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Boltz AJ, Hooper N, Satalich J, Cheatham S, O'Connell R, Rao N, Garcia RE, Collins CL, Chandran A. Epidemiology of Hamstring Tears in National Collegiate Athletic Association Athletes: Findings From the National Collegiate Athletic Association Injury Surveillance Program Between 2014/2015 and 2018/2019. Clin J Sport Med 2024:00042752-990000000-00198. [PMID: 38896546 DOI: 10.1097/jsm.0000000000001240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/23/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE To describe the epidemiology of hamstring tears in National Collegiate Athletic Association (NCAA) sports. DESIGN Descriptive epidemiology study. Athletic trainers from NCAA schools reported injuries to the NCAA Injury Surveillance Program. SETTING A convenience sample of NCAA hamstring tear injuries during the 2014/2015 through 2018/2019 academic years. PATIENTS OR PARTICIPANTS NCAA student-athletes. INDEPENDENT VARIABLES Sport, sex, event type, season segment, injury history, and activity at the time of injury. MAIN OUTCOME MEASURES Injury counts, rates, and proportions were used. RESULTS Two thousand ninety-six hamstring tears from 8 474 400 athlete-exposures (AEs) were reported (2.47 per 10 000 AEs). Rates were highest in Men's Soccer (5.97 per 10 000 AEs) and Women's Soccer (3.13 per 10 000 AEs), among all Men's and Women's sports, respectively. Competition-related rates in Men's and Women's sports were highest in 2015 to 2016 then followed a decreasing pattern across the remainder of the study period. Among sex-comparable sports, rates were higher in men's (compared with women's) Baseball/Softball, Soccer, and Track and Field. The prevalence of recurrent injuries was comparable among men's (14.8%) and women's (11.5%) sports. Time loss hamstring tears were more prevalent in Men's sports than Women's sports [injury proportion ratio = 1.33; 95% confidence interval, (1.21, 1.47)]. CONCLUSIONS Overall, hamstring tear rates were higher across all Men's sports compared with Women's sports. Rates across event type were comparable in several sports; and so, adjustments to practice are needed considering that practice environments are more modifiable than competitions. Indeed, improving hamstring tear prevention programs to reduce the burden of this injury in NCAA athletes remains critical.
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Affiliation(s)
- Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana
- Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan
| | - Nicholas Hooper
- Department of General Surgery, Virginia Commonwealth University, Richmond, Virginia; and
| | - James Satalich
- Department of Orthopedic Surgery, Virginia Commonwealth University, Richmond, Virginia
| | - Seth Cheatham
- Department of Orthopedic Surgery, Virginia Commonwealth University, Richmond, Virginia
| | - Robert O'Connell
- Department of Orthopedic Surgery, Virginia Commonwealth University, Richmond, Virginia
| | - Neel Rao
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana
| | - Reagan E Garcia
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana
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Sprouse B, Chandran A, Rao N, Boltz AJ, Johnson M, Hennis P, Varley I. Injury and illness surveillance monitoring in team sports: a framework for all. Inj Epidemiol 2024; 11:23. [PMID: 38858694 PMCID: PMC11163858 DOI: 10.1186/s40621-024-00504-6] [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: 03/04/2024] [Accepted: 05/07/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Sport-related injuries and illnesses can negatively impact athlete welfare at all standards of participation in team sports. Injury and illness surveillance (IIS), and the development of monitoring systems, initiates the sequence of injury and illness prevention. Operational IIS monitoring systems help to appraise epidemiological estimates of injury and illness incidence and burden in various athlete populations. However, the methodological underpinnings of various monitoring systems are not harmonized or widely documented, with the presence of efficient and successful programmes rarely showcased at non-elite levels. The aim is to provide a framework that guides the development of IIS, which will enhance overall surveillance, to indirectly inform injury prevention strategies. METHODS The