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Ghorbani M, Nouri H, Heydarian M, Mottaghitalab M, Zarei H. Lower limbs kinematic analysis during a jump landing task in soccer players with unilateral anterior cruciate ligament reconstruction. BMC Sports Sci Med Rehabil 2024; 16:221. [PMID: 39456100 PMCID: PMC11515238 DOI: 10.1186/s13102-024-01012-2] [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: 06/08/2024] [Accepted: 10/24/2024] [Indexed: 10/28/2024]
Abstract
BACKGROUND Fatigue leads to an acute decline in muscle strength, altered patterns of lower extremity muscle activation, changes in hip and knee kinematics. In terms of the effects of fatigue on knee joint kinematics during plyometric training, there is still a lack of knowledge regarding kinematic differences between athletes who passed the ACL reconstructions rehabilitation period and healthy athletes. Therefore, this study aimed to compare lower limb joint kinematic parameters between reconstructed cruciate ligament and healthy control soccer players during jump landing in a fatigued setting. METHODS Lower limb kinematic parameters were recorded in 20 professional soccer players (age, 24.95 ± 2.92 years; body mass, 77.20 ± 12.88 kg; height, 1.77 ± 3.19 m) during jump landing task before and after the fatigue protocol. The control group consisted of healthy subjects and the experimental group consisted of subjects with ACL reconstruction by thigh transplantation. Kinematic data was recorded with 4 cameras to measure lower limb angles at first foot contact and maximum range of motion. RESULTS The results showed that before fatigue, there was only a significant difference between the two groups in the maximum range of motion of the non-involved hip joint (P = 0.022) and angle of the involved hip at first contact (P = 0.049). In other data on joint range of motion or initial contact angle, no significant difference was observed between the two groups (P > 0.05). After fatigue protocol, there was a significant difference in initial foot contact in non-involved (P = 0.030), and involved (P = 0.020) hip joint angles between the two groups. However, no significant difference in initial contact angle or range of motion of other joints was observed between the groups. CONCLUSIONS This study shows that plyometric fatigue does not contribute to numerous changes in contact angles and range of motion in lower extremity joints in healthy soccer players and those with a history of cruciate ligament repairs.
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Affiliation(s)
- Moosareza Ghorbani
- Corrective Exercises and Sports Injury Department, Faculty of Physical Education & sport sciences, University of Guilan, Rasht, Iran
| | - Hamed Nouri
- Faculty of Physical Education and Sport Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Mona Heydarian
- Department of Sports Injuries, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Mohammad Mottaghitalab
- Sports Biomechanics Department, Faculty of Physical Education & sport sciences, University of Guilan, Rasht, Iran
| | - Hamed Zarei
- Corrective Exercises and Sports Injury Department, Faculty of Physical Education & sport sciences, University of Guilan, Rasht, Iran.
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Bonell Monsonís O, Balsiger P, Verhagen E, Gouttebarge V, Spörri J, Bolling C. "Health is Just the Basic Requirement for Optimal Performance and Winning": Stakeholders' Perceptions on Testing and Training in Competitive Alpine Skiing, Snowboarding and Freestyle Skiing. Sports Med 2024:10.1007/s40279-024-02106-0. [PMID: 39271637 DOI: 10.1007/s40279-024-02106-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND AND OBJECTIVE Competitive alpine skiing, snowboarding and freestyle skiing, all different in nature and risks, are known for their high injury and illness burden. Testing measures and training methods may be considered for athletes' preparation to support performance enhancement while safeguarding their health. We explored the perspectives and perceptions of competitive alpine skiing, snowboarding and freestyle skiing stakeholders regarding testing and training practices in their competitive snow sports. METHODS We conducted an exploratory qualitative study based on grounded theory principles through 13 semi-structured interviews about testing and training practices with athletes, on-snow and off-snow coaches, managers and healthcare providers from different national teams. The interviews were inductively analysed through a constant comparative data analysis. RESULTS Participants described winning as the end goal of testing and training practices, which requires athletes to perform in their best condition. To do so, they mentioned two main targets: performance enhancement and health protection. Participants acknowledged health as a premise to perform optimally, considering testing and monitoring approaches, goal setting, and training to support and protect athlete performance. This continuous cyclic process is driven by communication and shared decision making among all stakeholders, using testing and monitoring outputs to inform goal setting, training (e.g. on-snow and off-snow) and injury prevention. Such an approach helps athletes achieve their goal of winning while being fit and healthy throughout their short-term and long-term athletic career development. CONCLUSIONS The ultimate goal of testing measures and training methods in such competitive snow sports is winning. Performance enhancement and health protection act as pillars in systematic, tailored and flexible processes to guarantee athletes' best preparation to perform. Moreover, athletes' assessments, goal setting, monitoring tools, open communication and shared decision making strongly guide this cyclic process.
