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PubMed2001

A profile of Little Athletes' injuries and the prevention methods used.

This study provides a profile of injuries sustained by Little Athletes and the injury prevention strategies they employed. The sample comprised 388 registered Little Athletes from seven Sydney New South Wales Clubs. Results from the survey and fieldwork suggested that at least one out of five Little Athletes had one or more injuries resulting from their participation in the current season. However, athletes aged under 11 to under 15 years were more likely to be injured than those in the younger age groups. The older athletes were also likely to have sustained more than four injuries during the season. Athletes reported low use of both warm up and warm down methods. Coaches, age managers and parents were portrayed as the key providers of information concerning injury prevention strategies. It was therefore noted that a valuable opportunity exists to create and design an innovative, age progressive educational package for Little Athletes, parents and coaches.

Adolescent↗

PubMed2001

Report of the NASPE policy conference on arrhythmias and the athlete.

INTRODUCTION: This consensus statement summarizes the proceedings of The Expert Consensus Conference on Arrhythmias in the Athlete of the North American Society of Pacing and Electrophysiology (NASPE) on detecting, evaluating, and treating athletes with cardiovascular disorders that predispose to cardiac arrhythmias. METHODS AND RESULTS: The participants in the open policy conference were selected by the codirectors (Drs. Estes and Olshansky) based on expertise and contributions to the literature. All participants provided a referenced summary of their presentation. The writing group used the information from all published scientific studies, clinical trials, registries, clinical experience, and expert opinion to make recommendations regarding screening, evaluation, management, eligibility for competition, and a range of other medical, social, and legal issues regarding the recreational and competitive athlete. The codirectors of the symposium synthesized the participants' reports for this and made revisions according to suggestions of all members of the writing committee. The manuscript was reviewed by four independent reviewers assigned by the NASPE Committee for the Development of Position Statements and NASPE Board of Trustees. CONCLUSION: Despite considerable advances in knowledge regarding the diagnosis, therapy, and mechanisms of arrhythmias in the athlete, much remains unknown. Continued basic, clinical, and epidemiologic research is needed. Current screening techniques to detect athletes lack sensitivity and specificity. Evaluation of standardized screening programs with tracking of long-term outcomes is needed. Officials from athletic, academic, medical, and legal institutions need to form strategic partnerships to develop policy related to assessment of risk and assumption of responsibility for athletic activities.

Arrhythmias, Cardiac↗

PubMed2000

[Incidence of dental, mouth, and jaw injuries and the efficacy of mouthguards in top ranking athletes].

The aim of the study was to determine the prevalence of orofacial injuries among German top athletes and their attitudes to mouthguards. A questionnaire was mailed to athletes of 10 German contact sports associations. 64.3 percent (303) of the athletes returned questionnaires. 62 percent (188) of the respondents reported that at some time they wore a mouthguard for sports participation. 47.3% (male: 57.8%, female: 38.3%) of these were currently using one. 50% of the mouthguards were custom made by dentists, and 50% were shop bought (boil-and-bite). 32 percent of the participants had, at some time during their sports career, suffered an orofacial injury. The incidence of fractured anterior upper teeth and completely knocked out teeth for athletes without mouthguards was 7 and 14, respectively. Whereas for athletes wearing mouthguards one fractured tooth was reported. Athletes with mouthguards complained of problems with speaking (19.9%) rather than of breathing (3.4%) and fitting difficulties (4.8%). Boil-and-bite mouthguards caused more fitting problems than custom-made ones. As prevalence of oral injuries in body-contact sports is high, athletes should be advised that custom-made mouthguards offer the greatest comfort, fit, durability, and protection against dental injuries.

Adult↗

PubMed2002

[Can meniscal suture repair in athletes prevent early development of osteoarthritis without compromising the preinjury sports activity level].