process involved all members of the research group initially discussing the research gaps, scope of the project, and the aims of the article. Unique experiences were shared, and specific and global challenges and barriers to IIS at all standards of team sport participation were identified. A tiered system of data collection with corresponding content were produced, with experiences and guidance provided throughout the article. RESULTS The literature has been reviewed and using first-hand experience in conducting IIS programmes in complex and diverse sport settings, the authors have identified key enablers and barriers for best practise as time, technological and human resources, reporter/practitioner training, and medical expertise. Areas of greatest importance regarding the conducting of IIS have been outlined, providing guidance and recommendations across all levels of team sport participation. These areas include definitions, data context, collection procedures, handling, security, ethics, storage, dissemination, quality, compliance, and analysis. Given the barriers to IIS, 3-tiered levels of data collection and content have been proposed. The levels indicate data collection variables, with a focus on sufficiency and achievability, aiming to support the successful conducting of IIS in team sports across all standards of participation. Future opportunities in IIS have been discussed, with several predictive measures and analytical techniques expanded upon. CONCLUSIONS The framework provides universal guidance for implementing IIS monitoring systems, facilitating athletes, coaches, parents/guardians, governing bodies and practitioners to implement IIS processes, identify challenges, complete analysis, and interpret outcomes at all standards of participation.
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Affiliation(s)
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, USA
| | - Neel Rao
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, USA
| | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, USA
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Ian Varley
- Nottingham Trent University, Nottingham, UK
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Cohen JL, Cade WH, Harrah TC, Costello JP, Kaplan LD. The Surgical Management of NCAA Division 1 College Football Injuries Post COVID-19: A Single Institution Retrospective Review. J Strength Cond Res 2024; 38:906-911. [PMID: 38241463 DOI: 10.1519/jsc.0000000000004720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
ABSTRACT Cohen, JL, Cade, WH, Harrah, TC, Costello II, JP, and Kaplan, LD. The surgical management of NCAA Division 1 college football injuries post COVID-19: A single institution retrospective review. J Strength Cond Res 38(5): 906-911, 2024-The unprecedented COVID-19 pandemic had a significant impact on college football operations, including athletes' training regimens. As a result of these changes, concern for increased injury susceptibility post COVID-19 regulations has become a point of discussion. The current study sought to evaluate the incidence of surgical injury among NCAA Division 1 college football players at the authors' institution during the first full season after start of the COVID-19 pandemic compared with previous years. Retrospective chart review was performed for all players who sustained injuries requiring surgery while a member of the NCAA Division 1 football program during the 2009-2021 seasons. A p -value of ≤0.05 was used to determine significance. A total of 23 surgical injuries occurred in 22 players during the 2021 season compared with 121 in 118 players in the 12 previous seasons combined ( p = 0.0178; RR = 1.47). There was a significant increase in shoulder injuries ( n = 13 vs. n = 31; p = <0.0001; RR = 3.05) and specifically a significant increase in labral tears ( n = 10 vs. n = 30; p = 0.0003; RR = 2.74). No difference was seen in knee injuries ( n = 10 vs. n = 77; p = 0.27; RR = 1.35) and specifically no difference in anterior cruciate ligament injuries ( n = 3 vs. n = 31; p = 0.77; RR = 1.17). This phenomenon is multifactorial in nature, but alterations to players' training and preparations because of the COVID-19 pandemic likely resulted in suboptimal conditioning, leading to the increased incidence of surgical injuries emphasizing the importance of adequate strength training and conditioning.