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Affiliation(s)
- Oriol Bonell Monsonís
- Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam Collaboration on Health and Safety in Sports, Amsterdam UMC, University Medical Centres-Vrije Universiteit Amsterdam, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Amsterdam, The Netherlands.
| | - Peter Balsiger
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Evert Verhagen
- Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam Collaboration on Health and Safety in Sports, Amsterdam UMC, University Medical Centres-Vrije Universiteit Amsterdam, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Amsterdam, The Netherlands
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Caroline Bolling
- Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam Collaboration on Health and Safety in Sports, Amsterdam UMC, University Medical Centres-Vrije Universiteit Amsterdam, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands
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Hou W, Li X, Wen Y, Du X. Global research trends in skiing from 1974 to 2023: A bibliometric analysis. Heliyon 2024; 10:e35471. [PMID: 39170295 PMCID: PMC11336741 DOI: 10.1016/j.heliyon.2024.e35471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024] Open
Abstract
This study analyzes 1643 documents related to skiing from 1974 to 2023 using the Web of Science Core Collection database, employing CiteSpace and VOSviewer for quantitative analysis. Findings reveal a growing literature output, with the past five years contributing to 36.2 % of publications. Norway leads in total publications and collaboration intensity, with the University of Salzburg and the Norwegian University of Science and Technology as prominent institutions. The research spans a wide range of disciplines such as Sport Sciences, Physiology, etc., and interdisciplinary intersections with engineering, computer science, etc. have become a future research trend. The research focuses on the analysis of skiers' sports performance, the analysis of skiing-induced sports injuries, the biomechanical analysis of skiers' postures, and the analysis of skiing-induced respiratory diseases. The study highlights the evolution of research focus from skiing injuries to injury prevention and sports performance enhancement. This comprehensive overview aids scholars in understanding skiing research hotspots and future trends efficiently.
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Affiliation(s)
- Wenlong Hou
- School of Sports and Health Engineering, Hebei University of Engineering, Handan, China
| | - Xiaoliang Li
- School of Sports and Health Engineering, Hebei University of Engineering, Handan, China
| | - Yan Wen
- School of Sports and Health Engineering, Hebei University of Engineering, Handan, China
| | - Xincheng Du
- School of Sports and Health Engineering, Hebei University of Engineering, Handan, China
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Fan Z, Min L, He W, Yang Y, Ma W, Yao J. Efficacy of multicomponent interventions on injury risk among ice and snow sports participants-a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2024; 16:135. [PMID: 38890690 PMCID: PMC11186188 DOI: 10.1186/s13102-024-00921-6] [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: 01/25/2024] [Accepted: 06/07/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Ice and snow sports, which are inherently high risk due to their physically demanding nature, pose significant challenges in terms of participant safety. These activities increase the likelihood of injuries, largely due to reduced bodily agility and responsiveness in cold, often unpredictable winter environments. The critical need for effective injury prevention in these sports is emphasized by the considerable impact injuries have on the health of participants, alongside the economic and social costs associated with medical and rehabilitative care. In the context of ice and snow sports environments, applying the E principles of injury prevention to evaluate intervention measures can guide the implementation of future sports safety and other health promotion intervention measures in this field. When well executed, this approach can substantially reduce both the frequency and severity of injuries, thereby significantly enhancing the safety and long-term viability of these challenging sports. OBJECTIVE The objective of this study was to rigorously assess and statistically substantiate the efficacy of diverse injury prevention strategies in ice and snow sports, aiming to bolster future safety measures with solid empirical evidence. DESIGN Systematic review and meta-analysis. METHODS The overarching aim of this research was to meticulously aggregate and scrutinize a broad spectrum of scholarly literature, focusing on the quantifiable efficacy of diverse, multicomponent intervention strategies in mitigating the incidence of injuries within the realm of ice and snow sports. This endeavour