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At least 757 records · Page 42Linked to original sources

Anterior shoulder stabilization in collision athletes: arthroscopic versus open Bankart repair.

BACKGROUND: Collision athletes are reported to be at high risk for redislocation after anterior stabilization of shoulder instability. Some authors have suggested that arthroscopic stabilization produces results similar to those of open stabilization. PURPOSE: To evaluate the results of anterior shoulder stabilization in collision athletes and to compare the clinical results between the arthroscopic and open methods. HYPOTHESIS: Open stabilization might produce better results than does arthroscopic stabilization in collision athletes. STUDY DESIGN: Cohort study; Level of evidence, 4. METHODS: Forty-eight shoulders of 46 collision athletes were enrolled for this study. The mean age of the patients at the time of surgery was 20 years, and the mean follow-up period was 72 months (range, 30-136 months). Sixteen shoulders underwent arthroscopic stabilization; 32 shoulders had open repairs. RESULTS: Visual analog scale, Rowe, and Constant scores improved after surgery, but no statistically significant difference was found between the arthroscopic and open repair groups. Thirty-seven athletes (83%) returned to near-preinjury sports activity levels (>/= 90% recovery) after operation. Two patients (4%) had subluxation and 6 (12.5%) had redislocation after surgery. The number of shoulders with postoperative subluxation or dislocation was 4 (25%) in the arthroscopic group and 4 (12.5%) in the open group (P = .041). Revision surgery was performed on 5 shoulders (10.4%). CONCLUSIONS: There were 8 (16.5%) instances of postoperative instability among the collision athletes studied. The arthroscopic group yielded a higher failure rate than did the open group. The authors believe open stabilization to be a more reliable method for anterior shoulder instability in collision athletes.

Adolescent↗

The effect of a balance training program on the risk of ankle sprains in high school athletes.

BACKGROUND: Ankle sprains are the most common musculoskeletal injuries that occur in athletes, and they have a profound impact on health care costs and resources. HYPOTHESIS: A balance training program can reduce the risk of ankle sprains in high school athletes. STUDY DESIGN: Randomized controlled clinical trial; Level of evidence, 1. METHODS: Seven hundred and sixty-five high school soccer and basketball players (523 girls and 242 boys) were randomly assigned to either an intervention group (27 teams, 373 subjects) that participated in a balance training program or to a control group (28 teams, 392 subjects) that performed only standard conditioning exercises. On-site athletic trainers recorded athlete exposures and sprains. RESULTS: The rate of ankle sprains was significantly lower for subjects in the intervention group (6.1%, 1.13 of 1000 exposures vs 9.9%, 1.87 of 1000 exposures; P = .04). Athletes with a history of an ankle sprain had a 2-fold increased risk of sustaining a sprain (risk ratio, 2.14), whereas athletes who performed the intervention program decreased their risk of a sprain by one half (risk ratio, 0.56). The ankle sprain rate for athletes without previous sprains was 4.3% in the intervention group and 7.7% in the control group, but this difference was not significant (P = .059). CONCLUSION: A balance training program will significantly reduce the risk of ankle sprains in high school soccer and basketball players.

Adolescent↗

Direct injury to the axillary nerve in athletes playing contact sports.

We performed long-term followup (31 to 276 months) of 11 contact athletes who had sustained isolated injuries to their axillary nerves during athletic competition. There were no known shoulder dislocations. Electromyographs were taken of 10 patients, and all patients had confirmation of clinically defined injuries that were confined to their axillary nerves. Nine injuries were sustained while tackling opposing players in football; two were sustained in hockey collisions. In seven athletes, the mechanism of injury was a direct blow to the anterior lateral deltoid muscle. In four athletes, there were simultaneous contralateral neck flexion and ipsilateral shoulder depression. At followup, all patients had residual deficits of axillary sensory and motor nerve function. There had been no deltoid muscle improvement in three patients, moderate improvement in two patients, and major improvement in six patients. However, shoulder function remained excellent, with all athletes maintaining full range of motion and good-to-excellent motor strength. Axillary nerve exploration and neurolysis in four patients did not significantly affect the outcomes. Although no patient had full recovery of axillary nerve function, 10 of 11 athletes returned to their preinjury levels of sports activities, including professional athletics.

