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Stenerson LR, Melton BF, Bland HW, Ryan GA. Running-Related Overuse Injuries and Their Relationship with Run and Resistance Training Characteristics in Adult Recreational Runners: A Cross-Sectional Study. J Funct Morphol Kinesiol 2023; 8:128. [PMID: 37754962 PMCID: PMC10532616 DOI: 10.3390/jfmk8030128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
This study aimed to characterize running-related injuries (RRIs), explore their relationship with run and resistance training (RT) parameters, and identify perceived prevention measures among adult recreational runners. An anonymous online survey was designed and distributed via social media and email. Data were analyzed with chi-square, t-test, or analysis of variance (ANOVA), with significance accepted at p ≤ 0.05. Data from 616 participants (76.8% female, age: 42.3 ± 10.5 y) were analyzed. Most runners (84.4%) had an injury history, with 44.6% experiencing one in the past year. The most common RRI sites included the foot/ankle (30.9%) and knee (22.2%). RRI prevalence was higher in those running >19 miles weekly (48.4%, p = 0.05), but there were no differences based on RT participation status. Among those using RT, relatively more RRIs were observed in runners who trained the hip musculature (50.3%, p = 0.005) and did not include the upper body (61.6%, p < 0.001). A disproportionately high RRI prevalence was found for several of the other risk-reduction strategies. RRIs remain a substantial problem, particularly around the ankle/foot and knee. Higher run volume and performance motives were positively associated with RRIs. Most runners incorporated RRI risk-reduction techniques, with over half using RT. The current study did not determine whether preventative strategies were implemented before or after injury; therefore, prospective studies controlling for previous injuries are required to evaluate the effectiveness of RT in preventing future RRIs.
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Affiliation(s)
- Lea R. Stenerson
- Department of Health and Human Performance, Concordia University of Chicago, River Forest, IL 60305, USA;
- Department of Biology, Regis University, Denver, CO 80221, USA
| | - Bridget F. Melton
- Department of Health and Human Performance, Concordia University of Chicago, River Forest, IL 60305, USA;
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA 30458, USA
| | - Helen W. Bland
- Department of Health Policy and Community Health, Georgia Southern University, Statesboro, GA 30458, USA;
| | - Greg A. Ryan
- Department of Health Sciences, Piedmont University, Demorest, GA 30535, USA
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Relph N, Greaves H, Armstrong R, Prior TD, Spencer S, Griffiths IB, Dey P, Langley B. Running shoes for preventing lower limb running injuries in adults. Cochrane Database Syst Rev 2022; 8:CD013368. [PMID: 35993829 PMCID: PMC9394464 DOI: 10.1002/14651858.cd013368.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Lower-limb running injuries are common. Running shoes have been proposed as one means of reducing injury risk. However, there is uncertainty as to how effective running shoes are for the prevention of injury. It is also unclear how the effects of different characteristics of running shoes prevent injury. OBJECTIVES To assess the effects (benefits and harms) of running shoes for preventing lower-limb running injuries in adult runners. SEARCH METHODS We searched the following databases: CENTRAL, MEDLINE, Embase, AMED, CINAHL Plus and SPORTDiscus plus trial registers WHO ICTRP and ClinicalTrials.gov. We also searched additional sources for published and unpublished trials. The date of the search was June 2021. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs involving runners or military personnel in basic training that either compared a) a running shoe with a non-running shoe; b) different types of running shoes (minimalist, neutral/cushioned, motion control, stability, soft midsole, hard midsole); or c) footwear recommended and selected on foot posture versus footwear not recommended and not selected on foot posture for preventing lower-limb running injuries. Our primary outcomes were number of people sustaining a lower-limb running injury and number of lower-limb running injuries. Our secondary outcomes were number of runners who failed to return to running or their previous level of running, runner satisfaction with footwear, adverse events other than musculoskeletal injuries, and number of runners requiring hospital admission or surgery, or both, for musculoskeletal injury or adverse event. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility and performed data extraction and risk of bias assessment. The certainty of the included evidence was assessed using GRADE methodology. MAIN RESULTS We included 12 trials in the analysis which included a total of 11,240 participants, in trials that lasted from 6 to 26 weeks and were carried out in North America, Europe, Australia and South Africa. Most of the evidence was low or very low certainty as it was not possible to blind runners to their allocated running shoe, there was variation in the definition of an injury and characteristics of footwear, and there were too few studies for most comparisons. We did not find any trials that compared running shoes with non-running shoes. Neutral/cushioned versus minimalist (5 studies, 766 participants) Neutral/cushioned shoes may make little or no difference to the number of runners sustaining a lower-limb running injuries when compared with minimalist shoes (low-certainty evidence) (risk ratio (RR) 0.77, 95% confidence interval (CI) 0.59 to 1.01). One trial reported that 67% and 92% of runners were satisfied with their neutral/cushioned or minimalist running shoes, respectively (RR 0.73, 95% CI 0.47 to 1.12). Another trial reported mean satisfaction scores ranged from 4.0 to 4.3 in the neutral/ cushioned group and 3.6 to 3.9 in the