were associated with hip/groin pain. Conclusions PROs, pain and reduced strength on the adductor squeeze test, reduced range of motion in internal rotation and bent knee fall out are the outcome measures that best differentiate athletes with hip/groin pain from those without this pain.
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Affiliation(s)
- Andrea B Mosler
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Rintje Agricola
- Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Adam Weir
- Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Per Hölmich
- Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Arthroscopic Center Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Kay M Crossley
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia School of Allied Health, La Trobe University, Victoria, Australia
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Serner A, Tol JL, Jomaah N, Weir A, Whiteley R, Thorborg K, Robinson M, Hölmich P. Diagnosis of Acute Groin Injuries: A Prospective Study of 110 Athletes. Am J Sports Med 2015; 43:1857-64. [PMID: 25977522 DOI: 10.1177/0363546515585123] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Acute groin injuries are common in high-intensity sports, but there are insufficient data on injury characteristics such as injury mechanisms and clinical and radiological findings. PURPOSE To describe these characteristics in a cohort of athletes. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS A total of 110 male athletes (mean age, 25.6 ± 4.7 years) with sports-related acute groin pain were prospectively included within 7 days of injury from August 2012 to April 2014. Standardized history taking, a clinical examination, magnetic resonance imaging (MRI), and/or ultrasound (US) were performed. RESULTS The most frequent injury mechanism in soccer was kicking (40%), and change of direction was most frequent in other sports (31%). Clinically, adductor injuries accounted for 66% of all injuries and primarily involved the adductor longus on imaging (91% US, 93% MRI). The iliopsoas and proximal rectus femoris were also frequently injured according to all examination modalities (15%-25%). Acute injury findings were negative in 22% of the MRI and 25% of the US examinations. Of the clinically diagnosed adductor injuries, 3% (US) and 6% (MRI) showed a radiological injury in a different location compared with 35% to 46% for clinically diagnosed iliopsoas and proximal rectus femoris injuries. CONCLUSION Adductor injuries account for the majority of acute groin injuries. Iliopsoas and proximal rectus femoris injuries are also common. More than 1 in 5 injuries showed no imaging signs of an acute injury. Clinically diagnosed adductor injuries were often confirmed on imaging, whereas iliopsoas and rectus femoris injuries showed a different radiological injury location in more than one-third of the cases. The discrepancy between clinical and radiological findings should be considered when diagnosing acute groin injuries.
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Affiliation(s)
- Andreas Serner
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Johannes L Tol
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Nabil Jomaah
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Adam Weir
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Rodney Whiteley
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | | | - Per Hölmich
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
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Bisciotti GN, Auci A, Di Marzo F, Galli R, Pulici L, Carimati G, Quaglia A, Volpi P. Groin pain syndrome: an association of different pathologies and a case presentation. Muscles Ligaments Tendons J 2015; 5:214-22. [PMID: 26605198 PMCID: PMC4617224 DOI: 10.11138/mltj/2015.5.3.214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND groin pain affects all types of athletes, especially soccer players. Many diseases with different etiologies may cause groin pain. PURPOSE offer a mini review of groin pain in soccer accompanied by the presentation of a case report highlighting the possible association of more clinical frameworks into the onset of groin pain syndrome, in order to recommend that clinical evaluations take into account possible associations between bone, muscle and tendon such as inguinal canal disease. CONCLUSION the multifactorial etiology of groin pain syndrome needs to be examined with a comprehensive approach, with standardized clinical evaluation based on an imaging protocol in order to evaluate all possible diseases. STUDY DESIGN Mini review- Case report (Level V).