In a retrospective study we evaluated the outcome of arthroscopic assisted meniscal repair in athletes on different competitive sports levels. Examination included early osteoarthritic changes and full recovery in sports activities. Fifty athletes were followed up with an average of 6,5 years after meniscal refixation from 1984 through 1998. Twenty-three patients had isolated full-thickness meniscal tears, twenty-seven an associated rupture of the anterior cruciate ligament. Preoperative sports levels were evaluated with Tegners score. Reexamination included Lysholm score, IKDC score and Fairbanks score. With no persisting anterior knee instability 86 % of the professional athletes returned to former full sports activities on competitive levels. Noncompetitive athletes returned in all cases (100 %) to their former level. Fairbanks score increased by 0,1 observing minimal osteoarthitic signs. However, persisting anterior knee instability showed on reexamination poor results. Only one third of all athletes were able to return to former activity levels. Osteoarthritic changes were observed in all patients. Professional athletes had the most severe osteoarthritic changes with an increase of 0,8 in the Fairbanks score. The results demonstrate that complete recovery on sports activities is not possible without reconstruction of the anterior cruciate ligament. Isolated meniscal repair shows poor results in persisting anterior knee instability and does not prevent increasing osteoarthritic changes in athletes.

Adolescent↗

PubMed2006

Imagery use by injured athletes: a qualitative analysis.

The purpose of this study was to expand our knowledge and increase our understanding of imagery use by athletes in sport-injury rehabilitation using a qualitative approach. The participants were 10 injured athletes who were receiving physiotherapy at the time they were interviewed. During the interviews, the athletes provided extensive information about their use of imagery during injury rehabilitation and it was clear that they believed imagery served cognitive, motivational and healing purposes in effectively rehabilitating an injury. Cognitive imagery was used to learn and properly perform the rehabilitation exercises. They employed motivational imagery for goal setting (e.g. imagined being fully recovered) and to enhance mental toughness, help maintain concentration and foster a positive attitude. Imagery was used to manage pain. The methods they employed for controlling pain included using imagery to practise dealing with expected pain, using imagery as a distraction, imagining the pain dispersing, and using imagery to block the pain. With respect to what they imaged (i.e. the content of their imagery), they employed both visual and kinaesthetic imagery and their images tended to be positive and accurate. It was concluded that the implementation of imagery alongside physical rehabilitation should enhance the rehabilitation experience and, therefore, facilitate the recovery rates of injured athletes. Moreover, it was recommended that those responsible for the treatment of injured athletes (e.g. medical doctors, physiotherapists) should understand the benefits of imagery in athletic injury rehabilitation, since it is these practitioners who are in the best position to encourage injured athletes to use imagery.

Adolescent↗

PubMed1999

A longitudinal examination of athletes' emotional and cognitive responses to anterior cruciate ligament injury.

OBJECTIVE: To determine the emotional and cognitive impact of injury and surgery on physical recovery in injured athletes. DESIGN: A prospective longitudinal study comparing the psychosocial and physical recovery of competitive and recreational athletes. SETTING: Tertiary-care sports medicine center. PARTICIPANTS: Twenty-seven athletes (15 men and 12 women) who required anterior cruciate ligament (ACL) reconstruction surgery. INTERVENTIONS: A repeated-measures design used to compare the psychosocial and physical changes for 6 months after ACL surgery. MAIN OUTCOME MEASURES: Emotional (mood) and cognitive (coping) functions and physical recovery (range of motion, physician-rated level of recovery, and physician permission to return to sport). RESULTS: There was a significant time-effect difference in mood, with a greater mood disturbance and recovery rate for competitive athletes than recreational athletes. Differences in mood and pain coping were significant at 2 weeks and 2 months after surgery. CONCLUSION: Athletes experience significant mood changes throughout rehabilitation, which may hinder rehabilitation early in the process. Longer-term rehabilitation was not impacted by mood or pain coping. Future studies might focus on examining the process over a longer time period (1-2 years after surgery). Physicians should be aware of these findings and appropriately counsel and motivate athletes toward more favorable positive psychological and physical outcomes.

Adaptation, Psychological↗

PubMed2002

Functional performance deficits in athletes with previous lower extremity injury.