Adolescent↗

Pre-competition habits and injuries in Taekwondo athletes.

BACKGROUND: Over the past decade, there has been heightened interest in injury rates sustained by martial arts athletes, and more specifically, Taekwondo athletes. Despite this interest, there is a paucity of research on pre-competition habits and training of these athletes. The purpose of this pilot study was to assess training characteristics, competition preparation habits, and injury profiles of Taekwondo athletes. METHODS: A retrospective survey of Canadian male and female Taekwondo athletes competing in a national tournament was conducted. Competitors at a Canadian national level tournament were given a comprehensive survey prior to competition. Items on training characteristics, diet, and injuries sustained during training and competition were included. Questionnaires were distributed to 60 athletes. RESULTS: A response rate of 46.7% was achieved. Of those that responded, 54% dieted prior to competition, and 36% dieted and exercised pre-competition. Sixty-four percent of the athletes practised between 4-6 times per week, with 54% practicing 2 hours per session. Lower limb injuries were the most common (46.5%), followed by upper extremity (18%), back (10%), and head (3.6%). The majority of injuries consisted of sprains/strains (45%), followed by contusions, fractures, and concussions. More injuries occurred during training, including 59% of first injuries. CONCLUSION: More research needs to be conducted to further illustrate the need for appropriate regulations on weight cycling and injury prevention.

Adolescent↗

Alcohol and the athlete.

Alcohol and the athlete have been linked together since ancient times. It continues to be the most commonly consumed drug among the athletic population. Alcohol use carries significant potential adverse effects for both the health and welfare of the individual. It is suggested that alcohol related problems may be more prevalent in the athletic population due to their risk taking mentality and the age profile of athletes (18- to 24-year-old males). Alcohol consumption also appears to have a causative effect in sports related injury, with an injury incidence of 54.8% in drinkers compared with 23.5% in nondrinkers (p < 0.005). This may be due in part to the hangover effect of alcohol consumption, which has been shown to reduce athletic performance by 11.4%. Alcohol is a potentially lethal drug and is a banned substance for certain Olympic sports. Education is the cornerstone for appropriate social use of this drug. Athletes and coaches need to be aware of the sports related adverse effects of alcohol consumption and its role in sports injury and poor physiological performance. It is recommended that alcohol should be avoided by the serious athlete.

Adolescent↗

Neuromuscular and hormonal factors associated with knee injuries in female athletes. Strategies for intervention.

Female athletes who participate in jumping and cutting sports are 4 to 6 times more likely to sustain a serious knee injury than male athletes participating in the same sports. More than 30,000 serious knee injuries are projected to occur in female intercollegiate and high school athletics in the US each year. The majority of these injuries occur by non-contact mechanisms, most often during landing from a jump or making a lateral pivot while running. Knee instability, due possibly to decreased neuromuscular strength and coordination or increased ligamentous laxity, may underlie the increased incidence of knee injury in females. Neuromuscular training can significantly increase dynamic knee stability in female athletes. Female sex hormones (i.e. estrogen, progesterone and relaxin) fluctuate radically during the menstrual cycle and are reported to increase ligamentous laxity and decrease neuromuscular performance and, thus, are a possible cause of decreases in both passive and active knee stability in female athletes. Oral contraceptives stabilise hormone levels during the menstrual cycle and may function to either passively or actively stabilise the knee joint. The long term objective of clinicians and researchers should be to determine the factors that make women more susceptible than men to knee ligament injury and to develop treatment modalities to aid in the prevention of these injuries. The immediate objectives of this review are to examine how female and male athletes differ in neuromuscular and ligamentous control of the lower extremity. The review will examine the effects of neuromuscular training on knee stability. The effects of female hormone levels and oral contraceptives on neuromuscular control of the female athletes' knee will also be discussed.