entailed an exhaustive extraction of data from esteemed academic databases, encompassing publications up to September 30, 2023. In pursuit of methodological excellence and analytical rigor, the study employed advanced bias assessment methodologies, notably the AMSTAR 2 and GRADE approaches, alongside sophisticated random-effects statistical modelling. This comprehensive approach was designed to ensure the utmost validity, reliability, and scholarly integrity of the study's findings. RESULTS Fifteen papers, including 9 randomized controlled trials, 3 case‒control studies, and 3 cohort studies with 26,123 participants and 4,382 injuries, were analysed. The findings showed a significant reduction in injury rates through various interventions: overall injury prevention (RR = 0.50, 95% CI 0.42-0.63), educational training (RR = 0.50, 95% CI 0.34-0.73), educational videos (RR = 0.53, 95% CI 0.34-0.81), protective equipment (RR = 0.64, 95% CI 0.46-0.87), and policy changes (RR = 0.28, 95% CI 0.16-0.49). Subgroup analysis revealed potential heterogeneity in compliance (p = 0.347). Compared to controls, multicomponent interventions effectively reduced injury rates. CONCLUSION This systematic review and meta-analysis demonstrated that multicomponent interventions significantly prevent injuries in ice and snow sports. By applying the E principles of injury prevention and constructing a framework for practical injury prevention research in ice and snow sports, we can gradually shift towards a systemic paradigm for a better understanding of the development and prevention of sports injuries. Moreover, sports injury prevention is a complex and dynamic process. Therefore, high-quality experiments in different scenarios are needed in future research to provide more reliable evidence, offer valuable and relevant prevention information for practitioners and participants, and help formulate more effective preventive measures in practice.
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Affiliation(s)
- Zhanjiang Fan
- College of Educational Sciences, Xinjiang Normal University, Urumqi, 830017, China.
- Department of Physical Education, Xinjiang Agricultural University, Urumqi, 830052, China.
| | - Lanbin Min
- College of Educational Sciences, Xinjiang Normal University, Urumqi, 830017, China
| | - Wenbin He
- College of Educational Sciences, Xinjiang Normal University, Urumqi, 830017, China
| | - Yaorong Yang
- Department of Physical Education, Xinjiang Agricultural University, Urumqi, 830052, China
| | - Wen Ma
- College of Physical Education, Xinjiang Normal University, Urumqi, 830017, China
| | - Jiayi Yao
- No. 126 Middle School of Urumqi, Xinjiang, Urumqi, 830057, China
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Bonell Monsonís O, Spörri J, Warsen M, Bolling C, Gouttebarge V, Verhagen E. We know a lot about little and little about a lot: A contextualized scoping review on injury prevention in alpine ski racing. Scand J Med Sci Sports 2024; 34:e14533. [PMID: 37955281 DOI: 10.1111/sms.14533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/19/2023] [Accepted: 10/25/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Our goal was to summarize and contextualize the available literature on alpine ski racing injury epidemiology, injury etiology, injury prevention measures, injury prevention context, and implementation issues. MATERIALS AND METHODS We searched four electronic databases using predetermined search terms. We included original studies that assessed injury, injury risk factors, and injury mechanisms, and assessed and reported the effect of an injury prevention measure in alpine ski racing. Two authors independently conducted title-abstract screening, and one performed the full-text review. For data synthesis and categorization, we used the Translating Research into the Injury Prevention Practice framework and a modified and adapted version of the Haddon matrix. RESULTS Of the 157 included studies, most corresponded to injury epidemiology and etiology, whereas few studies encompassed injury prevention measure development, implementation and evaluation. Preventive interventions targeting equipment, rules and regulations, course design and snow preparation were the most prevalent in the literature. Furthermore, various contextual factors in the current literature have been found, including gender, competition level, countries and federations, and time periods within a season. CONCLUSIONS We provided an in-depth and comprehensive overview of the current state-of-the-art in the alpine ski racing context. We know a lot about little and little about a lot across all the areas associated with injury prevention in such context. The limitations in the literature yield a road map for designing future injury prevention studies to address the key gaps identified. A more comprehensive context-driven approach throughout all stages of injury prevention would benefit the ultimate implementation of effective preventive strategies.
