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Romero-Morales C, López-López D, Almazán-Polo J, Mogedano-Cruz S, Sosa-Reina MD, García-Pérez-de-Sevilla G, Martín-Pérez S, González-de-la-Flor Á. Prevalence, diagnosis and management of musculoskeletal disorders in elite athletes: A mini-review. Dis Mon 2024; 70:101629. [PMID: 37716840 DOI: 10.1016/j.disamonth.2023.101629] [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] [Indexed: 09/18/2023]
Abstract
Musculoskeletal injuries in elite sports are ones of the most impact issue because their remarkable impact on performance caused by drastic absence of training and competition and a progressive deterioration in physical health, emotional and social athletes' dimensions. Also, the prevalence of epidemiologic research found an incidence of musculoskeletal disorders vary within sports and in elite athletes which is even higher as a consequence of higher demand physical performance. This way, the loss of physical performance due to an sport injury impacts not only the individual economic sphere of the professional but also that ofsports entities, reaching, according to some studies, a loss estimated in the range of 74.7 million pounds. Thus, the purpose of this article is to review and to provide an overview of the most common musculoskeletal injuries in elite sports precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or musculoskeletal injuries that may alter performance and general health in the elite athletes.
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Affiliation(s)
- Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol , Universidade da Coruña, 15403 Ferrol, Spain.
| | - Jaime Almazán-Polo
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Sara Mogedano-Cruz
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - María Dolores Sosa-Reina
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | | | - Sebastián Martín-Pérez
- Faculty of Health Sciences, Universidad Europea de Canarias, La Orotava, Santa Cruz de Tenerife 38300, Spain
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Pedrosa M, Martins B, Araújo R. It's in the game: A review of neurological lesions associated with sports. J Neurol Sci 2023; 455:122803. [PMID: 37995461 DOI: 10.1016/j.jns.2023.122803] [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: 07/22/2023] [Revised: 10/24/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
INTRODUCTION The practice of sports may lead to neurological injuries. While relatively uncommon (overall incidence of approximately 2.5%), and mostly benign and transient, some conditions may be life-threatening and permanent. Thus, both clinical neurologists and sports physicians should be aware of their existence and relevance. We aimed to review all sports-related neurological injuries and illnesses reported in the literature. METHODS Following SANRA guidelines, we performed a narrative review and searched PubMed and Scopus databases. Relevant sports were selected based on their recognition as an Olympic sport by the International Olympic Committee. Chronic traumatic encephalopathy (CTE) and other neurodegenerative disorders were not included. RESULTS A total of 292 studies were included concerning 33 different sports. The most reported neurological injury was damage to the peripheral nervous system. Traumatic injuries have also been extensively reported, including cerebral haemorrhage and arterial dissections. Non-traumatic life-threatening events are infrequent but may also occur, e.g. posterior reversible encephalopathy syndrome, cerebral venous thrombosis, and arterial dissections. Some conditions were predominantly reported in specific sports, e.g. yips in baseball and golf, raising the possibility of a common pathophysiology. Spinal cord infarction due to fibrocartilaginous embolism was reported in several sports associated with minor trauma. CONCLUSION Sports-related neurological injuries are increasingly receiving more social and medical attention and are an important cause of morbidity and mortality. This review may serve as a guide to physicians managing these challenging situations.
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Affiliation(s)
| | - Bárbara Martins
- Neurology Department, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal; Clinical Neuroscience and Mental Health Department, Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Rui Araújo
- Neurology Department, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal; Clinical Neuroscience and Mental Health Department, Faculty of Medicine, University of Porto, Porto, Portugal
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Symptom distribution and development in thoracic disc surgery – A retrospective case series of 664 patients. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2022.101497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kato K, Otoshi K, Hakozaki M, Konno SI. Progressive enlargement of thoracic ossification of the ligamentum flavum in professional baseball pitchers: a report of two cases. J Int Med Res 2021; 49:3000605211059465. [PMID: 34796768 PMCID: PMC8661027 DOI: 10.1177/03000605211059465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Both systemic and local factors might influence the development of ossification of the ligamentum flavum (OLF); however, whether specific physical activities play a role in the development of OLF remains unclear. This report presents two cases of thoracic radiculopathy owing to progressive enlargement of thoracic OLF within a few years in Japanese professional baseball pitchers. Two left-handed, Japanese, professional baseball pitchers in their 20s experienced thoracic radiating pain. Mild hypesthesia of the lower thoracic vertebral levels was observed, and an increase in the size of the OLF within a few years was identified in the lower thoracic spine using computed tomography and magnetic resonance imaging. Neither patient exhibited myelopathy and were, therefore, treated conservatively. Both patients were able to return to playing in top condition within 4 months after onset. The findings in these cases suggest that thoracic OLF might increase in size and become exacerbated in certain individuals, such as professional pitchers, who experience repeated, localized, mechanical stress on the thoracic spine, irrespective of age.