Athletic Injuries↗

Legal considerations in treating the injured athlete.

This article is intended to inform physical therapists about legal considerations impacting the practice of sports physical therapy. Our objective is to generate an awareness of these issues to enhance the quality of physical therapy provided to injured athletes and to minimize potential legal liability. Three areas in which physical therapists who treat injured athletes need to be particularly careful are: 1) providing treatment designed to enable continued play with an injury before it is fully healed, 2) informing an athlete of the potential health risks of continued athletic activity in his or her physical condition, and 3) evaluating and advising an athlete concerning his or her ability to resume athletic activity. Based on the parallels between industrial rehabilitation and sports physical therapy, the authors propose that consensus objective criteria and guidelines should be established to assist therapists in advising referring physicians and athletes whether return to play is appropriate under the circumstances.

Athletic Injuries↗

Orthopaedic care of the aging athlete.

Increasing numbers of middle-aged and older adults participate in sports, and athletes wish to remain active as they age. Understanding the anatomic, physiologic, and psychosocial differences between older and younger athletes can help aging athletes maintain function. Athletic capacity may be sustained well into advanced age, and many of the physiologic consequences of aging may be mitigated or reversed by regular exercise. Most injuries in older athletes are chronic and overuse injuries that result in diminished flexibility and endurance. In addition, many aging athletes have medical and musculoskeletal problems that mandate tailoring athletic activity to the patient's general health and functional requirements.

Age Factors↗

Overuse injuries in the pediatric and adolescent athlete.

A growing number of pediatric orthopedic patients fall into two dissimilar groups: the obese patient with problems related to obesity, and the young athlete injured during sports. While there is widespread recognition of pediatric orthopedic diseases related to obesity, the injuries resulting from "overuse" or over participation in sports are less understood and recognized. The majority of athletes involved in team sports in the Unites States are grade school and interscholastic athletes. The motivation for participation in sports varies greatly. Young athletes at risk for injury include the reluctant athlete who is not in the aerobic condition necessary to participate in sports, the eager athlete who initiates participation too vigorously, and the ambitious athlete who chronically "overtrains".

Adolescent↗

Care of the high school athlete: prevention and treatment of medical emergencies.

An important duty of any sports medicine physician is the care of athletes on the field and at the sidelines. Orthopaedic surgeons, who are trained to treat most musculoskeletal injuries, may not be as well prepared to treat the variety of medical issues and emergencies that are encountered in the "on-the-field" setting. In treating adolescent and high school athletes, advance preparation by the physician is critical for such entities as exercise-induced asthma, anaphylaxis, certain cardiac conditions, seizures, diabetes, and heat illnesses. The initial approach to the athlete who "goes to ground" always remains the same--management of the airway (with cervical spine precautions); establishment and maintenance of breathing and circulation; a limited neurologic examination to assess function; and removal of the athlete from the hazardous environment. Additional treatment is dictated by the specific illness or injury. As is usually the case, prevention is the best form of treatment. Many conditions can be detected at the preparticipation physical examination, which includes a thorough history and focused physical examination. Specific cardiovascular conditions that may be screened for include hypertrophic cardiomyopathy, Marfan syndrome, some congenital coronary artery abnormalities, and electrophysiologic rhythm disturbances. This examination also offers one of the best opportunities to provide information to athletes regarding optimal management of any chronic medical diseases. In preparation for an athletic event, excessive environmental heat and humidity may be addressed with several preventive strategies. Physicians also may be asked to provide counseling and make decisions about return to play for athletes who have had certain infectious diseases, including upper and lower respiratory infections and infectious mononucleosis.

Adolescent↗

The young female athlete.