minimalist running shoe group out of a total of 5. Hence neutral/cushioned running shoes may make little or no difference to runner satisfaction with footwear (low-certainty evidence). Motion control versus neutral / cushioned (2 studies, 421 participants) It is uncertain whether or not motion control shoes reduce the number of runners sustaining a lower-limb running injuries when compared with neutral / cushioned shoes because the quality of the evidence has been assessed as very low certainty (RR 0.92, 95% CI 0.30 to 2.81). Soft midsole versus hard midsole (2 studies, 1095 participants) Soft midsole shoes may make little or no difference to the number of runners sustaining a lower-limb running injuries when compared with hard midsole shoes (low-certainty of evidence) (RR 0.82, 95% CI 0.61 to 1.10). Stability versus neutral / cushioned (1 study, 57 participants) It is uncertain whether or not stability shoes reduce the number of runners sustaining a lower-limb running injuries when compared with neutral/cushioned shoes because the quality of the evidence has been assessed as very low certainty (RR 0.49, 95% CI 0.18 to 1.31). Motion control versus stability (1 study, 56 participants) It is uncertain whether or not motion control shoes reduce the number of runners sustaining a lower-limb running injuries when compared with stability shoes because the quality of the evidence has been assessed as very low certainty (RR 3.47, 95% CI 1.43 to 8.40). Running shoes prescribed and selected on foot posture (3 studies, 7203 participants) There was no evidence that running shoes prescribed based on static foot posture reduced the number of injuries compared with those who received a shoe not prescribed based on foot posture in military recruits (Rate Ratio 1.03, 95% CI 0.94 to 1.13). Subgroup analysis confirmed these findings were consistent between males and females. Therefore, prescribing running shoes and selecting on foot posture probably makes little or no difference to lower-limb running injuries (moderate-certainty evidence). Data were not available for all other review outcomes. AUTHORS' CONCLUSIONS Most evidence demonstrates no reduction in lower-limb running injuries in adults when comparing different types of running shoes. Overall, the certainty of the evidence determining whether different types of running shoes influence running injury rates was very low to low, and as such we are uncertain as to the true effects of different types of running shoes upon injury rates. There is no evidence that prescribing footwear based on foot type reduces running-related lower-limb injures in adults. The evidence for this comparison was rated as moderate and as such we can have more certainty when interpreting these findings. However, all three trials included in this comparison used military populations and as such the findings may differ in recreational runners. Future researchers should develop a consensus definition of running shoe design to help standardise classification. The definition of a running injury should also be used consistently and confirmed via health practitioners. More researchers should consider a RCT design to increase the evidence in this area. Lastly, future work should look to explore the influence of different types or running shoes upon injury rates in specific subgroups.
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Affiliation(s)
- Nicola Relph
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | | | - Ross Armstrong
- Institute of Health, University of Cumbria, Carlisle, UK
| | - Trevor D Prior
- Podiatric Surgery, Homerton University Hospital, London, UK
| | - Sally Spencer
- Health Research Institute, Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | | | - Paola Dey
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | - Ben Langley
- Department of Sport & Physical Activity, Edge Hill University, Ormskirk, UK
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3
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Comparison between side-lying and standing positions for hip abductor strength assessment. J Bodyw Mov Ther 2022; 30:181-186. [DOI: 10.1016/j.jbmt.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 11/08/2021] [Accepted: 02/04/2022] [Indexed: 11/23/2022]
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Hegedus EJ, Ickes L, Jakobs F, Ford KR, Smoliga JM. Comprehensive Return to Competitive Distance Running: A Clinical Commentary. Sports Med 2021; 51:2507-2523. [PMID: 34478108 DOI: 10.1007/s40279-021-01547-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 01/02/2023]
Abstract
Running injuries are very common, and there are well-established protocols for clinicians to manage specific musculoskeletal conditions in runners. However, competitive and elite runners may experience different injuries than the average recreational runner, due to differences in training load, biomechanics, and running experience. Additionally, injury-specific rehabilitation protocols do not consider the broader goal of return to competitive running, including the unique psychosocial and cardiorespiratory fitness needs of elite athletes. This review aims to suggest a guideline for running-specific progression as part of a comprehensive rehabilitation program for injured competitive runners. Tools to evaluate an athlete's psychosocial preparedness to return to competition are presented. Recommendations are also provided for monitoring cardiorespiratory fitness of injured runners, including the nuances of interpreting these data. Finally, a six-phase training paradigm is proposed to guide clinicians as they help competitive runners transition from the early stages of injury through a full return to competition.
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Affiliation(s)
- Eric J Hegedus
- Department of Physical Therapy, One University Parkway, High Point University, High Point, NC, 27268, USA. .,Physical Therapy Program, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA.
