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Docking SI. Counting the costs of sports injuries: The need for economic evidence. J Sci Med Sport 2024; 27:285. [PMID: 38777496 DOI: 10.1016/j.jsams.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Affiliation(s)
- S I Docking
- Musculoskeletal Health and Wiser Health Care Units, School of Preventive Medicine and Public Health, Monash University, Melbourne
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2
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Docking SI, Rio E, Cook J, Orchard JW, Fortington LV. The prevalence of Achilles and patellar tendon injuries in Australian football players beyond a time-loss definition. Scand J Med Sci Sports 2018; 28:2016-2022. [PMID: 29572969 DOI: 10.1111/sms.13086] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2018] [Indexed: 12/15/2022]
Abstract
Little is known about the prevalence and associated of morbidity of tendon problems. With only severe cases of tendon problems missing games, players that have their training and performance impacted are not captured by traditional injury surveillance. The aim of this study was to report the prevalence of Achilles and patellar tendon problems in elite male Australian football players using the Oslo Sports Trauma Research Centre (OSTRC) overuse questionnaire, compared to a time-loss definition. Male athletes from 12 professional Australian football teams were invited to complete a monthly questionnaire over a 9-month period in the 2016 pre- and competitive season. The OSTRC overuse injury questionnaire was used to measure the prevalence and severity of Achilles and patellar tendon symptoms and was compared to traditional match-loss statistics. A total of 441 participants were included. Of all participants, 21.5% (95% CI: 17.9-25.6) and 25.2% (95% CI 21.3-29.4) reported Achilles or patellar tendon problems during the season, respectively. Based on the traditional match-loss definition, a combined 4.1% of participants missed games due to either Achilles or patellar tendon injury. A greater average monthly prevalence was observed during the pre-season compared to the competitive season. Achilles and patellar tendon problems are prevalent in elite male Australian football players. These injuries are not adequately captured using a traditional match-loss definition. Prevention of these injuries may be best targeted during the off- and pre-season due to higher prevalence of symptoms during the pre-season compared to during the competitive season.
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Affiliation(s)
- S I Docking
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Vic., Australia.,Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), La Trobe University, Bundoora, Vic., Australia
| | - E Rio
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Vic., Australia.,Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), La Trobe University, Bundoora, Vic., Australia
| | - J Cook
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Vic., Australia.,Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), La Trobe University, Bundoora, Vic., Australia
| | - J W Orchard
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - L V Fortington
- Australian Centre for Research into Injury in Sports and its Prevention (ACRISP), Federation University Australia, Ballarat, Vic., Australia
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Spang C, Alfredson H, Docking SI, Masci L, Andersson G. The plantaris tendon: a narrative review focusing on anatomical features and clinical importance. Bone Joint J 2017; 98-B:1312-1319. [PMID: 27694583 DOI: 10.1302/0301-620x.98b10.37939] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 05/24/2016] [Indexed: 11/05/2022]
Abstract
In recent years, the plantaris tendon has been implicated in the development of chronic painful mid-portion Achilles tendinopathy. In some cases, a thickened plantaris tendon is closely associated with the Achilles tendon, and surgical excision of the plantaris tendon has been reported to be curative in patients who have not derived benefit following conservative treatment and surgical interventions. The aim of this review is to outline the basic aspects of, and the recent research findings, related to the plantaris tendon, covering anatomical and clinical studies including those dealing with histology, imaging and treatment. Cite this article: Bone Joint J 2016;98-B:1312-19.