It is important that girls and young women participate in sports and develop skills that promote lifelong athletic participation, because of the psychological, sociologic, and physiologic benefits associated with exercise. When an athlete begins intensive, competitive exercise training at a young age, or when the preoccupation with thinness supersedes a desire to be healthy, potential morbidity results. Lack of information and the strong desire to win contribute to this problem. There is relatively little known about the long-term physical and psychological effects of early intensive athletic training and the female athlete triad on the young female athlete. In addition to the need for further research in these areas, there is a need for education of physicians, coaches, trainers, athletes, and parents. The preparticipation physical examination is an excellent opportunity for the physician to screen for the triad disorders and educate athletes and parents on healthy nutrition, normal menstrual function, and the benefits of exercise.

Adolescent↗

Common injuries in the child or adolescent athlete.

As more primary care physicians enter the field of Sports Medicine, they will inevitably encounter more injured young athletes than what they may have experienced in their private practices. Recognizing the differences that exist between the young athlete and adult is essential in properly diagnosing and rehabilitating these athletes. As mentioned in our previous article (Caring for the School-Aged Athlete, Primary Care, December 1994), comprehensive care of the young athlete can be quite involved and somewhat different from care of the adult population. This article focuses on some specific injuries unique to younger, skeletally immature athletes, while mentioning the differential diagnosis of some of the other common sports injuries shared by both younger and older athletes.

Adolescent↗

Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis.

CONTEXT: Ephedra and ephedrine sometimes are used for weight loss or enhanced athletic performance, but the efficacy and safety of these compounds are uncertain. OBJECTIVE: To assess the efficacy and safety of ephedra and ephedrine used for weight loss and enhanced athletic performance. DATA SOURCES: We searched 9 databases using the terms ephedra, ephedrine, adverse effect, side effect, efficacy, effective, and toxic. We included unpublished trials and non-English-language documents. Adverse events reported to the US Food and Drug Administration MedWatch program were assessed. STUDY SELECTION: Eligible studies were controlled trials of ephedra or ephedrine used for weight loss or athletic performance and case reports of adverse events associated with such use. Eligible studies for weight loss were human studies with at least 8 weeks of follow-up; and for athletic performance, those having no minimum follow-up. Eligible case reports documented that ephedra or ephedrine was consumed within 24 hours prior to an adverse event or that ephedrine or an associated product was found in blood or urine, and that other potential causes had been excluded. Of the 530 articles screened, 52 controlled trials and 65 case reports were included in the adverse events analysis. Of more than 18 000 other case reports screened, 284 underwent detailed review. DATA EXTRACTION: Two reviewers independently identified trials of efficacy and safety of ephedra and ephedrine on weight loss or athletic performance; disagreements were resolved by consensus. Case reports were reviewed with explicit and implicit methods. DATA SYNTHESIS: No weight loss trials assessed duration of treatment greater than 6 months. Pooled results for trials comparing placebo with ephedrine (n = 5), ephedrine and caffeine (n = 12), ephedra (n = 1), and ephedra and herbs containing caffeine (n = 4) yielded estimates of weight loss (more than placebo) of 0.6 (95% confidence interval, 0.2-1.0), 1.0 (0.7-1.3), 0.8 (0.4-1.2), and 1.0 (0.6-1.3) kg/mo, respectively. Sensitivity analyses did not substantially alter the latter 3 results. No trials of ephedra and athletic performance were found; 7 trials of ephedrine were too heterogeneous to synthesize. Safety data from 50 trials yielded estimates of 2.2- to 3.6-fold increases in odds of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations. Data are insufficient to draw conclusions about adverse events occurring at a rate less than 1.0 per thousand. The majority of case reports are insufficiently documented to allow meaningful assessment. CONCLUSIONS: Ephedrine and ephedra promote modest short-term weight loss (approximately 0.9 kg/mo more than placebo) in clinical trials. There are no data regarding long-term weight loss, and evidence to support use of ephedra for athletic performance is insufficient. Use of ephedra or ephedrine and caffeine is associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations.

Anti-Obesity Agents↗

Risk of osteoarthritis associated with long-term weight-bearing sports: a radiologic survey of the hips and knees in female ex-athletes and population controls.