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Affiliation(s)
| | - Alessio Auci
- Dipartimento di Diagnostica Ospedaliera, Radiodagnostica, ASL1 Massa-Carrara, Italy
| | | | - Roberto Galli
- Department of Health Science, Postgraduate School in Occupational Medicine, University of Genoa San Martino, Genoa, Italy
| | - Luca Pulici
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - Giulia Carimati
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - Alessandro Quaglia
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - Piero Volpi
- Department of Knee Orthopedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
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Whittaker JL, Small C, Maffey L, Emery CA. Risk factors for groin injury in sport: an updated systematic review. Br J Sports Med 2015; 49:803-9. [PMID: 25833903 DOI: 10.1136/bjsports-2014-094287] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 03/11/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND The identification of risk factors for groin injury in sport is important to develop and implement injury prevention strategies. OBJECTIVE To identify and evaluate the evidence examining risk factors for groin injury in sport. MATERIAL AND METHODS Nine electronic databases were systematically searched to June 2014. Studies selected met the following criteria: original data; analytic design; investigated a risk factor(s); included outcomes for groin injury sustained during sport participation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed and two independent authors assessed the quality and level of evidence with the Downs and Black (DB) criteria and Oxford Centre of Evidence-Based Medicine model, respectively. RESULTS Of 2521 potentially relevant studies, 29 were included and scored. Heterogeneity in methodology and injury definition precluded meta-analyses. The most common risk factors investigated included age, hip range of motion, hip adductor strength and height. The median DB score across studies was 11/33 (range 6-20). The majority of studies represented level 2 evidence (cohort studies) however few considered the inter-relationships between risk factors. There is level 1 and 2 evidence that previous groin injury, higher-level of play, reduced hip adductor (absolute and relative to the hip abductors) strength and lower levels of sport-specific training are associated with increased risk of groin injury in sport. CONCLUSIONS We recommended that investigators focus on developing and evaluating preparticipation screening and groin injury prevention programmes through high-quality randomised controlled trials targeting athletes at greater risk of injury.
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Affiliation(s)
- Jackie L Whittaker
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
| | | | - Lorrie Maffey
- Faculty of Medicine, Division of Sport Medicine, University of British Columbia, Vancouver, British Columbia, Canada School of Rehabilitation Science, McMaster University, Canada
| | - Carolyn A Emery
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Canada Department of Pediatrics and Department of Community Health Sciences, Alberta Children's Hospital Research Institute for Child and Maternal Health, Cummings School of Medicine, University of Calgary, Calgary, Canada
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Sherry MA, Johnston TS, Heiderscheit BC. Rehabilitation of Acute Hamstring Strain Injuries. Clin Sports Med 2015; 34:263-84. [DOI: 10.1016/j.csm.2014.12.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Esteve E, Rathleff MS, Bagur-Calafat C, Urrútia G, Thorborg K. Prevention of groin injuries in sports: a systematic review with meta-analysis of randomised controlled trials. Br J Sports Med 2015; 49:785-91. [DOI: 10.1136/bjsports-2014-094162] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2015] [Indexed: 11/04/2022]
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Paul DJ, Nassis GP, Whiteley R, Marques JB, Kenneally D, Chalabi H. Acute responses of soccer match play on hip strength and flexibility measures: potential measure of injury risk. J Sports Sci 2015; 32:1318-23. [PMID: 24998865 DOI: 10.1080/02640414.2014.927069] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Regular measurements of groin risk factors may offer a preventive measure against injury. Therefore, the aim of this study was to (1) determine minimal detectable change (MDC) and reliability of hip flexibility and strength measures and to (2) identify the effect soccer match play load has on these measures. Reliability was determined for bent knee fall out test, hip abduction and adduction (hand-held dynamometry (HHD)) in 20 trained youth male soccer players. Reliability was evaluated with the intra-class correlation coefficient (ICC[2,1]), 95% confidence intervals (CI). Hip strength and flexibility measures were taken before and after an international friendly match. Intra-rater reliability ICC ranges were bent knee fall out (0.75-0.90), abduction (0.83-0.90) and adduction (0.72-0.96). Inter-rater ICCs (95% CI) were bent knee fall out test [0.75 (0.39-0.90) right, 0.71 (0.27-0.89) left hip]; abduction [0.80 (0.50-0.92) right, 0.81 (0.53-0.92) left hip] and adduction [0.72 (0.31-0.89) right, 0.70 (0.26-0.88) left hip]. MDCs were as low as 20.7% of the mean for hip flexibility and 12.5% for strength. In conclusion, HHD and the bent knee fall out test are reliable tools to measure changes in hip strength and flexibility. Finally, a threshold may exist in which match play load negatively impacts hip flexibility.