OBJECTIVE: To evaluate the influence of previously treated, though clinically resolved, lower extremity injury on performance in a timed 20-meter shuttle run. DESIGN: Case control study. SETTING: National Collegiate Athletic Association (NCAA) Division I college during the 2000/2001 preparticipation physicals. PARTICIPANTS: NCAA Division I athletes (n = 213) participated in this research study. Athletes were excluded if they presently had an unresolved lower extremity injury or low back pain. MAIN OUTCOME MEASURES: Time to complete a 20-meter shuttle run was recorded. Previous lower extremity injury and college year were recorded via a short questionnaire. RESULTS: A significantly slower response time on the 20-meter shuttle run was observed in freshman athletes with a history of a lower extremity injury, as compared with freshmen without a previous injury (p = 0.01). No significant difference was noted in non-freshman collegiate athletes regardless of injury history (p = 0.98). CONCLUSION: Kinetic chain deficits may exist long after symptomatic recovery from injury resulting in functional deficits, which may be missed on a standard physical assessment. The slower shuttle run times observed in freshmen with previous lower extremity injury may be a manifestation of insufficient treatment received at the high school level or the benefit of a mandatory core strengthening program in returning athletes. Further study is necessary to identify and validate the cause-and-effect relationship. CLINICAL RELEVANCE: This study may support residual functional deficits in incoming college athletes, which may be related to inadequate care in the high school setting.

Adolescent↗

PubMed2003

Reports of head injury and symptom knowledge among college athletes: implications for assessment and educational intervention.

OBJECTIVE: To identify the prevalence of head injuries and related symptoms among college athletes and examine knowledge of head injury consequences and behavioral tendencies of athletes in the presence of symptoms. DESIGN: Retrospective survey. PARTICIPANTS: A total of 461 male and female athletes beginning competitive play at the University of Akron (Akron, OH) during the years 1995 to 2001. MAIN OUTCOME MEASURES: Responses to survey questions were analyzed to determine the frequency of concussions and injury-related symptoms (eg, dizziness, headache, nausea or vomiting) in addition to behavioral responses in the presence of certain symptoms (eg, playing with headache, failure to report symptoms while playing). Written responses to queries regarding symptom knowledge were analyzed for thematic content and were used to identify deficiencies in signs and symptoms of concussion. RESULTS: Nearly 32% of all athletes had experienced a blow to the head causing dizziness, with over 1/4 confirming various somatic symptoms following a blow to the head (eg, seeing stars, nausea or vomiting, head pain). Continuing to play despite symptom presence was noted (eg, dizziness, 28.2%; headache, 30.4%), with 19.5% reporting a concussion diagnosis. Knowledge of head injury consequences was found to be deficient, with 56% indicating no knowledge of the possible consequences following a head injury. Of those providing responses, the majority reflected awareness of cognitive (eg, memory problems) and physical (eg, brain damage) consequences. CONCLUSIONS: A sizable number of athletes may enter collegiate play with a previous concussion diagnosis, and many more are likely to have experienced symptoms suggestive of a mild head injury. Of considerable concern is the tendency to play while symptomatic (eg, headache, dizziness) and the failure to report symptoms while playing--especially among football players (25.2%). The apparent deficiency in athlete knowledge of head injury consequences raises concern regarding athlete recognition of potentially problematic symptoms and represents an important area for educational intervention.

Athletic Injuries↗

PubMed2006

Short-term outcome of conservative treatment in athletes with symptomatic lumbar disc herniation.

OBJECTIVE: The purpose of this study was to clarify the efficacy of conservative treatment in athletes with symptomatic lumbar disc herniation, especially in terms of their ability to return to their original sporting activities. DESIGN: A total of 71 consecutive athletes (53 men and 18 women), who consulted our sports medicine clinic during the 10-yr period between September 1993 and October 2003 because of severe low back pain or leg pain/numbness due to lumbar disc herniation (confirmed on magnetic resonance images), were studied. The mean age of the subjects was 21 yrs. All of them were conservatively treated by advising them to discontinue their sporting activities, with or without short-term medication. After the subjective symptoms had reduced by >80%, individual training was started to allow the athletes to return to their original sporting activities. RESULTS: A total of 56 athletes (78.9%) could return to their original sporting activities at an average of 4.7 mos (range, 1-12 mos) after the start of treatment and were able to sustain the activities for > or =6 mos, the minimum duration of follow-up in this study. The outcome of the conservative treatment was not influenced by the intensity of the sporting activity. Multiple logistic regression analyses showed that the only factor influencing the ability of the athletes to return to their original sporting activities was the severity of the symptoms before the start of treatment. CONCLUSION: The results of this study suggest that the short-term outcome of conservative treatment in athletes with symptomatic lumbar disc herniation may be satisfactory in terms of control of the symptoms and the ability of the athletes to return to their original sporting activities and that the subjective symptoms before treatment may be a key factor influencing the success of the conservative management. Randomized controlled trials, or even comparative follow-up studies, are needed to confirm our results.