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Affiliation(s)
- Jacob L Cohen
- Department of Orthopaedics, UHealth Sports Medicine Institute, University of Miami, Coral Gables, Florida; and
| | - William H Cade
- Department of Orthopaedics, UHealth Sports Medicine Institute, University of Miami, Coral Gables, Florida; and
| | - Tanner C Harrah
- Department of Orthopaedics, UHealth Sports Medicine Institute, University of Miami, Coral Gables, Florida; and
| | | | - Lee D Kaplan
- Department of Orthopaedics, UHealth Sports Medicine Institute, University of Miami, Coral Gables, Florida; and
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Bergstein VE, Agarwal AR, Solon LF, Mikula JD, Best MJ, LaPorte DM. Epidemiologic trends in hand injuries in the National Football League from 2009-2010 to 2019-2020. PHYSICIAN SPORTSMED 2023:1-7. [PMID: 37994029 DOI: 10.1080/00913847.2023.2286942] [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: 09/27/2023] [Accepted: 11/20/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVES In American football, hand injuries have been shown to negatively impact performance. The purpose of this study is to characterize the prevalence and severity of hand injuries in National Football League (NFL) players. METHODS A public online database was utilized to identify hand injuries in NFL players from 2009-2010 to 2019-2020. The primary outcome was to analyze the overall incidence of hand injuries (including wrist, metacarpus, finger, and thumb), injury type by each aforementioned anatomic location, and player position. Injury severity was evaluated based on percentage of injuries in which players returned to play (RTP), number of games missed before RTP, and the percentage of injuries resulting in the player being placed on injured reserve (IR). RESULTS Of the 6,127 players included, 847 (13.8%) players sustained a hand injury, of which 24.8%, 34.3%, 17.9%, and 22.9% occurred at the wrist, metacarpus, finger, and thumb, respectively. Of the injured players, 97.4% returned to play following their injury, 14.8% were put on IR, and an average of 1.7 (SD 3.3) games were missed. Quarterbacks were the most likely to sustain hand injuries at all anatomic locations. Wrist injuries were associated with the lowest RTP rate (93.3%), the most players placed on injured reserve (28.6%), and the greatest number of games missed (mean 2.5, SD 4.2). CONCLUSION Hand injuries decreased in prevalence by 65.6% over the 11 NFL seasons evaluated. This trend coincides with the implementation of several safety rules that relate to components of play involving the hands. Quarterbacks experienced the greatest prevalence and severity for all hand injuries. Wrist injuries represent the anatomic location associated with the greatest severity. These findings may be able to inform tailored injury prevention practices by position, and advocate for the further adoption of safety rules to protect players from further injury.
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Affiliation(s)
- Victoria E Bergstein
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amil R Agarwal
- Department of Orthopaedic Surgery, The George Washington University, Washington, DC, USA
| | - Lorenzo F Solon
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jacob D Mikula
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew J Best
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dawn M LaPorte
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Willwerth SB, Lempke LB, Lugade V, Meehan WP, Howell DR, DeJong Lempke AF. Ankle Sprain History Does Not Significantly Alter Single- and Dual-Task Spatiotemporal Gait Mechanics. J Sport Rehabil 2023; 32:903-909. [PMID: 37758257 DOI: 10.1123/jsr.2022-0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 10/03/2023]
Abstract
CONTEXT Single- and dual-task walking gait assessments have been used to identify persistent movement and cognitive dysfunction among athletes with concussions. However, it is unclear whether previous ankle sprain injuries confound these outcomes during baseline testing. The purpose of this study was to determine the effects of (1) ankle sprain history and (2) time since prior ankle sprain injury on single- and dual-task spatiotemporal gait outcomes and cognitive measures. DESIGN Cross-sectional study. METHODS We assessed 60 college Division-I athletes (31 with ankle sprain history; 13 females and 18 males, 19.3 [0.8] y; 29 with no ankle sprain history, 14 females and 15 males, 19.7 [0.9] y) who completed injury history forms and underwent concussion baseline testing. Athletes completed single- and dual-task gait assessments by walking back and forth along an 8-m walkway for 40 seconds. Athletes wore a smartphone with an associated mobile application on their lumbar spine to record spatiotemporal gait parameters and dual-task cognitive performance. Separate multivariate analyses of variance were used to assess the effects of ankle sprain injury history on spatiotemporal measures, gait variability, and cognitive performance. We performed a multivariate regression subanalysis on athletes who reported time since injury (n = 23) to assess temporal effects on gait and cognitive performance. RESULTS Athletes with and without a history of ankle sprains had comparable spatiotemporal and gait variability outcomes during single- (P = .42; P = .13) and dual-task (P = .75; P = .55) conditions. Additionally, ankle sprain injury history did not significantly influence cognitive performance (P = .35). Finally, time since ankle sprain did not significantly affect single- (P = .75) and dual-task gait (P = .69), nor cognitive performance (P = .19). CONCLUSIONS Ankle sprain injury history did not significantly alter spatiotemporal gait outcomes nor cognitive performance during this common clinical assessment. Future studies may consider including athletes with ankle sprain injury history during concussion assessments.
