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Abdou H, Wilkins SG, Sheth AH, Salehi PP, Lee YH. Epidemiology and patterns of gymnastics-related head & neck trauma injuries: A NEISS database study. Am J Emerg Med 2024; 80:87-90. [PMID: 38520802 DOI: 10.1016/j.ajem.2024.03.012] [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: 08/21/2023] [Revised: 02/14/2024] [Accepted: 03/10/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVE To describe the epidemiology and patterns of gymnastics-related Head & Neck trauma injuries using the NEISS database from 2001 to 2020. STUDY DESIGN AND SETTING Cross-sectional analysis of a national database. METHODS Gymnastics-related ED visits between 2001 and 2020 were queried from the NEISS database. Bivariate chi-squared analyses were used to compare injury demographics, location, type, and disposition. Fracture location was identified using the narrative description of each case and were divided into subtypes for further analysis. RESULTS 1455 gymnastics-related head and neck traumatic injuries were identified. The majority were in females (65.8%). The most common presenting age group was pediatric (≤18 years) (92.7%), and the largest racial group was Caucasian (51.5%). Of all location subtypes, facial injuries were the most common presenting injury type overall (45.2%). Regarding injury types, lacerations were most common (36.8%), followed by dental injury (30.7%) and fractures (21.2%). The most common location of head and neck fractures was the nose (45.8%), followed by cervical spine (16.7%) and orbit (13.3%). The majority (95.7%) of gymnastics-related head and neck traumatic injuries presenting to the ED were treated and discharged. CONCLUSION This study characterizes gymnastics-related head and neck injuries which is a topic that is under-studied. The findings from this study are helpful for gymnasts and those who care for them including providers, coaches and guardians, and this data may help inform future guidelines for treatment and injury prevention.
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Affiliation(s)
- Hisham Abdou
- Yale School of Medicine, New Haven, CT, United States of America
| | - Sarah G Wilkins
- Yale School of Medicine, New Haven, CT, United States of America
| | - Amar H Sheth
- Yale School of Medicine, New Haven, CT, United States of America
| | - Parsa P Salehi
- Nassif MD Plastic Surgery, 120 South Spalding Drive #301, Beverly Hills, CA 90212, United States of America
| | - Yan Ho Lee
- Department of Surgery (Division of Otolaryngology), Yale University School of Medicine, New Haven, CT, United States of America.
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Fraile-Martinez O, García-Montero C, Fraile-Martinez M, Pekarek L, Barrena-Blázquez S, López-González L, Álvarez-Mon MÁ, Pekarek T, Casanova C, Álvarez-Mon M, Diaz R, Saez MA, Ortega MA. A comprehensive study of the academic benefits and practical recommendations to include resistance training programs in institutional education. Front Psychol 2024; 15:1387162. [PMID: 38817830 PMCID: PMC11139023 DOI: 10.3389/fpsyg.2024.1387162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/16/2024] [Indexed: 06/01/2024] Open
Abstract
The connection between physical activity and cognitive function has become a focus of attention in educational research in recent years. Regular exercise has been shown to have significant positive effects on physical health, but it also appears to have a significant impact on cognitive function and academic performance. Of all the exercise modalities, resistance training has drawn interest for its ability to improve cerebral abilities in addition to physical well-being. However, there is limited available knowledge exploring the relationship between resistance training regimens and academic performance. This narrative review aims to investigate the underlying mechanisms linking resistance training to academic performance. Firstly, we will examine the biological mechanisms and psychosocial links that potentially connect resistance training to academic performance to find and describe the different mechanisms by which resistance training improves academic performance. In the next part of the work, we delve into the existing observational and intervention studies that have explored the relationship between resistance training and academic performance. Lastly, we provide practical recommendations for including resistance training in institutional education settings, emphasizing the need of dispelling myths and addressing barriers to increase participation as well as the relevance of considering key training variables and adaptation of protocols to developmental stages, always guided by a properly trained professional. Overall, the available evidence supports that resistance training provides potential benefits to the academic performance of youth students with many biological and psychosocial factors that explain this relationship. However, most of the studies are observational, and broader interventional studies are needed to understand and maximize the benefits of this type of physical exercise.
