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Low injury rates in elite athletes.

A group of 453 elite young athletes (231 boys, 222 girls) in five two year age groups from 8-16 years of age was followed up for two years in order to identify self reported injuries over that period. Four sports were studied, namely football (soccer), gymnastics, tennis, and swimming. The injury rate was low with just over half the children suffering one or more injuries per year, with the majority of those injured sustaining one injury only. Over the two year period of intensive sporting activity this amounted to less than one injury per 1000 hours of training. The highest risk of injuries was in football (67%) and the lowest in swimming (37%). Most injuries (70%) were acute and of a minor nature, although overuse injuries did require longer periods off training and competition than acute injuries (20 v 13 days). Footballers appeared to sustain more significant injuries than other sports as judged by the time required to resume training and/or competition (16 days after acute and 57 after overuse). No significant associations were found between injury rate, injury severity, sex, and pubertal status with the single exception of female gymnasts in whom more injuries occurred in the latter stages of puberty. Only four of the 453 athletes reported injury as a reason for retiring from their chosen sports. Most injuries in elite young athletes are minor, their prevalence is low and, at least in the short to medium term, do not constitute a significant health problem.

Adolescent↗

Morphological effects of mechanical forces on the human humerus.

Various mechanical forces produce a variable stimulus intensity on bone and have different effects on its growth and development. The aim of this project was to study the effects of a variety of mechanical forces on human humerus morphology. This was investigated by measuring the cortical thickness (cm) and diameter (cm) of the humerus at its proximal, middle and distal thirds from radiographs. The humerus of each of 46 men (five controls, six swimmers, eight gymnasts, seven javelin throwers, nine discus throwers and 11 weightlifters) was radiographed on both right and left sides. The humerus size variation among the participants, in order of increasing size, was found to be as follows: gymnasts, controls, swimmers, javelin throwers, weightlifters and discus throwers respectively. The humeral cortex was largest in the weightlifters, being significantly (P less than 0.05) thicker at distal, medial and proximal sites. The proximal and distal humeral sites in javelin and discus throwers were significantly thicker than those of the control subjects. From the results, static load would seem to provide a higher stimulus to bone than dynamic loading.

Biomechanical Phenomena↗

Fractures in the collegiate athlete.

PURPOSE: To determine the demographics and incidence of fractures in collegiate athletes. STUDY DESIGN: Retrospective review of prospectively collected data. METHODS: Division I collegiate athletes who sustained a fracture while enrolled at the university from 1986 to 2000 were identified through training room records. Type and location of fracture, sport, gender, age, position, height, and weight were recorded and analyzed. Team information was obtained from athletic department records and was used to calculate incidence. RESULTS: Between 1986 and 2000, 5900 Division I athletes at our institution sustained 349 primary fractures (5.9%). By gender, the incidence did not differ significantly between males and females (P =.236), except in water polo where the men sustained significantly more fractures. By type, females sustained significantly more stress fractures (P =.001) than males. Overall, by location, the hand contributed the greatest number of total fractures. By sport, the incidence rate was highest in basketball (0.081) for male athletes and in gymnastics (0.069) for female athletes. The incidence of a second fracture during the study period was twice the rate of the first fracture. CONCLUSIONS: As expected, athletes participating in contact sports contributed the greatest number of fractures. Participation in basketball for men and in gymnastics for women posed the greatest risk. Female athletes sustained significantly more stress fractures.

Adult↗

Calcaneocuboid joint instability: a novel operative technique for anatomic reconstruction.

A case history of a 13-year-old female national top-level gymnast, suffering from calcaneocuboid joint instability, is presented. The procedure was done as an anatomic repair by capsular reefing, which was augmented using a local periosteal flap. Initially, the athlete twisted her ankle. Clinical investigation revealed no sign of a lateral ankle ligament injury, but following this initial examination, recurrent giving-way of the foot occurred. She additionally felt significant but diffuse pain on the lateral side of the foot during loading in training and competition. For 2 months she was unable to run and conservative treatment failed. Diagnosis of a calcaneocuboid instability was established 4 months after the initial lesion by clinical and x-ray stress examination of the calcaneocuboid joint. Open surgery was successfully performed. Early functional posttreatment was done and the patient returned to full high-level gymnastics ability 16 weeks after surgery. Two years later, a similar injury occurred to the opposite calcaneocuboid joint and the same operative procedure again led to full sports ability.