OBJECTIVE: To estimate the risk of osteoarthritis (OA) of the hip and knee due to long-term weight-bearing sports activity in ex-elite athletes and the general population. METHODS: A retrospective cohort study was conducted of 81 female ex-elite athletes (67 middle- and long-distance runners, and 14 tennis players), currently ages 40-65, recruited from original playing records, and 977 age-matched female controls, taken from the age-sex register of the offices of a group general practice in Chingford, Northeast London, England. The definition of OA included radiologic changes (joint space narrowing and osteophytosis) in the hip joints, patellofemoral (PF) joints, and tibiofemoral (TF) joints. RESULTS: Compared with controls of similar age, the ex-athletes had greater rates of radiologic OA at all sites. This association increased further after adjustment for height and weight differences, and was strongest for the presence of osteophytes at the TF joints (odds ratio [OR] 3.57, 95% confidence interval [95% CI] 1.89-6.71), at the PF joints (OR 3.50, 95% CI 1.80-6.81), narrowing at the PF joints (OR 2.97, 95% CI 1.15-7.67), femoral osteophytes (OR 2.52, 95% CI 1.01-6.26), and hip joint narrowing (OR 1.60, 95% CI 0.73-3.48), and was weakest for narrowing at the TF joints (OR 1.17, 95% CI 0.71-1.94). No clear risk factors were seen within the ex-athlete groups, although the tennis players tended to have more osteophytes at the TF joints and hip, but the runners had more PF joint disease. Within the control group, a small subgroup of 22 women who reported long-term vigorous weight-bearing exercise had risks of OA similar to those of the ex-athletes. Ex-athletes had similar rates of symptom reporting but higher pain thresholds than controls, as measured by calibrated dolorimeter. CONCLUSION: Weight-bearing sports activity in women is associated with a 2-3-fold increased risk of radiologic OA (particularly the presence of osteophytes) of the knees and hips. The risk was similar in ex-elite athletes and in a subgroup from the general population who reported long-term sports activity, suggesting that duration rather than frequency of training is important.

Adult↗

Practical use of the International Olympic Committee Medical Commission Position Stand on the Female Athlete Triad: a case example.

UNLABELLED: The female athlete triad consists of the interrelated problems of disordered eating, amenorrhea, and osteoporosis, and it is believed to affect female athletes in all sports and at all levels of competition. OBJECTIVE: The current article highlights the Position Stand on the Female Athlete Triad of the International Olympic Committee's Medical Commission (IOCMC). METHOD: The literature related to disordered eating, energy availability, amenorrhea, and bone loss in athletes is briefly reviewed. A hypothetical case is presented to illustrate some of the common issues and problems encountered when working with athletes affected by the triad, such as the effect of weight on performance in "thin" sports, coach involvement, sport participation by symptomatic athletes, and treatment resistance/motivation. RESULTS: Strategies recommended by the position stand for managing those issues and problems are presented regarding the referral, evaluation, and treatment phases of the management process. CONCLUSION: Implications of the position stand are discussed in terms of the IOCMC's endorsement of the athlete's health being primary to her performance.

Adult↗

Urinary epinephrine and norepinephrine levels in women athletes during training and competition.

Training and competitive epinephrine and norepinephrine levels and proportions were compared in two groups of women athletes to determine whether changes in catecholamine excretion reflect the added mental stress of athletic competition on physical effort. An intercollegiate basketball team and a group of track and field athletes volunteered as subjects. Competitive epinephrine urinary levels were significantly (P less than 0.01) higher than training levels. A concomitant rise in the norepinephrine with an increase in physical effort was observed in both groups of athletes following training sessions as well as after athletic competition. Track and field athletes trying to qualify for an international team exhibited significantly ( less than 0.01) higher epinephrine levels than the team members; thus suggesting that anticipation of competition imposes a mental stress on an athlete. Constant changes in the catecholamine pattern as against a normal work load have yet to be established.

Adolescent↗

Relationship of body composition and cardiovascular fitness to lipoprotein lipid profiles in master athletes and sedentary men.

