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PubMed2006

The "bench-presser's shoulder": an overuse insertional tendinopathy of the pectoralis minor muscle.

BACKGROUND: Tendinopathies of the rotator cuff muscles, biceps tendon and pectoralis major muscle are common causes of shoulder pain in athletes. Overuse insertional tendinopathy of pectoralis minor is a previously undescribed cause of shoulder pain in weightlifters/sportsmen. OBJECTIVES: To describe the clinical features, diagnostic tests and results of an overuse insertional tendinopathy of the pectoralis minor muscle. To also present a new technique of ultrasonographic evaluation and injection of the pectoralis minor muscle/tendon based on use of standard anatomical landmarks (subscapularis, coracoid process and axillary artery) as stepwise reference points for ultrasonographic orientation. METHODS: Between 2005 and 2006, seven sportsmen presenting with this condition were diagnosed and treated at the Cape Shoulder Institute, Cape Town, South Africa. RESULTS: In five patients, the initiating and aggravating factor was performance of the bench-press exercise (hence the term "bench-presser's shoulder"). Medial juxta-coracoid tenderness, a painful active-contraction test and bench-press manoeuvre, and decrease in pain after ultrasound-guided injection of a local anaesthetic agent into the enthesis, in the absence of any other clinically/radiologically apparent pathology, were diagnostic of pectoralis minor insertional tendinopathy. All seven patients were successfully treated with a single ultrasound-guided injection of a corticosteroid into the enthesis of pectoralis minor followed by a period of rest and stretching exercises. CONCLUSIONS: This study describes the clinical features and management of pectoralis minor insertional tendinopathy, secondary to the bench-press type of weightlifting. A new pain site-based classification of shoulder pathology in weightlifters is suggested.

Adolescent↗
PubMed1991

Ice hockey injuries: incidence, nature and causes.

In this prospective study, we have investigated incidence of injuries of different severity, types of injury, and mechanisms of injury during ice hockey games. All twelve Swedish elite hockey teams were observed during the season 1988-1989 when a total number of 664 games were played. There was a total number of 285 injuries, of which the majority were minor (61%) and only 9% were classified as major. Seventy-four per cent of the injuries occurred during games and 26% during practice. The overall incidence of injury was 53.0 per 1000 player-game hours. Eighty-five per cent of injuries were caused by trauma and 15% by over-use. Injuries were most often localized to the head/face (39%) or the lower limb (32%). Most injuries resulted from stick contact or player contact including checking. A reduction of minor and moderate injuries should be possible by stricter enforcement of the hockey rules, and more widespread use of visors.

Athletic Injuries↗
PubMed1991

Acquired venous aneurysms.

A case is reported of acquired venous aneurysms in the superficial forearm veins of an oarsman. The aetiology, presentation and complications are discussed.

Adult↗
PubMed1992

A survey of golf injuries in amateur golfers.

A survey of 461 amateur golfers was undertaken to assess golf injuries. There were 193 respondents of whom 57% reported injuries. Wrist, back, muscle, elbow and knee problems were the most likely ailments to compromise a player's game. Overuse and poor technique were the main aetiological factors. Attention to those factors in addition to maintenance of physique would reduce the incidence of these problems.

Adolescent↗
PubMed1992

Spondylolysis in fast bowlers: principles of prevention and a survey of awareness among cricket coaches.

Back injury in general, and spondylolysis in particular, represents a serious threat to the fast bowler. Hereditary factors, poor technique, overuse, and poor preparation for fast bowling may combine to produce the 'at risk' bowler. Three first-class county coaches were interviewed to establish a level of awareness of the lesion, with an emphasis on preparation of fast bowlers and the roles of technique alteration and bowling prescription in reducing the risk of back injury.

Athletic Injuries↗
PubMed1993

Overuse injury and growing bones: the young athlete at risk.

Increasing numbers of children are becoming involved in competitive sport. International trends in pre-adolescent sports participation are mirrored in New Zealand, where promising young athletes are being exposed to high-intensity training from an earlier age. As a consequence, overuse injuries which were traditionally described in more mature athletes are now becoming recognized in pre-adolescents. The immature musculoskeletal system is less able to cope with repetitive biomechanical stress. Sites of overuse injury reflect the sites of rapid musculoskeletal development. It therefore behoves all medical practitioners, but particularly those in primary care, to be aware of the young athlete at risk. Inherent in the presentation of such musculoskeletal insult there often lurks an over-enthusiastic parent. We are all well reminded of the covert pressures adults may bring to bear upon children. Psychological, as well as physical injury often results.

Bone Development↗
PubMed1994

Sports-related injuries in elderly men still active in sports.

By means of a questionnaire with a complementary interview and physical examination, the site and nature of sports injuries were investigated over a 10-year period (1977-1987) in 97 elderly athletes (age range 70-81 years). The athletes were still active in training and competition with a mean competition background of 15 years. Of the subjects studied 30 were strength/power athletes and the remaining 67 endurance athletes. Altogether we found 273 sports-related injuries (169 acute and 104 overuse injuries). Of the injuries 75% had occurred in the lower extremities. The most commonly injured part of the body was the knee (20% of all cases). Sprains of the thigh and knee were the most frequent types of acute injury. In most cases the treatment prescribed was rest and physiotherapy. Surgery had been necessary in ten cases (3.7% of all injuries). Mean withdrawal from normal sporting activity had, in general, been 2-3 weeks. Of the injuries, one in five had, however, lasted over several years causing some disability during sporting activities.

Accidental Falls↗
PubMed1994

The scientific basis for the use of biomechanical foot orthoses in the treatment of lower limb sports injuries--a review of the literature.