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Affiliation(s)
- Kinshi Kato
- Department of Orthopaedic Surgery, 183174Fukushima Medical University School of Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Kenichi Otoshi
- Department of Orthopaedic Surgery, 183174Fukushima Medical University School of Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Michiyuki Hakozaki
- Department of Orthopaedic Surgery, 183174Fukushima Medical University School of Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Shin-Ichi Konno
- Department of Orthopaedic Surgery, 183174Fukushima Medical University School of Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
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Abstract
ABSTRACT Trunk pain is a common cause of performance limitation and time away from sport in athletes. However, atraumatic trunk injuries are underrepresented in medical literature and underrecognized clinically. Delays in diagnosis and initiation of appropriate treatment can increase injury morbidity and return-to-play time. Currently, evidence-based guidelines for diagnosis and treatment of trunk pain in athletes are limited. Thus, we provide an overview of atraumatic sport-related injuries to the thoracic spine (disc herniation, scoliosis, kyphosis), ribcage (bone stress injury, costochondritis, Tietze syndrome, slipping rib syndrome, costovertebral or costotransverse joint dysfunction), and chest and abdominal wall musculature (intercostal, serratus anterior, oblique strains, regional myofascial pain), highlighting sport-specific biomechanical considerations. We aim to increase awareness of these causes of trunk pain among sports medicine providers in an effort to guide diagnostic and treatment recommendations that will ultimately improve overall musculoskeletal health in athletes.
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Affiliation(s)
- Alexandra Gundersen
- Department of PM&R, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA
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Brown NJ, Shahrestani S, Lien BV, Ransom SC, Tafreshi AR, Ransom RC, Sahyouni R. Spinal pathologies and management strategies associated with cervical angina (pseudoangina): a systematic review. J Neurosurg Spine 2021; 34:506-513. [PMID: 33276331 DOI: 10.3171/2020.7.spine20866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/06/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cervical angina, or pseudoangina pectoris, is a noncardiac syndrome of chest pain that often mimics angina pectoris but is a disease of the spine. Diagnosis of cervical angina can be difficult and is often overlooked, although once identified, it can be successfully managed through conservative therapies and/or a variety of surgical interventions. Ultimately, cervical angina is an important component of the list of differential diagnoses in noncardiac chest pain. In the present study, the authors report the first comprehensive systematic review of the range of cervical and thoracic pathologies associated with cervical angina, as well as the different treatment methods used to manage this condition. METHODS A systematic review was performed according to PRISMA guidelines and using PubMed, Web of Science, and Cochrane databases from database inception to April 29, 2020, to identify studies describing spinal pathologies related to cervical angina. The following Boolean search was performed: ("cervical" OR "thoracic") AND ("angina" OR "chest pain") AND ("herniation" OR "OPLL"). Variables extracted included patient demographics, cervical angina pain location, pathology and duration of symptoms, treatment and/or management method, and posttreatment pain relief. RESULTS Upon careful screening, 22 articles published between 1976 and 2020 met the study's inclusion/exclusion criteria, including 5 case series, 12 case reports, and 5 retrospective cohort studies. These studies featured a total of 1100 patients, of which 95 met inclusion criteria (mean patient age 51.7 years, age range 24-86 years; 53.6% male). Collectively, symptom durations ranged from 1.5 days to 90 months. Cervical herniation (72.6%) accounted for the majority of cervical angina cases, and surgical interventions (84.4%) predominated over physical therapy (13.0%) and medical management strategies (9.1%). Every patient assessed at follow-up reported relief from symptoms related to cervical angina. CONCLUSIONS Cervical angina is a noncardiac syndrome of chest pain associated with a broad range of cervical and thoracic spinal pathologies, the most common of which is cervical disc herniation. Although difficult to diagnose, it can be successfully treated when identified through first-line conservative management or surgical interventions in refractory cases.
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Affiliation(s)
- Nolan J Brown
- 1School of Medicine, University of California, Irvine, California
| | | | - Brian V Lien
- 1School of Medicine, University of California, Irvine, California
| | - Seth C Ransom
- 3College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Ali R Tafreshi
- 4Department of Neurological Surgery, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania
| | - Ryan Chase Ransom
- 5Department of Neurologic Surgery, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; and
| | - Ronald Sahyouni
- 1School of Medicine, University of California, Irvine, California
- 6Department of Neurological Surgery, University of California, San Diego, California
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Ishii M, Nishimura Y, Hara M, Eguchi K, Nagashima Y, Awaya T, Ando R, Haimoto S, Wakabayashi T. Thoracic Disc Herniation Manifesting as Abdominal Pain Alone Associated with Thoracic Radiculopathy. NMC Case Rep J 2020; 7:161-165. [PMID: 33062562 PMCID: PMC7538457 DOI: 10.2176/nmccrj.cr.2019-0247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/03/2020] [Indexed: 11/20/2022] Open
Abstract
Symptomatic thoracic disc herniation (TDH) with thoracic radiculopathy alone is an extremely rare condition. Here, we report a rare case of TDH in a 52-year-old man who presented with medically refractory severe right flank pain. Based on pain distribution, pain intensity changes according to truncal position, ineffectiveness of intercostal nerve block, and radiological findings, his pain was determined to be caused by TDH at T9-10 level. Symptomatic TDH often requires invasive surgery. However, TDH with radiculopathy alone can be treated via a posterior approach without spinal cord manipulation or spinal fusion. We could eliminate the pain by removing TDH with hemilaminectomy and microdiscectomy using an O-arm-based navigation system.
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Affiliation(s)
- Motonori Ishii
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
| | - Yusuke Nishimura
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
| | - Masahito Hara
- Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi, Japan
| | - Kaoru Eguchi
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
| | - Yoshitaka Nagashima
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
| | - Takayuki Awaya
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
| | - Ryo Ando
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
| | - Shoichi Haimoto
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
| | - Toshihiko Wakabayashi
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan
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