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Affiliation(s)
- Darren J Paul
- a National Sports Medicine Programme, Excellence in Football Project , Aspetar Qatar Orthopaedic and Sports Medicine Hospital , Doha , Qatar
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Grant JA, Bedi A, Kurz J, Bancroft R, Gagnier JJ, Miller BS. Ability of preseason body composition and physical fitness to predict the risk of injury in male collegiate hockey players. Sports Health 2015; 7:45-51. [PMID: 25553212 PMCID: PMC4272692 DOI: 10.1177/1941738114540445] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Injuries in collegiate ice hockey can result in significant time lost from play. The identification of modifiable risk factors relating to a player’s physical fitness allows the development of focused training and injury prevention programs targeted at reducing these risks. Purpose: To determine the ability of preseason fitness outcomes to predict in-season on-ice injury in male collegiate ice hockey players. Study Design: Prognostic cohort study. Level of Evidence: Level 3. Methods: Athlete demographics, percentage body fat, aerobic capacity (300-m shuttle run; 1-, 1.5-, 5-mile run), and strength assessment (sit-ups, push-ups, grip strength, bench press, Olympic cleans, squats) data were collected at the beginning of 8 successive seasons for 1 male collegiate ice hockey team. Hockey-related injury data and player-level practice/game athlete exposure (AE) data were also prospectively collected. Seventy-nine players participated (203 player-years). Injury was defined as any event that resulted in the athlete being unable to participate in 1 or more practices or games following the event. Multivariable logistic regression was performed to determine the ability of the independent variables to predict the occurrence of on-ice injury. Results: There were 132 injuries (mean, 16.5 per year) in 55 athletes. The overall injury rate was 4.4 injuries per 1000 AEs. Forwards suffered 68% of the injuries. Seventy percent of injuries occurred during games with equal distribution between the 3 periods. The mean number of days lost due to injury was 7.8 ± 13.8 (range, 1-127 days). The most common mechanism of injury was contact with another player (54%). The odds of injury in a forward was 1.9 times (95% CI, 1.1-3.4) that of a defenseman and 3 times (95% CI, 1.2-7.7) that of a goalie. The odds of injury if the player’s body mass index (BMI) was ≥25 kg/m2 was 2.1 times (95% CI, 1.1-3.8) that of a player with a BMI <25 kg/m2. The odds ratios for bench press, maximum sit-ups, and Olympic cleans were statistically significant but close to 1.0, and therefore the clinical relevance is unknown. Conclusion: Forwards have higher odds of injury relative to other player positions. BMI was predictive of on-ice injury. Aerobic fitness and maximum strength outcomes were not strongly predictive of on-ice injury.
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Affiliation(s)
- John A Grant
- Department of Surgery, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Asheesh Bedi
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan ; Department of Athletics, University of Michigan, Ann Arbor, Michigan
| | - Jennifer Kurz
- School of Physical Therapy, Washington University School of Medicine, St. Louis, Missouri
| | - Richard Bancroft
- Department of Athletics, University of Michigan, Ann Arbor, Michigan
| | - Joel J Gagnier
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan ; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Bruce S Miller
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan ; Department of Athletics, University of Michigan, Ann Arbor, Michigan
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Verrall GM, Esterman A, Hewett TE. Analysis of the Three Most Prevalent Injuries in Australian Football Demonstrates a Season to Season Association Between Groin/Hip/Osteitis Pubis Injuries With ACL Knee Injuries. Asian J Sports Med 2014; 5:e23072. [PMID: 25520768 PMCID: PMC4267488 DOI: 10.5812/asjsm.23072] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 02/10/2014] [Indexed: 11/21/2022] Open
Abstract
Background: Injuries are common in contact sports like Australian football. The Australian Football League (AFL) has developed an extensive injury surveillance database that can be used for epidemiological studies. Objectives: The purpose of this study is to identify any association between the three most prevalent injuries in the AFL. Patients and Methods: From the AFL injury surveillance data 1997-2012 the injury incidence (new injuries per club per season) and the injury prevalence data (missed games per club per season) were analysed to detect the three most common injuries that would cause a player to miss a match in the AFL. The three most prevalent injuries in the AFL are hamstring strains, groin/hip/osteitis pubis injuries and Anterior Cruciate Ligament (ACL) knee injuries. Following this, further study was undertaken to detect the presence of any statistical relationship between injury incidences of the three most prevalent injuries over this sixteen year study period. Results: Statistical analysis demonstrates for any given year that there was an association between having a groin/hip/osteitis pubis injuriy and having a knee ACL injury (P < 0.05) over the entire sixteen years. In other words if the number of groin/hip/osteitis pubis injuries in any given season were higher than average (alternatively lower) then the number of knee ACL injuries were also higher than average (alternatively lower) for that same season. Hamstring injuries had the highest variance of incidence of the three most prevalent injuries. Conclusions: Analysis of the AFL injury data demonstrates an association between incidence of groin/hip/osteitis pubis injuries and incidence of knee ACL injuries for any given playing season. This finding is difficult to explain with further research being required.