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Affiliation(s)
- Oscar Fraile-Martinez
- Department of Medicine and Medical Specialties (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Cielo García-Montero
- Department of Medicine and Medical Specialties (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Marcos Fraile-Martinez
- Department of Medicine and Medical Specialties (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Leonel Pekarek
- Department of Medicine and Medical Specialties (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Silvestra Barrena-Blázquez
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Surgery Service, University Hospital Principe de Asturias, Alcala de Henares, Spain
| | - Laura López-González
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | - Miguel Ángel Álvarez-Mon
- Department of Medicine and Medical Specialties (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Tatiana Pekarek
- Department of Medicine and Medical Specialties (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Carlos Casanova
- Department of Medicine and Medical Specialties (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialties (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Immune System Diseases-Rheumatology Service, University Hospital Principe de Asturias, Alcala de Henares, Spain
| | - Raul Diaz
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Surgery Service, University Hospital Principe de Asturias, Alcala de Henares, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | - Miguel A. Saez
- Department of Medicine and Medical Specialties (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Pathological Anatomy Service, Central University Hospital of Defence-UAH, Madrid, Spain
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialties (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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Ranieri R, Illuminati M, Conti M, Delle Rose G, Minelli M, Castagna A. Surgical Treatment of Shoulder Pathologies in Professional Gymnasts: Findings, Treatment, and Clinical Outcomes. J Clin Med 2024; 13:2183. [PMID: 38673456 PMCID: PMC11050636 DOI: 10.3390/jcm13082183] [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] [Revised: 03/11/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Background: This study aims to investigate the impact of shoulder surgery on professional gymnasts through a case series, analyzing the mechanisms of injury and the shoulder lesion patterns, and reporting the clinical outcomes and return to sport. Methods: Twenty-nine surgically treated shoulders in twenty-seven professional gymnasts were retrospectively analyzed. Patients were stratified based on predominant symptoms and anatomical lesions in painful or unstable shoulders. Demographic and injury data, pathological findings, surgical procedure information, and data on time and level of return to sport were collected. Results: The average age of participants was 20.2 ± 3.8 years. Acute traumatic onset was reported in 51.8% of cases. Shoulders were categorized as painful in 13 cases and unstable in 16 cases. The most common pathologies were capsulolabral injuries (72%), biceps injuries (48%), and rotator cuff injuries (40%). All of the athletes returned to training within an average of 7.3 months, while the return to competition rate was 56%, achieved in an average of 10.3 months. The sport-specific subjective shoulder value was 84.8% ± 16.6%. Half of the patients who stopped competition reported reasons related to symptom persistence, while the other half reported personal reasons. No significant difference in the return to sport was reported in the cases of painful or unstable shoulder. Conclusions: Professional gymnasts requiring shoulder surgery commonly present multiple and complex lesions. Returning to training was possible in all cases; however, the possibility of persisting symptoms and other personal factors which may compromise the return to competition should be discussed with the athlete to give them insights into the possible outcomes.
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Affiliation(s)
- Riccardo Ranieri
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Rozzano, Italy; (R.R.); (M.M.); (A.C.)
| | - Matteo Illuminati
- Department of Orthopaedics and Traumatology, University Vita-Salute San Raffaele, IRCCS San Raffaele Hospital, Via Olgettina 58, 20132 Milan, Italy
| | - Marco Conti
- IRCCS Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Rozzano, Italy; (M.C.); (G.D.R.)
| | - Giacomo Delle Rose
- IRCCS Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Rozzano, Italy; (M.C.); (G.D.R.)
| | - Marco Minelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Rozzano, Italy; (R.R.); (M.M.); (A.C.)
| | - Alessandro Castagna
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Rozzano, Italy; (R.R.); (M.M.); (A.C.)
- IRCCS Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Rozzano, Italy; (M.C.); (G.D.R.)
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4
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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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6
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Shim SS, Confino JE, Vance DD. Common Orthopaedic Injuries in CrossFit Athletes. J Am Acad Orthop Surg 2023; 31:557-564. [PMID: 37155727 DOI: 10.5435/jaaos-d-22-01219] [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: 12/31/2022] [Accepted: 04/01/2023] [Indexed: 05/10/2023] Open
Abstract
CrossFit is a high-intensity exercise program that has gained popularity over the past few decades. CrossFit combines movements from Olympic weight lifting, gymnastics, powerlifting, and high-intensity interval training. As CrossFit continues to expand, knowledge of the associated orthopaedic injuries to aid providers in diagnosis, treatment, and prevention will be increasingly important. The most common CrossFit injuries occur in the shoulder (25% of all injuries), spine (14%), and knee (13%). Male athletes are markedly more likely to experience injuries than female athletes, and injuries occur markedly less when there is supervised coaching of the athletes. The most common causes of injury in CrossFit include improper form and exacerbation of a prior injury. The purpose of this article was to review the literature to aid clinicians in identifying and treating common orthopaedic injuries in CrossFit athletes. Understanding the injury patterns, treatment, and prevention options is important for a successful recovery and return to sport.