| | - Lindsey Ickes
- Department of Exercise Science, One University Parkway, High Point University, High Point, NC, 27268, USA
| | - Franziska Jakobs
- Department of Exercise Science, One University Parkway, High Point University, High Point, NC, 27268, USA
| | - Kevin R Ford
- Department of Physical Therapy, One University Parkway, High Point University, High Point, NC, 27268, USA
| | - James M Smoliga
- Department of Physical Therapy, One University Parkway, High Point University, High Point, NC, 27268, USA
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van Poppel D, van der Worp M, Slabbekoorn A, van den Heuvel SSP, van Middelkoop M, Koes BW, Verhagen AP, Scholten-Peeters GGM. Risk factors for overuse injuries in short- and long-distance running: A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:14-28. [PMID: 32535271 PMCID: PMC7856562 DOI: 10.1016/j.jshs.2020.06.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/25/2020] [Accepted: 05/04/2020] [Indexed: 05/13/2023]
Abstract
PURPOSE The aim of this study was to review information about risk factors for lower extremity running injuries in both short-distance (mean running distance ≤20 km/week and ≤10 km/session) and long-distance runners (mean running distance >20 km/week and >10 km/session). METHODS Electronic databases were searched for articles published up to February 2019. Prospective cohort studies using multivariable analysis for the assessment of individual risk factors or risk models for the occurrence of lower extremity running injuries were included. Two reviewers independently selected studies for eligibility and assessed risk of bias with the Quality in Prognostic Studies Tool. The GRADE approach was used to assess the quality of the evidence. RESULTS A total of 29 studies were included: 17 studies focused on short-distance runners, 11 studies focused on long-distance runners, and 1 study focused on both types of runners. A previous running-related injury was the strongest risk factor for an injury for long-distance runners, with moderate-quality evidence. Previous injuries not attributed to running was the strongest risk factor for an injury for short-distance runners, with high-quality evidence. Higher body mass index, higher age, sex (male), having no previous running experience, and lower running volume were strong risk factors, with moderate quality evidence, for short-distance runners. Low-quality evidence was found for all risk models as predictors of running-related injuries among short- and long-distance runners. CONCLUSION Several risk factors for lower extremity injuries have been identified among short- and long-distance runners, but the quality of evidence for these risk factors for running-related injuries is limited. Running injuries seem to have a multifactorial origin both in short- and long-distance runners.
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Affiliation(s)
- Dennis van Poppel
- Research Group Diagnostics, Avans University of Applied Sciences, Breda, 4818 CR, the Netherlands.
| | - Maarten van der Worp
- Stichting Academie Instituut Fysiotherapie PLUS, Utrecht, 3581 MD, the Netherlands
| | - Anouk Slabbekoorn
- Research Group Diagnostics, Avans University of Applied Sciences, Breda, 4818 CR, the Netherlands
| | | | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC Medical University Center, Rotterdam, 3015 CE, the Netherlands
| | - Bart W Koes
- Department of General Practice, Erasmus MC Medical University Center, Rotterdam, 3015 CE, the Netherlands; Center for Muscle and Joint Health, University of Southern Denmark, Odense, 5230, Denmark
| | - Arianne P Verhagen
- Research Group Diagnostics, Avans University of Applied Sciences, Breda, 4818 CR, the Netherlands; Department of General Practice, Erasmus MC Medical University Center, Rotterdam, 3015 CE, the Netherlands; Discipline of Physiotherapy, Graduate School of Health, University of Technology, Sydney, Chippendale NSW 2008, Australia
| | - Gwendolyne G M Scholten-Peeters
- Research Group Diagnostics, Avans University of Applied Sciences, Breda, 4818 CR, the Netherlands; Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, the Netherlands
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Effectiveness of Field-Based Resistance Training Protocols on Hip Muscle Strength Among Young Elite Football Players. Clin J Sport Med 2020; 30:470-477. [PMID: 30418198 DOI: 10.1097/jsm.0000000000000649] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this study was to examine the effects of an 8-week progressive resistance training program on hip joint muscles' strength measures, using the Copenhagen adduction (CA) and the sliding hip (SH) exercises. DESIGN Prospective randomized controlled trial. SETTING Sport training and medical centers. PARTICIPANTS Forty-two young male football athletes (age 17.5 ± 1.1 years; height 178.3 ± 3.2 cm; body mass 66.1 ± 8.6 kg) allocated to a CA, SH, and matched control (C) group. INTERVENTIONS Two weekly sessions of CA and SH. MAIN OUTCOME MEASURES Maximal eccentric strength test for the hip adductor (EHAD) and maximal eccentric strength test for the hip abductor (EHAB) muscles, and the relative EHAD/EHAB ratio assessed through a break test in the side-lying position. RESULTS No significant differences between groups were found at baseline for any of the assessed variables (all P > 0.053). The CA group had a significant strength increase in the right and left leg (d = 2.11, d = 1.9, respectively). The SH group also had a significant strength increase in the right and left leg (d = 1.68 and d = 1.67, respectively). The CA group presented EHAD/EHAB improvements in the right and left leg (d = 0.84 and d = 1.14, respectively). The SH group also presented EHAD/EHAB improvements in the right and left leg (d = 1.34 and d = 1.44, respectively). CONCLUSIONS Both exercises' protocols were effective in inducing significant increases on EHAD, EHAB, and EHAD/EHAB ratio when compared with the control group. Practitioners should be aware of the training effectiveness of both protocols.