Adolescent↗

Flexibility enhancement with vibration: Acute and long-term.

INTRODUCTION: The most popular method of stretching is static stretching. Vibration may provide a means of enhancing range of motion beyond that of static stretching alone. PURPOSE: This study sought to observe the effects of vibration on static stretching to determine whether vibration-aided static stretching could enhance range of motion acquisition more than static stretching alone in the forward split position. METHODS: Ten highly trained male volunteer gymnasts were randomly assigned to experimental (N = 5) and control (N = 5) groups. The test was a forward split with the rear knee flexed to prevent pelvic misalignment. Height of the anterior iliac spine of the pelvis was measured at the lowest split position. Athletes stretched forward and rearward legs to the point of discomfort for 10 s followed by 5 s of rest, repeated four times on each leg and split position (4 min total). The experimental group stretched with the device turned on; the control group stretched with the device turned off. A pretest was followed by an acute phase posttest, then a second posttest measurement was performed following 4 wk of treatment. Difference scores were analyzed. RESULTS: The acute phase showed dramatic increases in forward split flexibility for both legs (P < 0.05), whereas the long-term test showed a statistically significant increase in range of motion on the right rear leg split only (P < 0.05). Effect sizes indicated large effects in all cases. CONCLUSION: This study showed that vibration can be a promising means of increasing range of motion beyond that obtained with static stretching in highly trained male gymnasts.

Biomechanical Phenomena↗

Dynamic balance in high level athletes.

The purpose of this study was to investigate dynamic balance performance in highly skilled athletes. Participating athletes were currently competing at the collegiate Division I, professional, elite, or Olympic levels, or their individual coaches believed the athlete performed comparably to these levels. High level male and female gymnasts (n=57, M age=17.3 yr., SD=4.1), soccer players (n=58, M age= 19.8 yr., SD=1.6), swimmers (n=70, M age= 17.1 yr., SD=2.5), and individuals with no formal competitive sport experience (n=61, M age= 16.8 yr., SD= 2.0) volunteered. Dynamic balance performance was measured on a stabilometer, which requires participants to continuously adjust posture to maintain an unstable platform in the horizontal position for 30 sec. Each participant performed 3 practice trials followed by 7 test trials. Analysis indicated that athletes were superior to nonathletes in balance performance. Gymnasts performed better on the dynamic balance task than all other groups. Soccer players and swimmers performed similarly and were superior to the control subjects. There was no difference between the performance of men and women. Moderate to high negative correlations were found between dynamic balance performance and height and weight.

Adolescent↗

Chronometric comparison of actual and imaged complex movement patterns.

The authors' aim in this study was to consider the functional equivalence of internal imagery, external imagery, and action execution. Sixteen elite gymnasts imaged and performed a complex gymnastic vault. Ten performers imaged from an internal perspective, and 6 used an external perspective. Although the results revealed that the time to image the entire motor task did not significantly differ from the time required to physically perform it, irrespective of the imagery perspective used, the temporal organization of the action was different within the imagery conditions than it was in the physical condition. The results do not provide support for the principle of temporal functional equivalence. The authors discuss the results in light of recent findings from the cognitive neuroscience and psychology literatures.

Adolescent↗

A study of the effects on the ovarian cycle of athletic training in different sports.