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Affiliation(s)
- Oriol Bonell Monsonís
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health and Sports, Amsterdam, The Netherlands
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Marit Warsen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Caroline Bolling
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam UMC Location University of Amsterdam, Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Amsterdam Movement Sciences, Musculoskeletal Health and Sports, Amsterdam, The Netherlands
- Amsterdam UMC Location University of Amsterdam, Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health and Sports, Amsterdam, The Netherlands
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6
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Burtscher M, Kopp M, Millet GP, Burtscher J, Ruedl G. Creating awareness about exercise-based ACL prevention strategies in recreational alpine skiers. Br J Sports Med 2023; 57:955-956. [PMID: 37185227 DOI: 10.1136/bjsports-2023-106782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 05/17/2023]
Affiliation(s)
- Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Gregoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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Rauch A. [Knee injuries in winter sports]. ORTHOPADIE (HEIDELBERG, GERMANY) 2022; 51:870-881. [PMID: 36239771 PMCID: PMC9663366 DOI: 10.1007/s00132-022-04317-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/05/2022]
Abstract
Winter sports represent a relevant entity for knee injuries due to their great popularity. In alpine skiing and snowboarding, knee joint injuries are the most common affected body regions, while in ice hockey they are in third place. Various accident mechanisms lead to different injury types and severities. In addition to medial collateral ligament injuries, anterior cruciate ligament injuries are of particular importance. In professional sports, severe combination injuries are more common. Therapy is exemplified using the anterior cruciate ligament rupture. The gold standard is replacement ligament surgery. The return-to-sport rate of 80% for skiing and snowboarding is comparable to summer sports such as football, basketball or baseball. For ice hockey, it is even better. Prevention is possible by targeted training programs, but also by optimizing the equipment and its adjustment.
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Affiliation(s)
- Alexander Rauch
- ECOM - Praxis für Orthopädie, Sportmedizin & Unfallchirurgie, Arabellastraße 17, 81925, München, Deutschland.
- Sporttraumatologie und Kniechirurgie, ATOS-Klinik München, Effnerstraße 38, 81925, München, Deutschland.
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Westin M, Mirbach LI, Harringe ML. Side-to-side differences in knee laxity and side hop test may predispose an anterior cruciate ligament reinjury in competitive adolescent alpine skiers. Front Sports Act Living 2022; 4:961408. [PMCID: PMC9613961 DOI: 10.3389/fspor.2022.961408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
An anterior cruciate ligament (ACL) injury is a common, severe injury in alpine skiing, and anterior cruciate ligament reconstruction (ACLR) is frequently performed in competitive alpine skiers younger than 20 years old. To reduce the reinjury rate, both intrinsic and extrinsic risk factors should be examined. The aim of this study was to investigate possible intrinsic risk factors for an ACL reinjury in competitive alpine skiers. A cohort of 384 alpine skiers (191 males/193 females) from the Swedish ski high schools were prospectively followed during their high school years. The students were clinically examined and physically tested prior to each ski season. In addition, the RAND 36-Item health survey 1.0 (SF-36, Copyright 1994 Medical Outcome Trust, distributed by RAND Corporation) and injuries were prospectively registered. Thirty-one of the skiers (five males/26 females) had undergone an ACLR before entering the ski high school. This cohort was analyzed with respect to the occurrence of, and possible risk factors for an ACL reinjury (including ipsilateral and contralateral ACL injuries). Skiers who sustained an ACL reinjury were called the “ACL reinjury group,” and those who did not sustain an ACL reinjury were called the “ACL injury group.” Notably, 12 of the 31 students (39%), ten female and two male skiers, aged 16.5 (SD 0.5) years, sustained an ACL reinjury during the two first years at the ski high school. In addition, 10 of the 12 ACL reinjuries occurred within 10–23 months from the first injury [m 14.8 (SD4.7)] and two ACL reinjuries occurred at 29 and 47 months, respectively, from the first injury. It is noted that eight of the ACL reinjuries were to the ipsilateral knee and four to the contralateral knee. There were no differences between the groups with respect to muscle flexibility in the lower extremity, Beighton score, and one leg hop for distance or square hop test. Side-to-side differences were found with respect to knee joint laxity, >3 mm, measured with KT-1000 arthrometer (p = 0.02), and the side hop test (p = 0.04). RAND 36-Item health survey did not predict an ACL reinjury. In conclusion, a side-to-side difference in the side hop test and knee joint laxity (KT-1000) may predispose an ACL reinjury in competitive adolescent alpine skiers.