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Limited Support for Trunk and Hip Deficits as Risk Factors for Athletic Knee Injuries: A Systematic Review With Meta-analysis and Best-Evidence Synthesis. J Orthop Sports Phys Ther 2020; 50:476-489. [PMID: 32741330 DOI: 10.2519/jospt.2020.9705] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine whether neuromuscular deficits in trunk and hip-related function are risk factors for athletic knee injuries. DESIGN Etiology systematic review with meta-analysis. LITERATURE SEARCH Six online databases (MEDLINE, Web of Science, Embase, CINAHL, Scopus, and SPORTDiscus) were searched up to April 2019. STUDY SELECTION CRITERIA Studies assessing trunk and hip neuromuscular function as risk factors for knee injuries in healthy athletic populations were included. DATA SYNTHESIS Outcomes were synthesized quantitatively using meta-analysis of odds ratios, and qualitatively using best-evidence synthesis. RESULTS Twenty-one studies met the inclusion criteria. There was very low-certainty evidence that greater hip external rotation strength protected against knee injuries (odds ratio = 0.78; 95% confidence interval: 0.70, 0.87; P<.05). There was limited evidence that deficits in trunk proprioception and neuromuscular control, and the combination of excessive knee valgus and ipsilateral trunk angle when landing unilaterally from a jump, may be risk factors for knee injuries. CONCLUSION Most variables of trunk and hip function were not risk factors for injuries. Further research is required to confirm whether hip external rotation strength, trunk proprioception and neuromuscular control, and the combination of knee valgus angle and ipsilateral trunk control are risk factors for future knee injuries. J Orthop Sports Phys Ther 2020;50(9):476-489. Epub 1 Aug 2020. doi:10.2519/jospt.2020.9705.
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Brindle RA, Ebaugh DD, Willson JD, Finley MA, Shewokis PA, Milner CE. Relationships of hip abductor strength, neuromuscular control, and hip width to femoral length ratio with peak hip adduction angle in healthy female runners. J Sports Sci 2020; 38:2291-2297. [PMID: 32543341 DOI: 10.1080/02640414.2020.1779489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A large peak hip adduction angle during running is a risk factor for several overuse injuries in women. The purpose of this study was to determine if female runners with a large peak hip adduction angle have differences in eccentric hip abductor muscle strength, hip neuromuscular control, and/or hip width to femoral length ratio (HW:FL) compared to those with a small angle. Hip adduction during running, hip strength, hip control, and HW:FL were measured in sixty healthy female runners (1.66 ± 0.06 m; 63.2 ± 8.3 kg; 27 ± 6 years). Data from twenty runners with the largest and twenty with the smallest peak hip adduction angles were analysed. Between-group differences in hip strength, control, and HW:FL were determined using independent t-tests (p < 0.05). Variables that were significantly different between groups were entered into a regression model. Runners in both groups had similar hip strength (p = 0.90) and control (p = 0.65). HW:FL was greater in the large peak angle group (p = 0.04), but only explained a small amount of peak hip adduction angle variance for all sixty runners (R2 = 0.05). Alarge peak hip adduction angle in some healthy female runners may simply be instinctive as there were no deficiencies in the strength or neuromuscular control constructs assessed.
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Affiliation(s)
- Richard A Brindle
- ReHAB Group, Department of Physical Therapy and Rehabilitation Sciences, Drexel University , Philadelphia, PA, USA
| | - D David Ebaugh
- Department of Physical Therapy, University of Delaware , Newark, DE, USA
| | - John D Willson
- Department of Physical Therapy, East Carolina University , Greenville, NC, USA
| | - Margaret A Finley
- ReHAB Group, Department of Physical Therapy and Rehabilitation Sciences, Drexel University , Philadelphia, PA, USA
| | - Patricia A Shewokis
- Nutrition Sciences Department, College of Nursing and Health Professions, Drexel University , Philadelphia, PA, USA.,School of Biomedical Engineering, Science and Health Systems, Drexel University , Philadelphia, PA, USA
| | - Clare E Milner
- ReHAB Group, Department of Physical Therapy and Rehabilitation Sciences, Drexel University , Philadelphia, PA, USA
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Drury B, Ratel S, Clark CC, Fernandes JF, Moran J, Behm DG. Eccentric Resistance Training in Youth: Perspectives for Long-Term Athletic Development. J Funct Morphol Kinesiol 2019; 4:E70. [PMID: 33467385 PMCID: PMC7739302 DOI: 10.3390/jfmk4040070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023] Open
Abstract
The purpose of this narrative review is to discuss the role of eccentric resistance training in youth and how this training modality can be utilized within long-term physical development. Current literature on responses to eccentric exercise in youth has demonstrated that potential concerns, such as fatigue and muscle damage, compared to adults are not supported. Considering the importance of resistance training for youth athletes and the benefits of eccentric training in enhancing strength, power, speed, and resistance to injury, its inclusion throughout youth may be warranted. In this review we provide a brief overview of the physiological responses to exercise in youth with specific reference to the different responses to eccentric resistance training between children, adolescents, and adults. Thereafter, we discuss the importance of ensuring that force absorption qualities are trained throughout youth and how these may be influenced by growth and maturation. In particular, we propose practical methods on how eccentric resistance training methods can be implemented in youth via the inclusion of efficient landing mechanics, eccentric hamstrings strengthening and flywheel inertia training. This article proposes that the use of eccentric resistance training in youth should be considered a necessity to help develop both physical qualities that underpin sporting performance, as well as reducing injury risk. However, as with any other training modality implemented within youth, careful consideration should be given in accordance with an individual's maturity status, training history and technical competency as well as being underpinned by current long-term physical development guidelines.