AIM: The purpose of this research was to investigate the effects of sports training on the ovarian cycle of athletes of various disciplines, and of non-athletes, their participation and their performance in competition as well as the appearance of symptoms of discomfort pre and during the duration of menstruation. METHODS: Athletes from the disciplines of basketball, track athletics, gymnastics, swimming, synchronized swimming and water polo as well as non-athletes took part in this research. All the participants, both athletes and non-athletes were selected and completed a specially designed questionnaire. RESULTS: The results of the research showed that there are no significant differences in the menarche to the duration of the ovarian cycle and to the duration of the menstrual flow. Also, the involvement in different athletic disciplines appears to affect to different degrees the regularity of the cycle although this does not prevent the athlete from participating in training and in competition. The effects are sometimes beneficial to their performance and sometimes they could have a negative effect on their performance. Regarding the symptoms and the discomforts which occasionally appeared pre and during the duration of menstruation e.g. headache symptoms, these appear to be greatly decreased in the athletes of swimming, synchronized swimming and water polo and perhaps this is a result of the beneficial effects of the water. The percentage for abdominal pain appeared decreased for certain disciplines (such as swimming) or stable both pre and during the duration of menstruation. Concerning the pain in the thoracicolumbar region, the percentages were different for every sport: a noticeable decrease was recorded for the athletes of swimming, gymnasts, synchronized swimming, water polo, track athletes and the non-athletes, but with an increase for the basketball players. For the symptoms of weakness and fatigue, the percentages were increased for all the athletic disciplines as well as for the non-athletic during the duration of menstruation compared with pre menstruation, although for the percentages for symptoms of nervousness, the picture was different, that is, the percentages appeared decreased during the duration of menstruation. CONCLUSION: In conclusion, where problems appear in the function of the ovarian cycle, the assistance of a specialist gynaecologist is considered essential when we are sure that these problems are not caused by training, malnutrition or psychological factors.

Adolescent↗

[Working conditions of female workers in the system of "Soiuzgostsirk" (the Soviet State Circus)].

Labour activity of those engaged in the system of Soyuzgostsirk was analyzed. It was established that unsatisfactory sanitary and hygienic situation for members of the orchestra, workers taking care of animals and others, physical and neuroemotional load of gymnasts, acrobats and their assistants, induced uncomfortable work posture of conjurers and gymnasts were in some cases regarded as the main unfavourable occupational factors. The health state of the above professional groups was assessed. Preventive measures aimed at sanitation of labour conditions and decrease of disease rates were developed.

Animal Husbandry↗

Age at menarche, family size, and birth order in athletes at the Montreal Olympic Games, 1976.

Age at menarache, family size, and birth order in 145 athletes at the Montreal Olympic Games, 1976, were determined through interview. The athletes represented 27 countries, but 76% came from Canada, Great Britain and the United States. On the average, athletes attained menarche later than the general population in their respective countries, the mean age at menarche for the sample of 139 athletes who had attained menarche at the time of the survey being 13.66 +/- 0.12 years. Six athletes had not yet attained menarche at the time of the survey. Gymnasts, runners and rowers attained menarche significantly later than swimmers, but gymnasts, runners, rowers and jumpers/hurdlers did not differ significantly among themselves in the age at menarche. Correlations between age at menarche and family size and birth order were significant, but low to moderate in magnitude. Athletes from larger families tended to have, on the average, later menarche than those from smaller families, this trend being more apparent in rowers and track and field athletes.

Adolescent↗

[Features of the structure of the metacarpal bones of athletes in different specialties].

Metacarpal bones have been examined in hand X-ray photos of 125 sportsmen at the age of 17-18 years who go in for swimming (dynamic loading on the hand) and competitive gymnastics (static loading on the hand). Under the effect of systematic trainings, which are connected with an increased loading on the hand, a number of morphological changes take place in the metacarpal bones. A prolonged loading of the dynamic character delays the synostosis process in the distal parts of the forearm bones and contributes to lengthening the I, III and IV and to widening the I-V metacarpal bones. As demonstrate decreasing indices of compactness in the swimmers, the widening diaphisis of the metacarpal bones occurs at the expense of dilatation of the medullary cavity. The static loadings result in a greater delay of the synostosis processes in the upper extremity parts mentioned, in a greater width of the I-III, V metacarpal bones in boy-gymnasts. The increased index of compactness demonstrates that the widening diaphysis of the metacarpal bones takes place at the expense of thickening of the compact substance and narrowing of the medullary cavity.