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Affiliation(s)
- Geoffrey M. Verrall
- South Australian Sports Institute, Adelaide, Australia
- SPORTSMED.SA Sports Medicine Clinic, Adelaide, Australia
- Corresponding author: Geoffrey M. Verrall, SPORTSMED.SA Sports Medicine Clinic, Adelaide, Australia. Tel: +61-883628111, Fax: +61-883626635, E-mail:
| | - Adrian Esterman
- School of Nursery and Midwifery, University of South Australia, Adelaide, Australia
| | - Timothy E. Hewett
- Departments of Physiology and Cell Biology, Sports Health and Performance Institute, Ohio State University, Columbus, USA
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Cheatham SW, Hanney WJ, Kolber MJ, Salamh PA. Adductor-related groin pain in the athlete. PHYSICAL THERAPY REVIEWS 2014. [DOI: 10.1179/1743288x14y.0000000147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Ryan J, DeBurca N, Mc Creesh K. Risk factors for groin/hip injuries in field-based sports: a systematic review. Br J Sports Med 2014; 48:1089-96. [PMID: 24795341 DOI: 10.1136/bjsports-2013-092263] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Groin/hip injuries are common in the athletic population, particularly in sports requiring kicking, twisting, turning and rapid acceleration and deceleration. Chronic hip, buttock and groin pain account for 10% of all attendances to sports medicine centres. Understanding risk factors for field-based sports (FBS) players is important in developing preventive measures for injury. OBJECTIVE This systematic review aims to identify and examine the evidence for groin/hip injury risk factors in FBS. METHODS 14 electronic databases were searched using keywords. Studies were included if they met the inclusion criteria and investigated one or more risk factors with relation to the incidence of groin/hip injuries in FBS. Studies were accumulated and independently analysed by two reviewers under a 12-point quality assessment scale (modified CASP (for cohort study design) assessment scale). Owing to the heterogeneity of studies and measures used, a meta-analysis could not be conducted. As a result risk factors were pooled for analysis and discussion. RESULTS Of the 5842 potentially relevant studies, 7 high-quality studies were included in this review. Results demonstrated that previous groin/hip injury was the most prominent risk factor, identified across four studies (OR range from 2.6 (95% CI 1.1 to 6.11) to 7.3, (p=0.001)), followed by older age (OR 0.9, p=0.05) and weak adductor muscles (OR 4.28, 95% CI 1.31 to 14.0, p=0.02) each identified in two studies. Eight other significant risk factors were identified once across the included studies. CONCLUSIONS 11 significant risk factors for groin/hip injury for FBS players were identified. The most prominent risk factor identified was previous groin/hip injury. Future research should include a prospective study of a group of FBS players to confirm a relationship between the risk factors identified and development of groin/hip injuries.