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Affiliation(s)
- Benjamin Drury
- Department of Applied Sport Sciences, Hartpury University, Gloucestershire GL19 3BE, England, UK;
| | - Sébastien Ratel
- Laboratoire des Adaptations Métaboliques à l’Exercice en conditions Physiologiques et Pathologiques (AME2P, EA 3533), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Cain C.T. Clark
- Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5RW, England, UK;
| | - John F.T. Fernandes
- Department of Applied Sport Sciences, Hartpury University, Gloucestershire GL19 3BE, England, UK;
| | - Jason Moran
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3WA, UK;
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s Newfoundland and Labrador, A1C 5S7C, Canada;
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Abstract
Patellofemoral pain (PFP) is a common musculoskeletal-related condition that is characterized by insidious onset of poorly defined pain, localized to the anterior retropatellar and/or peripatellar region of the knee. The onset of symptoms can be slow or acutely develop with a worsening of pain accompanying lower-limb loading activities (eg, squatting, prolonged sitting, ascending/descending stairs, jumping, or running). Symptoms can restrict participation in physical activity, sports, and work, as well as recur and persist for years. This clinical practice guideline will allow physical therapists and other rehabilitation specialists to stay up to date with evolving PFP knowledge and practices, and help them to make evidence-based treatment decisions. J Orthop Sports Phys Ther. 2019;49(9):CPG1-CPG95. doi:10.2519/jospt.2019.0302.
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11
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Hu H, Zheng Y, Liu X, Gong D, Chen C, Wang Y, Peng M, Wu B, Wang J, Song G, Zhang J, Guo J, Dong Y, Wang X. Effects of neuromuscular training on pain intensity and self-reported functionality for patellofemoral pain syndrome in runners: study protocol for a randomized controlled clinical trial. Trials 2019; 20:409. [PMID: 31288849 PMCID: PMC6617607 DOI: 10.1186/s13063-019-3503-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 06/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patellofemoral pain syndrome (PFPS) is common and affects approximately 15% of individuals at different ages and activity levels. As a non-surgical intervention, physiotherapy is widely used to treat PFPS. Neuromuscular training exercise is one of the most effective methods for decreasing musculoskeletal pain and improving knee function. However, the effectiveness of neuromuscular training exercise for treating PFPS is not without argument. The purpose of this study is to evaluate the effect of neuromuscular training exercise on patellofemoral pain and whether the neuromuscular training exercise have more advantage effects than taping and health education. METHODS We will operate a prospective, single-blind, randomized controlled trial of 60 patients with patellofemoral pain. Individuals will be indiscriminately assigned to two intervention groups and a health education group. The neuromuscular training exercise which includes the muscle strength training, balance training and knee joint proprioception training, and taping group will use "Y" and "I" type taping on the participants three times a week for three months. The health education group will be given education lectures once each week and which last for three months. The primary outcome measures include the adverse events, visual analog scale for pain, and Anterior Knee Pain Scale Index, which is a knee function self-report questionnaire to evaluate the function of the knee especially for PFPS patients. The secondary outcome measures are the muscle strength and endurance of knee joint flexion and extensor muscles, knee joint proprioception, muscle thickness of the quadriceps femoris, knee function ability, and quality of life. We will manage the intention-to-treat analysis for individuals who will withdraw from this study. DISCUSSION According to previous studies, neuromuscular training exercise and the taping method are effective treatment for PFPS patients. In this study, we will perform a neuromuscular training exercise for patients with PFPS. We believe that this study may prove the effectiveness of neuromuscular training exercise in treating PFPS. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1800014995 . Registered on 27 February 2018.
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Affiliation(s)
- Haoyu Hu
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Yili Zheng
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Xiaochen Liu
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Di Gong
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Changcheng Chen
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Yizu Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Mengsi Peng
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Bao Wu
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Juan Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Ge Song
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Juan Zhang
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Jiabao Guo
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Yulin Dong
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai RD, Shanghai, China. .,Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, 200438, China.