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Affiliation(s)
- Sarah B Willwerth
- Micheli Center for Sports Injury Prevention, Waltham, MA,USA
- Department of Orthopedics, Division of Sports Medicine, Boston Children's Hospital, Boston, MA,USA
| | - Landon B Lempke
- School of Kinesiology, University of Michigan, Ann Arbor, MI,USA
| | - Vipul Lugade
- Division of Physical Therapy, Binghamton University, Binghamton, NY,USA
| | - William P Meehan
- Micheli Center for Sports Injury Prevention, Waltham, MA,USA
- Department of Orthopedics, Division of Sports Medicine, Boston Children's Hospital, Boston, MA,USA
- Harvard Medical School, Harvard, MA,USA
| | - David R Howell
- Sports Medicine Center, Children's Hospital Colorado, Aurora, CO,USA
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO,USA
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Apostolakos JM, Brusalis CM, Uppstrom T, R Thacher R, Kew M, Taylor SA. Management of Common Football-Related Injuries About the Shoulder. HSS J 2023; 19:339-350. [PMID: 37435133 PMCID: PMC10331269 DOI: 10.1177/15563316231172107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 07/13/2023]
Affiliation(s)
- John M Apostolakos
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA
| | | | - Tyler Uppstrom
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA
| | - Ryan R Thacher
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA
| | - Michelle Kew
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA
| | - Samuel A Taylor
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA
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Kuitunen I, Immonen V, Pakarinen O, Mattila VM, Ponkilainen VT. Incidence of football injuries sustained on artificial turf compared to grass and other playing surfaces: a systematic review and meta-analysis. EClinicalMedicine 2023; 59:101956. [PMID: 37125402 PMCID: PMC10139885 DOI: 10.1016/j.eclinm.2023.101956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
Background Prior reviews have not conducted statistical synthesis of injury incidence on artificial turf in football. To analyse and compare the incidence of injuries sustained playing football (soccer) on artificial turf compared to grass and other playing surfaces. Methods This was a systematic review and meta-analysis. We searched PubMed, Scopus, SPORTDiscus, and Web of Science databases in October 2022 without filters. All observational studies (prospective or retrospective) that analysed injuries sustained playing football on artificial turf and which included a control group that played on grass or other surface were included. Studies were included if they reported the number of injuries and the exposure time for the playing surfaces. Risk of bias was assessed by Newcastle-Ottawa Scale. A random effects model was used to calculate the pooled incidence rate ratios (IRR) with 95% confidence intervals. Protocol was registered with PROSPERO on October 30th, 2022. Registration number: CRD42022371414. Findings We screened 1447 studies, and evaluated 67 full reports, and finally included 22 studies. Risk of bias was a notable issue, as only 5 of the 22 studies adjusted their analysis for potential confounders. Men (11 studies: IRR 0.82, CI 0.72-0.94) and women (5 studies: IRR 0.83, CI 0.76-0.91) had lower injury incidence on artificial turf. Professional players had a lower incidence of injury (8 studies: IRR 0.79, CI 0.70-0.90) on artificial turf, whereas there was no evidence of differences in the incidence of injury in amateur players (8 studies: IRR 0.91, CI 0.77-1.09). The incidence of pelvis/thigh (10 studies: IRR 0.72, CI 0.57-0.90), and knee injuries (14 studies: IRR 0.77, CI 0.64-0.92) were lower on artificial turf. Interpretation The overall incidence of football injuries is lower on artificial turf than on grass. Based on these findings, the risk of injury can't be used as an argument against artificial turf when considering the optimal playing surface for football. Funding No specific funding was received for this study.