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Affiliation(s)
- Stephanie S Shim
- From the Department of Orthopedics, Columbia University at Mount Sinai Medical Center, Miami Beach, FL (Shim and Vance), and the Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY (Confino)
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7
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Fryar C, Howell DR, Seehusen CN, Tilley D, Casey E, Sweeney EA. Link Between the Female Athlete Triad and Gymnastics-Related Injury in Retired Collegiate Gymnasts. Clin J Sport Med 2023:00042752-990000000-00117. [PMID: 37185819 DOI: 10.1097/jsm.0000000000001148] [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: 07/14/2022] [Accepted: 03/02/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES To compare gymnastics-related injuries between former collegiate gymnasts who did and did not report components of the female athlete triad (Triad) during college, including disordered eating or menstrual irregularity. We hypothesized that athletes reporting these 2 triad symptoms would have higher rates of time loss injury and injuries requiring surgery. DESIGN Retrospective case-control. SETTING Online survey. PATIENTS Four hundred seventy former collegiate gymnasts. INTERVENTIONS Athletes completed online survey distributed through social media. MAIN OUTCOME MEASURES Participants were grouped based on self-reported menstrual irregularity and disordered eating during college. We compared time loss injuries, injuries resulting in surgery, and injury locations between the groups using χ2 analyses. RESULTS Seventy percent (n = 328) of participants in this study reported a time loss college injury without surgery, and 42% (n = 199) reported an injury during college that required surgical treatment. A significantly greater proportion of gymnasts with only disordered eating reported a time loss gymnastics injury (without surgery) compared with those who reported only menstrual irregularity during college (79% vs 64%; P =0 .03). A significantly greater proportion of the disordered eating-only group reported a spine injury compared with the menstrual irregularity-only group (P = 0.007) and the group who reported neither menstrual irregularity nor disordered eating (P = 0.006). CONCLUSIONS College gymnasts who experienced disordered eating were more likely to experience a nonsurgical time loss injury while in college, as well as spine injury compared with those with menstrual irregularity. Sports medicine providers should be aware of the association between injuries and individual components of Triad in gymnasts beyond bone stress injuries.
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Affiliation(s)
- Caroline Fryar
- Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, Florida
| | - David R Howell
- Department of Orthopedics, University of Colorado, Aurora, Colorado
- Sports Medicine Center, Children's Hospital Colorado, Aurora, Colorado
| | | | - David Tilley
- Champion Physical Therapy & Performance, Watham, Massachusetts; and
| | - Ellen Casey
- Department of Physiatry, Hospital for Special Surgery, New York, New York
| | - Emily A Sweeney
- Department of Orthopedics, University of Colorado, Aurora, Colorado
- Sports Medicine Center, Children's Hospital Colorado, Aurora, Colorado
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Trikha R, Greig DE, Shi BY, Schroeder GG, Chernoff DJ, Jones KJ, Kremen TJ. Multicenter Analysis of the Epidemiology of Injury Patterns and Return to Sport in Collegiate Gymnasts. Orthop J Sports Med 2023; 11:23259671231154618. [PMID: 36860774 PMCID: PMC9969444 DOI: 10.1177/23259671231154618] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/08/2022] [Indexed: 03/03/2023] Open
Abstract
Background Gymnastics requires intense year-round upper and lower extremity strength training typically starting from an early age. As such, the injury patterns observed in these athletes may be unique. Purpose To characterize the types of injuries and provide return-to-sport data in male and female collegiate gymnasts. Study Design Descriptive epidemiology study. Methods A conference-specific injury database was utilized to perform a retrospective review of injuries for male and female National Collegiate Athletic Association (NCAA) Division I gymnasts within the Pacific Coast Conference between 2017 and 2020 (N = 673 gymnasts). Injuries were stratified by anatomic location, sex, time missed, and injury diagnoses. Relative risk (RR) was used to compare results between sexes. Results Of the 673 gymnasts, 183 (27.2%) experienced 1093 injuries during the study period. Injuries were sustained in 35 of 145 male athletes (24.1%) as compared with 148 of 528 female athletes (28.0%; RR, 0.86 [95% CI, 0.63-1.19]; P = .390). Approximately 66.1% (723/1093) of injuries occurred in a practice setting, compared with 84 of 1093 injuries (7.7%) occurring during competition. Overall, 417 of 1093 injuries (38.2%) resulted in no missed time. Shoulder injuries and elbow/arm injuries were significantly more common in male versus female athletes (RR, 1.99 [95% CI, 1.32-3.01], P = .001; and RR, 2.08 [95% CI, 1.05-4.13], P = .036, respectively). In total, 23 concussions affected 21 of 673 athletes (3.1%); 6 concussions (26.1%) resulted in the inability to return to sport during the same season. Conclusion For the majority of musculoskeletal injuries, the gymnasts were able to return to sport during the same season. Male athletes were more likely to experience shoulder and elbow/arm injuries, likely because of sex-specific events. Concussions occurred in 3.1% of the gymnasts, highlighting the need for vigilant monitoring. This analysis of the incidence and outcomes of injuries observed in NCAA Division I gymnasts may guide injury prevention protocols as well as provide important prognostic information.