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Relph N, Greaves H, Armstrong R, Gichuru P, Prior TD, Griffiths IB, Spencer S, Dey P, Langley B. Running shoes for preventing lower limb running injuries in adults. Hippokratia 2019. [DOI: 10.1002/14651858.cd013368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Nicola Relph
- Edge Hill University; Faculty of Health and Social Care; Ormskirk UK
| | - Henrike Greaves
- Liverpool John Moores University; Tom Reilly Building, Byrom Street, Liverpool UK L3 3AF
| | - Ross Armstrong
- Edge Hill University; Department of Sport & Physical Activity; St Helens Road Ormskirk UK L39 4QP
| | - Phillip Gichuru
- Edge Hill University; Faculty of Health and Social Care; Ormskirk UK
| | - Trevor D Prior
- Homerton University Hospital; Podiatric Surgery; Homerton Row London UK E9 6SR
| | - Ian B Griffiths
- Pure Sports Medicine; Level 2 Cabot Place West Canary Wharf London London UK E14 4QT
| | - Sally Spencer
- Edge Hill University; Postgraduate Medical Institute; St Helens Road Ormskirk Lancashire UK L39 4QP
| | - Paola Dey
- Edge Hill University; Faculty of Health and Social Care; Ormskirk UK
| | - Ben Langley
- Edge Hill University; Department of Sport & Physical Activity; St Helens Road Ormskirk UK L39 4QP
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13
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Bulat M, Korkmaz Can N, Arslan YZ, Herzog W. Musculoskeletal Simulation Tools for Understanding Mechanisms of Lower-Limb Sports Injuries. Curr Sports Med Rep 2019; 18:210-216. [DOI: 10.1249/jsr.0000000000000601] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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The relationship between hip muscle strength and dynamic knee valgus in asymptomatic females: A systematic review. Phys Ther Sport 2019; 37:197-209. [DOI: 10.1016/j.ptsp.2018.05.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 04/01/2018] [Accepted: 05/18/2018] [Indexed: 12/21/2022]
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15
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Rethinking patellofemoral pain: Prevention, management and long-term consequences. Best Pract Res Clin Rheumatol 2019; 33:48-65. [DOI: 10.1016/j.berh.2019.02.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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16
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Torp DM, Donovan L, Gribble PA, Thomas AC, Bazett-Jones DM, Beard MQ. No baseline strength differences between female recreational runners who developed an injury and injury free runners during a 16-week formalized training program. Phys Ther Sport 2018; 34:1-7. [DOI: 10.1016/j.ptsp.2018.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 07/20/2018] [Accepted: 08/04/2018] [Indexed: 12/13/2022]
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17
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Neal BS, Lack SD, Lankhorst NE, Raye A, Morrissey D, van Middelkoop M. Risk factors for patellofemoral pain: a systematic review and meta-analysis. Br J Sports Med 2018; 53:270-281. [PMID: 30242107 DOI: 10.1136/bjsports-2017-098890] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Patellofemoral pain (PFP) is a prevalent condition commencing at various points throughout life. We aimed to provide an evidence synthesis concerning predictive variables for PFP, to aid development of preventative interventions. METHODS We searched Medline, Web of Science and SCOPUS until February 2017 for prospective studies investigating at least one potential risk factor for future PFP. Two independent reviewers appraised methodological quality using the Newcastle-Ottawa Scale. We conducted meta-analysis where appropriate, with standardised mean differences (SMD) and risk ratios calculated for continuous and nominal scaled data. RESULTS This review included 18 studies involving 4818 participants, of whom 483 developed PFP (heterogeneous incidence 10%). Three distinct subgroups (military recruits, adolescents and recreational runners) were identified. Strong to moderate evidence indicated that age, height, weight, body mass index (BMI), body fat and Q angle were not risk factors for future PFP. Moderate evidence indicated that quadriceps weakness was a risk factor for future PFP in the military, especially when normalised by BMI (SMD -0.69, CI -1.02, -0.35). Moderate evidence indicated that hip weakness was not a risk factor for future PFP (multiple pooled SMDs, range -0.09 to -0.20), but in adolescents, moderate evidence indicated that increased hip abduction strength was a risk factor for future PFP (SMD 0.71, CI 0.39, 1.04). CONCLUSIONS This review identified multiple variables that did not predict future PFP, but quadriceps weakness in military recruits and higher hip strength in adolescents were risk factors for PFP. Identifying modifiable risk factors is an urgent priority to improve prevention and treatment outcomes.
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Affiliation(s)
- Bradley S Neal
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Pure Sports Medicine, London, UK
| | - Simon D Lack
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Pure Sports Medicine, London, UK
| | | | - Andrew Raye
- Sports and Exercise Medicine, Queen Mary University of London, London, UK
| | - Dylan Morrissey
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Physiotherapy Department, Barts Health NHS Trust, London, UK
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18
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Rabelo NDDA, Lucareli PRG. Response the letter to the editor for the masterclass: Do hip muscle weakness and dynamic knee valgus matter for the clinical evaluation and decision-making process in patients with patellofemoral pain? Braz J Phys Ther 2018; 22:432-433. [PMID: 29804648 PMCID: PMC6157464 DOI: 10.1016/j.bjpt.2018.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 10/16/2022] Open
Affiliation(s)
- Nayra Deise Dos Anjos Rabelo
- Human Motion Analysis Laboratory, Rehabilitation Science Department, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Paulo Roberto Garcia Lucareli
- Human Motion Analysis Laboratory, Rehabilitation Science Department, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil.
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19
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Neal BS, Barton CJ, Birn-Jeffrey A, Daley M, Morrissey D. The effects & mechanisms of increasing running step rate: A feasibility study in a mixed-sex group of runners with patellofemoral pain. Phys Ther Sport 2018; 32:244-251. [PMID: 29879639 DOI: 10.1016/j.ptsp.2018.05.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVES To explore feasibility of recruitment and retention of runners with patellofemoral pain (PFP), before delivering a step rate intervention. DESIGN Feasibility study. SETTING Human performance laboratory. PARTICIPANTS A mixed-sex sample of runners with PFP (n = 11). MAIN OUTCOME MEASURES Average/worst pain and the Kujala Scale were recorded pre/post intervention, alongside lower limb kinematics and surface electromyography (sEMG), sampled during a 3 KM treadmill run. RESULTS Recruitment and retention of a mixed-sex cohort was successful, losing one participant to public healthcare and with kinematic and sEMG data lost from single participants only. Clinically meaningful reductions in average (MD = 2.1, d = 1.7) and worst pain (MD = 3.9, d = 2.0) were observed. Reductions in both peak knee flexion (MD = 3.7°, d = 0.78) and peak hip internal rotation (MD = 5.1°, d = 0.96) were observed, which may provide some mechanistic explanation for the identified effects. An increase in both mean amplitude (d = 0.53) and integral (d = 0.58) were observed for the Vastus Medialis Obliqus (VMO) muscle only, of questionable clinical relevance. CONCLUSIONS Recruitment and retention of a mixed sex PFP cohort to a step rate intervention involving detailed biomechanical measures is feasible. There are indications of both likely efficacy and associated mechanisms. Future studies comparing the efficacy of different running retraining approaches are warranted.