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Affiliation(s)
- Julianne Ryan
- Department of Physiotherapy, University Hospital Galway, Galway, Ireland
| | - Neasa DeBurca
- Department of Physiotherapy, University Hospital Galway, Galway, Ireland
| | - Karen Mc Creesh
- Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
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Chaudhari AMW, Jamison ST, McNally MP, Pan X, Schmitt LC. Hip adductor activations during run-to-cut manoeuvres in compression shorts: implications for return to sport after groin injury. J Sports Sci 2014; 32:1333-40. [PMID: 24669858 DOI: 10.1080/02640414.2014.889849] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Athletes at high risk of groin strains in sports such as hockey and soccer often choose to wear shorts with directional compression to aid in prevention of or recovery from hip adductor strains. Large, eccentric contractions are known to result in or exacerbate strain injuries, but it is unknown if these shorts have a beneficial effect on hip adductor muscle activity. In this study, surface electromyography (EMG) of the adductor longus and ground reaction force (GRF) data were obtained simultaneously on 29 healthy individuals without previous history of serious injury while performing unanticipated 45° run-to-cut manoeuvres in a laboratory setting wearing shorts with non-directional compression (control, HeatGear, Under Armour, USA) or shorts with directional compression (directional, CoreShort PRO, Under Armour, USA), in random order. Average adductor activity in the stance leg was significantly lower in the directional condition than in the control condition during all parts of stance phase (all P < 0.042). From this preliminary analysis, wearing directional compression shorts appears to be associated with reduced stance limb hip adductor activity. Athletes seeking to reduce demand on the hip adductors as they approach full return to activities may benefit from the use of directional compression shorts.
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Affiliation(s)
- Ajit M W Chaudhari
- a Department of Orthopaedics , The Ohio State University , Columbus , OH , USA
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Sedaghati P, Alizadeh MH, Shirzad E, Ardjmand A. Review of sport-induced groin injuries. Trauma Mon 2013; 18:107-12. [PMID: 24350166 PMCID: PMC3864393 DOI: 10.5812/traumamon.12666] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 07/22/2013] [Accepted: 09/16/2013] [Indexed: 11/16/2022] Open
Abstract
CONTEXT Groin injuries are among the most common injuries co-existing with sports. The aim of this review was to outline the epidemiology and identify risk factors, as well as examine preventative and interventional measures for reducing the occurrence of this form of injury among athletes. EVIDENCE ACQUISITION An electronic, systematic search for relevant keywords, either separately or in combination was sought in the academic scientific databases. RESULTS Groin injuries, acute or chronic, consist of a high percentage of injuries that manifest with pain. Despite the specific tendency for injury among some sports, such injuries make up 2-5% of sport-induced injuries. There are few available reports on lower limb injuries, especially groin injuries, in Iran. Numerous factors predispose to groin injuries. A lengthy list of preventive/ treatment measures, from preliminary to sophisticated, have been proposed. CONCLUSIONS Although using a programmed strategy designed to decrease the risk of groin injuries by taking a strategic approach to exercise may alleviate complications, in some cases the chronic nature of the injury may threaten the professional life of the athlete. More research is required to plan suitable programs for reducing the risk of this type of injury in athletes.
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Affiliation(s)
- Parisa Sedaghati
- Department of Physical Training and Sport Sciences, Kish International Campus, University of Tehran, Tehran, IR Iran
| | | | - Elham Shirzad
- Department of Corrective Exercises and Sports Injuries, University of Tehran, Tehran, IR Iran
| | - Abolfazl Ardjmand
- Physiology Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding author: Abolfazl Ardjmand, Physiology Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel.:+98-3615550021, Fax: +98-3615621157, E-mail:
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Almeida MO, Silva BNG, Andriolo RB, Atallah AN, Peccin MS. Conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain. Cochrane Database Syst Rev 2013; 2013:CD009565. [PMID: 23740671 PMCID: PMC9719104 DOI: 10.1002/14651858.cd009565.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Musculoskeletal, ligamentous and osseous groin injuries are common in athletes and may result in a delay of several months to resume sports. Even then, this may not be at the former level of sport activity. The treatment of exercise-related groin pain is mainly conservative (non-surgical), using interventions such as exercises, electrotherapy, manual therapy and steroid injections. OBJECTIVES To assess the effects (benefits and harms) of conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain. SEARCH METHODS We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (December 2011); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 4); MEDLINE (1948 to November week 3 2011); EMBASE (1980 to Week 49 2011); CINAHL (1982 to December 2011); LILACS (1982 to December 2011); PEDro (1929 to December 2011), SPORTDiscus (1985 to December 2011), OTseeker (to December 2011), reference lists of papers and conference proceedings (2000 to 2011). SELECTION CRITERIA Randomized controlled trials and quasi-randomized controlled trials evaluating conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain were included. Studies comparing conservative with surgical treatments were excluded. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and conducted risk of bias assessments. There was no pooling of data. MAIN RESULTS Two studies, involving a total of 122 participants who had experienced adductor-related groin pain for at least two months, were included in this review. All but one of the participants were male athletes aged between 18 and 50 years old. Both studies were assessed as 'high risk of bias' for at least one source of bias domain. The 'successful treatment' outcome reported in both studies was based primarily on pain measures.One study, based on an intention-to-treat analysis, found a significant difference favouring exercise therapy (strengthening with an emphasis on the adductor and abdominal muscles and training muscular co-ordination) compared with 'conventional' physiotherapy (stretching exercises, electrotherapy and transverse friction massage) in successful treatment at 16-week follow-up (25/34 (74%) versus 10/34 (29%); risk ratio (RR) 2.50, 95% CI 1.43 to 4.37, P = 0.001). Similarly, of those followed-up significantly more athletes treated by exercise therapy returned to sport at the same level (23/29 (79%) versus 4/30 (13%); RR 5.95, 95% CI 2.34 to 15.09, P = 0.0002). Although still favouring the exercise group, the differences between the two groups in patients' subjective global assessment at 16 weeks and successful treatment at 8 to 12 years follow-up were not statistically significant.The second study (54 participants) found no significant differences at 16-week follow-up between a multi-modal treatment (heat, manual therapy and stretching) and exercise therapy (the same intervention as in the above study) for the outcomes of successful treatment (14/26 (54%) versus 12/22 (55%); RR 0.99, 95% CI 0.59 to 1.66, P = 0.96) and return to full sports participation (13/26 (50%) versus 12/22 (55%); RR 0.92, 95% CI 0.53 to 1.58, P = 0.75). Those returning to full sports participation returned on average 4.5 weeks earlier after receiving multi-modal therapy (mean difference -4.50 weeks, 95% CI -8.60 to -0.40, P = 0.03) than those in the exercise therapy group. This study reported that there were no complications or side effects found in either intervention group. AUTHORS' CONCLUSIONS The available evidence from the randomized trials is insufficient to advise on any specific conservative modality for treating exercise-related groin pain. While still low quality, the best evidence is from one trial which found that exercise therapy (strengthening of hip and abdominal muscles) in athletes improves short-term outcomes (based primarily on pain measures) and return to sports compared with physiotherapy consisting of passive modalities. Given the low quality of the available evidence from both included trials, further randomized trials are necessary to reinforce their findings.
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Affiliation(s)
- Matheus O Almeida
- Brazilian Cochrane Centre, Centro de Estudos de Medicina Baseada em Evidências e Avaliação Tecnológica em Saúde, São Paulo,Brazil.
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Hegedus EJ, Stern B, Reiman MP, Tarara D, Wright AA. A suggested model for physical examination and conservative treatment of athletic pubalgia. Phys Ther Sport 2013; 14:3-16. [DOI: 10.1016/j.ptsp.2012.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 03/12/2012] [Accepted: 04/06/2012] [Indexed: 12/14/2022]
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Rogalski B, Dawson B, Heasman J, Gabbett TJ. Training and game loads and injury risk in elite Australian footballers. J Sci Med Sport 2013; 16:499-503. [PMID: 23333045 DOI: 10.1016/j.jsams.2012.12.004] [Citation(s) in RCA: 167] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 12/07/2012] [Accepted: 12/13/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the relationship between combined training and game loads and injury risk in elite Australian footballers. DESIGN Prospective cohort study. METHODS Forty-six elite Australian footballers (mean±SD age of 22.2±2.9 y) from one club were involved in a one-season study. Training and game loads (session-RPE multiplied by duration in min) and injuries were recorded each time an athlete exerted an exercise load. Rolling weekly sums and week-to-week changes in load were then modelled against injury data using a logistic regression model. Odds ratios (OR) were reported against a reference group of the lowest training load range. RESULTS Larger 1 weekly (>1750 AU, OR=2.44-3.38), 2 weekly (>4000 AU, OR=4.74) and previous to current week changes in load (>1250 AU, OR=2.58) significantly related (p<0.05) to a larger injury risk throughout the in-season phase. Players with 2-3 and 4-6 years of experience had a significantly lower injury risk compared to 7+ years players (OR=0.22, OR=0.28) when the previous to current week change in load was more than 1000 AU. No significant relationships were found between all derived load values and injury risk during the pre-season phase. CONCLUSIONS In-season, as the amount of 1-2 weekly load or previous to current week increment in load increases, so does the risk of injury in elite Australian footballers. To reduce the risk of injury, derived training and game load values of weekly loads and previous week-to-week load changes should be individually monitored in elite Australian footballers.