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Affiliation(s)
- Rishi Trikha
- Department of Orthopaedic Surgery, David Geffen School of Medicine
at the University of California, Los Angeles, Los Angeles, California, USA.,Rishi Trikha, MD, UCLA Orthopaedic Surgery, 1225 15th Street,
Suite 2100, Santa Monica, CA 90404, USA (
)
| | - Danielle E. Greig
- Department of Orthopaedic Surgery, David Geffen School of Medicine
at the University of California, Los Angeles, Los Angeles, California, USA
| | - Brendan Y. Shi
- Department of Orthopaedic Surgery, David Geffen School of Medicine
at the University of California, Los Angeles, Los Angeles, California, USA
| | - Grant G. Schroeder
- Department of Orthopaedic Surgery, David Geffen School of Medicine
at the University of California, Los Angeles, Los Angeles, California, USA
| | - Daniel J. Chernoff
- Department of Orthopaedic Surgery, David Geffen School of Medicine
at the University of California, Los Angeles, Los Angeles, California, USA
| | - Kristofer J. Jones
- Department of Orthopaedic Surgery, David Geffen School of Medicine
at the University of California, Los Angeles, Los Angeles, California, USA
| | - Thomas J. Kremen
- Department of Orthopaedic Surgery, David Geffen School of Medicine
at the University of California, Los Angeles, Los Angeles, California, USA
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9
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Farooqi A, Talwar D, Tata R, Harwood K, Maguire K. Comparison of pediatric performance athlete injuries presenting to emergency departments. PHYSICIAN SPORTSMED 2023; 51:64-72. [PMID: 34696657 DOI: 10.1080/00913847.2021.1996863] [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: 01/25/2023]
Abstract
OBJECTIVE Pediatric injuries in performance sports represent a significant healthcare burden and account for over 50,000 annual Emergency Department (ED) visits in the United States. The objective of this study was to characterize and compare pediatric injury presentation across the most common performance sports. METHODS The National Electronic Injury Surveillance System (NEISS) database was retrospectively analyzed for pediatric injuries (3-18 years) related to gymnastics, dance, or cheerleading from 2015-2019. Cases were categorized as children (˂11 years) or adolescent (≥11 years). Injuries were categorized as orthopedic (fractures, dislocations, sprain, strains), non-orthopedic (contusion, internal injury, laceration), concussion, or other/unknown. Case narratives were used to categorize mechanism of injury as contact or non-contact. Appropriate sample NEISS weights estimation was applied for statistical analysis and Confidence Intervals (CI). RESULTS A total of 393,110 injuries were observed over the five-year study period, with a mean of 78,622 annual injuries. Gymnastics, dance, and cheerleading accounted for 136,422 injuries, 96,416 injuries, and 160,272 injuries, respectively. Most cases were adolescent (71%; 95% CI: 68-74%) and occurred in a sports-related setting (65%, 95% CI: 57-72%). Gymnastics had the highest proportion of injuries among children (50%) as compared to dancers (25%) or cheerleaders (12%) (p < 0.01). Non-contact injuries most affected the lower extremity (43-68%) and resulted in an orthopedic diagnosis (63-71%), and contact injuries had a higher proportion of injuries affecting the head, neck, and face (29-51%) and non-orthopedic diagnoses (29-38%). Gymnastics had the most upper extremity non-contact injuries (42%) and dance the most lower extremity non-contact injuries (68%) (p < 0.01). Cheerleading had the highest incidence of overall concussions (8%), contact injuries (47%), and concussions due to contact injury (15%). CONCLUSION Pediatric gymnasts, cheerleaders, and dancers have important similarities and differences in injury pattern which may lead to the development of sport-specific injury prevention programs for pediatric performance athletes.