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Affiliation(s)
- Ilari Kuitunen
- Institute of Clinical Medicine and Department of Paediatrics, University of Eastern Finland, Kuopio, Finland
- Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland
- Boys National Teams, The Finnish Football Association, Helsinki, Finland
- Corresponding author. Department of Pediatrics, Kuopio University Hospital, Puijonlaaksontie 2, PL 100, 70029, Kuopio, Finland.
| | - Ville Immonen
- Boys National Teams, The Finnish Football Association, Helsinki, Finland
| | - Oskari Pakarinen
- Faculty of Medicine and Health Technologies, Tampere University, Tampere, Finland
| | - Ville M. Mattila
- Faculty of Medicine and Health Technologies, Tampere University, Tampere, Finland
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland
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Nocera A, Sbrollini A, Romagnoli S, Morettini M, Gambi E, Burattini L. Physiological and Biomechanical Monitoring in American Football Players: A Scoping Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:3538. [PMID: 37050597 PMCID: PMC10098592 DOI: 10.3390/s23073538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 06/19/2023]
Abstract
American football is the sport with the highest rates of concussion injuries. Biomedical engineering applications may support athletes in monitoring their injuries, evaluating the effectiveness of their equipment, and leading industrial research in this sport. This literature review aims to report on the applications of biomedical engineering research in American football, highlighting the main trends and gaps. The review followed the PRISMA guidelines and gathered a total of 1629 records from PubMed (n = 368), Web of Science (n = 665), and Scopus (n = 596). The records were analyzed, tabulated, and clustered in topics. In total, 112 studies were selected and divided by topic in the biomechanics of concussion (n = 55), biomechanics of footwear (n = 6), biomechanics of sport-related movements (n = 6), the aerodynamics of football and catch (n = 3), injury prediction (n = 8), heat monitoring of physiological parameters (n = 8), and monitoring of the training load (n = 25). The safety of players has fueled most of the research that has led to innovations in helmet and footwear design, as well as improvements in the understanding and prevention of injuries and heat monitoring. The other important motivator for research is the improvement of performance, which has led to the monitoring of training loads and catches, and studies on the aerodynamics of football. The main gaps found in the literature were regarding the monitoring of internal loads and the innovation of shoulder pads.
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Chandran A, Moffit RE, DeJong Lempke AF, Boltz AJ, Alexander AS, Robison HJ, Kerr ZY, Collins CL, Wikstrom EA. Epidemiology of Lateral Ligament Complex Tears of the Ankle in National Collegiate Athletic Association (NCAA) Sports: 2014-15 Through 2018-19. Am J Sports Med 2023; 51:169-178. [PMID: 36592020 DOI: 10.1177/03635465221138281] [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] [Indexed: 01/03/2023]
Abstract
BACKGROUND Epidemiological studies of lateral ankle sprains in NCAA sports are important in appraising the burden of this injury and informing prevention efforts. PURPOSE To describe the epidemiology of lateral ankle sprains in NCAA sports during the 2014-15 through 2018-19 seasons. STUDY DESIGN Descriptive epidemiology study. METHODS Injury and exposure information collected within the NCAA Injury Surveillance Program (ISP) were examined. Counts, rates, and proportions of lateral ankle sprains were used to describe injury incidence by sport, event type (practices, competitions), season segment (preseason, regular season, postseason), injury mechanism (player contact, noncontact, and surface contact, injury history (new, recurrent), and time loss (time loss [≥1 day], non-time loss). Injury rate ratios (IRRs) were used to examine differential injury rates, and injury proportion ratios (IPRs) were used to examine differential distributions. RESULTS A total of 3910 lateral ankle sprains were reported (4.61 per 10,000 athlete exposures) during the study period, and the overall rate was highest in men's basketball (11.82 per 10,000 athlete exposures). The competition-related injury rate was higher than the practice-related rate (IRR, 3.24; 95% CI, 3.04-3.45), and across season segments, the overall rate was highest in preseason (4.99 per 10,000 athlete exposures). Lateral ankle sprains were most often attributed to player-contact mechanisms in men's (43.2%) and women's sports (35.1%), although injuries were more prevalently attributed to player contact in men's than in women's sports (IPR, 1.23; 95% CI, 1.13-1.34). Overall, 49.7% of all lateral ankle sprains were time loss injuries. CONCLUSIONS The findings of this study are consistent with previous epidemiological investigations of lateral ankle sprains among NCAA athletes. Results offer additional context on differential injury mechanisms between men's and women's sports and on injury risk across the competitive season. Future research may examine the effectiveness of deploying injury prevention programs before the start of a season.