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Affiliation(s)
- Bradley S Neal
- Sports & Exercise Medicine, Queen Mary University of London, United Kingdom; Pure Sports Medicine, London, United Kingdom
| | - Christian J Barton
- Sports & Exercise Medicine, Queen Mary University of London, United Kingdom; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia; School of Allied Health, La Trobe University, Melbourne, Victoria, Australia; Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Aleksandra Birn-Jeffrey
- Sports & Exercise Medicine, Queen Mary University of London, United Kingdom; School of Engineering and Materials Science, Queen Mary University of London, United Kingdom
| | - Monica Daley
- Comparative Biomedical Sciences, Royal Vetinary College, United Kingdom
| | - Dylan Morrissey
- Sports & Exercise Medicine, Queen Mary University of London, United Kingdom; Physiotherapy Department, Bart's Health NHS Trust, London, United Kingdom.
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20
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Neto JBDS, Fukuda TY. Letter to editor in chief: Do hip muscle weakness and dynamic knee valgus matter for the clinical evaluation and decision making process in patients with patellofemoral pain? Braz J Phys Ther 2018; 22:431-432. [PMID: 29804649 DOI: 10.1016/j.bjpt.2018.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 03/27/2018] [Accepted: 05/03/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- João Barboza da Silva Neto
- Instituto Trata - Joelho e Quadril, São Paulo, SP, Brazil; Faculdade de Medicina do ABC, Santo André, SP, Brazil.
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21
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Lack S, Neal B, De Oliveira Silva D, Barton C. How to manage patellofemoral pain - Understanding the multifactorial nature and treatment options. Phys Ther Sport 2018; 32:155-166. [PMID: 29793124 DOI: 10.1016/j.ptsp.2018.04.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/11/2018] [Accepted: 04/11/2018] [Indexed: 12/18/2022]
Abstract
Patellofemoral pain (PFP) is one of the most prevalent conditions within sports medicine, orthopaedic and general practice settings. Long-term treatment outcomes are poor, with estimates that more than 50% of people with the condition will report symptoms beyond 5 years following diagnosis. Additionally, emerging evidence indicates that PFP may be on a continuum with patellofemoral osteoarthritis. Consensus of world leading clinicians and academics highlights the potential benefit of delivering tailored interventions, specific to an individual's needs, to improve patient outcome. This clinical masterclass aims to develop the reader's understanding of PFP aetiology, inform clinical assessment and increase knowledge regarding individually tailored treatment approaches. It offers practical application guidance, and additional resources, that can positively impact clinical practice.
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Affiliation(s)
- Simon Lack
- Sports and Exercise Medicine, William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom; Pure Sports Medicine, London, United Kingdom.
| | - Bradley Neal
- Sports and Exercise Medicine, William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom; Pure Sports Medicine, London, United Kingdom
| | - Danilo De Oliveira Silva
- Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia; Laboratory of Biomechanics and Motor Control, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Christian Barton
- Sports and Exercise Medicine, William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom; Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
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22
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Brund RBK, Rasmussen S, Nielsen RO, Kersting UG, Laessoe U, Voigt M. The association between eccentric hip abduction strength and hip and knee angular movements in recreational male runners: An explorative study. Scand J Med Sci Sports 2017; 28:473-478. [DOI: 10.1111/sms.12923] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2017] [Indexed: 01/03/2023]
Affiliation(s)
- R. B. K. Brund
- Physical Activity and Human Performance; SMI®; Department of Health Science and Technology; Aalborg University; Aalborg Denmark
| | - S. Rasmussen
- Orthopaedic Surgery Research Unit; Science and Innovation Center; Aalborg University Hospital; Aalborg Denmark
- Department of Clinical Medicine; Aalborg University
| | - R. O. Nielsen
- Section for Sport Science; Department of Public Health; Aarhus University; Aarhus Denmark
| | - U. G. Kersting
- Physical Activity and Human Performance; SMI®; Department of Health Science and Technology; Aalborg University; Aalborg Denmark
| | - U. Laessoe
- Physical Activity and Human Performance; SMI®; Department of Health Science and Technology; Aalborg University; Aalborg Denmark
- Physiotherapy and Research & Development Department; UCN; Aalborg Denmark
| | - M. Voigt
- Physical Activity and Human Performance; SMI®; Department of Health Science and Technology; Aalborg University; Aalborg Denmark
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23
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Running related gluteus medius function in health and injury: A systematic review with meta-analysis. J Electromyogr Kinesiol 2016; 30:98-110. [DOI: 10.1016/j.jelekin.2016.06.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/21/2016] [Accepted: 06/14/2016] [Indexed: 11/17/2022] Open
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24
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Hip abductor strength and lower extremity running related injury in distance runners: A systematic review. J Sci Med Sport 2016; 20:349-355. [PMID: 27693442 DOI: 10.1016/j.jsams.2016.09.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/26/2016] [Accepted: 09/11/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Determine the association between hip abduction strength and lower extremity running related injury in distance runners. DESIGN Systematic review. METHODS Prospective longitudinal and cross sectional studies that quantified hip abduction strength and provided diagnosis of running related injury in distance runners were included and assessed for quality. Effect size was calculated for between group differences in hip abduction strength. RESULTS Of the 1841 articles returned in the initial search, 11 studies matched all inclusion criteria. Studies were grouped according to injury: iliotibial band syndrome, patellofemoral pain syndrome, medial tibial stress syndrome, tibial stress fracture, and Achilles tendinopathy, and examined for strength differences between injured and non-injured groups. Meaningful differences were found in the studies examining iliotibial band syndrome. Three of five iliotibial band syndrome articles found weakness in runners with iliotibial band syndrome; two were of strong methodological rigor and both of those found a relationship between weakness and injury. Other results did not form associative or predictive relationships between weakness and injury in distance runners. CONCLUSIONS Hip abduction weakness evaluated by hand held dynamometer may be associated with iliotibial band syndrome in distance runners as suggested by several cross sectional studies but is unclear as a significant factor for the development of patellofemoral pain syndrome, medial tibial stress syndrome, tibial stress fracture or Achilles tendinopathy according to the current literature. Future studies are needed with consistent methodology and inclusion of all distance running populations to determine the significance of hip abduction strength in relationship to lower extremity injury.