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Affiliation(s)
- Ali Farooqi
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States
| | - Divya Talwar
- Department of Orthopaedics, Clinical Orthopaedic Surgery, Children's Hospital of Pennsylvania, Philadelphia, PA, United States
| | - Ravi Tata
- Drexel School of Medicine, Philadelphia, Unites States
| | - Kathleen Harwood
- Department of Orthopaedics, Clinical Orthopaedic Surgery, Children's Hospital of Pennsylvania, Philadelphia, PA, United States
| | - Kathleen Maguire
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States.,Department of Orthopaedics, Clinical Orthopaedic Surgery, Children's Hospital of Pennsylvania, Philadelphia, PA, United States
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10
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Pei YA, Mahmoud MA, Baldwin K, Franklin C. Comparing Musculoskeletal Injuries across Dance and Gymnastics in Adolescent Females Presenting to Emergency Departments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:471. [PMID: 36612793 PMCID: PMC9819499 DOI: 10.3390/ijerph20010471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Studies have yet to identify if there are any differences in musculoskeletal injury patterns between dance and gymnastics. This study aimed to determine if different injury patterns exist in adolescent females participating in those two popular sports. (2) Methods: A cross-sectional study was conducted using data collected from patients presenting to U.S. emergency departments participating in the publicly available, de-identified U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) throughout the year 2020. Regression analyses were performed to explore if injury patterns were predictive of gymnastics or dancing participation. (3) Results: 518 adolescent females with dance-related injuries and 597 adolescent females with gymnastics-related injuries in 2020 were examined. Strain/sprains (33.3%) and fractures (37.3%) were the most reported dance- and gymnastics-related diagnoses, respectively. Participants were 74% less likely to have a strain/sprain diagnosis in gymnastics compared to dance (OR = 0.26, 95% CI [0.18, 0.38]) and were 3.84 times more likely to have a fracture diagnosis from gymnastics compared to dance (OR = 3.84, 95% CI [2.67, 5.57]), even after adjusting for body party injured. (4) Conclusions: Dance is associated with more sprains while gymnastics typically resulted in a greater likelihood for fractures.
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Affiliation(s)
- Yixuan A. Pei
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mattia A. Mahmoud
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Keith Baldwin
- Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Corinna Franklin
- Department of Orthopedics & Rehabilitation, Yale School of Medicine, New Haven, CT 06510, USA
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11
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Eyssartier C, Billard P, Robert M, Thoreux P, Sauret C. Which typical floor movements of men's artistic gymnastics result in the most extreme lumbar lordosis and ground reaction forces? Sports Biomech 2022:1-16. [PMID: 36377511 DOI: 10.1080/14763141.2022.2140702] [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: 03/11/2022] [Accepted: 10/23/2022] [Indexed: 11/16/2022]
Abstract
Back pain is prevalent among gymnast populations and extreme flexion or extension of the lumbar spine along with high ground reaction forces (GRFs) are known to increase intervertebral stress. The aim of this study was to determine which postures and dynamic conditions among common floor movements provide the greatest risk of injury in men's artistic gymnastics (MAG). For this purpose, lumbar spine curvatures, obtained through a full-body subject-specific kinematic model fed by motion capture data, and GRFs on feet and hands were compared between typical floor movements of MAG (pike jump, round off back handspring, front handspring, forward and backward tucked somersaults) performed by six adolescent gymnasts. The round off back handspring and the pike jump resulted respectively in the largest lumbar extension and flexion, and the forward tucked somersault take-off in the highest GRF. At ground impacts, the largest lumbar flexion was during the backward tucked somersault landing and only the back handspring hands ground contact phase led to lumbar extension. Such identification of high-risk conditions should enable better back pain management in gymnastics through more tailored training adaptations, particularly in case of pathologies or musculoskeletal specificities.