Adolescent↗

A force-torque analysis of the kip on the horizontal bar.

The purpose of this study was to determine the forces and torques on the horizontal bar during the kip. Six Canadian male gymnasts were filmed using a high speed camera during a short gymnastic routine including a kip on a horizontal bar which was wired with strain and torque gauges. During the performance, voltage outputs representing force and torque were amplified and recorded on tape. The force-torque data were then subjected to computer analysis. Maximum forces and torques were determined and force-angle plots were normalized by dividing force by body weight. The range of maximum forces was 1344-1563 N with a mean of 1444 N, which was approximately 2.3 times the body weight. The maximum forces were obtained when the center of mass was almost directly below the bar with the timing of maximum force application ranging +/- 0.1 sec from either side of 180 degrees. Maximum torques ranged from 10.0-21.0 N X m (Mean 17.3 N X m).

Adult↗

A force and torque analysis of giant swings on the horizontal bar.

The purpose of this study was to make a kinetic comparison of backward and forward giant swings on the horizontal bar. Six Canadian gymnasts of national calibre were filmed using a high speed camera during the performance of giant swings on a horizontal bar which was equipped with strain and torque gauges. Prior to filming, the horizontal bar was calibrated by force application at various angles. During the performances, voltage outputs representing force and torque were amplified and recorded on tape. The force/torque data were then subjected to computer analysis. Forces were plotted circularly against the angle at which the forces acted on the bar using an x-y plotter. Maximum forces and torques for both forward and backward giant swings were compared. Polar force plots were then normalized by dividing force by body weight. A superposition of curves for 11 backward giant swings and 12 forward giant swings has produced two models representing good performance of giant swings by national gymnasts. Deviations from the models may be useful in correction of errors in execution of the swings. This method could provide instantaneous feedback on performance technique without requiring film analysis.

Biomechanical Phenomena↗

Interventions for preventing and treating backache in pregnancy.

BACKGROUND: More than a third of women experience back pain during pregnancy. OBJECTIVES: The objective of the review was to assess the effects of preventive interventions and treatments for backache in pregnancy. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. SELECTION CRITERIA: Randomised trials of any treatment to reduce the incidence or severity of back pain in pregnancy, or to prevent back pain arising in pregnancy. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted independently by two reviewers. MAIN RESULTS: One trial of 109 women was included. This cross-over trial compared the use of a special shaped pillow to fit under the woman's abdomen (Ozzlo pillow) with a standard pillow. Women experienced less pain in the week when they used the Ozzlo pillow than in the week with the standard pillow (odds ratio 0.32, 95% confidence interval 0.18 to 0.58). REVIEWER'S CONCLUSIONS: Specially shaped pillows appear to help reduce back pain in late pregnancy and improve sleep.

Back Pain↗

Low back pain and physical exercise in leisure time in 38-year-old men and women: a 25-year prospective cohort study of 640 school children.

A cohort of 38-year-old men and women were studied for leisure time physical exercise in relation to low back pain (LBP), education, work, social class and smoking by a self-administered questionnaire. At the age of 14 years, the subjects had been interviewed by their school doctor regarding history of LBP and radiographs of the thoracic and lumbar spine were taken. The results show no positive correlation between radiographic changes and LBP in the adolescent period and decreased physical activity in adulthood. Physical activity for at least 3 h/week reduces the risk of LBP measured as lifetime, 1-year and point prevalence. Eighty-five percent of the subjects who reported taking physical exercise for at least 3 h/week had participated in sports activity almost constantly since their school days and these reported being in better condition than the rest of the cohort. Otherwise they did not have a healthier mode of life. No physical exercise during leisure time was associated with a short school education, unskilled work, unemployment and sickness, low social class, divorce, living in an apartment and smoking. Sixty percent had never or not for many years been interested in participating in sports. Badminton and tennis were the most common sports practised (36%), followed by gymnastics (32%), ball games-soccer and team handball-(25%), running (20%) and swimming (18%). Gymnastics and swimming seem to reduce LBP significantly. Our results show a falling interest in participating in sports activities over time, with 68% of the subjects being members of an athletic association previously, but only 29% currently. Women were more physically inactive during leisure time, probably because of their dual role. Logistic regression analysis indicates that physical activity is related to a long school education, high social class and regular sports activity over time.