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25
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Shedding Light on the Etiology of Sports Injuries: A Look Behind the Scenes of Time-to-Event Analyses. J Orthop Sports Phys Ther 2016; 46:300-11. [PMID: 26954269 DOI: 10.2519/jospt.2016.6510] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The etiological mechanism underpinning any sports-related injury is complex and multifactorial. Frequently, athletes perceive "excessive training" as the principal factor in their injury, an observation that is biologically plausible yet somewhat ambiguous. If the applied training load is suddenly increased, this may increase the risk for sports injury development, irrespective of the absolute amount of training. Indeed, little to no rigorous scientific evidence exists to support the hypothesis that fluctuations in training load, compared to absolute training load, are more important in explaining sports injury development. One reason for this could be that prospective data from scientific studies should be analyzed in a different manner. Time-to-event analysis is a useful statistical tool in which to analyze the influence of changing exposures on injury risk. However, the potential of time-to-event analysis remains insufficiently exploited in sports injury research. Therefore, the purpose of the present article was to present and discuss measures of association used in time-to-event analyses and to present the advanced concept of time-varying exposures and outcomes. In the paper, different measures of association, such as cumulative relative risk, cumulative risk difference, and the classical hazard rate ratio, are presented in a nontechnical manner, and suggestions for interpretation of study results are provided. To summarize, time-to-event analysis complements the statistical arsenal of sports injury prevention researchers, because it enables them to analyze the complex and highly dynamic reality of injury etiology, injury recurrence, and time to recovery across a range of sporting contexts.
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26
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Ishøi L, Sørensen CN, Kaae NM, Jørgensen LB, Hölmich P, Serner A. Large eccentric strength increase using the Copenhagen Adduction exercise in football: A randomized controlled trial. Scand J Med Sci Sports 2015; 26:1334-1342. [PMID: 26589483 DOI: 10.1111/sms.12585] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 11/30/2022]
Abstract
Hip adductor injuries are frequent in football, and players with low adductor strength appear to be at increased risk of injury. High adductor muscle activity has been shown in the Copenhagen Adduction exercise (CA); however, an associated strength gain has not been investigated. This study aims to examine the eccentric hip adduction strength (EHAD) gain using the CA in-season. Two U-19 sub-elite football teams, including 24 football players, were randomized to either an 8-week supervised progressive training program in addition to the usual training (intervention) or to continue training as usual (control). EHAD, eccentric hip abduction strength (EHAB), and side-bridge endurance were measured using reliable test procedures at baseline and follow-up by a blinded tester. There was a significant interaction between group and time on EHAD, EHAB, and EHAD/EHAB ratio (P < 0.025). The intervention group demonstrated a 35.7% increase in EHAD (P < 0.001); a 20.3% increase in EHAB (P = 0.003), and 12.3% increase in EHAD/EHAB ratio (P = 0.019). No significant within-group differences were found in the control group (P > 0.335). Compliance was 91.25%, and median muscle soreness ranged from 0 to 2. The CA implemented in-season with an 8-week progressive training program elicited a large significant increase in EHAD, EHAB, and EHAD/EHAB ratio.
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Affiliation(s)
- L Ishøi
- Department of Physiotherapy, Metropolitan University College, Copenhagen, Denmark.
| | - C N Sørensen
- Department of Physiotherapy, Metropolitan University College, Copenhagen, Denmark
| | - N M Kaae
- Department of Physiotherapy, Metropolitan University College, Copenhagen, Denmark
| | - L B Jørgensen
- Muskuloskeletal Rehabilitation Research Unit, Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark
| | - P Hölmich
- Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Sports Orthopedic Research Center - Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager & Hvidovre, Denmark
| | - A Serner
- Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Sports Orthopedic Research Center - Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager & Hvidovre, Denmark
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