A number of studies demonstrate that highly conditioned older athletes are leaner than their sedentary counterparts, and have lipoprotein profiles similar to that of young individuals. It is not clear whether the high maximal aerobic capacity (VO2max) or lean body habitus is the major determinant of the favorable lipoprotein lipid profiles present in older athletes. The objective of this study was to determine whether body composition or VO2max was the major determinant of lipoprotein lipid profiles among 61 master (age 63 +/- 6 years, mean +/- SD) athletes (VO2max > 40 mL/kg/min), 39 age-matched lean (% body fat < 25%), and 51 obese (% body fat > 25%) sedentary men. Plasma high density lipoprotein cholesterol (HDL-C) concentrations were 25% higher in that athletes than in the lean sedentary men, and 42% higher than in the obese sedentary men. Triglyceride (TG) concentrations were 24% lower in the master athletes than in the lean sedentary men, and 51% lower than in the obese sedentary group. Plasma low density lipoprotein cholesterol (LDL-C) levels were 9% lower in the athletes than in the other groups of sedentary individuals. In stepwise multiple regression analysis the percent body fat was the major independent predictor of HDL-C and TG levels accounting for 29% and 41% of the variation in these levels, respectively. The VO2max accounted for an additional 6% of the variance in HDL-C levels and 2% of the variance in TG levels. These cross-sectional results suggest that the favorable lipoprotein profile of master athletes is largely due to their lean body habitus, with a small independent contribution from their higher levels of cardiovascular fitness. Thus, regular vigorous aerobic exercise and maintenance of low body fat may prevent the commonly observed age-associated deterioration in lipoprotein concentrations.

Aerobiosis↗

A follow-up of GH-dependent biomarkers during a 6-month period of the sporting season of male and female athletes.

In order to verify the effects of the sporting season (entailing periods of training, competition, recovery, resting) on GH-dependent parameters in male and female athletes from different sporting disciplines, 47 male and female athletes (3 rowers, 5 swimmers, 7 alpine skiers, 3 soccer players, 7 middle distance runners, 14 sprinters, 4 triathletes, 1 road walker, 3 cyclists) were followed-up for a period of 6 months. Blood samples were taken every two months for the evaluation of IGF-I, N-terminal propeptide of type III procollagen (PIIINP) and C-terminal cross-linked telopeptide of type I collagen (ICTP). Abnormal IGF-I, PIIINP and ICTP levels were observed during the follow-up period in 7/100 (7%), 9/100 (9.0%) and 8/100 (8%) samples of the male group, respectively, and in 9/88 (10.2%), 1/88 (1.1%) and 0/88 (0%) samples of the female group, respectively. Abnormal levels appeared to be randomly distributed over the different periods of the sporting season and within male and female subjects, with the large majority of abnormal values being found in the younger athletes. Taking into account all the tests done during the 6-month period (no. 564), individual markers falling outside the normal range (for age) were observed in a small number of instances (34/564 tests done, 24/300 for males and 10/264 for females). When our method for the detection of exogenous recombinant GH (rhGH) administration, based on the concomitant determination of these three peripheral GH-dependent markers and on the attribution of specific scores, was applied in the same athlete at a given time point of the 6-month period, the prevalence of a positive score was extremely low (ie, 3/188 samples or 1.6%). Total positive scores were actually recorded in only three male athletes (2 swimmers and 1 skier, aged <21 yr) at one occasion during the 6-month period considered. In contrast, no total positive scores were found in female athletes (ie, 0/88 samples). In conclusion, the concentrations of IGF-I, PIIINP and ICTP were stable and not significantly modified during 6 months of a sporting season (entailing periods of training, competition, recovery, resting) in athletes from different sporting disciplines. Therefore our method, based on the concomitant determination of three peripheral GH-dependent biomarkers appears safe, acceptable, relatively inexpensive and repeatable (in case of positive or suspected values) immediately or at different intervals of the sporting season. Further additional studies are requested to precise the cut-off values for narrower age-class subdivisions in both genders in order to improve the proposed method.

Adolescent↗