Adult↗

PubMed2005

Athletic pubalgia: definition and surgical treatment.

INTRODUCTION: Athletic pubalgia, or "sports hernia," affects people actively engaged in sports. Previously described in high-performance athletes, it can occur in recreational athletes. It presents with inguinal pain exacerbated with physical activity. Examination reveals absence of a hernia with pubic point tenderness accentuated by resisted adduction of the hip. Diagnosis is by history and physical findings. Treatment with an internal oblique flap reinforced with mesh alleviates symptoms. METHODS: A retrospective review from December 1998 to November 2004 for patients with athletic pubalgia who underwent operative repair was performed. Descriptive variables included age, gender, laterality, sport, time to presentation, outcome, anatomy, and length of follow-up. RESULTS: Twelve patients, 1 female, with median age 25 years were evaluated. Activities included running (33%), basketball (25%), soccer (17%), football (17%), and baseball (8%). The majority were recreational athletes (50%). Median time to presentation was 9 months, with a median 4 months of follow-up. The most common intraoperative findings were nonspecific attenuation of the inguinal floor and cord lipomas. All underwent open inguinal repair, with 9 being reinforced with mesh. Four had adductor tenotomy. Results were 83.3% excellent and 16.7% satisfactory. All returned to sports. CONCLUSION: Diagnosis of athletic pubalgia can be elusive, but is established by history and physical examination. It can be found in recreational athletes. An open approach using mesh relieves the pain and restores activity.

Adolescent↗

PubMed1992

Inguinal surgery in athletes with chronic groin pain: the 'sportsman's' hernia.

Fifty athletes with chronic undiagnosed groin pain underwent surgical exploration and inguinal hernia repair. Six months later, all athletes were sent questionnaires to assess their return to sport, level of pain (using analogue pain scores) and the overall result of their surgery. Operative findings revealed a significant bulge in the posterior inguinal wall in 40 athletes. Forty-four athletes (88%) replied to the questionnaire. Forty-one athletes (93% of respondents) had returned to normal activities. Pain scores indicated a marked improvement in their level of pain (P less than 0.001). Thirty-three athletes (75%) rated the result as good and 10 (23%) as improved. It is concluded that athletes with chronic groin pain who are unable to compete in active sport should be considered for routine inguinal hernia repair if no other pathology is evident after clinical examination and investigation.

Adolescent↗

PubMed1998

Oral injury and mouthguard usage by athletes in Japan.

The use of mouthguards in contact sports effectively prevents oral injury and preserves oral structures. We investigated oral injuries and awareness concerning mouthguards among Japanese high school soccer and rugby players. Athletes were asked a series of questions concerning their history of oral injury while participating in sports, and their pattern of mouthguard use was determined. The data were evaluated statistically using chi-square analysis. The incidence of oral injuries was 32.3% for soccer athletes and 56.5% for rugby athletes, with 0.8% and 24.1% of the respective groups having mouthguards. There were significant differences between the soccer and rugby groups (P < 0.001). Although 81.8% of soccer athletes thought mouthguards were unnecessary, only 26.2% of rugby athletes shared this opinion and there was a significant difference between the soccer and rugby groups. Many soccer athletes had insufficient knowledge about mouthguards and were not concerned about preventing oral injury, although it was in fact a common problem in their sport. Athletes as well as coaches must be made aware of the high risk of oral injury when playing soccer, rugby, and other contact sports.