While it is documented that many overuse injuries of the lower limb can be relieved with the use of biomechanical foot orthoses, what remains unclear is how an orthosis can produce this effect. A review of the literature indicates that biomechanical orthoses will reduce rearfoot movement, but the effect on knee function is negligible and the clinical significance of excessive rearfoot movement is yet to be proven. While many athletes may potentially benefit from the use of biomechanical orthoses, further research is necessary to justify and, if indicated, promote the use of biomechanical foot arthoses by athletes suffering from overuse injuries.

Athletic Injuries↗
PubMed1994

An epidemiological investigation of training and injury patterns in British triathletes.

During the competitive season of 1990, 155 British triathletes whose competitive distances varied from sprint to full ironman, and who self-classified themselves as recreational, intermediate or élite, kept a training diary for an 8-week period. They gave details of injuries sustained while training for, or competing in, triathlons. The mean(s.d.) distances covered each week were: swimming, 4.2(2.6) km; cycling, 100.2(70.6) km; and running 23.4(15.2) km; mean(s.d.) training time was 7(3.4) h per week, and a mean(s.d.) of 7.9(3.4) training sessions were completed per week. At least one injury was reported by 37% of the participants. The most frequently affected sites were the ankle/foot, thigh, knee, lower leg and the back. Overuse was the reported cause in 41% of the injuries, two-thirds of which occurred during running. The likelihood of an injury was positively associated with experience in triathlon. Average injury rate was 5.4 injuries per 1000 h of training (95% confidence interval: 4-7.2) and 17.4 per 1000 h of competition (95% confidence interval: 10.9-27.9). Injury incidence was unrelated to the mean amount of weekly training or competition, intensity or frequency of training.

Adult↗
PubMed1996

Low back pain and other overuse injuries in a group of Japanese triathletes.

OBJECTIVE: To document the incidence of low back pain and other overuse injuries in a group of triathletes, and to investigate any associations with various physical and triathlon related factors. METHODS: By means of a questionnaire, the physical characteristics, training habits, and the incidences of overuse injuries of 92 Japanese triathletes (70 males, 22 females) were documented. Student's t and chi 2 tests were used to determine the significance of any associations with injury incidence, as well as differences between subjects experiencing or not experiencing low back pain in the previous year. RESULTS: Low back pain was experienced by 32% of subjects in the previous year. The majority (54%) of low back pain episodes lasted under seven days, suggesting mainly soft tissue involvement, and 19% lasted over three months, suggesting involvement of the intervertebral discs. Weekly trunk flexor muscle training frequency was significantly greater (P = 0.035) for the low back pain subjects. Close to significant differences for average weekly cycling time, trunk flexor muscle training time, and low intensity aerobic training, as well near significant associations for weight training and average weekly triathlon training load, were also found. No other factors were significantly associated with low back pain. Low back injuries accounted for 28% of all injuries. Only the knee was a more common single site of injury (33%). CONCLUSIONS: The three most common injuries suffered by the triathletes were of the knee, back and shoulder. The low back pain suffered by many triathletes could be of a potentially serious nature. It is suggested that cycling is a major risk factor for low back pain in triathletes.

Adult↗
PubMed1996

Musculoskeletal injuries in the ultramarathon: the 1990 Westfield Sydney to Melbourne run.

OBJECTIVE: To document the injuries sustained by participants in a 1005 km ultramarathon. METHODS: Clinical notes were reviewed on entrants in the 1005 km Sydney to Melbourne ultramarathon. An injury was recorded following self referral by a participant or if the history obtained from the runner or his support crew indicated the likelihood of a significant injury which could have an impact upon performance. RESULTS: 64 injuries were found in 32 runners. The knee (31.3%) and ankle (28.1%) regions were most commonly injured. The most common single diagnosis was retropatellar pain syndrome, and Achilles tendinitis and medial tibial stress syndrome were the next most common injuries. Peritendinitis/tendinitis of the tendons passing under the extensor retinaculum at the ankle, an injury infrequently reported in other sports, was common (19% of all injuries). CONCLUSIONS: The injuries were typically associated with running but 12 (19% of the total) involved the tendons of the muscles of the anterior compartment of the lower leg, and in almost every case the major site of inflammation was at the extensor retinaculum at the anterior aspect of the ankle. This injury appears to be relatively specific to the ultramarathon-"ultramarathoner's ankle".

Adult↗
PubMed1997

Repetitive strain injury to the foot in elite women kendoka.

OBJECTIVE: To account for the apparent high incidence of pain in the feet of elite women kendo players. METHODS: A clinical evaluation was done by a chiropractor, the women were interviewed about their kendo experience, and the conditions and frequency of training and ground reaction forces were measured on a Kistler force plate during the kendo attacking action. RESULTS: Four out the five women presented with plantar fasciitis. They had all practised for some time on wooden floors laid on concrete, for between two to four hours a week. They warmed up conscientiously but cool down was more cursory. The force plate results showed that they were hitting the floor with a mean force of four times body weight during a transient impact. CONCLUSIONS: High motivation for practice and training, hard floors, ignoring painful feet, and cursory postpractice cool down probably produced the condition. Postpractice icing and stretching were found to be most effective in the short term. In the longer term reducing the level of impact, either by training on sprung floors or changing the footwork, might reduce the incidence and intensity of the fasciitis.

Athletic Injuries↗
PubMed1997

Stress fracture of the proximal humeral epiphysis in an elite junior badminton player.

An elite junior badminton player presented with a chronic painful dominant shoulder after an intense training course. An acute stress fracture to the proximal humeral epiphysis was found. Two-plane radiography will identify abnormalities of the growth plate but comparative films of the unaffected side may also be required to differentiate subtle changes. Rest with subsequent rehabilitation is the appropriate management of these injuries although ideally they should be subjected to primary prevention.

Adolescent↗