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Affiliation(s)
- C Eyssartier
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC-Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, France
- Fédération Française de Gymnastique, Paris, France
| | - P Billard
- Fédération Française de Gymnastique, Paris, France
| | - M Robert
- Fédération Française de Gymnastique, Paris, France
| | - P Thoreux
- Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Université Sorbonne Paris Nord, Arts et Métiers Institute of Technology, IBHGC-Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, France
| | - C Sauret
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC-Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, France
- Centre d'Etudes et de Recherche sur l'Appareillage des Handicapés, Institution Nationale des Invalides, France
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12
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Jiang Y. INJURIES IN AEROBIC EXERCISE: CAUSES AND PREVENTIONS. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228052022_0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Professional aerobic exercises require high performance from exercisers. Injuries are common during their execution. Understanding the causal reasons is essential for prevention methods to reduce athletes’ injuries. Objective: Investigate the influential factors of ligament injuries caused by aerobic exercise. Methods: This paper analyzes the injuries caused by aerobic exercise through mathematical statistics. Time, course, degree of injury, location of the injury, cause, early treatment time, primary approach, treatment methods, recovery conditions, and speed in recovery time of sports injuries were investigated. Results: Injuries are mainly concentrated at the hip, knee, and ankle joint level; sprains are the first injuries, followed by muscle strains, lower back muscle contractures, kneecap deformities, and joint ligament injuries. The leading causes of injuries were poor warm-up, excessive load, technical errors, and fatigue. Conclusion: Various physiotherapy methods can improve the recovery rate from ligament injuries. This method can also improve sports ligament injuries’ prevention and treatment effects. Evidence Level II; Therapeutic Studies - Investigating the result.
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13
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Nicolay RW, Moore LK, DeSena TD, Dines JS. Upper Extremity Injuries in CrossFit Athletes-a Review of the Current Literature. Curr Rev Musculoskelet Med 2022; 15:402-410. [PMID: 35867271 DOI: 10.1007/s12178-022-09781-4] [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: 06/21/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE OF REVIEW Cross-discipline fitness, or CrossFit, has exploded in popularity during the last two decades. During this time, there have been a high volume of patients presenting to clinicians with a wide range of associated injuries. Given the high intensity, high repetition, and competitive nature of CrossFit training and competition, athletes are vulnerable to injury, particularly upper extremity injury. The rate of injury to the shoulder, elbow, and wrist in CrossFit is higher when compared to traditional weight-training and more comparable to elite-level gymnastics and Olympic-style lifting. Due to the growing popularity of CrossFit-style exercise and the relatively high rate of injury among its participants, clinicians are likely to encounter these athletes. The purpose of this review is to familiarize clinicians with CrossFit and the associated injuries they will likely encounter. RECENT FINDINGS The medical literature focusing on CrossFit has demonstrated exponential growth, with the first article published in 2012 and 59 articles published in 2020. Although the body of literature is growing, there are no high-level studies focusing on CrossFit. The literature mainly consists of level IV and V studies, primarily consisting of case reports and case series. Recent studies have proven that CrossFit athletes are vulnerable to high rates of upper extremity injury and a few studies have identified risk factors for injury. Future high-level research is required to study modifiable risk factors, diagnostic criteria, and treatment options for these high-risk athletes in order to improve the safety of their sport. The CrossFit body of research is limited to level IV and V studies; however, the literature is clear, CrossFit athletes face a high rate of upper extremity injury. For this reason, clinicians must be familiar with CrossFit and its associated pathology. The goal of this review is to familiarize clinicians with CrossFit and the associated pathologies they will likely encounter.
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Affiliation(s)
- Richard W Nicolay
- Hospital for Special Surgery, 429 E. 75th St., New York, NY, 10021, USA.