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Affiliation(s)
- Maria Westin
- Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden,Aleris Sports Medicine and Ortopedi, Sabbatsbergs Hospital, Stockholm, Sweden
| | | | - Marita L. Harringe
- Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden,Aleris Sports Medicine and Ortopedi, Sabbatsbergs Hospital, Stockholm, Sweden,*Correspondence: Marita L. Harringe
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Tucker NJ, Kelley N, Strage KE, Mauffrey C, Parry JA. Pelvic ring injuries after alpine ski and snowboard accidents. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2022:10.1007/s00590-022-03331-x. [PMID: 35831489 DOI: 10.1007/s00590-022-03331-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/23/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this study was to analyze the patient/injury characteristics and associated hospital course of patients sustaining traumatic pelvic ring injuries after alpine ski and snowboard accidents at a level one trauma center in the Rocky Mountain region. METHODS Patient/injury characteristics were obtained from patients presenting with pelvic ring injuries after alpine ski (n = 55) and snowboard (n = 9) accidents. Characteristics and outcomes analyzed included mechanism of injury, pelvic ring classification (Young-Burgess and Tile), hospital admission, physical therapy (PT) clearance, ambulation, length of stay, inpatient morphine milligram equivalents (MME), and discharges to rehabilitation facility. RESULTS Snowboarders were more often younger, male, tobacco/substance users, and more likely to be injured by a fall from height than skiers. There were no differences in injury classification or hospital course outcomes between alpine sports. Most common injuries included lateral compression type 1 (LC1) injuries (37.5%), isolated pubic ramus fractures (31.3%), and isolated iliac wing fractures (15.6%). LC1 injuries were unstable in 50% of cases and associated with increased admissions (proportional difference: 47.5%, CI: 23.8-64.5%, p = 0.0002), longer time to PT clearance (median difference(MD): 1.0 day, CI: 0-2.0, p = 0.03), longer LOS (MD: 2.0, CI: 0-2.0, p = 0.02), and increased inpatient MMEs (MD: 197.9 MME, CI: 30.0-420.0, p = 0.02), as compared to other pelvic ring injuries. CONCLUSION The majority of pelvic ring injuries from alpine ski and snowboard accidents were LC1 injuries, half of which were unstable, resulting in longer hospital stays, time to PT clearance/ambulation, and opioid use.
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Affiliation(s)
- Nicholas J Tucker
- Department of Orthopedics, Denver Health Medical Center, Denver Health, 777 Bannock St, MC 0188, Denver, CO, 80204, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Naomi Kelley
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Katya E Strage
- Department of Orthopedics, Denver Health Medical Center, Denver Health, 777 Bannock St, MC 0188, Denver, CO, 80204, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Cyril Mauffrey
- Department of Orthopedics, Denver Health Medical Center, Denver Health, 777 Bannock St, MC 0188, Denver, CO, 80204, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Joshua A Parry
- Department of Orthopedics, Denver Health Medical Center, Denver Health, 777 Bannock St, MC 0188, Denver, CO, 80204, USA.
- University of Colorado School of Medicine, Aurora, CO, USA.