Adolescent↗

Local critical power is an index of local endurance.

The hypothesis that critical power (CP) is significantly lower than the maximal aerobic power of the knee extensors has been tested in nine endurance-trained subjects, seven gymnasts and seven weight lifters. CP was calculated as being equal to the slope of the linear relationship between exhaustion time and work performed at exhaustion on a knee-extension ergometer. CP was compared with the power output at the end of a progressive knee-extension exercise (P(peak)) and the power outputs corresponding to exhaustion times equal to 4 (P(4 min)), 6 (P(6 min)), 8 (P(8 min)) and 10 min (P(10 min)), calculated according to the linear relationship between work and exhaustion time. The hypothesis that CP corresponds to a steady state in metabolic and physiological parameters was tested in the gymnasts and the weight lifters by comparing CP with the fatigue thresholds of the integrated electromyogram (iEMG(FT)), lactate level (La(FT)), oxygen uptake (VO(2FT)) and heart rate (HR(FT)). The results of the present study demonstrate that the value of CP of a local exercise cannot be considered as the equivalent of the maximal aerobic power for general exercises. The values of P(4 min), P(6 min), P(8 min), P(10 min) and P(peak) were significantly higher than CP, and corresponded to 138, 126, 119, 115 and 151% CP, respectively. The results of the present study indicate that CP can be considered as an index of muscular endurance. Indeed, La(FT), iEMG (FT), VO(2FT) and HR(FT) were not significantly different from CP. All of these fatigue thresholds were significantly correlated with CP (r > 0.92). Moreover, the highest coefficient of correlation (r=0.71; P < 0.01) between the percentage of maximal aerobic power in cycling that corresponds to a blood lactate concentration of 4 mmol x l(-1) (OBLA%) and the different local aerobic indices was observed with CP.

Adult↗

Which instrument is more suitable to assess health-related quality of life: Nottingham Health Profile or Short-Form-36?

BACKGROUND: Recent publications in rehabilitation research describe a new category of outcome measures, so-called patient-reported outcomes (PROs). This is an umbrella term for different degrees of subjective symptom intensity, treatment satisfaction and, particularly, health-related quality of life (HrQoL). Given the countless new developments in the field of HrQoL, it has become difficult to select the most appropriate or the best instrument for outcome-oriented studies. We evaluated and compared the two most frequently used questionnaires to assess HrQoL, namely the Nottingham Health Profile (NHP) and the MOS Short-Form-36 Health Survey (SF-36) with regard to their applicability in gerontology. METHODS: A sample of active "elderly gymnasts" (mean age, 68 years) was compared with a "young" control group (mean age, 36 years). Both groups were asked to fill out the two questionnaires and enter on a visual analogue scale (VAS) their assessment of the suitability of each instrument for application in a scientific study. RESULTS: While the control group generally favoured the SF-36 and rated this questionnaire significantly better than the NHP, the two survey instruments were given nearly the same rating by the elderly gymnasts. Younger experimental subjects particularly objected to the wording of the items (all of these were found to be negatively oriented) and the dichotomous response format of the NHP (it allows only yes-no answers in contrast to the SF-36 which offers several graded choices) while elderly patients considered this limited range of responses to be an advantage of the NHP. CONCLUSIONS: The decision in favour of or against a survey instrument should always be made individually for each situation, based on the test criteria and the characteristics of the study population. In elderly patients with stronger symptoms, one may well decide in favour of the NHP despite its disadvantages (limited response format, floor effects, less frequent use of the questionnaire).

Aged↗