Adolescent↗

PubMed2003

Oro-facial injury and mouthguard usage by athletes in Nigeria.

OBJECTIVE: To determine the extent of awareness concerning mouthguard use for sports as well as the amount and type of oro-facial trauma associated with sporting activities among Nigerian athletes. DESIGN: A questionnaire survey. MATERIALS AND METHODS: A questionnaire was completed by 273 athletes (91% completion rate) who participated in the National Sports festival in May 2002 in Benin City, Nigeria. The sample was representative of all the 36 states in Nigeria including the Federal capital territory, Abuja. Descriptive statistics were employed and the data were further analysed using the chi-square test. RESULTS: Awareness concerning mouthguards was claimed by 226 (82.8%) of the athletes but significantly fewer athletes who claimed awareness of the devices were using them. Only 93 (41.2%) of this mouthguard-aware group knew of the three types of mouthguard available. Of all the respondents, 131 (48.0%) believed that wearing mouthguards would reduce the prevalence and/or severity of oro-facial injuries during sports. In all, 158 (57.9%) of them had one form of oro-facial injury or the other with contact sports accounting for most of them (78.5%) while 21.5% resulted from non-contact events. The prevalence of oro-facial injuries was significantly lower while wearing mouth protectors. CONCLUSIONS: Although the majority of the athletes claimed awareness of mouthguards, less than one-third used them. Over half of the athletes were not sure that mouthguards could reduce the prevalence and/or severity of oro-facial injuries. There is need to educate the athletes more concerning mouthguards.

Adolescent↗

PubMed1993

Surgical treatment of dislocations of the acromioclavicular joint in the athlete.

The treatment of the sports related dislocation of the acromioclavicular joint remains controversial. This study was carried out to determine whether or not a combined surgical procedure consisting of repair and polydioxanone (PDS)-cord augmentation of the coracoclavicular ligaments, fixation of the acromioclavicular joint with a single Kirschner wire as well as the repair of the acromioclavicular ligament permitted return to athletic activity. Athletes were examined with regard to their range of motion, pain and their ability to return to the performance level achieved before the injury. During the period 1986-1989, 21 athletes were treated. Follow-up averaged 22 months. Return of athletes to previous performance level was related to their original degree of activity. Two recreational once-a-week athletes did not return to this level, 19 patients, including five competitive athletes, continued their previous activities. There was no correlation between coracoclavicular ossification or post-traumatic arthritis and a good or excellent result. We recommend the operative treatment of acromioclavicular separations in athletes.

Acromioclavicular Joint↗

PubMedDate not supplied

A history of low back injury is a risk factor for recurrent back injuries in varsity athletes.

In this prospective study, we investigated whether a history of previous low back injury and dissatisfaction with a coach and teammates could predict future low back injury in varsity athletes during a 1-year follow-up period. Of 679 Yale varsity athletes surveyed in 1999, 18.3% (124) reported that they had sustained a low back injury within the past 5 years, and 6.8% (46) sustained a low back injury in the follow-up season. There were no differences in incidence rates between men and women or between athletes involved in contact or noncontact sports. A history of low back injury was the significant predictor for sustaining low back injury in the following year, and athletes who reported previous low back injury were at three times greater risk. Athletes who still had pain at the time of the survey were six times more likely to sustain a low back injury than were athletes without a history of low back injury. These results suggest that some risk factors associated with a history of low back injury predispose athletes to sustain recurrent injury. They may be congenital or a result of insufficient recovery time after the first low back injury episode.

Adult↗

PubMedDate not supplied

Jump landing strategies in male and female college athletes and the implications of such strategies for anterior cruciate ligament injury.