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Schoeb T, Fröhlich S, Frey WO, Verhagen E, Farshad M, Spörri J. The ISPA Int Injury Prevention Programme for Youth Competitive Alpine Skiers: A Controlled 12-Month Experimental Study in a Real-World Training Setting. Front Physiol 2022; 13:826212. [PMID: 35309082 PMCID: PMC8929391 DOI: 10.3389/fphys.2022.826212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/28/2022] [Indexed: 01/14/2023] Open
Abstract
Evidence-based injury prevention programmes for youth competitive alpine skiers are widely absent. The aims of this controlled 12-month experimental study were to introduce a novel injury prevention programme targeted to the injury patterns of youth skiers, called ISPAInt, and to compare the differences in injury occurrence between an intervention group (IG) additionally performing the ISPAInt programme and an independent, historical control group (CG) following their regular training routines. None of the skiers of the CG were part of the IG and vice versa. The study was directly conducted within the real-world youth development structures of skiers competing at the under 16 years (U16) level in Switzerland. Seventy-one skiers (aged 14.4 ± 0.3 years) assigned to the IG were compared to 58 age- and gender-matched controls. The IG was offered the ISPAInt programme with the recommendation to perform it at least once per week. Skiers’ adherence to this recommendation was surveyed but not enforced. Injuries were recorded using the Oslo Sports Trauma Research Centre Questionnaire. Primary outcomes were the absolute injury rates (number of injuries/100 athletes per season) and epidemiological incidence proportion (number of injured athletes/100 athletes per season). The secondary outcome was the average 2-weekly prevalence of traumatic knee, knee overuse, and lower back overuse injuries. There were lower absolute rates of all traumatic injuries [rate/risk difference, RD: −57.1 (−98.1, −16.0); rate/risk ratio, RR: 0.665 (0.485, 0.884)] and overuse injuries [RD: −35.9 (−71.0, −0.7); RR: 0.699 (0.493, 0.989)] in the IG than in the CG. Likewise, the epidemiological incidence proportion for all overuse injuries was smaller in the IG [RD: −28.4 (−44.8, −12.0); RR: 0.598 (0.435, 0.822)], while the proportion of skiers suffering from traumatic injuries did not significantly differ between the groups. Notably, the IG particularity differed from the CG in the average 2-weekly prevalence of knee trauma, knee overuse, and lower back overuse complaints, three of the major injury-related hot spots in youth skiers. Based on these promising results, the ISPAInt programme may have great potential to prevent injuries in youth competitive alpine skiers, and the underlying exercises should be considered complementary training content at the U16 level.
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Affiliation(s)
- Thierry Schoeb
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Stefan Fröhlich
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Walter O Frey
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Mazda Farshad
- Spine Surgery, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Spine Centre, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
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Spörri J, Müller E, Kröll J. "When you're down, stay down": A lesson for all competitive alpine skiers supported by an ACL rupture measured in vivo. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:14-20. [PMID: 34852295 PMCID: PMC8847912 DOI: 10.1016/j.jshs.2021.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/02/2021] [Accepted: 11/16/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND During an experiment, a ski racer equipped with various measurement devices suffered an anterior cruciate ligament (ACL) rupture in his right knee. The aim of this study was to describe the underlying injury mechanism from a functional perspective. METHODS Eight giant slalom turns (i.e., 4 left turns), followed by 1 left turn at which the ACL injury occurred, were recorded by 2 video cameras, electromyography of 4 relevant muscle groups, inertial measurement units to measure knee and hip angles, and pressure insoles to determine ground reaction forces. RESULTS Due to a loss of balance, the ski racer began to slide sideways at the apex of a left turn. During sliding, his right (outside) leg was actively abducted upward without touching the ground. The ski racer then attempted to stand up again by dropping his leg back towards the snow surface. The end of this dropping was accompanied by a decrease in electromyographic activity in the knee stabilizing muscles. Once the inside edge of the outer ski caught the snow surface, a rapidly increasing peak force, knee flexion, and an aggressive sudden activation of the vastus medialis muscle were observed, while biceps femoris and rectus femoris further decreased their activation levels. This likely resulted in excessive anterior translation of the tibia relative to the femur, causing damage to the ACL. CONCLUSION Our example emphasizes that ski racers should not get up until they stop sliding. Remember: "When you're down, stay down."