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Affiliation(s)
- C Spang
- Umeå University, 901 87 Umeå, Sweden
| | - H Alfredson
- University College London Hospitals, 170 Tottenham Court Road, London W1T 7HA, UK
| | - S I Docking
- Federation University, Lydiard Street South, Ballarat VIC 3350, Australia
| | - L Masci
- Pure Sports Medicine Clinic, Cabot Place West, London E14 4QS, UK
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Cook JL, Rio E, Purdam CR, Docking SI. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Br J Sports Med 2016; 50:1187-91. [PMID: 27127294 PMCID: PMC5118437 DOI: 10.1136/bjsports-2015-095422] [Citation(s) in RCA: 210] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2016] [Indexed: 11/25/2022]
Abstract
The pathogenesis of tendinopathy and the primary biological change in the tendon that precipitates pathology have generated several pathoaetiological models in the literature. The continuum model of tendon pathology, proposed in 2009, synthesised clinical and laboratory-based research to guide treatment choices for the clinical presentations of tendinopathy. While the continuum has been cited extensively in the literature, its clinical utility has yet to be fully elucidated. The continuum model proposed a model for staging tendinopathy based on the changes and distribution of disorganisation within the tendon. However, classifying tendinopathy based on structure in what is primarily a pain condition has been challenged. The interplay between structure, pain and function is not yet fully understood, which has partly contributed to the complex clinical picture of tendinopathy. Here we revisit and assess the merit of the continuum model in the context of new evidence. We (1) summarise new evidence in tendinopathy research in the context of the continuum, (2) discuss tendon pain and the relevance of a model based on structure and (3) describe relevant clinical elements (pain, function and structure) to begin to build a better understanding of the condition. Our goal is that the continuum model may help guide targeted treatments and improved patient outcomes.
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Affiliation(s)
- J L Cook
- School of Allied Health, La Trobe University, Bundoora, Australia Australian Centre for Research into Injury in Sport and its Prevention, Federation University
| | - E Rio
- School of Allied Health, La Trobe University, Bundoora, Australia Australian Centre for Research into Injury in Sport and its Prevention, Federation University
| | - C R Purdam
- Australian Centre for Research into Injury in Sport and its Prevention, Federation University Department of Physical Therapies, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia
| | - S I Docking
- School of Allied Health, La Trobe University, Bundoora, Australia Australian Centre for Research into Injury in Sport and its Prevention, Federation University
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Docking SI, Cook J, Rio E. The diagnostic dartboard: is the bullseye a correct pathoanatomical diagnosis or to guide treatment? Br J Sports Med 2016; 50:959-60. [DOI: 10.1136/bjsports-2015-095484] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2015] [Indexed: 11/03/2022]
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Cook JL, Docking SI. "Rehabilitation will increase the 'capacity' of your …insert musculoskeletal tissue here…." Defining 'tissue capacity': a core concept for clinicians. Br J Sports Med 2015; 49:1484-5. [PMID: 26255142 DOI: 10.1136/bjsports-2015-094849] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 07/17/2015] [Indexed: 11/03/2022]
Affiliation(s)
- J L Cook
- Centre for Sport & Exercise Medicine, La Trobe University, Bundoora, Australia . Australian Centre of Research into Injury in Sport and its Prevention (ACRISP), Federation University, Ballarat, Australia
| | - S I Docking
- Australian Centre of Research into Injury in Sport and its Prevention (ACRISP), Federation University, Ballarat, Australia School of Primary Health Care, Monash University, Frankston, Australia
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Docking SI, Cook J. Pathological tendons maintain sufficient aligned fibrillar structure on ultrasound tissue characterization (UTC). Scand J Med Sci Sports 2015; 26:675-83. [DOI: 10.1111/sms.12491] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2015] [Indexed: 12/31/2022]
Affiliation(s)
- S. I. Docking
- Monash Tendon Research Group (MONSTERs); Monash University; Frankston Victoria Australia
- Australian Centre of Research into Injury in Sport and its Prevention (ACRISP); Federation University; Ballarat Victoria Australia
| | - J. Cook
- Monash Tendon Research Group (MONSTERs); Monash University; Frankston Victoria Australia
- Australian Centre of Research into Injury in Sport and its Prevention (ACRISP); Federation University; Ballarat Victoria Australia
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Docking SI, Rosengarten SD, Cook J. Achilles tendon structure improves on UTC imaging over a 5-month pre-season in elite Australian football players. Scand J Med Sci Sports 2015; 26:557-63. [PMID: 25943892 DOI: 10.1111/sms.12469] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2015] [Indexed: 01/28/2023]
Abstract
Pre-season injuries are common and may be due to a reintroduction of training loads. Tendons are sensitive to changes in load, making them vulnerable to injury in the pre-season. This study investigated changes in Achilles tendon structure on ultrasound tissue characterization (UTC) over the course of a 5-month pre-season in elite male Australian football players. Eighteen elite male Australian football players with no history of Achilles tendinopathy and normal Achilles tendons were recruited. The left Achilles tendon was scanned with UTC to quantify the stability of the echopattern. Participants were scanned at the start and completion of a 5-month pre-season. Fifteen players remained asymptomatic over the course of the pre-season. All four echo-types were significantly different at the end of the pre-season, with the overall echopattern suggesting an improvement in Achilles tendon structure. Three of the 18 participants developed Achilles tendon pain that coincided with a change in the UTC echopattern. This study demonstrates that the UTC echopattern of the Achilles tendon improves over a 5-month pre-season training period, representing increased fibrillar alignment. However, further investigation is needed to elucidate with this alteration in the UTC echopattern results in improved tendon resilience and load capacity.