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Affiliation(s)
- Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Reagan E Moffit
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Alexandra F DeJong Lempke
- Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA.,University of Michigan School of Kinesiology, Ann Arbor, Michigan, USA
| | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA.,Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Erik A Wikstrom
- Motion Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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10
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Luxenburg D, Wasserman NA, Geller JS, Perez JR, Burke J, Kaplan LD. Hamstring injuries in the national football league: An epidemiological study. J Orthop 2023; 35:111-114. [PMID: 36467428 PMCID: PMC9708442 DOI: 10.1016/j.jor.2022.11.010] [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: 11/14/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background While numerous studies have evaluated National Football League injuries, there is limited literature evaluating hamstring injuries sustained in games. Our primary aim is to analyze the effect of player position on the relative incidence of hamstring injuries in the National Football League. Our secondary aims are to analyze the effects of field surface, week of the season, and short rest weeks. Methods Official National Football League game books containing injury data from the 2013-2016 regular seasons were used. Data were analyzed to determine the incidence of hamstring injuries by field surface, rest, and week of the season. Field surface was considered either turf or grass. Short rest was considered four days. Relative incidence of hamstring injuries by position was performed with standardized incidence ratios. P values < 0.05 were considered statistically significant. Results Seventy-eight qualifying hamstring injuries were identified and included in our analysis. Linebackers had the highest relative incidence per play with a standardized incidence ratio of 2.02 (CI: 1.14-2.91), followed by Defensive Backs (1.62; 95% CI: 1.14-1.62). Offensive linemen and defensive linemen had standardized incidence ratios significantly less than 1. Fifty-seven percent of hamstring injuries occurred on turf fields (p = 0.082). There was no significant difference between the proportion of hamstring injuries that occurred on short rest and the proportion of games played on short rest (p = 0.959). Hamstring injuries were not more likely to occur than the pooled group of all other types of injuries on short rest (p = 0.861). With a 17-week season, the mean week of hamstring injury was 8.05 (95% CI: 7.06-9.04), while the median week was 7.5. Conclusions Linebackers and Defensive Backs have the highest relative incidence of hamstring injuries compared to other position groups, while offensive and defensive linemen have the lowest. Field surface and a short rest period did not show significance.