BACKGROUND: Female athletes are more likely than male athletes to injure the anterior cruciate ligament. Causes of this increased injury incidence in female athletes remain unclear, despite numerous investigations. HYPOTHESIS: Female athletes will exhibit lower hamstring muscle activation and smaller knee flexion angles than male athletes during jump landings, especially when the knee muscles are fatigued. STUDY DESIGN: Controlled laboratory study. METHODS: Eight female and six male varsity college basketball athletes with no history of knee ligament injury performed jump landings on the dominant leg from a maximum height jump and from 25.4 cm and 50.8 cm high platforms under nonfatigued and fatigued conditions. Knee joint angle and surface electromyographic signals from the quadriceps, hamstring, and gastrocnemius muscles were recorded. RESULTS: Women landed with greater knee flexion angles and greater knee flexion accelerations than men. Knee muscle activation patterns were generally similar in men and women. CONCLUSION: As compared with male college basketball players, female college basketball players did not exhibit altered knee muscle coordination characteristics that would predispose them to anterior cruciate ligament injury when landing from jumps. This conclusion is made within the parameters of this study and based on the observation that hamstring muscle activation was similar for both groups. The greater knee flexion we observed in the female subjects would be expected to decrease their risk of injury. CLINICAL RELEVANCE: Factors other than those evaluated in this study need to be considered when attempting to determine the reasons underlying the increased incidence of anterior cruciate ligament injuries consistently observed in elite female athletes.

Adaptation, Physiological↗

PubMedDate not supplied

Intraarticular injuries associated with anterior cruciate ligament tear: findings at ligament reconstruction in high school and recreational athletes. An analysis of sex-based differences.

BACKGROUND: Despite research on the increased risk of anterior cruciate ligament tears in female athletes, few studies have addressed sex differences in the incidence of associated intraarticular injuries. HYPOTHESIS: When patients are stratified by sport and competition level, no sex differences exist in either the mechanism of injury or pattern of intraarticular injuries observed at anterior cruciate ligament reconstruction. STUDY DESIGN: Prospective cohort study. METHODS: Two hundred twenty-one athletes undergoing anterior cruciate ligament reconstruction met our inclusion criteria of anterior cruciate ligament tear as a singular event without reinjury or history of prior injury or surgery in either knee. Data were collected on competition level (high school, amateur), sport (basketball, soccer, skiing), mechanism of injury, articular cartilage injuries, and meniscal tears. Data were statistically analyzed by sex with the chi-square test and Student's t-test. RESULTS: High school athletes had no significant sex differences in mechanism of injury. Female soccer athletes had fewer medial meniscal tears than did male athletes, and female basketball players had fewer medial femoral condyle injuries. At the amateur level, female basketball players had more contact injuries, an earlier onset of swelling, and fewer lateral meniscal tears than did male players. CONCLUSION: At the high school level, male and female athletes shared a common mechanism of injury, and yet the female athletes had fewer intraarticular injuries in basketball and soccer. If such intraarticular injuries prove to be a significant risk factor for poor long-term outcome, women may enjoy a better prognosis after reconstruction.

Adolescent↗

PubMed2005

Fifth metatarsal Jones fracture fixation with a 4.5-mm cannulated stainless steel screw in the competitive and recreational athlete: a clinical and radiographic evaluation.

BACKGROUND: Fifth metatarsal Jones fractures are common in the athletic population. Optimal screw selection for operative treatment has not been determined. HYPOTHESIS: A 4.5-mm cannulated screw used for fixation of the fifth metatarsal Jones fractures in athletes is an effective treatment approach. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The authors studied 23 consecutive athletes (24 feet) who were treated surgically with a 4.5-mm cannulated screw for fifth metatarsal fractures (Jones fracture) with clinical and radiographic assessments. RESULTS: There have been no refractures to date. Clinical healing was 100%. The mean percentage healing as shown on radiographs was 98.9%, with a range of 90% to 100%. All athletes returned to sport at a mean time of 7.5 weeks (range, 10 days to 12 weeks). Two athletes experienced a "reinjury" without need for operative treatment. All athletes were recommended to wear orthoses until their competitive careers were completed. CONCLUSION: Fixation with a stainless steel 4.5-mm cannulated screw gives 100% clinical healing and near-100% healing as shown on radiographs. CLINICAL RELEVANCE: The 4.5-mm cannulated screws can yield reliable and effective healing as evidenced by clinical assessment and radiographs of fifth metatarsal Jones fractures in athletes.

Adolescent↗