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Affiliation(s)
- S I Docking
- Monash Tendon Research Group (MONSTERs), Monash University, Melbourne, Victoria, Australia.,Australian Centre of Research into Injury in Sport and its Prevention (ACRISP), Federation University, Ballarat, Victoria, Australia
| | - S D Rosengarten
- Department of Physiotherapy, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - J Cook
- Monash Tendon Research Group (MONSTERs), Monash University, Melbourne, Victoria, Australia.,Australian Centre of Research into Injury in Sport and its Prevention (ACRISP), Federation University, Ballarat, Victoria, Australia
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van Ark M, Docking SI, van den Akker-Scheek I, Rudavsky A, Rio E, Zwerver J, Cook JL. Does the adolescent patellar tendon respond to 5 days of cumulative load during a volleyball tournament? Scand J Med Sci Sports 2015; 26:189-96. [PMID: 25694241 DOI: 10.1111/sms.12426] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2015] [Indexed: 12/15/2022]
Abstract
Patellar tendinopathy (jumper's knee) has a high prevalence in jumping athletes. Excessive load on the patellar tendon through high volumes of training and competition is an important risk factor. Structural changes in the tendon are related to a higher risk of developing patellar tendinopathy. The critical tendon load that affects tendon structure is unknown. The aim of this study was to investigate patellar tendon structure on each day of a 5-day volleyball tournament in an adolescent population (16-18 years). The right patellar tendon of 41 players in the Australian Volleyball Schools Cup was scanned with ultrasound tissue characterization (UTC) on every day of the tournament (Monday to Friday). UTC can quantify structure of a tendon into four echo types based on the stability of the echo pattern. Generalized estimating equations (GEE) were used to test for change of echo type I and II over the tournament days. Participants played between eight and nine matches during the tournament. GEE analysis showed no significant change of echo type percentages of echo type I (Wald chi-square = 4.603, d.f. = 4, P = 0.331) and echo type II (Wald chi-square = 6.070, d.f. = 4, P = 0.194) over time. This study shows that patellar tendon structure of 16-18-year-old volleyball players is not affected during 5 days of cumulative loading during a volleyball tournament.
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Affiliation(s)
- M van Ark
- Center for Sports Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - S I Docking
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - I van den Akker-Scheek
- Center for Sports Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A Rudavsky
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - E Rio
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - J Zwerver
- Center for Sports Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J L Cook
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
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Docking SI, van Schie JTM, Daffy J, Rosengarten S, Cook JL. BILATERAL CHANGES IN UNILATERAL ACHILLES TENDINOPATHY QUANTIFIED USING ULTRASOUND TISSUE CHARACTERISATION. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-092459.47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rosengarten S, Docking SI, van Schie JTM, Daffy J, Cook JL. TENDON RESPONSE IN ACHILLES TENDON OF AUSTRALIAN FOOTBALL PLAYERS USING ULTRASOUND TISSUE CHARACTERISATION. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-092459.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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van Schie HTM, Docking SI, Daffy J, Praet SE, Rosengarten S, Cook. JL. ULTRASOUND TISSUE CHARACTERISATION, AN INNOVATIVE TECHNIQUE FOR INJURY-PREVENTION AND MONITORING OF TENDINOPATHY. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-092459.27] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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