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Affiliation(s)
- Brent Rogalski
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia; West Coast Eagles Football Club, Perth, Australia.
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Do the short-term benefits of physical training for sport-related groin injuries persist? Clin J Sport Med 2012; 22:522-3. [PMID: 23117339 DOI: 10.1097/jsm.0b013e318275d47b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Herman K, Barton C, Malliaras P, Morrissey D. The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review. BMC Med 2012; 10:75. [PMID: 22812375 PMCID: PMC3408383 DOI: 10.1186/1741-7015-10-75] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 07/19/2012] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Lower limb injuries in sport are increasingly prevalent and responsible for large economic as well as personal burdens. In this review we seek to determine which easily implemented functional neuromuscular warm-up strategies are effective in preventing lower limb injuries during sports participation and in which sporting groups they are effective. METHODS Seven electronic databases were searched from inception to January 2012 for studies investigating neuromuscular warm-up strategies and injury prevention. The quality of each included study was evaluated using a modified version of the van Tulder scale. Data were extracted from each study and used to calculate the risk of injury following application of each evaluated strategy. RESULTS Nine studies were identified including six randomized controlled trials (RCT) and three controlled clinical trials (CCT). Heterogeneity in study design and warm-up strategies prevented pooling of results. Two studies investigated male and female participants, while the remaining seven investigated women only. Risk Ratio (RR) statistics indicated 'The 11+' prevention strategy significantly reduces overall (RR 0.67, confidence interval (CI) 0.54 to 0.84) and overuse (RR 0.45, CI 0.28 to 0.71) lower limb injuries as well as knee (RR 0.48, CI 0.32 to 0.72) injuries among young amateur female footballers. The 'Knee Injury Prevention Program' (KIPP) significantly reduced the risk of noncontact lower limb (RR 0.5, CI 0.33 to 0.76) and overuse (RR 0.44, CI 0.22 to 0.86) injuries in young amateur female football and basketball players. The 'Prevent Injury and Enhance Performance' (PEP) strategy reduces the incidence of anterior cruciate ligament (ACL) injuries (RR 0.18, CI 0.08 to 0.42). The 'HarmoKnee' programme reduces the risk of knee injuries (RR 0.22, CI 0.06 to 0.76) in teenage female footballers. The 'Anterior Knee Pain Prevention Training Programme' (AKP PTP) significantly reduces the incidence of anterior knee pain (RR 0.27, CI 0.14 to 0.54) in military recruits. CONCLUSIONS Effective implementation of practical neuromuscular warm-up strategies can reduce lower extremity injury incidence in young, amateur, female athletes and male and female military recruits. This is typically a warm-up strategy that includes stretching, strengthening, balance exercises, sports-specific agility drills and landing techniques applied consistently for longer than three consecutive months. In order to optimize these strategies, the mechanisms for their effectiveness require further evaluation.
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Affiliation(s)
- Katherine Herman
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, Bancroft road, London, E1 4DG, UK
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Morrissey D, Graham J, Screen H, Sinha A, Small C, Twycross-Lewis R, Woledge R. Coronal plane hip muscle activation in football code athletes with chronic adductor groin strain injury during standing hip flexion. ACTA ACUST UNITED AC 2012; 17:145-9. [DOI: 10.1016/j.math.2011.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 11/17/2011] [Accepted: 12/12/2011] [Indexed: 02/07/2023]
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