| | - Laura K Moore
- Hospital for Special Surgery, 429 E. 75th St., New York, NY, 10021, USA
| | - Tyler D DeSena
- New York University, 50 W. 4th St, New York, NY, 10012, USA
| | - Joshua S Dines
- Hospital for Special Surgery, 429 E. 75th St., New York, NY, 10021, USA
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14
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Glynn B, Laird J, Herrington L, Rushton A, Heneghan NR. Analysis of landing performance and ankle injury in elite British artistic gymnastics using a modified drop land task: A longitudinal observational study. Phys Ther Sport 2022; 55:61-69. [DOI: 10.1016/j.ptsp.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 10/19/2022]
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15
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Chandran A, Boltz AJ, Morris SN, Robison HJ, Nedimyer AK, Collins CL, Register-Mihalik JK. Epidemiology of Concussions in National Collegiate Athletic Association (NCAA) Sports: 2014/15-2018/19. Am J Sports Med 2022; 50:526-536. [PMID: 34898299 DOI: 10.1177/03635465211060340] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Updated epidemiology studies examining sports-related concussions (SRCs) are critical in evaluating recent efforts aimed at reducing the incidence of SRCs in National Collegiate Athletic Association (NCAA) sports. PURPOSE To describe the epidemiology of SRCs in 23 NCAA sports during the 2014/15-2018/19 academic years. STUDY DESIGN Descriptive epidemiology study. METHODS SRC and exposure data collected in the NCAA Injury Surveillance Program were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics by sport, event type (practices, competitions), injury mechanism (player contact, surface contact, equipment/apparatus contact), and injury history (new, recurrent). 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 3497 SRCs from 8,474,400 athlete-exposures (AEs) were reported during the study period (4.13 per 10,000 AEs); the competition-related SRC rate was higher than was the practice-related SRC rate (IRR, 4.12; 95% CI, 3.86-4.41). The highest SRC rates were observed in men's ice hockey (7.35 per 10,000 AEs) and women's soccer (7.15 per 10,000 AEs); rates in women's soccer and volleyball increased during 2015/16-2018/19. Player contact was the most prevalently reported mechanism in men's sports (77.0%), whereas equipment/apparatus contact was the most prevalently reported mechanism in women's sports (39.2%). Sex-related differences were observed in soccer, basketball, softball/baseball, and swimming and diving. Most SRCs reported in men's sports (84.3%) and women's sports (81.1%) were reported as new injuries. CONCLUSION Given the increasing SRC rates observed in women's soccer and volleyball during the latter years of the study, these results indicate the need to direct further attention toward trajectories of SRC incidence in these sports. The prevalence of equipment/apparatus contact SRCs in women's sports also suggests that SRC mechanisms in women's sports warrant further investigation. As most SRCs during the study period were reported as new injuries, the prevalence of recurrent SRCs in men's and women's ice hockey is also noteworthy.
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Affiliation(s)
- Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Sarah N Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - Aliza K Nedimyer
- Curriculum in Human Movement Science, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, 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
| | - Johna K Register-Mihalik
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,STAR Heel Performance Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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16
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A Survey on Stretching Practices in Women and Men from Various Sports or Physical Activity Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083928. [PMID: 33918033 PMCID: PMC8068839 DOI: 10.3390/ijerph18083928] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022]
Abstract
Recommendations for prescribing stretching exercises are regularly updated. It appears that coaches progressively follow the published guidelines, but the real stretching practices of athletes are unknown. The present study aimed to investigate stretching practices in individuals from various sports or physical activity programs. A survey was completed online to determine some general aspects of stretching practices. The survey consisted of 32 multiple-choice or open-ended questions to illustrate the general practices of stretching, experiences and reasons for stretching. In total, 3546 questionnaires were analyzed (47.3% women and 52.7% men). Respondents practiced at the national/international level (25.2%), regional level (29.8%), or recreationally (44.9%). Most respondents (89.3%) used stretching for recovery (74.9%) or gains of flexibility (57.2%). Stretching was generally performed after training (72.4%). The respondents also indicated they performed stretching as a pre-exercise routine (for warm-up: 49.9%). Static stretching was primarily used (88.2%) but when applied for warm-up reasons, respondents mostly indicated performing dynamic stretching (86.2%). Only 37.1% of the respondents indicated being supervised. Finally, some gender and practice level differences were noticed. The present survey revealed that the stretching practices were only partly in agreement with recent evidence-based recommendations. The present survey also pointed out the need to improve the supervision of stretching exercises.
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17
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Momma D, Iwamoto W, Endo K, Sato K, Iwasaki N. Stress Distribution Patterns Across the Shoulder Joint in Gymnasts: A Computed Tomography Osteoabsorptiometry Study. Orthop J Sports Med 2020; 8:2325967120962103. [PMID: 33244475 PMCID: PMC7678403 DOI: 10.1177/2325967120962103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/26/2020] [Indexed: 12/22/2022] Open
Abstract
Background: The distribution pattern of subchondral bone density is an indicator of stress distribution over a joint surface under long-term physiologic loading. The biomechanical characteristics of the articular surfaces of the shoulder joint in gymnasts can be determined by measuring this distribution pattern. Purpose: To evaluate the distribution of subchondral bone density across the shoulder joint in male collegiate gymnasts and to determine the effects of gymnastic activities on its articular surfaces under long-term loading conditions using computed tomography osteoabsorptiometry (CTOAM). Study Design: Descriptive laboratory study. Methods: CT image data were obtained from both shoulders of 12 asymptomatic male collegiate gymnasts (gymnast group; mean age, 19.4 years; range, 18-22 years) and 10 male collegiate volunteers (control group; mean age, 20.2 years; range, 18-22 years). The distribution pattern of subchondral bone density across the articular surfaces of each shoulder joint was assessed by CTOAM. Quantitative analysis was performed of the locations and percentages of high-density areas on the articular surface. Results: Stress distribution patterns over the articular surfaces differed between the gymnasts and the controls. In the gymnasts, high-density areas were detected on the posterosuperior articular surface of the humeral head and the anterosuperior and/or posterosuperior articular surface of the glenoid. Mean bone density was greater in the gymnasts than in the controls (P < .0001). Conclusion: Stress distribution over the articular surfaces of the shoulder joint was affected by gymnastic activities. Stress was concentrated over the superior part of the glenohumeral joint in male collegiate gymnasts. Clinical Relevance: The present findings suggest that gymnastic activities increase stress to the articular surfaces of the superior glenohumeral joint. This supports the notion that mechanical conditions play a crucial role in the origin of disorders particular to gymnastic activities.