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Affiliation(s)
- Dylan Luxenburg
- University of Miami Department of Orthopaedics, United States
| | | | | | - Jose R. Perez
- University of Miami Department of Orthopaedics, United States
| | - Jonathan Burke
- University of Miami Department of Orthopaedics, United States
| | - Lee D. Kaplan
- University of Miami Department of Orthopaedics, United States
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Waltzman D, Sarmiento K, Ferrell D, Kern V, Roghaar C. A Description of Suspected Concussions in Football-Related Activities among K-12 Students in Utah. J Sch Nurs 2022:10598405221138731. [PMID: 36408989 PMCID: PMC10413338 DOI: 10.1177/10598405221138731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
The circumstances and nature of concussions among youth who play tackle, flag, or touch football are not well understood. This study used data from Utah's Student Injury Reporting System (SIRS) to explore suspected concussions among K-12 students sustained during participation in football-related activities (tackle, flag, or touch football). Descriptive statistics and chi-square analyses showed that 54.7% of suspected concussions due to football-related activity were among elementary and middle school and 41.3% were among high school students. Most suspected concussions resulted from being struck by or against something (81.9%) and occurred during school-sanctioned games and practices (37.9%), lunch, lunch recess, and recess (34.8%), or physical education class (22.7%). The type of school activity and context for suspected concussions varied by school level. School nurses and others in Utah may use study findings to customize concussion prevention efforts by school level and activity.
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Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Atlanta, GA, USA
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Atlanta, GA, USA
| | - Deanna Ferrell
- Utah Department of Health (UDOH), Violence and Injury Prevention Program (VIPP), Salt Lake City, Utah, USA
| | - Vanonda Kern
- Utah Department of Health (UDOH), Violence and Injury Prevention Program (VIPP), Salt Lake City, Utah, USA
| | - Chloe Roghaar
- Utah Department of Health (UDOH), Violence and Injury Prevention Program (VIPP), Salt Lake City, Utah, USA
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Koscso JM, McElheny K, Carr JB, Hippensteel KJ. Lower Extremity Muscle Injuries in the Overhead Athlete. Curr Rev Musculoskelet Med 2022; 15:500-512. [PMID: 35913667 PMCID: PMC9789236 DOI: 10.1007/s12178-022-09786-z] [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] [Accepted: 07/09/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Lower extremity (LE) injuries are a common source of disability and time-loss for overhead athletes, and muscles have been found to be the predominant soft tissue structure affected. The current review highlights the orthopaedic literature examining lower extremity muscle injuries in overhead athletes in regard to epidemiology, diagnosis, and conventional and emerging treatment measures. RECENT FINDINGS The hamstring muscles have been found to be the most commonly injured lower extremity muscle group in professional baseball, followed by the adductors, quadriceps, iliopsoas, and gastrocnemius-soleus complex. Strains and contusions comprise over 90% of these muscle injuries. Various advanced imaging grading systems have been developed to help characterize the nature of a muscle injury, although a clear and consistent prognostic utility of these systems is still unclear. The vast majority of lower extremity muscle injuries in overhead athletes are managed nonoperatively, and there is promising data on the use of emerging treatments such as platelet-rich plasma and blood flow restriction therapy. Lower extremity muscle injuries-often referred to as strains-are a relatively common issue in high-demand overhead athletes and can be a significant source of time-loss. Within baseball, position players are affected far more often than pitchers, and sprinting and fielding are the most common activities leading to strains. Magnetic resonance imaging (MRI) is considered the gold standard imaging modality to evaluate these muscle injuries and will allow for a detailed assessment of tissue damage. Nonetheless, return-to-play is often dictated by a given athlete's progression through a nonoperative rehabilitation protocol, with surgical intervention reserved for less common, select injury patterns.
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Affiliation(s)
| | - Kathryn McElheny
- Hospital for Special Surgery, 535 E 70th St, New York, NY 10021 USA
| | - James B. Carr
- Hospital for Special Surgery, 535 E 70th St, New York, NY 10021 USA
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Hartnett DA, Milner JD, Bodendorfer BM, DeFroda SF. Lower extremity injuries in the baseball athlete. SAGE Open Med 2022; 10:20503121221076369. [PMID: 35154741 PMCID: PMC8832566 DOI: 10.1177/20503121221076369] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/10/2022] [Indexed: 01/02/2023] Open
Abstract
Baseball is unique in its multiple facets: pitching, hitting, base rounding, and fielding are distinct activities that require different athletic skills to perform at a high level. Likewise, these different aspects of the game can contribute to a multitude of varying injuries. While high-velocity overhead throwing, along with batting, can produce a plethora of upper extremity injuries that often garner attention, injuries to the lower extremity can severely impact a player’s performance and ability to compete. The rigors of the short, explosive sprinting required for base running, as well as the dynamic movement required for fielding, create ample opportunity for lower limb injury, and even subtle pathology can affect a pitcher’s ability to perform or increase their long-term risk of injury. Chronic injury from conditions such as femoroacetabular impingement and hip labral tears can also occur. The purpose of the present review is to summarize the relevant epidemiology, pathophysiology, and treatment of lower extremity injuries in baseball athletes, with reference to current research into the prevention and management of such injuries.