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Affiliation(s)
- Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich 8008, Switzerland; University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich 8008, Switzerland.
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Ri 5400, Austria
| | - Josef Kröll
- Department of Sport Science and Kinesiology, University of Salzburg, Hallein-Ri 5400, Austria
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Kiers K, Kröll J, Mitterbauer G, Scherr J, Spörri J. Perceptions of experts on key injury risk factors in alpine ski racing as a function of stakeholder role and associated level of competition. BMJ Open Sport Exerc Med 2021; 7:e001111. [PMID: 34603741 PMCID: PMC8449969 DOI: 10.1136/bmjsem-2021-001111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives (1) To update experts' priorities of perceived key injury risk factors in alpine ski racing based on a framework and list derived 10 years ago, (2) to identify additionally emerging risk factors since then and (3) to compile a list with countermeasure suggestions. Methods A sample of 532 expert stakeholders (athletes, coaches, team medical staff, Ski Racing Suppliers (SRS) and International Ski Federation (FIS) representatives) from the World Cup (WC), European Cup (EC) and FIS-race level participated in a cross-sectional online survey. Experts were asked to name those risk factors with the highest believed impact on injury risk and rank them according to their current priority from a predefined list. In addition, experts were encouraged to name additional (not listed) risk factors and to suggest countermeasures. Results Regardless of stakeholder role and competition level, snow-related factors appeared to have the highest perceived priority. However, WC athletes' and coaches' perceptions were also related to equipment, while at the EC and FIS-race level fatigue and physical fitness-related factors were considered important. Athletes' perceptions were largely in agreement with SRS (ie, snow-related and equipment-related factors). At the same time, while coaches, team medical staff and FIS representatives additionally emphasised fatigue and physical fitness-related factors. Conclusion Experts' perceptions on key injury risk factors in alpine ski racing depend on the stakeholder role and differ between the competition levels. Thus, to develop effective prevention measures and to successfully implement them, all relevant stakeholders should be given a voice, and prevention efforts should be targeted to the specific level.
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Affiliation(s)
- Kirsten Kiers
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Josef Kröll
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Gerald Mitterbauer
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Johannes Scherr
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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Gualotuña C, Ramos TI. Reporte de caso de postcirugía de ligamento cruzado anterior. BIONATURA 2021. [DOI: 10.21931/rb/2021.06.03.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
El ligamento cruzado anterior (LCA) es la lesión de la rodilla con mayor prevalencia en los atletas. Los avances en la técnica quirúrgica y la fijación de injertos han permitido a los pacientes participar en una rehabilitación funcional postoperatoria temprana. Este tratamiento está dirigido a lograr un mayor rango de movimiento, progresando hacia la movilización, fortalecimiento y control neuromuscular propioceptivo de la articulación. Existen varios protocolos de rehabilitación con variaciones en ejercicios específicos, progresión a través de fases y componentes claves que permiten la recuperación funcional. El objetivo final de la fisioterapia es devolver al paciente al nivel de rendimiento anterior a la lesión, incluidos el movimiento y la fuerza, sin dañar ni alargar el injerto. Presentamos el reporte de un caso con una lesión de LCA compleja, que recupero la funcionalidad de la articulación por aplicación de plan de tratamiento fisioterapéutico de forma inmediata a su intervención quirúrgica.
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Affiliation(s)
- Clara Gualotuña
- Sistema Integrado de Salud, Área de Fisioterapia Universidad de las Fuerzas Armadas ESPE Av. General Rumiñahui s/n, PO BOX. 171-5-231B, Sangolquí, Ecuador
| | - Thelvia I. Ramos
- Departamento Ciencias de la Vida y de la Agricultura, Universidad de las Fuerzas Armadas ESPE, Av. General Rumiñahui s/n, PO BOX. 171-5-231B, Sangolquí, Ecuador
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