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Affiliation(s)
- Daisuke Momma
- Center for Sports Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Wataru Iwamoto
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kaori Endo
- Faculty of Medicine and Graduate School of Medicine, Department of Orthopaedic Surgery, Hokkaido University, Sapporo, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Norimasa Iwasaki
- Faculty of Medicine and Graduate School of Medicine, Department of Orthopaedic Surgery, Hokkaido University, Sapporo, Japan
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18
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Yanagiya T, Hata K, Takeshita T, Noro H, Yoshida T, Koyama M, Miyamoto A. Athletic event-specific characteristics in floating toes during the static standing posture. J Phys Ther Sci 2020; 32:342-347. [PMID: 32425352 PMCID: PMC7192739 DOI: 10.1589/jpts.32.342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/25/2020] [Indexed: 11/26/2022] Open
Abstract
[Purpose] We aimed to determine the cause of floating toe syndrome, along with methods
for correction and prevention. [Participants and Methods] We recruited 93 Japanese male
students. Participants were grouped, according to primary sport, as Sprinters (SPR),
Swimmers (SWM), Gymnasts (GYM), Kendoists (KND) and Controls (CON). Degree of floating toe
syndrome was measured according to whether any toe was not in full contact with the ground
in a static standing posture—the Floating Toe Point (FTP). Two points were given for each
toe that was not at the FTP. The sum of the FTP was defined as the Floating Toes Score
(FTS), and was classified as follows: Normalcy (over 18 points), Incomplete Contact
(between 10 and 17 points), and Floating Toes (Under 9 points). [Results] The mean FTS for
all participants (10.40 ± 5.803) met the criteria for Floating Toes. Scores were highest
for SWMs (13.46 ± 5.710), followed by GYMs (13.26 ± 4.505), and SPRs (12.00 ± 4.870), who
all met the criteria for Incomplete Contact. Both KNDs (6.55 ± 5.409) and CONs (9.45 ±
4.824) met the criteria for Floating Toes. [Conclusion] SWMs had the highest FTSs,
followed by GYMs, and SPRs. KNDs had the lowest FTS. However, no group was classified as
Normal. We suggest that athletes who practice or train with bare feet do not necessarily
have higher FTSs, if evaluated in the standing posture.
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Affiliation(s)
- Toshio Yanagiya
- Graduate School of Health and Sports Science, Juntendo University: 1-1 Hiaraga-gakuendai, Inzai City, Chiba 270-1695, Japan
- Institute of Health and Sports Science & Medicine, Juntendo University, Japan
| | - Keiichiro Hata
- Graduate School of Health and Sports Science, Juntendo University: 1-1 Hiaraga-gakuendai, Inzai City, Chiba 270-1695, Japan
| | - Tomonari Takeshita
- Graduate School of Health and Sports Science, Juntendo University: 1-1 Hiaraga-gakuendai, Inzai City, Chiba 270-1695, Japan
- Institute of Health and Sports Science & Medicine, Juntendo University, Japan
| | - Hiroaki Noro
- Graduate School of Health and Sports Science, Juntendo University: 1-1 Hiaraga-gakuendai, Inzai City, Chiba 270-1695, Japan
| | - Taira Yoshida
- Graduate School of Health and Sports Science, Juntendo University: 1-1 Hiaraga-gakuendai, Inzai City, Chiba 270-1695, Japan
- Gifu Sports Science Center, Japan
| | - Motoki Koyama
- Graduate School of Health and Sports Science, Juntendo University: 1-1 Hiaraga-gakuendai, Inzai City, Chiba 270-1695, Japan
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