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Affiliation(s)
- Davis A Hartnett
- Department of Orthopaedic Surgery, The Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - John D Milner
- Department of Orthopaedic Surgery, The Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Blake M Bodendorfer
- Miller Orthopedic Specialists, Council Bluffs, IA, USA
- Miller Orthopedic Specialists, Omaha, NE, USA
| | - Steven F DeFroda
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, MO, USA
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Aukerman DF, Bohr AD, Poddar SK, Romano R, Petron DJ, Ghajar J, Giza CC, Lumba-Brown A, McQueen MB, Harmon KG. Risk of Concussion After a Targeting Foul in Collegiate American Football. Orthop J Sports Med 2022; 10:23259671221074656. [PMID: 35141342 PMCID: PMC8819763 DOI: 10.1177/23259671221074656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Abstract
Background: The targeting rule was adopted by the National Collegiate Athletic
Association (NCAA) in 2008 to discourage dangerous contact during collegiate
American football competition. Although targeting rules have been emphasized
as a means to reduce concussion rates, there is currently no evidence that
targeting plays are higher risk for concussion than other plays in American
football. Purpose: To compare the rate of concussion occurring during targeting versus
nontargeting plays in American collegiate football. Study Design: Cross-sectional study. Methods: Concussions occurring in games in the 2016-2019 Pac-12 Conference were
classified as having occurred during either (1) a play where a targeting
penalty was called or (2) all other plays. Targeting plays were further
categorized to either those in which the call was upheld or those overturned
by the on-field official after replay review. The number of targeting plays
and the total number of plays during games were also recorded. Concussion
incidence (per 1000 plays) and risk ratios were calculated. Results: Overall, 538 games with 68,670 plays were reviewed, during which 213
concussions occurred (15 during plays where targeting was called and 198 on
other plays) and 141 targeting penalties were called. The incidence of
concussion was 106.4/1000 plays for targeting plays (including 141.2/1000
upheld targeting fouls and 53.6/1000 overturned targeting fouls) and
2.9/1000 plays for nontargeting plays. The risk of concussion during
targeting plays was 36.9 (95% CI, 22.4-60.7) times greater than that for all
other plays. The risk of concussion during targeting plays upheld was 49.0
(95% CI, 28.5-84.2) times greater than that for all other plays. Conclusion: Concussion risk was significantly higher during plays in which targeting was
called, especially those in which targeting fouls were upheld. Clinical Relevance: This study supports eliminating or reducing targeting from American football.
The results of this study suggest that players should be screened for
concussion after targeting plays are called.
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Affiliation(s)
- Douglas F. Aukerman
- Sports Medicine, Samaritan Health Services, Corvallis, Oregon, USA
- Oregon State University, Corvallis, Oregon, USA
| | - Adam D. Bohr
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Sourav K. Poddar
- Family Medicine and Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Russell Romano
- Athletic Medicine, University of Southern California, Los Angeles, California, USA
| | - David J. Petron
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
| | - Jamshid Ghajar
- Neurosurgery, Brain Performance Center, Stanford University, Stanford, California, USA
| | - Christopher C. Giza
- Pediatrics and Neurosurgery, University of California, Los Angeles, California, USA
| | - Angela Lumba-Brown
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Matthew B. McQueen
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Kimberly G. Harmon
- Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington, USA
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