Bowlegs and Intensive Football Training in Children and Adolescents

High Prevalence of Varus Knee Malalignment in Adolescent Football Players-Clinical Lower Leg Axis Measurements of Male Junior Football Players Aged 7 to 18 Years

BACKGROUND

Football, as the most popular sport worldwide, has long been under suspicion of causing varus knee alignment as early as adolescence. However, no causal relationship has yet been found. The first step to do so would be to determine the prevalence of lower leg malalignment among male junior football players depending on age, performance level and the number of active seasons played.

METHODS

Leg axis alignment in frontal plane was determined in male junior football players of different age levels between 7 and 18 years by measuring the intercondylar/intermalleolar distance (ICD/IMD) in an upright position. In addition to anthropometric data, multiple sport-specific data such as the start of their football career or training time per week were collected by means of questionnaires (clinical trial registration number: DRKS00020446).

RESULTS

207 male junior football players were included in this survey. The mean age was 12.8 years. Within the group of 15 to 18 year olds, the prevalence of varus knee malalignment was highest at just under a third (32.1%). In the subpopulation that played actively for more than ten seasons, 28.9% showed varus leg axis. Regarding performance level, the highest IMD/ICD values and highest prevalence of varus alignment were found among football players who play on a semi-professional level (16.7%), compared to amateur (11.4%) and high-performance levels (2.8%).

CONCLUSIONS

Further research is necessary to investigate if this high prevalence of varus knee in children of a higher age and higher playing levels is due to the selection bias of football players with varus knee or a real development of varus knee in individuals.

Youth soccer players: patterns of injury involving the primary growth plates of epiphyses

Youth soccer (football) is immensely popular internationally. Earlier participation, sport sub-specialization, and year-around practice have led to an increased incidence of injury from both acute trauma and repetitive overuse. The growth plates (physes) of the immature skeleton are particularly vulnerable to injury and delayed diagnosis can lead to future growth disturbance and long-term morbidity. Familiarity with the various components of the growth plate complex necessary for ensuring normal endochondral ossification is fundamental in understanding the various patterns of imaging findings following injury. This review discusses the zonal columnar arrangement of the growth plate proper and the contrasting function of the vasculature within the subjacent epiphysis and metaphysis. This is followed by an evidence-based discussion of the common patterns of injury involving the epiphyseal primary growth plate observed among youth soccer players: subcategorized into physeal fractures (direct injury) and physeal stress injuries (indirect insult to subjacent metaphysis). In this section, the role of imaging and characteristic imaging features will be discussed. While the normal physiologic and pathophysiologic mechanisms can be applied to other growth plates, such as primary growth plates underlying the apophyses and secondary growth plates surrounding the secondary ossificiation centers, which also undergo endochondral ossification, the current review is focused on injuries involving the primary growth plates underlying epiphyses.

FROM GARRINCHA'S LEGS TO NEYMAR'S LEGS: THE GENU VARUM AND VALGUM IN SOCCER. HISTORICAL OVERVIEW AND UPDATE

The presence of abnormalities in knee alignment (genu varum and genu valgum) is extremely common in soccer. It can occur in the junior league / youth academy and perpetuate itself throughout the professional career. The consequences of years of high-level sports practice in players with genu varum / genu valgum can be harmful to the knees. By observing football matches of the present and the past, the authors of the article noted that great Brazilian soccer players were, or are, affected by the malalignment of the knees: Garrincha (the most famous), Leandro, Dunga, Romário, Rivaldo and Neymar. This study aims to discuss the relationship between high-performance sport and the development of these orthopedic deformities, serving as a tool for updating the trauma-orthopedic knee subspecialty. Level of Evidence III, Retrospective comparative study.

Lean and mean? Associations of level of performance, chronic injuries and BMI in sport climbing

Objectives

To assess possible associations between performance level (achieved level of difficulty), chronic injuries and body mass index (BMI) in sport climbing.

Method

Retrospective survey.

Setting

Web-based questionnaire.

Participants

667 active climbers (385 reported having chronic injuries).

Outcome measure

BMI, performance level in sport climbing, onset of a climbing-related injury, preferred style of climbing, education, gender.

Statistics

Descriptive statistics and general linear model(GLM) performed with SPSS V.25 for windows.

Result

No associations were found between level of performance in sport climbing, onset of a climbing-related injury, preferred style of climbing, education, gender and BMI.

Conclusion

BMI is not associated with climbing-related chronic injury or level of performance in climbing. The average BMI of climbers up to the elite level is similar to that of a lower rate of performance.

Clinical relevance

The findings in this study suggest that there is no need for maintaining a low BMI to be able to reach elite levels in climbing.